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15188S POST THIS CARD NEAR FRONT OF BUILDINGPERMIT CITY OF CUPERTINO - - INSPECTION DIVISION JOB INSPECTION RECORD q(� ��yI�yyt JOB ADOI ESS I � l y --N --�� UNIT# LOT #t v t� n t OWNER I P CONTRACTOR , NUMBER 151$$ PERMIT EXPIRATION PERMIT EXPIRES IF WORK ' IS NOT STARTED WITHIN ANCE OR 180 DAYS FROM AN DAYS OF PERMIT IROM LAST CALLED INSPECTION. INSPECTION DA E INSPECTOR INSPEC IONRECORD FOUNDATION NOTE: GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. LIFER - PREGUNITE PERMIT VALIDATION I----� ` t I'S NCE. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - UNDERGROUND / SLAB PLUMBING . �� R,� ELECTRICAL MECHANICAL fir.. BLD�.I` .ECT El LO. MEc+. PLO. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUA,ION t SIFT. PLUMBING - MECHANICAL -/ -' PERmD TO _J C I�Il,I, 1/ �lJ iT-YYP'E ELECTRICAL FRAMING -/ - STUN IES CONSTR INSULATION UCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED so IT FLooR nNEA - TOTALACREAGE ROOF NOTE: NO FINAL INSP, SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID DIAPHRAGM BUILDING USE ED 0 RES IND CON PB 0"'., El ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO - /a - : w ` ROUGH SAN.# PLUBING M ELECT. ENERGY -—,/ TRACT NO PARR CEL NO UBS OWJR PAN PLUMBING ENERGY— NERGYMECHANICAL ME —CH A N I C ALL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT, FINAL TEST ZONING ENG SITe NO. INSULATION PLUMBING ST GAS TE`ZTj GAS FINE SPR INK Y ❑ N ❑ ENERGY T.I4 Y [DN ❑ MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLooDmNC v N� 4Luc ! Y ❑ N❑ EXTERIOR SHEAR -(LDOT ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. FEE SUMMARY SHEETROCK GRADE -77--F EXTERIOR LATH .Z BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC `Zs PLAN CHECK FEE GAS SEISMIC FEE , NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY I OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LOI NG FINALISSIGNED BY BUILDING INSPECTOR. MICROFILMLU ' ARRANGE FOR INSPECTION BY PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. O� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - —SEE PERMIT FOR EXPIRATION DATE — ELECTRIC _ PLUMBING MECHANICAL CONST. TAX _ IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL l OFFICE COPY r _ APPf ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY 10 O ZZ F O 1 =. N L CL 0 U 0 LL U U.1 } n Z A 111 BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING — ELECTRICAL— PLUMBING — MECHANICAL PERMIT NUMBER 15188 BUILDING a/ REss Q rIC� OWNER S "" El Jf,, PXONE QTY. ELECTRIC PERMIT FEE' PLAN CHECK VALIDATION COkITRACTOR, NAME I UTLETS-SWITC HES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 LIC. NO. CONTRACTOR', ADDRESS APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPLICATION ARCHITECT OR ENGINEER e eb LIc. o. PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO, SIGNS TRANS. 3.00 ARCH, OR ENG' I aoo Ess F zir Q SPECIAL CIRCUIT 5,00 PERMIT VALIDATION n ; n t�� ISSUANCE DATE EMP. METER OR POLE INS. 20.00 APPLICANT s ADDRESS Wb , T�Np 5401 a �- MOTORS SEE FEE SCH, _X SERVICE CHANGE 20.0 LICENSED CON" ACTORS DECLARATION 1 hereby affirm that 1 am licensed under provisions of Chapter 9,\ (commencing with Section 7000) of Division 3 of the Business and Professions Code, ap my license is in full (lone and effect. License Lic. Number pBLDG. ELECT.PLC. ([]—. MECH. A Date Contractor. 