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HomeMy WebLinkAbout9091 POST THIS CARD NEAR FRONT OF BUILDING PERM [DUMBER CITY ,OF CUPERTINO fg� a - INSPECTION DIVISION JOB INSPECTION RECORD i .- II/�1 PERMIT EXPIRATION JOB ADDR ES V l .UNIT LOTd# , i - - PERMIT.EXPIRES IF WORK OWNER CONTRACTOR ISNOT STARTED WITHIN . INSPEC ON DATE INSPECTOR I I INSPEItTION RECORD 760 DAYS OF PERMIT ISSU- FOUNDATION • 7 `ANCE OR 180 DAYS FROM , UFER LASTCALLEDINSPECTION. PREGUNITE 4 PERMIT VALIDATION. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING- ,. �-C.��.":�"•' ,%,./" . ' ELECTRICAL 1 I ISSUANCE DATE - I' ' MECHANICAL. - eLoc. ELECT. PI-G.. MECR.. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED :r BUILDING PERMIT ' ' WOOD FLOOR INFORMATION PLUMBING VALUATION - $/FT. � � - I MECHANICAL - - •P /; f ✓, f,T . -ELECTRICAL 1 Ell TTO , FRAMING - - INSULATION - .� STD IES TYPE CONSTRr-- ' - OCC.GROUP' :RES.UNITS ' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - - - ROOF - - - SO.FT,FLOOR AREA TOTAL ACREAGE DIAPHRAGM I . ^ .. - •. _ BUILDING USE .'RES IND CON PI3 Ober APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED n ©`ll ❑ ' ❑ ❑ ❑ - ROUGH SEL3)E2 II 'I Sb . ASSESSORS PARCEL NO. PLUMBINGGAS TEST - _ ••••�)- TRACT NO. 4PAR CEL NO. MECHANICAL .' " - ' ELECTRICAL - FINALS -DATE INSP. ACC.DATE ACC FILE NO. FRAMING SANS# " ZONING ENG.SITE NO. 'I _INSULATION � � PLUMBING ZONING • GAS MECHANICAL FIRE SPRINK ENERGY T-74 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING t Y ❑ NE) v ❑ NF] •� FLOOD ZONE A.L.U.C. r 1 LATH—INTERIOR ELECTRICAL " - LATH-EXTERIOR 'a FIRE DEPT`. - -Y❑ "❑ ?' ❑ N❑ L. SHEETROCK - GRADE '' _. : FEE SUMMARY ' SHEAR INTERIOR BUILDING - 4 SHEAR EXTERIOR TEMPORARY APPROVALS ' BUILDING ,,;:f FIREWALLS ELECTRIC PLAN CHECK, •�'," GAS FEE - ,•,� •' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY: SEISMIC FEE 1 OCCUPANCY OF BUILDING ISNOTPERMITTED. UNTIL BUILDING'FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM l ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED IN PLUMBING !` (.I. z -PLEASE GIVE JOB ADDRESS WHEN PHONING. r' — / — SEE PERMIT FOR EXPIRATION DATE - MECHANICAL . IMPORTANTI U,:CONST.�TAX ` . PLEASE READ REVERSE SIDE BEFORE s �, TOTAL CALLING FOR FINAL INSPECTION. y '! ', OFFICE COPY • . - ✓ i s . APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -, USE BALL POINT-PEN ONLY ' BUILDING PROJECT IDENTI FICATION - ITNUMBER BUILDING APPLICATION & PERMIT ' A AO,/�/ / f-- l� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 9 0 91 OwrvER' L PLAN CHECK VALIDATION . r4 /` �Ur y� TV. ELECTRIC PERMIT ,FEE- L PHONE O CTOR S NA /'M q�( OUTLETS-SWITCHESRECEP 10.00/1.00 �� 6L"/S Lie No. S'3315 _LIGHTING FIXTURES 10.00/1.00 CONTRACTORS A '/J/{} �J/'�^'�,J APPLIANCES-RESIDENTIAL 4.00 .__C) PHON PANELS 1 10.00 DATE OF APPLICATION e HORncHITECT PANELS (OVER 200 AMP) _20.00 PLAN CHECK FEE " P.C.NO. ' ENGINEER , - LIC. SIGNS TRANS. 3.00 AARH.OR DDRESS ENG. SPECIAL CIRCUIT - 5,00 PERMIT VALIDATION ZIP EMP:METER OR POLE INS. "20.00 ADDRESS - MOTORS SEE FEE SCH. -k SERVICE CHANGE 20.00 4p' w o o LICENSED CONTRACTORS DECLARATION ' TEMP.POLE - 30.00 � 1 G Z W I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE Q (commencing with Section 7000)of Division 3 of the Business andai-EliS. ELECT, PLG. MCH. F w w . LDi�cta�Class ellicense is in full fzProfessions Cad- Number o Contractor'74 M. - a x f BUILDING P RMIT S o o O X 3 OWNER-BUILDER DECLARATION INFORMATION N I hereby affirm that I am exempt from the Contractors License 'MISC.- REFER TO ORD , • F LL o a Law for the following reason.