The URL can be used to link to this page

8846 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO INSPECTION DIVISION 884 JOB INSPECTION RECORD PERMIT EXPIRATION I JOB ADDR SS UNIT# LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTO - IS NOT STARTED WITHIN. INSPECTION DATE INSP CTOR INSPECTION RECORD -180 DAYS OF PERMIT ISSU. FOUNDATION —Z ANCE OR,180 DAYS FROM LASTCALLED INSPECTION. UFER - PREGUNITE. PERMIT VALIDATION ., POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED E[►/� UNDERGROUND /SLAB Y((ppYY PLUMBING ELECTRICAL1 UANCEDATE MECHANICAL , BLDG. LECT. TO. CR, DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION S/FT. PLUMBING Sil. � - MECHANICAL ELECTRICAL - PERMIjT ` FRAMING - ' INSULATION' %TORIES TYPE co"srR. OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO.FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE .. R.S IND CON PR, O,hr, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ - ASSESSORS PARCEL N0, ROUGH PLUMBING GAS TEST, TRACT NO, PARCEL NO. MECHANICAL ELECTRICAL � - FINALS DATE INSP. ACC.DATE ACC.FILE NO. FRAMING I SAN # - INSULATION PLUMBING ZONING ENG.SITE No. GAS MECHANICAL - FIRESPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING C] NE] ❑ N❑ LATH—INTERIORELECTRICAL FL00020NE A.L.U.C. LATH—EXTERIOR > 6FIRE DEPT. .. Y E] N❑ Y 0 No SHEETROCK GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING P BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE. OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR'INSPECTION BY PHONING 252-4505, ELECTRIC o "ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE Z GIVE JOB ADDRESS WHEN PHONING, - SEE PERMIT FOR ,EXPIRATION DATE - " MECHANICAL IMPORTANT! CONST.TAX�, • PLEASE READ REVERSE SIDE BEFORE ",a,y CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY ' e APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMITNUMBER BUILDING APPLICATION & PERMIT 8846 ADDRESS BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OER'$ NWNAME PLAN CHECK VALIDATION S�OV41_L DTV. ELECTRIC PERMIT FEE FHONE NAE NAMTRA0T0R s, {�� OUTLETS-SWITCHES-RECEP 10.00/1.00 c/ VA -Mc-:E &J LIC.No. 1, - LIGHTING FIXTURES 10,00/1.00 0 CONTRACTOR'S 711> LOS GATX PPLIANCES-RESIDENTIAL 4.00 ADDRESS - bFEgrIakr),HONE3494PANELS 10.00 DATE OF APPLICATION ARCHITECT - PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIc.No. SIGNS TRANS. 3.00 ADDON'Ess ENG' SPECIAL CIRCUIT 5.00 tl'S9NgIt04sL10ATION IIP EMP.METER OR POLE I 20.00 C�A�L/ APPucprvrs ADDRMOTORS SEE FEE SCH. APR 7y I! PC ESS ��. �Lt a�.rv�y0 SERVICECHANGE E 4, 020".00 � S U, LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 City Of fjJ' Fi w 1 hereby affirm that 1 am licensed under provisions of Chapter 9 0 ISSUANCE DATE 4 (commencing with Section 70001 of Division 3 of tha Business amt BLOB.. ELECT. PL I., o z Professions Cod od my license is in full for��PPpp eIr'frcft. ' i O�, - License CI. _Lic.Numbef�--LL o Date Contractor Q y s J ��L��w�w 44444�rrrrr a O BE 4 BE U OWNER.BUILDF-R DEC ATION BUI DING RMIT MISC.- REFER TO ORD IN ORMATION E } H I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. H LL O J Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 ('O !' � w0 Code:Anycity orcounty which requires a permit to construct,alter, {� GvT..n BE 4 0 Improve,de111DI15h,Or repot!any SIIrCIOrC,prior 10 Il5 ISSranee,aI50 ELEC.CONTE. LIC.N0. ELEC. (N l G e " wD BE requires the applicant for such permit to file a signed statement that _ TOTAL PERMIT TO m he is licensed pursuant no the provisions of the Contractor's License r z i La.(Chapter 9(commencing with Section 7000)of Division 3 ofthe EE4 Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE a rc H $ the basis Ibr the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant boa civil penalty of not more than five hundred dollars($SOO).): ALTER-DRAIN -WATER (EA.) 5.00 Ste' ❑ 1,as owner of the property,or my employees with wageSaS BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do 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 inmrove,thereon,and who docs such work F IXTUR ES-'PER TRAP 5.00 SO.FT.F 0009 AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for sale.if,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner builder will have the burden of proving that he did not build or im- iGAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 S IND CON FB Omer ❑ 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. 7044,BusinessLAWN SPRINKLERS-1 INC 5 V.B. 600 ASSESSORS 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.) 1.00 contracts for such projects with a cunlractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.2001t/10.00 TRACT NO. PARCEL NO. ❑ 1 am exempt under Sec. ,B,&P.C,for this WATER HEATER W/VENT 6.00 reason Owner Data WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPFNSATION DECLARATION WATER TREATING EQUIP. I hereby affirm that l have a certificate ofconsenl to self-insure, ZONING ENG.SITE NO. or a certificale of Workers'Compensation Insur,gn ,pr certiified copy thereof(Sec.3800,Lab.C,1.'�R`ss-3 t OO cd Policy No.---JwCampmty 114(S/,J.•[_)±kj�.�_ 0 ❑ Certified copy is hereby furnis e I FIRE SPRINK ENERGY T-24 Fp A❑ ant le copy is filed im the ci y ins •ct ion division.149 MISC.- REFER TO ORD. v N v N� 0: CIi RT 'ICATI:017 EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 O ! FLOODZONE A.L.U.C. LU COMPENSATION INSURANCE PLG.CONTE. LIC.NO, ALG, / pN B' D (This se ion need not he completed if the permit is for one TOTAL l0 Y❑ N Y � N 2 bund!• .)tars(SIDD)or lersJ L) O certify that in the performance of the work for which this per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mil is issued, I shall not employ any person in any mannerso as to O W become subject m f the Workers'Compensation Laws oCalifornia. Date-Applicant BUILDING } roll NOTICE '1'O APPLICNT: If,after....king this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE V such provisionsor this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10XIC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IOPMC.EM.) 6.00 SEISMIC FEE /9 I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DU T 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,CY.CJ. HEATING UNIT(TO 100. .) 6.00 Lender's Name H EATING UN IT(OVER 100,0 TU.19:50 O_ Lenders Address - a. ELECTRIC 1 certify that I'have read this applicalion and State slut the above VENTILATION FAN ( Y - • 4,00 PO informationod " n correct. I sagree to comply building all city ucti county PLUMBING ordinances and stale laws relating m building l city and c, and BOILER-OOMP(3 H.P.or 100,000 .T.U. 0 hereby authorize representatives ection this city es enter upon the BOILER-COMP love,IOD B 1 FEE SCH. MECHANICAL o�Q above-mentioned crebyauriz properly forinsp of thi purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10,00 - CONST.TAX may i ny way ace ag' t said City in consequence of the gra of this perm' MECH.CONT. LLL.NO. MECH. TOTAL o20 1 TOTAL �a Sign ore of Applicant/Cnnlmctor Dale^ OFFICE COPY