The URL can be used to link to this page

3516 CITY OF CUPERTINO INSPECTIOP RECORD (Office Copy) 3516 111^5 La Paloma PlIT)J11T No . SANITARY DIST. NO. LOT NO. ADOPESS owl Patio Cover B. Merideth PROJECT OWNER JOB SITE PHONE NO. PERMIT ISSUED Date ELECTRICAL Building 5/10/83 Date Imsp. F] ectr ical Power Pole Plumbing UndLrCround Nechnn ical. Rough Hiring 'Temp. Gas/Fleet. Fla-11s Solar C�-c—1i I Fire Sprinkler Fixtures Int/Ext Si gn Notors Grounding Misc. Temp. Power Other FINAL INSPECTIONS Not Approved Date Insp. (-7s PLUMBING Electric Date Lnsp Plimbing, Backflow ifechan ical Underground Solar Underfloor Pool Partial. Rough Gradin , Rough Complete I'Lanninp Solar Rough Fire Dent. Water & Insulation Health Dept. Main Drain Buildinp R/of/S Drain Ocher Gas Other BUILDING Not Approved Date Insp. Vad Certification MECHANICAL Foundation Date Insp. Pre-Gunite Underfloor S.M. Slab-Membrane Ducts & Insulation Bond Beam Fire Dampers Underfloor Girders Fireplace Floor Steel Grease Duct & Hood Tiedowns One Hour Shaft Diaphrams Condensate Drain Seismic Bracing Equipment Anchorage llal..ls-Panels Flues & Comb. Air Frame Other Lath Not Approved Uallboards Int/Ext . Firewalls Other 'S-Z5 Not Approved BUILDING l' �t ELECTRICAL PLUMBING MECHANICAL MISCELLANEOUS AFIRLICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALI, POINT PEN ONLY' BE I.LDING PROJECT IDENTIFICATION - - PERMIT EH ADILDP APPLICATION & PERMIT 351 C 1 �L •ZS BUILDING-_ELECTRIC AL-PLUMBING=MECHANICAL �1 I OWN`ER'S PLAN CHECK VALIDATION NAME OTY. ELECTRIC PERMIT FEE orvrRAcroes - UTLETS-SWITCHES-RECEP 5.00/1.00 viiii- Pool, AME pppp-�' ,,,,�� 0.1��m UC,.O. � , LIGHTING FIXTURES 5.00/1.00 CONTRACTOR'SPPLIANCES-RESIDENTIAL - 4.00. - A /��,�1 PHON�44�5 PANELS 5.00 DATE OF APPLICATION ARCHITECT SIGNS .t 6.00 PLAN CHECK FEE P.C.N0, OR ENGINEER -LIC,NO, SIGNS,TRANS. - 3.00 . AARCH OR DDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION • ZIP .EMP. METER OR POLE INS. 15.00 APPLICANT'S MOTORS SEE FEE SCH. ADDRESS 04 SERVICE CHANGE 10.00 wo o LICENSED CONTRACTORS DECLARATION r �� a U v I hereby affirm that I am licensed under provisions of Chapter 9 - ISSUANCE DATE (commencing with$Teflon 7000)Of Division 3 of tie Business and BLDG. ELECT. PLG.In < MECH. z Professions Co anyLm license is in full for z o m - License Class. -r„�_Li,.Numb ❑ ❑ ❑ m H Date T7'J Contract BUILDING PERMIT it BE w a ow•NeR-BUILDER Ur: , RAI] INFORMATION aoa " MISC.- REFER TO ORD w 3 LL H I hereby affirm that am exempt Irom the i ssandors License VALUATION $/FT. - .. 0¢ Law for the following reason(Sec 7031.5,Business and Professions PERMIT ISSUANCE` - 6.00 Pi Code:Any city.or county whichrerleiresa pernarloamstn¢L alar. // off BEtoQQ improve, or repair any structure.prior to its issuance.also ELEC.CONTR. ` LIC.NO. ELEC. (, - - O C requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO a w m he is licensed pursuant to the provisions of the Comment's License C, F z r Law(Chapter 9(commencing with Section 7000)of Division 3 ofure ,/��KU Ot/PJ� a Toilets,and Professions Code)or that he is exempt Iloo,l om and QTY. PLUMBING PERMIT FEE it o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 4.00 of not more than live hundred dollars 15500).): ❑ 1,as owner of the property,or my employees with wage,as BACK FLOW PROTECT. DEVICE 2.00 ace.GROUP RES.UNITS their sole compensation,will do the work,and the,truer