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16378POST THIS CARD NEAR FRONT OF BUILDING CITY OF-CUPERTINO " INSPECTION DIVISION JOB INSPECTION RECORD �^r / JOB ADDRESS �2._i_c�, `e UNIT# _ _ LOT# - /� • OWNER `j CONTRACTOR Lk - Cb PERMIT NUMBER, 16378, PERMIT EXPIRATION PERMIT EXPIRES IF WORK' IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM, LASTCALLED INSPECTION 'I IN PE TION DATE I IN PECTOR INSPECTION RECORD FOUNDATION40 NOTE: - ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTI 0 STANDARDS. I UFER - - - - PREGUNITE - PERMIT VALIDATION _ C { �'' ... + issuANce DATE. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND./ SLAB PLUMBING - ELECTRICAL - - MECHANICALU2�D ' FOOTI ''I NS�xt�o IILDG ELECT . .� PLG . MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 1410ts'rl l?DoS , PD'%ja �% C jti\ BUN OIRNG MATIONT WOOD FLOOR PLUMBING` V NDe-F L -6R" RgwE E'I•c. L+peS R'Q-% OULP G{{>Q. C.IaLO L(�C:L vALUATION yofto SIFT. MECHANICAL _ ELECTRICAL - b- GI 't" Fo�Ti!-7j o 3 -Z -B - PErvMIT TO - L T STORIES r PECONSTR. FRAMING 0 - INSULATION - PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - OCc. GROUP RES UNITS ROOF NO FINAL INSP. SHALL BE MADE BEFORE THE C THE CONSTRUCTION TAX IS PAID SIR IT CLOOH AREA / � O TOTAL ACREAGE. ^ � ({{ DIAPHRAGM � ROOF SHEATHING RES IND 'LOGON usEFB DO— 0 C, 0 E APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS, . DATE INSP. ROUGH' ASSESSORS PARCEL NO. 326�r_ (63 PLUMBING " � � ELECSAN.T. ELECT. ENERGY TUBS &SHOWER PAN PLUMBING ENERGY' rHACT NO. PARCELNO, MECHANICAL - MECH.ENERGY - ELECTRICAL - BUILDING ENERGY ACC. DATE -ACC FILE NO - FRAMING .. ELECT. FINAL TEST INSULATION � � � PLUMBING � ZONING , ENG. SITE NO. ' GAS TEST - - - GAS MECHANICAL- FIRESPRINK - Y ❑ N[] ENERGY T 2 Y [:] NN[:] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE Y.[:]N❑ A.L U C.' Y L7'N❑ INTERIOR.SHEAR- FIRE DEPT. SHEETROCK - - - GRADE - - FEE SUMMARY EXTERIOR LATH BUILDING BUILDING %3.40#1 INTERIOR LATH '. TEMPORARY APPROVALS .. SCRATCHCOAT ELECTRIC - PLAN CHECK GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY 'SEISMIC FEE 2Z. OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, F ONE WORKING DAY BEFORE REQUIRED INSPECTION., . ; z PLEASE GIVE JOB ADDRESS WHEN PHONING: —SEE PERMIT,FOR EXPIRATION DATE — ELECTRIC PLUMBING 6` " MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLINGTOR FINAL INSPECTION. TOTAL -SK: OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION. allILDING APPLICATION & PERMIT -°3 6 BUILDING - ELECTRICAL- PLUMBING - MECHANICAL ALS AvO ATgc.P/.J6 A, • 'PERMITNUMBER 1 �+� r] I v OWNER'S NAME /Lr/LU, M G pP� \\ yp/ � i'I-�� 4E G EGPa9- PHONE til' %Plv GTY ELECTRIC PERMIT FEE PLAN CH ECK VA LIGATION DATE OF APPLICATION . PLAN CHECK FEE P.OZNO. NAME croRs NAME FOG AAI �'Al6i uc.No.- OUTLETS - SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRADDRESS Aoonsss ��DD ,��, 10251 /An GN !L. �Zf�NE ;Z57 --,'1L(, _ OR OR ENGINEER (�� �JLO'7%- ,>! IC No. APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PANELS (OVER 200 AMN 20.00 SIGNS TRANS. 3.00 ARCH, OR ENG. ADDRESS O • /✓OX �j ZO /o. CJAk'ATa la %✓O% T 5.00 PERMIT VALIDATION - ISSUANCE GATE(conmteocing POLE INS. 20 A0noness TaSEE '5ALaM A./E- LelE FEE SCH.,2.7378 20.00LICENSED CONTRACTORS DECLARATIONS 1 hereby affirm that 1 um licensed under prvisios of Chapter1 with Section 7000) of Division 3 of the Business anO Code, and my license is in full force and efftBLDG. License Class Lie. NumberDateContractr{yam DI:CLARA'rIONvW I hereby affnm that I um exempt four the Contractor's License Law l'ortheity orcountywhich requiresC. a einessund Professions Code: Anycity county any requires permit o its mane, alter, improve, demolish, m repair any slmctam, prior to its issuance, also requires the applicant for such permit to file .Signed statement that he is licensed pursuant to the Provisions of the )of1)icmr's License Law(ChapterProCommenCode) th Section is exempt Dtheren3 of the Business and Professions empt or that he is exempt therefrom and the basis for the alleged exemption. Any violation t to o action malty by any care thnt fora u permit dolga, the applicant toe Civil penalty of not more than five hundred