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15863POST THIS CARD, NEAR FRONT OF BUILII)I,NG ' PERMIT CITY OF CUPERTINO" 15863 1 INSPECTION DIVISION ' JOB -INSPECTION RECORD 1 7��y�% ,��,/��' �/���� �� � /�'�' `�✓ "� % \ ,( �1 'UNIT# - ! -• PERMIT EXPIRATION JOB ADDRESS ->I LOT# . � � PERMIT*EXPIRES IF WORK N OWNER u CONTRACTOR `ftkD�. Gqw IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU-' ANCE OR — DAYS DAYS FROM INSPECTION DAT INSPECTOR INSPECTION RECORD FOUNDATION- NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF LASTCALLED INSPECTION. , UFER PLRMIT VALIDATION PR EGUNITE CUPERTINO STANDARDS. -• GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING I �>) J"O. ISSUANCE LATE ELECTRICAL - MECHANICAL `aVy u ULDG. I ELECT I PLG. I MECH,- zl] . - DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED -INFORMATION BUILDING PERMIT WOOD FLOOR VALUATION SIFT. PLUMBING ' MECHANICAL ELECTRICAL PERMIT TO _ STOHICs IVPECONSTR. a11 FRAMING INSULATION OC .GROUP NITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE' THE CONSTRUCTION TAX IS PAID , I SO.I L R AREn i01n nLXC/.LE DIAPHRAGM r ROOF SHEATHING • �l BUIL-DING USE RES IND CON Pe OMS , . © ❑ ❑ ❑, ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSOR5 PARCEL NO I ROUGH SAN.q" 700 0� / 3 PSP—O%3� 3-.�_ E33 ` PLUMBING ELECT. ENERGY TRACT No. PARCEL NO TUBS & SHOWER PAN -2- PLUMBING ENERGY SIF MECHANICAL ,'T MECH. ENERGY ELECTRICAL BUILDING ENERGY . � ACC DATE ncc. PILE no FRAMING ELECT, FINAL TEST INSULATION PLUMBING - zownc } ENC. SITE No. 1 GAS TEST GAS FIRE STRINK '' (] N❑ ENERGYT"]a r �' N� MECHANICALS " COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR rj ELECTRICAL RELEASE FLOOD ZONE V 0 N[] n,L U YC- N[j� INTERIOR. SHEAR FIRE DEPT.- SHEETROCK '3 GRADE FEE SUMMARY EXTERIOR LATH BUILDING- BUILDING INTERIOR LATH' '7� TEMPORA APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE SEISMIC FEE GAS,. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR...MICROFILM- ARRANGE FOR INSPECTION BY PHONING 252-4505,' ELECTRIC PLUMBING d F� ONE WORKING'DAY BEFORE REQUIRED INSPECTION: 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL • —SEE PERMIT FOR EXPIRATION DATE — , CONST. TAX IMPORTANT! TOTAL PLEASE READ REVERSE51DE BEFORE ".CALLING " FOR FINAL INSPECTION. . OFFICE COPY p¢z Foo zwQ J gz DO ¢ ¢ ¢ U w 36» FLL0 ¢ ft SE0 p d w �y r i In i¢o ¢ I -p I ; • APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY _ ' BUILDING PROJECT IDENTIFICATION ; APPLICATION &PERMIT BUILDING - ELECTRICAL -PLUMBING - MECHANICAL PERMIT NUMBER I b 3 aDILOINGRE11812 Trinity Spring Court ADDSS Lot 301 3A OWNER'S NAME Wcgo iVpl T� q arson DevelopTent PNDHF 415/595-21 QTY, ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION NANMERAcroRs regxy Gw, Inc. uc. No B -4M7 UTLETS- SWITCHES -RECEP 10.00/1.00 ' LIGHTING FIXTURES .. ,10.00/1.00 CONTRACTORS 220--C TTn r, W1 phi Dr. ADDRESS /I/� /I (yam �.1 RX 94065 PHCNE415/595-21 APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 oncHUEcr Artcm Bdsseriany AIA sl ENGINEER Associate$uc.Ho. C-43009% PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE RC.N. SIGNS TRANS. 3.00 Roo Bis fNG. •a#100 SPECIAL CIRCUIT 5,00 PERMIT VALIDATION dlTta And HtS. e CA zip 92707 TEMP. METER OR POLE INS. . 20.00 APPLICANTS ADDRESS - DRESS 20-C Twin Dolphin Dr. M-.0 6465 MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION I hereby thine that 1 con licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code'Lmd my license is in full Lurceg��y / License Slpsy Co Number_ 7,=_; Dote Lic. N U,b ►j�C.Y ISSUANCE DATE ` BE Q ELECT. PLG. MECH. IYI r ri BUILDING PERMIT INFORMATION OWNER -BUILDER DECLARATION 1 um exempt from the Contractor's fCcraw 1 hereby collo following U. 703, a permit Code:Anycityor county icy sequiturap riot mconstrue,alter, Code:Law Any city orounty which to and construct. alter, improve, dmttolish, or repair any structure, prior ro its issuance, also require the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License �w MISC.