ore is not intended or offered for-sale (Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 4.00 Code:The Comment's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 4.00 SO.FT.FLOOR AREA TOTALACREAGE himself or through his own employccs,provided that such in+pro,c- mentsarenotintendedoroffered for sale,If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 4.00 or improvement is sold within one year of completion. Ilse owner- GAS-EA.SYSTEM-OVER 4 (EA.) 1.00 BUILDING USE builder will have the burden of proving that lie did not build or im- proveforpurposei le.).',s INDUSTRIAL WASTE INTER. 20.00 RES IND CON Pe Oft, ❑ I,as owner of the property con rtexclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct rhe project(Sec. 7044,Business. LAWN SPRINKLERS-1 INC 5 V.B. 5.00 ASSESSORS PAROEL NO ,I'dProfessions Code:The Contractor's License Law does not apply to an owner of property who builds nr improv..thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to fru Comracmr's License Law. SEWER-SANITARY-STORM EA'200ft/8.00 TRACT NO. PARCEL NO. ❑ I am exempt under Seca .B.&P.C.for ibis WATER HEATER W/VENT 4.00 reason Dare owner WATER SYSTEM 4.00 ACC.DATE ACC.FILE NO. WORKERSCOMPENSATION DECLARATION WATER TREATING EQUIP. 4.00 1 hereby affirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO. or o certificate of Workers'Compensation In,urancu,or u certified copy thereof(Sec.3800,Lab.C.). Policy No. Company _ 0 ❑ Certitied copy is hereby furnished. I FIRE SPRINK ENERGY T-24 Z 2 ❑ Certified copy is filed with the city inspection division. O Applicant MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ � N CERTIFICATF-OF EXI M Is FROM WORK 1.RS' PERMIT ISSUANCE 6.00 PLOOD ZONE A.L.0 c. LU > COMPFNSA'TION INSURANCE PLG.CONTR. ❑C.NO. PLG. , C 0 (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ Z) z hundred dollars 15100)or less.) U 0 1 certify that in the performance tQrk for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY F unit is issued,I shall not emplo y n any manner so as mU becoitt�suhjectdytp,e workers C ,p nawsuf California. BUILDING i Date Applicant ALTER OR ADD TO MECH. ' 4.00 } w NOTICE TO APPLICANT: If,attar making his Ccrt c:dc ul 19x- ' F. ? emption,you should become subject to the Workeri Compensation APPLIANCE 4.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)"C.F.M.) 3.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 5.00 SEISMIC FEE oTa I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 2.00 rhe performance of th,work for which this permit is issued(Sec. MICROFILM, 3097,CizC.), HEATING UNIT(TO 100,000 B.T.U.) 4.00_ Lender's Namc .H EATI NG UN IT(OVER 100,000 B.T.U.)7.50 ELECTRIC Lender's Address I certify that I have read thisapplication and state that the above - VENTILATION FAN (SINGLE) 3.00 - m onnetlon is correct. I agree to comply with all city and county BOILER-COMP13 H.P.or 100,000 B.T.U.) 4.00 PLUMBING ordinances and state laws r ting to building construction, and hy(Z"le .ne prose as of this city to enter upon the , BOILER-COMP IOvv 100.000 BTU)SEE FEE SCH. MECHANICAL sp pc f inspection purposes. i enutify and keep harmless Ore City of MISC.- REFER TO ORD. Clabii' es,judgments, costs and expenses which CONST.TAX mace he against said City in consequmee of the PERMIT ISSUANCE 3.00 n MECH.CONT. LIG NO.G re TOTAL TOTAL o2.� U Signature of APPli nr/Contravtor ])are ' OFFICE COPY