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15945POST THIS CARD NEAR FRONT OF BUILDING • CITY OF, CUPERTINO INSPECTION DIVISION ` JOB INSPECTION RECORD.. - �J � - JOB ADDRESS a•dci�7� c•P L:r^ �I/d UNIT# _LOT#' • ('� / � - OWNER .•!/i-✓%) AzC— - CONTRACTOR..: ]'0 "V IS -e— Cyd L.'s PERMIT NUMBER 'I 15945;., ! PERMIT EXPIRATION PERMIT EXPIRES IF WORK ' IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- - ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. " INSPECTION DATE .INSPECTOR INSPECTION RECORD FOUNDATION PAPI : Q NOTE: "� ALL GRADING. AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. - UFER yy PR EGUNITE , 9ffJ • PERMIT VALIDATION t' .•��'' •. - , „ ' •- - , 10 ISSUANCE RATEc " GARAGE SLABS - - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED " UNDERGROUND/SLAB PLUMBING O • ELECTRICAL MECHANICAL -Rc. LP"cr. tvLr,. MecR 00 NOT.POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED J , BUILDING PERMIT 'Ptv INFORMATION WOOD FLOOR VALUATION t^�O J SIFT. PLUMBING � � -' - - - MECHANICAL ELECTRICAL -T ,. PEIIMI ru0 --- FRAMING - - - INSULATION - F. STORIES TYPE CONSTR ' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED OCC. GROUP RES UNITS ' ROOF- NOTE: NO FNALNSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID - ' SOi FT FI,U.1 AREA TOTAL ALRFAGf DIAPHRAGM ROOF SHEATHING BUILDING USE RES' IND CON PB om. ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED,. FINALS DATE INSP.. _ROUGH' SAN:» ASSESSORS PgRCfi L NO PLUMBING - �9 ELECT. ENERGY -TRACT TUBS 8SHOWER PAN " � PLUMBING ENERGY No. PARCEL NO. MECHANICAL •. _ MECH: ENERGY - - - ELECTRICAL _ —OUILDINGENERGY ACC DATE ACC. FILE No FRAMING ,ELECT: FINAL TEST INSULATION -- PLUMBING zowmr, ENc, SITE No. . GAS TEST - GAS ' MECHANICAL -�J' FIRE SPRINK Y P . N❑ ENERGY T"7Ct Y ❑ No COVER NO WORK UNTIL ABOVE HAS BEENlIGNED HEATING - EXTERIOR -SHEAR '1 - ELECTRICAL RELEASE FLOOD TONE Y❑ N❑ 46UC. `❑ No INTERIOR SHEAR FIRE DEPT. SHEETROCK - GRADE _ FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH - TEMPORARY APPROVAL - SCRATCH COAT- - 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'EINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM_- ARRANGE FOR INSPECTION BY PHONING 252-4505, o�: ONE'WORKING DAY BEFORE REQUIRED INSPECTION. PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - (1�� ELECTRIC PLUMBING CZ0 — MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION.. TOTAL. �l OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY . PROJECT IDENTIFICATION PERMITNUMBER -„ 1 BU I LOING 9UIDING ADOREss 2'LzlS ^cr, Li, APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL 15945. OWNER'S (-� - - x`O ft�t„ , G . L.Z2p NJ{�ICJ 1 tcllL PHONE 00 DTY. ELECTRIC PERMIT FEE PLAN CHECK VAL DATION S� 7( ' DATE OF APPO CATION CO ACTOR'S N M ,,,,{{ ^^`'1QQ ^^�1 f'L , 400.5 LIC. No.1.'CJOS_(„ OUTLETS -SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACT R's ADORES--s��Qp� 2LJV HorvE7 000 APPLIANCES - RESIDENTIAL 4.00 , PANELS 10.00 ARRCHITECT ENGINEER LIC. NO, PANELS (OVER 200 AMPI 20,00 PLAN CHECK FEE ' SIGNS TRANS. 3.00 moo esu E.G. CIRCUIT 5.OQ PERMIT PERMIT VALIDATION 'nP KVy/j{/-ems , TEMP. METER OR POLE INS. 20.00 AOREss ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 q Y/ p/� g 19 V IS CE DATE BLOrr��� PLG. MECH. LICENSED CONTRACTORS DECLARATION I hereby afOrm sir I a��HiuI�. sed under provisions of Chapter 9 (commencing with ctiox�OQ�tf Division 3 of the Business and ss Profe' n o ,' n i II m full fo t ft� Llmnse c Nuntbur Date - _ ContrBelpL E(�_ C� V BUILDING PERMIT INFORMATION OWNER -BUILDER rn:cLnRnTI N I hereby Minn that I am exempt from the Contractors License a,&Isin essand Professions Law forthefollrrea reason(Sec, requires Any city Dreamily which requirese permit to construct,,alter,also M ISC.