- - REFER TO ORD VALUATION 152,727 .K ,2 PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO QTY. PLUMBING PERMIT FEE Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and - L STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 - by by applicant for a permit subjects the upplicanl to. civil penalty of not more than fvc hundred dollars (5500).1: ❑ I, as owner of the props:rty, or my employees with wages as their sole compensation, will do the work, and the structure Is not 2 5*R --.. ALTER -DRAIN &VENTWATER (EA.) 500 BACK FLOW PROTECT. DEVICE 4.00 OCG GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 704,, Businns and Professions Code: The Contractors License Law does not apply to an owner of FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA ,2349 TOTAL ACREAGE , property who builds or improves thereon, and who docs such work himself or through his own employee, provided that such improve- mentsarenotintendedorofferedforvle. If, however, the building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or int- prove 1, as omen purpose of the.l. ❑ I, as owner of the property, am exclusively contracting with GAS-EA.SYSTEM-11NC.40UTLETS 6.00 GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BuaOwG USE IND CON PB Omer ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. -30.00 licensed contractors to construct the pmico (See. 7044, Business and Professions Code The Contractor's License law does not apply to un owner of properly who builds or inprovca thumon. and who LAWNSPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPR I N KLERS= OVER 5(EA.) 1.00contracts ASSESSORS PARCEL NO. / 9 l for such projects with a contraclor(s) licensed pursuant to the Contractor's License law. SEWER -SANITARY -STORM EA. 200ft/10.00 - TRACT PARCEL NO. ❑ I um exempt under Sec.-, B &PC. for this reason - ryNO. �/d WATER HEATER W/VENT 6.00 Owner Dat, WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP, 5.00 WORK ERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to wIf insure, or a certifede of Workcrs' Compensation Insurance, or a eerlit ied ZONING ENG. SITE NO. ropy thereof (Sec. 3800, Lab.C.). I)nitE,d Pacific Policy No. Company ' _ FIRE SPRINK Y❑ N❑ ENERGY T-24 Y❑ N❑ C1 Certified copy is hereby furnished. D<Certifie Is W she cRY inspection division. ppucant_ MISC.- - REFER TO ORD. CERTIFICATE OI' EXE IPTION FROM WORKERS'PERMIT ISSUANCE 10.00 EL000 ZONE A.1_U.c. COMPENSATION INSURANCE ('this section need not be completed if the Bumfis is for one PLG. CONTR. uc. No. PLG. TOTAL Y ❑ IN Y ❑. N❑ hundred dollars IS 100) or less.) I certify that in the performance of the work for which this Iwr- mit is issued, 1 shall not employ any person in any manner so as to QTY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 00 bcconm Subject to she Workers' Compensation laws of California. Date - Applicant NOTIC17 TO APPLICANT: If, niter making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK $15.50 emptWn,'YOU should become subject to the Worker; Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. FEE AIR HANDLING UNIT (TO 10,DWC.F.M_) 4.00 AIRHANDLING UNIT(OVER 10=1C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the Performance of the work for which this permit is issmd (Sec. 3097, Civ.C.)I Lender's Name 56CUflfl.0 Lutdcr's Address__4th_Flr. SF -941. 1 certify that I have read this application and state than the above MICROFILM HEATING UNIT PTO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply withallcity and county, ordinances and state laws relating to building constnmtiun, and PLUMBING BOILER -COMP (3 H.P. or 100,000 B.T.U) 6.00 BOILER -COMP (Over 100,000BTU)SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the shove -mentioned property for inspection purpoms MISC. - REFER TO ORD. (We) agree to save, indcnmify and keep harmlass the City d 'upertino against liabilities, judgmmnts, costs and expenses which ay in any way accrue against said City in consequence, of the CONST. TAX PERMIT ISSUANCE 10.00 ani this perm,, �SY1Lo{� l 11/I Sr _� MECH. CONT. LIC. NO. MECH. TOTAL TOTAL y $1391.29 Sig tare of AppB /Contractor OUT, OFFICE COPY