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12426 POST THIS CARD NEAR FRONT OF BUILDING PERMIT� ��E CITY OF CUPERTINO INSPECTION DIVISION 26 JOB INSPECTION RECORD l � PERMIT EXPIRATION JOB ADDRESS //`r� L`yY,�[dLl-� L•./ UNIT# LOT# PERMIT EXPIRES IF WORK OWNER T' C, O CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ru-$� (J PfAA�- IIi OV¢TO- IIJ. ANCE OR 180 DAYS FROM LIFER LAST CALLED INSPECTION. PREGUNITE rI PERMIT VALIDATION POUR NO CONCRETE UNTILABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ELECT. PLG. MECH. El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING Cb_ -3 DZ � cVALUATION SIFT. _ � � �ChG MECHANICAL ��f� ELECTRICAL !- - PERMIT TO FRAMING o i r'C. •�,� INSULATION STORIES TYPE CONSTR. OCC.GROUP RES.UNITS 'PLACE'PLAUE NO SUBFLOOR UNTIL WBOVE HAS B EN SIGNED ROOF SO FT.FLOOR AREA TOTAL ACREAGE I � DIAPHRAGM ' BUILDING USE HES IND CON PB OR... APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ Cl ❑ ❑ 1:1 ROUG ASSESSOHS PARCEL NO. PLUMBING GAS TEST rHAcr no, PARCEL NO MECHANICAL ACC.DATE ACC FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING SAN it ZONING ENG.SITE NO. i INSULATION PLUMBING G o 'L — �] GAS f0ta 9/0/ ECHANICAL 2 _ FIRE SPRINK ENERGY T.24 COVR NO WORK UNTIL ABOVE HAS BEEN 9IGNED HEATING Y ❑ N[] V ❑ IN LATH—INTERIOR ELECTRICAL FLOOUtONE A.L.U.C. LATH-EXTERIOR FIRE DEPT. Y❑ N❑ I Y ❑ N❑ SHEETROCKGRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY I SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY.PHONING 252-4505, 4j� ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. ;{ PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - IMECHANICAL / -.... CONST.TAX IMPORTANT! A PLEASE READ REVERSE SIDE BEFORE kl . >+"+i[ 4i ly' -- I TOTAL CALLING FOR FINAL INSPECTION. I,O=TI KG COPY POST THIS CARD NEAR FRONT OF BUILDING• - PFRMIT NUMBER CITY OF CUPERTINO 12426 ' INSPECTION DIVISION I JOB INSPECTION RECORD _ �F PERMIT EXPIRATION JOBADDRESS- 1143 HollyHe Bd Lane UNIT# LOT# PERMIT EXPIRES IF WORK OWNER T. Ignacio CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ' ANC&OR 180 DAYS FROM LIFER ' L.A DINSPECTION. PREGUNITE - PERMIT VALIDATION AY 2. 61987 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED M ' UNDERGROUND /SLAB City-p{ Cupertino, PLUMBING / !_ ELECTRICAL' - IssuANc Ai MECHANICAL BLDG. ELECT. PLG. MECH, DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION PLUMBING ` WOOD FLOOR _ , VALUATION $/FT. / MECHANICAL ' ELECTRICAL _ , _PERM ITTO / FRAMING INSULATION - - - STORIES UYPIE CONSTR. OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO,FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE RES IND CON PB Ouhe, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ • ❑ ❑ ❑ ROUGH ' ASSESSORS PARCEL NO. PLUMBING GAS TEST ./j•' , TRACT NO. PARCEL NO. MECHANICAL ACC.DATE -ACC.FILE N0. ELECTRICAL FINALS DATE INSP. FRAMING SAN * I I ' PLUMBING ZONING ENG.SITE NO. INSULATION- '�,- GAS MECHANICAL FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1 HEATING Y ❑ N❑ Y ❑ N❑ FLOG LOOD ZONE A.L.U.C- LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEPT. • Y❑ N Y 0 N❑ SHEETROCK- - f GRADE FEE SUMMARY SHEAR INTERIOR BUILDING - A SHEAR EXTERIOR TEMPORARY APPROVAL BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM la w ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC 1- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 