(Sec.7031.5,Business and Professions 'PERMIT ISSUANCE 10.00 vALUAiION ,mss $/FT. " w0 Code:Anycity orcounty which requires a permit to construct,after, Q 0 improve,demolish,or repair any structure,prior to its issuance,also CLEC:CONTR. LIC.NO.- TE LEC. v�( O u requires the applicant for such permit[o file a signed statement that - TOTAL K$ he is licensed pursuant to the provisions of the Contractor's License PERMIT T iii Law.(Chapter 9(commencingwith Section 7000)of Division 3 ofthe _ Q Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ Q the basis for the ti alleged exemption,An g pAny violation of Section 703 L$ ST IES - TYPE CONSTR. w ; by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 O C.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 improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SG.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- lie mmre es anot intended or offered for sale.If,however,the building. GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,"(he owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 E IND CDN PR Other. ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 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 contraconts)licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00 . the Contractor's License Law. TRACT NO, PARCEL NO. I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6:00 - - ne -Date WATER SYSTEM 5.00 ACC..DATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP:' 5.00 " hereby affirm that I have a'certificate of consent toself-insure, p- ZONING ENG.SITE NO. or Re ertificate of Workers'Compensation Insurance,or a certified - copy thereof(Sce.3800,La IT C, ' Policy No, panI, c' O Cerlifie -opy is h mb fur is FIRE SPRINK ENERGY T24 Z ❑ tifi c d inspection division. - ' Appli an ISC:- � REFER TO ORD. y ❑ - N� v❑ 'N❑ F' rn 'PERMIT ISSUANCE 10.00 cc - .R ICATEOF :) PTION FROM WORKERS' _ FLOOD ZONE `A.L.U.C. LU COMPF.I SATION INSURANCE. PLG.CONTR. LIC.NO. PLG.'. y❑ N❑. V❑ N❑ CLO his section need not be completed if the permit is for one TOTA CD Z hundreddollars($100)or less.) V O 1 certify that in the performance of the work for which this perFEE SUMMARY LL F mit is issued,1 shall not employ any person in any manner so as to QTY. MECHANICAL PERMIT 'FEE' O W become subject tothe Workers'Compensation Laws of California. BUILDING y Date Applicant - ALTER OR ADD TO.MECH. 5.00 } N NOTICE TO APPLICANT: If,after making this Certificate of Ex. ♦- Z Emptier,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK, 'provisions of the Labor Code, you must forthwith comply with FEE i� U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10DWC.F.NL) 4.00 CONSTRUCTION LENDING AGENCY ' AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 SEISMIC FEE qT 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) - '5.00 ' the performance of the work for which this permit is issued(Sec. MICROFILM '3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's AddHEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC ress I certify that I have read this application'and state that the above VENTILATION FAN (SINGLE) .4.00 information n correct. I agree to comply with all city and county - PLUMBING ordinances and state laws relating to building Coity and county BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives.of this city, to enter upon the BOILER- OMP(Over 100,000 BTUI SEE FEE SCH. MECHANICAL / above-mentioned properly for inspection purposes. (We) agree to save, in keep harmless the City of - MIS REFER TO ORD. Cupertino a a' sl liabilit' s,judg a s, costs and expenses which pERMI .ISSUANCE 10,00 CONST.TAX may in wa aceto a a'nst Sr City in consequence of the gran' g i { MECH.CONT. I LIC.NO. MECH. ' J TOTAL TOTAL ' TOTAL sgn re of Appl' ant ntractor - Date - ` Off) OFFICE COPY ,