07 BUILDING PERMIT WNI'R-BUILDER UIiCLARATION I hereby affirm IIIat I ant us emfrom the Contractor's License Law for the following reason. (Sec 7031.5, BT;mv,sand Professions Code: Any silver county which requires a permit to construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file it 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 Po.Ivssioms Code)'or that he is exempt therefrom and the basis for the alleged exemption. AD, violation of Sccti.D 703 LS INFORMATION MISC. — REFER TO ORD VALUATION r3 ' K`7J W s� $/FT. l PERMIT ISSUANCE 40A0' IT ELEC. CONTE. LIC. NO. ELEC. y TOTAL OC6 //_ 9' PERMIT TO Kl OTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. `ALTER -DRAIN & VENT -WATER (EA.) 5.00 by any applicant for a permit subjects the applicant to a civil penalty .four more than five hundred doll... (S500).): ia— A s'yJT ❑ I, as owner "fill, property, ur my employees with wages., their sole compensation, will do the work, and the structure is not intended or offered lin sale (Sac. 7044, Business and Professions . BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AR EA,COND. 5.00 Code: The Contractors License Low does not apply to an owner of property who builds or improves thereon, and who does such work FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE himself or through his own employees, provided that such improve- mentsare Got iatcoded or offered for sale. If, however, the building d' 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 Wm he did not build or i on. prove for purpose of s;de.), Is. 1, s owner of the property, am exclusively contracting with ,,,.d contractors to construct the project (Sec. 7044, Business and Professions Code:' File Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who GAS - EASYSTEM -OVER 4 (EA) 200 . .. BUILDING USE RES IND CON PB Other C1 El El F-1ii INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO, �� LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts for such projects with a communes) licensed pursuant to the Contractor's License Law. ❑ I amzenlpt under Sec. .B.&P.C. for th'e lealon SEWER -SAN ITARY-STOflMEA. 200ft/10.00 TRACT NO. PARCEL NO. WATERH EATER W/VENT 6.00 Owner Date -14PAff 5 WATER SYSTEM 5.00 ACC.DATE ACC, FILENO. WORK Ii RECOMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby aftirm that I have u curtiGcate ofcnnscm to sol Ginsure, or a certificate of Workers Compensation Insurance, or a certified copy thereof fSec. 3800, Lab.C). d� I'olcy No. Company L 1 1_W .— ZONING ENG. SITE NO. ❑ Ccrlilie Py is hereby IOr I sit d. s Cerlifi py i, f e Ilh rd cd inspectimt division. FIRE SPRINK ENERGY TQ4 MISC. - REFER TO ORD. PERMIT ISSUANCE FLOOD ZONE A.L.u.c. CP-RTIFICAI'Ii OF i:xi"mp'F1ON FROM WORK):RS' PLG.CONTR. LIC. NO. PLG. 0 TOTAL CONIPENSAI'ION INSURANCE (I he, section need not be completed if the Permit is for on, Y IN C] Y❑ N❑ QTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars (S 100) or less ) I certify that in ole performance of the work for which this per- mit is issued, I shall not employ any person in airy manner so as to become subject to the Workers' Compensation Laws of C.limmia. Date APPlicant NOTICE 'FO APPLICANT: 11, alter making this Certificate of Ex- emplull. you should hecomc subject to the Workers' Cnmpensat ion provisions of the Labor Code, you must forthwith comply with or this shall be deemed revoked. BUILDING //QJ S 'a ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 such provisions permit CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). Lenders Nam, HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC O7 Lenders Address I certil' that I have read this applicaliom.nd state that the above information is is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and hereby auotorirc representatives of this city to enter upon the above-mentirned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of upertino against liabilities, judgments', costs and expenses which ay in any way accrue against said City in consequence of the VENTILATION FAN (SINGLE) 4.00 ' PLUMBING 0 615 BOILER-CUMP(3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL e 7� _ MISC. - REFER TO ORD. CONST. TAX 03 PERMIT ISSUANCE '96:00' MECH. CONT. LIC. NO. TOECH TAL 0 0(0 � TOTAL /Q run of Chis pcn»i a /] D((11(_ Signature of Applicant/Contractor Dfle OFFICE COPY