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10008
f r� 0 T THIS CARD NEAR FRONT OF B ING * CIT`�OF CUPERTIN� 0 INSPECTION DIVISION JOB INSPECTION RECORD ' JOB ADDRESS UNI LOT# _ MINE CONTRACTOR PERMIT NUMBER 10008 PERMIT EXP11rRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN , 180 DAYS OF PERMIT ISSU. - ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. I CTI DATE INSPECTOR SPECTI RE ORD FOUNDATI N _ UFER u U PREGUNITE - PERMIT VALIDATION Cl ' ISSUANCE ArE POUR NO CONCRETE UNTIL ABAEE GNED OVE HS BSI UNDERGROUND /SLAB PLUMBING - ELECTRICAL MECHANICAL rEf BLDG. ELECT. PLG. R.� LJdN DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION a SIFT. YL ' PLUMBING - MECHANICAL G ELECTRICAL I PERMIT To FRAMING —y INSULATION STORIES TYPE CONSTR. OCC. GROUP. RES. UNITS " PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF ( , SO, FT. FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE E MD CON PS Omer 0 ❑ Q 11 ASSESSORS PARCEL NO. ^,r APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH -��- PLUMBING GAS TEST _ TRACT NO PARCEL NO. MECHANICAL ELECTRICAL 3_ FINALS ACC, DATE. ACC FILE NO. FRAMING —Z SANINSULATION' _ UDATEINSP. PLUMBING GAS ZONING ENG. SITE NO. - MECHANICAL FIRE SPRINK YE] NO ENERGYT.]E Y ❑ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATIN LATH—INTERIOR ELECT IC ROODZONE YE] NE) A.L U.C. YC] "N[:j LATH—EXTERIOR' d V FIRE PT. SHEETROCKGRADE `$'.6 FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING -- SHEAR EXTERIOR . D—,fib U TEMPORARY APPROVALS - FIREWALLS - ELECTRIC. .PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM, ARRANGE FOR INSPECTION BY PHONING 252-4505, a�ONE WORKING DAY BEFORE REQUIRED INSPECTIO_ N. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX C ,-_ IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION."— TOTAL OFFICE COPY APPLICANT TO FINN INFORMATION WITHIN RED LINA- USE BALL POINT PEN ONLY 'BUILDING PROJE ENTI FICA APPLICA N&PE BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 1 0 0 08 I `}J{ mu L -DI . Ao 11 My ER's NAME Ta_a l„ T RDnE -6 DTV• ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION NAVERAcroRs II /^� .(// Fd, OR ' J W LIC.NO. 36333 UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTo s DDDREES-SEJI Le,] ��i`}rOI%� J�J vRONE Aa.(8� V� PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 ARCHITECT ENGIn EER �✓I C/L No. PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE G. NO. SIGNS TRANS. 3.00 ARCH.SSSS ENG�7 22 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION Alms TEMP. METER OR POLE INS. 20.00 APPLICANT', C1 AODREu A (^ 5 Air, ,..) _ MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION TEMP. POLE 30.00 I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. Qd my license is in full force eifep Lic. Numbcr (OD License �l� Ilp Date t! f -e'' 5 Contractor ISSUANCE DATE L T. PLG. MECH. ❑ aq I ING PERMIT 1^ INFORMATION OWNER -BUILDER exam tDECLARATION I hereby affirm that 1 am exempt Gmn the Contractor's License Law for the following my which (Sec. requires to ons t rofaions a, permit Code: Any city or county which requirese permit m Construct, alma improve, demolish, or repair any structure, prior to its issuance, also he is tic the applicant for such permit t. fide a signed statement thin he is licensed pursuant to the provisions of the License MISC. - REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION �� 4 f/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO Law (Chang 9(commencingwish Section ) fDict.r's 3 D ivision3 of Inc isexeof bais and Professions Code) or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE the the basis for the a ora exemption. Any v applica o to action malty by any applicant fora permits objects the $5000.licenttoacivilpenalty of not more than five hundred dollars 6500). P. STORIES TYPE CONSTR. ALTER-DRAIN-WATER(EA.)5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contracmr's License taw does not apply to an owner of r_3 FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-11NC.40UTLETS 6.00 property who builds or improves thereon, and who docs such work himself or through his own employees, provided that such improve- mentsamnotintendedorofferedforsale. IL however, the building SD. FT. FLOOR AREA TOTAL ACREAGE Orimprovement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or it.