Loading...
11776 �T PLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY p•, BUILDING PROJECT IDENTIFICATION PERMITNUMBER - i- SOILDING APPLICATION & PERMIT n ADDRESS - I i/�3 �ON e BUILDING—ELECTRICAL—PLUMBING —MECHANICAL OWNER'Sdd PLAN CHECK VALIDATION rvnMEjfbpt!/laGTa`/ eoNST.,(q S/J-- OTV. ELECTRIC PERMIT FEE �/� (, NAmTEsap ��-�.{RS Cpu sT. ('Q �j/G- / UTLETS-SWITCHES-RECEP 10.0011.00 d� x IN LIGHTING FIXTURES 10.00/1.0 �� CONTRACTOR'S '�_ �y1� ADDRESS/6./ S•�T•/AILtr N/O/PO, APPLIANCES-RESIDENTIAL Cy 9�j�J 2,O vHo ylq- / PANELS - 10.00 �� l AAF LICATION RCHIrecT PANELS (OVER 200 AMP) 20.00 ^ HECE P.C.NO. O OR ENGINEERj/ps AEI; cAM,,Z.kNo SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT 5,00 VA ADLIDATION ORE55 So/ S.SAe METER OR ISS ca zip / / EMP. M ' 20.0 3'R • APPLICANTS MOTORS SEE FpSCH.0 A/t6ADDRESSS.S/4se'�F/7pN/ WJE'/� l` SERVICE CHANGE 20. 0 0 0 o LICENSED CONTRACTORS DECLARATION Q Lwi o I hereby affirm that I um licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000)of Division 3 of the Business and D ELE PLG MECHI ` F D i Professions Code, d my license is in full for n ffecL, z O= - License Class Lie.Num a (nTodP3T 0 z H D Date Contract a y BUI DING PERMIT maw c OWNER-BUILDER DECLARATION INFORMATION o a U � MISC.— REFER TO OR w3 LL E. I hereby a(fum that I um exempt from the Controctoi s License uo¢ Law for the followingreason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 ///��xvALUATION $/FT. r - -I ' Code:Any city or county which requires permit to construct,alter, : �l/O O K G 2O improve,demolish,or repair any structure,prior.to its issuance,also ELEC.CONTR. LIC.NO. ./ Q ELEC. D , requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO n 11 wm he is licensed pursuant to the provisions of the Contractor's License f / se z so Law(Chapter 9(commencing with Section 7000)of Division 3 of the V a Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ gym the basisfor the alleged exemption.Any violation ofScv6ON703L$ STORIES TYPE ON TR. d ; � by any applicantfora pernil subjects the applicant loacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 / of not morn than live hundred dollars(5500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC. UP 'RES.UNITS x their Sole compensation,will 60 the work,and the structure is not intended or offered for sale (Sec. 7044,,Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work S FIXTURES-PER TRAP 5.00 So.F .FLo EA TO AL ACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for sale,l f,however,the building GAS-EA.SVSTEM-11NC.40UTLETS 6.00 T or improvement is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE ba"a,will fixes,the burden of proving that he did not build or im- R INDCON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ F-1 I--] E]❑ 1,as owner of the property,am exclusively contracting wills licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 6.00 gssESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply / to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1 3 tQ�—�7�Glo? contracts for such projects with a contractor(s)licensed pursuant to / the Contractor's License Law. SEWER-SAN ITARY-STOM.WMtAWbACT PARCEL NO. ❑ lam exempt under Sec.—,B.&P.C.for this / WATER HEATER W/VE 6.00 reason Owner - Date WATER SYSTEM I AD W " CC.DATE ACC.FILE N0. - WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a ccrlific2le of consent to sell-insure. ZONING ENG.SITE NO. or a certificate Of Workers'Compensation Insurance,or a certified copy theJ�d'(�SeC.3800,Lab CJ�� ��� �x•Q - Policy N8f . (o.�Company Q P Certified copy is hereby furnished FIRE SPRINK ENERGY T-24(. Z Z J4'Cerl fid o is file it t t inspect' div,'o - O ApplicantLrSo ` 'l:n T�✓a/yy���/S iCl'i�^.Tie/•��o. MISC.- REFER TO ORD. Y❑ N❑ y ❑ No � y CERTIF1 ATLOFEXfMPTIONFROMWORKERS. PERMIT ISSUANCE 10.00 FLOOOZONE A.L.uc. UJ > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. / CL 0 IThis section need not be completed it' the permit is I'or one TOTAL V❑ N❑ Y ❑ N❑ Z) Z hundred dollars IS 100)or less.) r ,U O I certify that in the performance of me work for which this per- TY.QMECHANICAL PERMIT FEE FEE SUMMARY L H mit is issued,1 shall not employ any person in any manner so as to Ow become subject to the Workers'Compensation Laws of California. BUILDING y Dec Applicant ALTER OR ADD TO MECH. , 5.00 , } In NOTIC17 TO APPLICANT: If,after making this Certificate of lie' FZ anption,you should become subject to the workeri Compensation o2 APPLIANCE 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 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVE C.F.M.) 6.2a,_ SEISMICFEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH D p the performance of the work for which this permit is issued(Sec. . MICROFILM 3097,Civ.C_). HEATING UNIT(TO 100,0 .T.U.) 8.00 ) Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 9 r I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply withall cd and county BOILER-COMP(3 H.P.0(100,000 B.T.U.) 6.001PLUMBING i ordinances and state laws relating to building construction, and f hereby aulhorix mprescmalives of this city toenter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which C0Nka.7A may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 granting of this permit. MECH.CONT. LIC.NO. MECH, ✓Po sTG 2LrioA Cp„fib_, rorAL / TOTAL Signature¢-ApphcantlCon raclor Date ' OFFICE COPY - 3/S-� POST THIS CARD NEARTRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO .. . 