Loading...
4986CITY OF CUPERTINO INSPECTION RECORD (OFFICE COPY) O 20 �lC� l n,�e� d �t� 3 ✓I � • E N0. D SS YR �!L{/1 D {� 1 OWNER FINAL INSPECTIONS DATE I INSP. Gas z _ Power Pole ELECTRICAL DATE JINSP.' AP,?LICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LD1 NG PROJECT I DENTI FICATI ON APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL PERMIT NUMBER ^x f1�•�f 86 BUILDING nooREss a9Irc l4oMg SPAc 3 OwNER'S CV -9 -4-V NAME �J['� Cos N -o PNDNE-7a9s9 a - QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION GATE APPLICATION LDNTRACTORS RMC RMC d '�%A� SPS sec. ND.Ef�O OUTLETS -SWITCHES -RECEP 5.00/1.00 LIGHTING FIXTURES 5.00/1.00 C .eels TOR S. 13$ '�)Jv[11-ONE 2yr-1`pC PPLIANCES- RESIDENTIAL 4.00 PANELS 5.00 ARCRrtECT OR ENGINEER - sec. No. slGrvs PAID 6.00 PLAN CHECK FEE P,C. NO. SIGNS TRANS. 3.00 ARCH ADDRESS ENG, ' ZIP SPECIAL CIRCUIT LJ 61 PERMIT VALIDATION S Y/9� / 155 E EMP. METER OR POLYINS. 15.00 APPLICANT'S ADDRESS MOTORS S(F,li}g•' SERVICE CHANGE 10.00 LICENSLD CONTRACTORS DECLARATION I hereby Rinm that I ran licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cod au my license is in lull for�yp f'c O License Class .- Lin. Numb. V1 Date ContractorEg OWNER -BUILDER DECLARATION I hereby affirm that I an, exempt from the Contractor's License Law for the following reason. (See, 7031.5. Business and Profession' Code: Any city or county which roxim esa permit to construct. alter. improve, demolish, or repair any structure, prior to its issuance, ulna requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant tea civil penalty of not more than five hundred dollars ($500).) ' O 1, as owner of the property, or my employees with wages as their sole compensation, will do The work, and the slectue, is not intended or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License Law does net apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mentsarenotintendedorofferedPorsale. If, however, the building er improvement is sold within one year of completion , the owner- builder will have the burden of proving that he did not build er int- prove for pulp.. of sale.). ❑ I, as owner, of the property, Lou, exclusively contracting with contractors e. construct the project (See 7044, Business and Professions Code: The Contractor's License Law does n ot apply to an owner of property who builds or improves thereon, and who coulnel, forsuch projects with a mntractorls) licensed pursuant to the Contractor' License Law. r`❑n l a to exempt under Sec. , B.&P.C. for this BLDG. ELECT_ PLG, MECH. - j BUILDING PERMIT FOR I `/AL I /FT. C QQ Q LJ MISC. - REFER TO ORD ISSUANCE 6.00 - ELEC. CONTR. LIC. NOPERMIT . ELEC. /6 Qi TOTAL PERMIT TO QTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN & VENT -WATER (EA.) 4.00 BACK FLOW PROTECT. DEVICE 2.00 OCC GROUP RES. UNITS ;-ZDRAINS-FLOOR, ROOF, AREA, COND. 4.00 `�.. FIXTURES: PER TRAP 4.00 '- GAS-EA.SYSTEM-11NC.40UTLsEETTS/L 4.�0ta0, GAS - EA. $V$TEM -OVER 4 IEA. f .IA I i.Y sO. PT. FLOOR AREA TOTAL ACREAGE BUILDING USE RES IND CON PB Omer El ❑ ❑ ❑ El INDUSTRIAL WASTE INTER. 20.00 LAWN SPRINKLERS- 1 INC L 0'. I 5.0 PJ ASSESSORS PARCEL NO. ' LAWN SPRINKLERS - OVER 5 (EA.) 1.00 SEWER -SANITARY -STORM 00f©'I@ TRACTNO. PARCEL NO. WATER HEATER W/VENT 4.00 Date Owner WORK ERS'COMPENSATION Of:CLARAI'IOR I hereby affirm trial I have a certificate of consent to self -inure, er a certifcale of Workers.' Cempensalion Insurance, or a ,,Id ,d copy thereof (Sec 3800. Lab.0 ) ,.Th Policy No. Company WATER SYSTEM 4.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 4.00 ZONING ENG_ SITE N1. ❑ Certified copy is hereby famished. R' C, ti opy is Iil of tl I oily "I non division. Applicant �p%I, a�e FIRE SPRINK v� N� ENERGY T 24 v MISC.- REFER TO ORD. CER1'I PICATE OF- EX LM PTION LROM WORK ERS' COMPENSATION' INSURANCE section need not be completed if the permit is for one hundred fell... 1$100) or less.) 1 certify that in the performance of the work for which this per. mit is issued, I shall not employ an person in an p Y Y I Y ma Calif se is tU become subject to the Wlicant Compensation Laws of California. Date Applicant NOTICE: 'r0 APPLICANT: If, after making this Certificate of Fe. anption, you should become subject to the Workers' Compensation provisions of the Labor Cade, you mull forthwilh comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I herebyaffirmthat there is a construction lending agency for the performance of the work for which this permit is issued (See. 3097. Cie.C.), Lender's Name Lender's Address I certify that l have read this application and state that the above inlcreeticr is correct. 1 agree Io comply wish all City and County o ordinances and state laws relating to building construction. and hereby atelne , rep... creative, of this city to Cuter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnifyp y and keep harmless the Cit' ch Caper fine against liabilities, judgments, costs and expanses which way accrue against said City in conuqucnce of the hisl •rmit, � .2 `?'-1 `I 4igr;-,�LAPP PERMIT ISSUANCE 6.00FLOODzoNE Y N A. L.0c. Y J[:3 PLG. CONTR.. LIC. NO. PLG.(This TOTAL OTV MECHANICAL PERMIT FEE FEE SUMMARY BUILDING Sd ALTER OR ADD TOME q,p0 APPLIANCE - 4.00 I AIR HANDLING UNI 0 P.M) 3.00 S PLAN CHECK ' FEE AIR HANDLING UNIT (OVER 10=C.F.M.)5.00 SEISMIC FEE EXHAUST HOOD ( 2.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 4.00 HEATI NG UNIT (OVER 100,000 B.T.U.)7.50 ELECTRIC / �b � VENTILATION FAN (SINGLE) 3.00 PLUMBING L O BOILER-CDI I3 H.P. or 100,000 B.T.U.) 4.00 BOILER -COMP (Over 100,000 BTU) BEE FEE $GH. MECHANICAL QV �� MISC. - REFER TO ORD. PERMIT ISSUANCE 3.00 _ CONST. TAX MECH. CONT. LIG NO. MECH. TOTAL c od / TOTAL //d06 licant/Conlmd.r Date OFFICE COPT