4 ti z PLEASE GIVE JOB ADDRESS WHEN PHONING: - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL: �( IMPORTANT! A CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN.ONLY BUIhPERMIT NUMB"PROJECT IDENTIFICATION BUILDINGAPPLICATION & PERMIT ADDRESS ORE55 i11+3 Ho+.t-Y H C4� u D q)�E BUILDING-ELECTRICAL-PLUMBING- 12426 MECHANICAL yx. ER'S PLAN CHECK VALIDATION NAME CITY. ELECTRIC PERMIT FEE T[ I rlQ C1 PHDNE252 59 1 CONTRACTORS O ji / , /�♦ NAME ,1 UTLETS-SWITCHES-RECEP 10.00/1.00 uc.No. LIGHTING FIXTURES 10.00/1,00 /at CONTRACTOR'S "x� J ADDRESS [APPLIANCES 4.00 PHONE PANELS 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 ARCH,OR ENG. SPECIAL CIRCUIT S,QO PERMITVALIDA 1 zlv EMP.METER OR POLE INS. 20.00 �f n ? is ADDRESSTs MOTORS' Es FE 8CFI. w /I r`,Y ra V 1" SERVICE CHANGE ` u 20.00 �rJJusup 81c no o o LICENSED CONTRACTORS DECLARATION *g Nlnerftn I G u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE w< N (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. r z z Professions Code,and my license is in full force and effect. l� License Class Lic.Number Date Contractor BUILDING PERMIT ¢ ¢w OWNER-BUILDER DECLARATION INFORMATION Z ;u y 1 herebyaffirm that I am exempt from the Contractor's License MISC.- REFER TO ORD P VALUATION $/FT. r a 0 J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 vi Code:Any city or county which requiresa permit toconstrucl,alter' a /� G ¢ Q 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. U r/ V w >D¢ requires the applicant for such permit to file a signed statement that .TOTAL PERMIT TO n x m u he is licensed pursuant to the provisions of the Contractor's License Fri Law(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe a Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE ¢r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES T P NSTR. i ; _ by any applicant for a permit subjects the applicant loacivil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500)): I&jf I•as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS 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 docs such work FIXTURES-PER TRAP 5.00 S. FT.FLOOR 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- GAS-EA.SYSTEM•OVER 4(EA.) 2.00 BUILDG USE t" I builder will have the burden of proving that be did not build or im- - IN RES 'IND CON PB od,ar prove for purpose of sale.), INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑' ❑ ❑ ❑ El licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 1 6.00 ASSESSORSPARCEL 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-O 5(EA.) _1.00 contracts for such projects with a contractor(s)licensed pursuant to gEWER-SANITARY-STOR A_n2 GI 10.00 the Contractors License Law. �1j. TRACT NO. PARCEL NO. ❑ 1 am exempt under Sec. .BAP.C.for this WATER HEATER W �t U 6.00 ea on O Owner1+w-r5� �./��' Date �Jw WATER SYSTEM �liI e 1 0 ACC.OATE ACC.FILE NO. WORKF.RS'COM ENSATION DECLARATION/ WATER TREATING EMO.' 5.00 1 hereby affirm that I have a certificate of consent to self-insure, ZONING ENG:SITE N0. or a certificate of Workers'Compensation Insurance.or a certi0ed copy thereof(Sec.3800,Lab.C). Policy No. Company - ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is filed with the city inspection division. MISC. REFER TO ORD. O Applicant Y ❑ N❑ Y ❑ N❑ ~ an PERMIT ISSUANCE 10.00 FLDOD ZONE A.L.u.c. - CERTIFICATE OF EXEMPTION FROM WORKERS' LU �_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. I.G.PO a O (This section need not be completed if the permit Is for one TOTAL Q Y❑ N❑ y ❑ No Z) Z hundred dollars(5100)or less.) , U O - 1 certify that in the performance of the work for which this per- dTY. MECHANICAL PERMIT FEE FEE SUMMARY LL mil is issued,I shall not employ any person in any manner so as to r•. become subject to the Workers Compensation Lows of California. Q tf w Date.Applicant ALTER OR ADD TO MECH. 5.00 BUILDING �� _ NOTICE TO APPLICANT: If,after making[his Certificate of Ex- F. ? 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 C.1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 1 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLINGUNIT IOVE ,OODGF.M.1; .00 SEISMIC FEE /Z I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DU )( '7 .00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). ' HEATING UNIT(TOT Orb 0 d.T.U.) 8. 10 Lender's Name HEATING UNIT(OVER 110 ,0 .�7 .50 ELECTRIC Lender's Address 1 certify that Ihay e read this application and state that the above 3 VENTILATION FAN r. 4.00 QO information is correct. I agree to comply with all city and county PLUMBING Q (3 H.P.or 100,000 B.T.U.) 6.00 ordinances and state laws relating to building construction, and BOILER-COMP hereby authorize representatives of this city to enter upon the aOILER•COMP (Over 100,0000TU)SEE FEE SCH. MECHANICAL J ' P�t above-mentioned property for inspection purposes. x.t (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE10,00 Q� CONST.TAX may in any way accrue against said City in consequence of the granting of this perm). MECH.CONT. - LIC.NO. MECH. CCU 3� !�, TOTAL TOTAL 7 �� Signature of Afall c tC ntractor ate J OFFICE COPY POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINOl°1-/n6 INSPECTION DIVISION _ JOB INSPECTION RECORD ,✓. PERMIT EXPI F. JOB ADDRESS 1143 Hollyliead Lane UNIT/k._..—_LOTYt PERMIT EXPIRES IF h OWNER T. Ignacio CONTRACTOR IS NOT STARTED WI INSPECTION DATE JINSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT FOUNDATION ANC E OR 180 DAYS F LIFER LA4•{±(;i1 DINSPECI 1-111A111 VALIIIAIWN PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB �,, L, Cupeltioo PLUMBING 7 ELECTRICAL iSSUANCV A��I MECHANICAL uuu; 1LrcT Pu;. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PER T WOOD FLOORINFORMATION PLUMBING vnu nl EN MECHANICAL ELECTRICAL ^P Hh IT TO FRAMING `J ULI•/•� STIORES YPE CU INSULATION OCC E:HOUP III's UI PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED DIAPHRAGM ROOF SO TT.EL( llN AHEA MAL AC Ise• BUILDING USE HIS IND CON P8 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 0 0 ❑ ❑ ASSESSORS PAHCI.L NC ROUGH PLUMBING GAS TEST . TRACT NO. PALACE MECHANICAL ELECTRICAL FINALS DATE INSP. "cc DATE ACC Fu FRAMING SAN 4 zoewc ENG.511 INSULATION PLUMBING GAS MECHANICAL FIRE SPflINK ENEflG COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING T ❑ No Y ❑ LATH-INTERIOR ELECTRICAL FLOOOIONE A.LIJ LATH-EXTERIOR FIRE DEPT. v❑ Nc] T o SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, vi+ ELECTRIC W ONE WORKING DAY BEFORE REQUIRED INSPECTION.' PLUMBING • .� Z 4� PLEASE GIVE JOB ADDRESS WHEN PHONING. i,, MECHANICAL { ' — SEE PERMIT FOR EXPIRATION DATE — ; h'. Fih CONST.TAX IMPORTANT! PLEASE READ RE SIDE BEFORE C I II:;:�:':,`T ::ri' CAI.LII\IG FOR FINAL INSPECTION. `�-�--y TOTAL