Dollars ():• ❑ Lmyem as owner the property, or my employees with wages as their sole compensation, will do the work, and the structure is rat intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of Property who builds or improves thereon, and who docs such work himself or through his owemployees, provided that ch improve- su mentsarenotintendedorofferedforsale. If, however, the building or improvement is sold within one year of completion, tire r e owne builder will have the burden Of proving that he did not build or am- Prove for purpose of sale.). ❑ 1.d as owner of the property, am exclusively .coetractaigBu with licensed contractors m construct the project La 7044, of apply and Professions Code: The Contractor's License Law does not apply to an owner of property who hadds or improves thereon,and who contracts for such projects with u contmetonsl licensed pursuant to the Contractor's License Law. ❑TRACT reasonlam exempt under Svu. C. fir this -e 7- WS"9, ' J �Professions ELECT. PLO. MECH. �Y�� QW.OwOWNER-BUILDER BUILDING PERMIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE I s03 10.00 VALUATION q/FT. D OQ ELEC. CONTR, LIC. NO. ELEC. f �� 1� OTAL l l { PERMtT,jO �d1/ri-IGr% / 4�X DTV. PLUMBING PERMIT FEE ALTER -DR AIN&VENT-WATER (EA.) 5.00 STORIES TYPE CONSTR. BACK FLOW PROTECTDEVICE 4.00 . OCC. GROUP RES. UNITS 2 J DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAPn - 5.00 ser fir. FLOOR AREA 66,65 TOTALACREAGE V4 GAS - EA. SYSTEM - I INC.4 OUTLETS 6.00 GAS- EA. SYSTEM - OVER 4 (EA.) - 2.00 BUILDING USE RES IND CON PB other � ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO._ _(�_IFo3 , LAWN SPR IN KLERS- OVER 5(EAJ 1.00�/ SEWER -SANITARY -STORM EA. 200ft/10.00 WATER WATER HEATER /VENT 6.00 NO, PARCEL NO, Owner Date WATER SYSTEM 5,00 woRKliRs•coMrervsnTlOry DECLARATION I hereby affirm that 1 have a certificate ofcnnsent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab.CJ. Policy No. Company ACC. DATE ACC FILE N0. WATER TREATING EQUIP. 5.00 /- oer V .] v{,J 'L 13 ING ZON ENG. SITE NO. ❑ Certilled copy is hereby furnished. ❑ Certified copy is filed with the city inspection division. Applicant FIRE SPRINK YE] N� _ZONE ENERGY T 24 v[] No MISC.- REFER TO ORD. CFRTIFICA'rl: OP EXHIA17ION PROM WORKERS' COMPENSATION INSURANCE (This seclion need not be Completed if the permit is for one hundred dollars (S 100) or Less.) I certify that h ] n performance of the work for which this per. mit is issued, e I shall not employ any person in any manner so is m Dltcbecome subject to the Workers' Compcmwlion Laws of California. Date - Applicant PERMIT ISSUANCE 10.00 1 toe FLOOD V N A.L.U.C. Y N� PLG. CONTE. LIC. NO. PLG TOTAL 6..11 I CITY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING" I��'3u� l cmvision you should become subject to the Workers' Compensation emplion, TO should scamANT: If, after making this Certificate of ion you mull forthwith comply with provisions io the Labor Cit shall such provisions or this permit shall be deemed revoked. CONS'FRUC"I ION LENDING AGENCY 1 hereby affirm Char there is a construction lending agency forEXHAUST lbe.perlurmance of the work for which this permit is issued (Sec. 3097, Civ.C.L Lender's Name LCnderi Address I certify that I have read this upplicalion and state that the above lafonration is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city 1, Brier upon be o- xbovmentioned property for inspection purposes. (We) agree to Save, indemnify and keep harmless the City of upertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the ranting of this permit. MECH. ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE _ AIR HANDLING UNIT (TO 10,00DOF.M.) 4.00 AIR HANDLING UNIT (OVER 10,000C.EM.) 6.00 SEISMIC FEE 4G� HOOD (WITH DUCT) 5.00 MICROFILM ELECTRIC /C �W 113 HEATING UNIT (TO 100,000 B.T. U.1 8.00 HEATI NGUN IT(OV ER 100,000 B.T.U.) 9.50 VENTILATION FAN (SINGLE) 4.00 - BOILER-COMP(3 H.P. or 100,000 B.T.U.) 6.00 PLUMBING j BOILER-COMP(Ox., 100,000ETUISEEFEESCH. MECHANICAL {' 5s1 It MISC. -� A�'iJC' 'TiE FER TO ORD. PERMIT ISSUANCE 10.00 �'Zv� CONST. TAX CONT. LIC. NO. MECH. TOTALr,65' ` TOTAL/6,5* 3 TOTAL '60 Slgnelrrc oI Applicant ,.mmc,, Date OFFICE OFFICE COPY' '