- GAS - EA. SYSTEM OVER 4 (EA.) 2.00 BUILDING USE prove for purfm,c oC sale. ). ❑ I, as ..net of the property, am exclusively contracting with RES IND CON PB Other ® ❑ 1:1 1:1 El. INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 600 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contract.,', License taw does not apply to an owner of property who builds or improv, thereon, and who ASSESSORS PARCEL NO. y ! 6 -16^O SO contracts for such projects with a contractod5) licensed pursuant to the Contractors License Law. t� SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C. for this reason 7612 WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.OATE ACC. FILE NO, WATER TREATING EQUIP. 5.00 WORK ERS'COMPENSATION DECLARATION 1 hereby affirm that 1 have a certificate of consent m self -insure, ZONING ENG, SITE NO. or a certificate of Workers Compensation Insurance, or u certified copy thereof (Sec, 38W, Lu ny, /L e - Poli_ cy�No. Company /�lCt'IFLF 4 Certifxd co y' is h by' fur d ❑ mit i d IeJ s tb he cit, inspection division. Applicant FIRE fPRINK v ❑ N❑ ENERGY T 24 V ❑ N❑ MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CFRTIPI TF Dl' EXENIPI'ION FROM WORKERS FLOOD ZONE A.L.U.C. CONIPENSATION INSURANCE (This section need not be completed if the permit is for ono Y ❑ N ❑ Y ❑ N ❑ PLG. CONTR. LIC. NO. PLG. TOTAL hund,ad dollars (S 100) or less.) I certify that in the perfommoce of the work for which this per. mit is issued, I shall not employ any person in any manner so as to QTY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING U become Subject to the Workers' Co rNmeation Laws of California. Dale Applicant ALTER OR ADD TO MECH. 5,00 NOTICE TO APPLICANT: If, at let making this Certificate of Ex- APPLIANCE 5.00 PLAN CHECK FEE emption, you should become subject to the Workers' Compensation provisions of the labor Code, you must forthwith comply with such provisions or this permbe it shall deemed revoked. AIR HANDLING UNIT (TO 10=C,F.NL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=CEM) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.L EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name << �� Lenders Addrclg��'-- H EATI NGUN IT IOV OVER 100,000 B.T.U.)9.50 ELECTRIC 1 certify that 1 have read this application and state that the above V ENTI LATION FAN (SINGLE) 4.00 information is correct, I agree to comply with all city and county ordinances and ,at, laws relating to building mnitruction, end BOILER-CONP(3 H.P. or 100,000 B.T.U.) 6.00 PLUMBING hereby authorize representatives of this city ro en to upon the above-mentioned property for inspection purposes. BOILER -COMP tOwr 100,000 BTU) SEE FEE SCH. MECHANICAL (We) agree to Save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and upenNs which may in any way accrue a Insaid City in consequence of the MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX 9 granting of this it, j, :f lROal u A pliant/ nntracmr Uatc MECH. CONT. LIC. NO. MECH. TOTAL TOTAL ?,74(10 OFFICE COPY IFINAL GRADE E SLIP File No. CITY OF CUPERTINO COPYE ` GAS SERVICE NOTICE `r 1,4 /S , 19 J/ To You are hereby authorized to connect the GAS service for Owner or Tenant 0,-. /-r. Q/7 _ At �7 ;- 3 (/,4%.. o 1^e i No. of Meters New Service Reconnect Move Service No. of Add. Meters Move �Meter � PLUMBING INSPECTOR BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg. Dept. ' Off i El Backflow Device '© Sewer Connection i 0. Plumbing Final Owner or Tenant�G--" �ccX ice Copy Sanitary Permit No. Fd ( Plumbing Permit No. /'D )L' r/ At Tracty Date Connected �"�1 9 K% 7 Date Fina &� PL Lot No. 319 1 % ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE hCITY OF CUPERTINO / may/ To You are hereby authorized to Connect electrical service for Owner or Tenant_ a=, Q o At -7 (� No. of Wires a, ze of Wires�L $Ize of Switch Motor Load Voltage > g Phase Heating Load K.W.- No .W. No. of Meter, .. Light 110 New Service K Reconnect Hery nt ]F0Three Wire More Seice No. of Add. Meters Power three Phoee Move Meter �� ELECTRICAL INSPECTOR CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE _ CITY OF CUPERTINO j- DATE- 19BLDG. PERMIT NO, THE BLDG. LOCATED AT j OWNED BY-p A 1A f HAS BEEN COMPLETEDI FOR USE AS C^� �� L (ALTERED)