- REFER TO ORD PERMIT ISSUANCE 40;00 e1 ;1- VALUATION / $/FT. ELEC. CONTR. LIC. NO. ELEC. '-1 - TOTAL v�+- imCodeprove, Im mires the n statement also Or repair h p structure, to file a signed requires the dp u applicant for such permit In file a signed statement that he is licensed pursuant ton the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) Division 3 of the ,� r PERMIT TO �W/.LJ/L///�/(� %�U Business and Professions Code) or that he is"exempt therefrom and m QTY. PLUMBING PERMIT FEE o the any basis for Nu alleged exemption. Any violation of Rection malty by any applicant fora permit subjectstile (S500plicant toacivil penally of not more than five hundred dollars (5500).):' .1 STORIES TYPE CONSTR. //'' B'V/V / / C ALTER -DRAIN 5.00 ❑ I, as owner of the property, or by employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 2- OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 2 - intended or offered for sale (Sec. 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of FIXTURES - PER TRAP 5.00 - GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 50. FT. FLOOR AREA TOTAL ACREAGE property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mentsarenotintendedor offered l'or sole. If, however, the building or improvement is sold within one ye:n of completion, the owner- builder will have the burden of proving that he did not build or ins- prove for purpose of sale.).INDUSTRIAL ❑ I, as owner of the property, am exclusively. contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Ono, ❑ ❑ ❑ El WASTE INTER3000 . licensed contractors m construct the project (Sec. 7044, Business and Professions Code: The Contractai s License Law does not apply to an owner of property who builds or improves thereon, and who LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 IEA.) 1.00 ASSESSORS PARCEL NO. , contracts for such projects with a contractor(,) licensed pursuant 10 the Contractor's License Law. ❑ lam exempt under Sea ,e.&P.C. Ibrlhls reason SEWER -SAN V -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 T" � ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 ' WORK F,RS'COMPENSA'I ION DECLARATION 1 hereby affirm that I have a certificate of consent 10 sell=insrue, ZONING ENG. SITE NO. or ehri��Ncale m nsation Insdrunc r u certified �etlil'ieA oryia he[ehy fu/�vhu�. Cetlificty is IjlEd NiLL Willy chy mspeclion division. ApplicamJ(��{-(-�'�WOW FIRE SPRINK YE] NEI ENERGY 24 Y[3 NEI. MISC.- REFER TO ORD. CERTIFICATECIF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. (This section need not be completed if the permit is for one PERMIT ISSUANCE 4ebeee%. FLOOD ZONE Y ❑ N ❑ A.LU.C. Y ❑ N PLG.CONTH. LIC. NO.PLG. CIL TOTAL hundred dollars (S 100) or IcS,.) I certify that in the performance of the work for which this per- mit is issued, I %hall not employ any person in any manner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensal ion Laws o' Calih,rniu. Date Applicant ALTER OR ADD TO MECH. - 5.00 NOTICE TO APPLICANT: If, after making this Certificate of Ex- APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 PLAN CHECK FEE emption, you should become subject to lire Workers'Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (OVER I0,000QRM.) 6.00 SEISMIC FEE l Z CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the Performance of the work (or which this permit is issued (Sec. 3097,C ,.CA EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Name HEATING UNIT (OVER 100,000 B.T.U.) ,p _ ELECTRIC �-z Od VENTILATION FAN (SINGLE) 4.00 - I certify that I have read this application and slate that the above information is emUcet. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING gO1LER-COh2fl (3 H.P. Or 100,000 B.T.U.) 6.00 hereby hereby enthorire representatives of This city to enter upon the above-mentioned property forinsp of inn �uity to BOILER -COMP (Over 100,000 BTUYSEE FEE SCH. MECHANICAL �'sa W 3'1agree to save, indemnify and oulf.harmless file City of - MISC. - REFER TO ORD. I in against hand 't14s, judg lents, costs and expenses which ma in a y sre arc a ainst aid City in consequence of the PERMIT ISSUANCE ig0g. � - CONST. TAX ran man f rout ^ e / - Q'1 Sit) MECH. CONT. UC. NO. f TOTALMECH. S' TOTAL 4 9 ignature Applicant actor 'Date OFFICE COPY )L ,.