11776 (_ INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 7873 L00riQ COUTG - UNIT# LOT# PERMIT EXPIRES IF WORK owrvEa Woolworth Const. Co. .Inc. CONTRACTORCO. _ IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION.RECORD —180 DAYS OF PERMIT ISSWI FOUNDATION ANCE OR 180 DAYS FROM\ LAST CALLED INSPECTION. LIFER AR 7 PERMIT VALIDATION PREGUNITE - • POUR 0 CONCR E UNTIL ABOVE HAS BEEN SIGNED — T UNDERGROUND,/"SLAB - PLUMBING ELECTRICAL - ISSUANCE DATE 8ID ELEC PLG. MECH. MECHANICAL 1 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ' BUIL•DING PER IT / INFORMATION. .WOOD FLOORma;w VALUATION $/FT. PLUMBING MECHANICAL - ELECTRICAL PERMIT TO FRAMING ✓ .^'. STORIES TYPE TVPECONBTR. ' INS CATION ✓ r� � OCC.GROUP -RES.UNITS — - PLACE NO'SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED �FL — 50 FT:FLODRi�E4 TOi LACREAGE ROOFf� 'DIAP.HRAGM ` _ BUILDING UBE .- - Res IND CON PB osier APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 0 El-- ASSE SSORSPARCELNO. ROUGH )71j,(H,61-vP70/° 04rr r-3 y7 3(-� /7- 6C PLUMBING .TRACT N PARCEL NO. GAS TEST I� MECHANICAL ACC.DATE ACC.FILE NO., ELECTRICAL FINALS MDATEINSP. FRAMING ? SAN # �6S INNING ENG.BITE NO. INSULATION ' PLUMBING GAs FIRE SPRINK ENERGY LI< ECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v �, NQ Y El �� LATH—INTERIOR - - ELECTRICAL FLOOD ZONE• A.L.UC. LATH—EXTERIOR ^��-�� FIRE DEPT. Y❑ NEI Yo/N❑ SHEETROCK y. y7 GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING — SHEAR EXTERIOR TEMPORARY°APPROVALS " BUILDING FIR EWALLSELECTRIC PLAN CHECK •i '. '.. GAS } NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE i `f OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING /. 0 PLEASE GIVE JOB ADDRESS WHEN'PHONING. Z MECHANICAL kr'. r — SEE PERMIT FOR EXPIRATION DATE - . CONST.TA IMPORTANT! / - PLEASE READ-REVERSE SIDE BEFORE • TOTAL CALLING FOR FINAL INSPECTION. ' ' OFFICE COPY - '� BUILDING INSPECTOR'S OFFICE CoPCo Distloo strict Copy CITY OF CUPERTINO O Backflow Device Sanitary Permit No. Sewer Connection Plumbing Permit No. Plumbing Final Lot No. Owner or TenantL`���%�� �p At-; f�Lon� Tract f Date Connected 19Date ina19� NeCIlL 70AWNG INSPECTOR t PG 8E. CITY OF CUPERTINO COPY GAS SERVICE NOTICE // y To You are hereby authorized to connect the GAS service for OwnerorTenant ,_e4�- nn� J le At eiotpf New Service le No. of MetersReconnect No. of Add. Meters Move Service Move ter PLUMBING INSPECT 0" V^ - FIWAL GRADE / File No. Da e l F Location I' Subject Notes i Approved ate Inspector i CITY OF CUPERTINO OFFICE 1 COPY i ;,'GAS SERVICE NOTICE ; d; f 7 r - i9 To You are hereby authorized to connect the GAS service for, . Owner br Tenant' +•-"' + � "� p: New Service NO. ofMeters tt' < '- "Reconnect'= ` No of Add Meters , Move Service - �, . "Move Meter. PLUMBING INSPECTOR i p, I BUILDING'INSPECTOR'S OFFICE I °CITY OF CUPERTINO B d9.oepi. Office Copy ❑ Backflow Device 'w , Sanitary Peri No / �❑ Sew' Connection '"7 _ Plumbing Penmlt No Cl Plumbing Final r Lot No. ' `Owner'dr"Tenant Tr Oct, 'y - Date Connected ' - _ I9_Date'Fi'nal' PLUMBING INSPECTOR CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE -(- 7 ........... 19.�R7 Building Permit No. 1172A Date ....... ... . ..... ......... The Building Located at 777e:7-7------4�eA�A-r7..... r:=- ---------------------------------- 7/.Owned by ..... ................. ------czl-------------------------- Has Been c-Qqmpleted)-�For Use As: ..................... ... . ..... .. - ---------- ......................................................----------------------------------------------------------------------------- ......................................................................................................................... ............ .................................. ....... ..... ............................................................................. PD-7 BUILDING INSPECTOR CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE 7 Date ...... .................... 19.!R7 Building Permit No. 11-7.7.6 The Building Located at ...... &f........ -------------------------------------- 6"ned by ......L-,/ ------------------------- Has Been or Use As:-rf7�-D..W. .. ----------------------------------------- �teed) F .... ................................................................................................................................................. .......................................................................................................................................... ................... ............................... .... ......................... ............................................. 4 .... .......................... . PD-7 BUI DING INSPECTOR I