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15189POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD F ��Iy� JOB ADQRESS Yom A �S�Y___uAq UNI4* _LOT# J\v�ry/ OWNER Il(�1 i CONTRACTOR n I'F.RMIi NUMBER 15189 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. .. INSPECTION DATEI INSPECTOR INSPECTION RECORD FOUNDATION 1AtCV�S -- - NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. ' . ' UFER PR EG UNITE PERMIT VALIDATION Sv ISSUANCE DATE GARAGE SLABS �j• POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED A UNDERGROUND/SLAB PLUMBING G� q L7 ELECTRICALO MECHANICAL V� �� gut Tau' ELen art{ ❑ PLGI MECH Q_j ❑ . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION ' I siFT. PLUMBING2-17 _- MECHANICAL 2- 7- j ELECTRICAL PERMIT i0 FRAMING /% INSULATION 22 1_ STORIES TYPE CONSiR - 1 OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSHALL BE MADE BEFORE THE CONSTRUCTION AX IS PAID 50 FL FLOOR ANf4 _ _ , `- TOTAL ACREAGE DIAPHRAGM BuuowG use RES IND CON PB, Om" ❑ ❑ ❑ ❑ 1:1 ROOF SHEATHING �-�q APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.11'- PLUMBING - ELECT. ENERGY TRACT NO. PARCEL NO., UBS SHOWER A LI PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC. FILE NO ELECTRICAL BUILDING ENERGY It FRAMING ELECT. FINAL TEST ZONING ENG. SITE NO. INSULATION PLUMBING GAS TEST Z,rj Q GAS FIRE SPRINA v ❑ NE] ENERGY L$4 v ❑ N� MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING If FLOOD LONE Yo NE] ALUC. �L NE] EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT, FEE SUMMARY SHEETROCK -plyGRADE EXTERIOR LATH BUILDING BUILDING .. INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT 9 ELECTRIC PLAN CHECK FEE GAS SEISMIC FEEOCCUPANCY NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING NNALISSIGNEDBY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, i. 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 -OFFICE COPY V 40 u -'0 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY -, BUILDING PROJECT IDENTIFICATION -1 APPLICATION & PERMIT PERMIT NUMBER 1518 9 BUILDING ADOR so , Q �) BUILDING -ELECTRICAL- PLUMBING -MECHANICAL OWNER'S IPLAN CHECK VALIDATION ME qk_wOTY. d PHONE ELECTRIC PERMIT FEE CONTRACTORS NP.EUTLETS ME -SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 Ole . NO. CONTRACTORS CONTRAS A PPLIANCES- RESIDENTIAL 4.00 PANELS 10.06 _ PHONE DATE OF APPLICATION' ARCHITECT OR ENGINEER T iCL64 t A1r%ra_.LI1.NQSIGNS PANELS (OVER 200 AMP) 20,00 PLAN CHECKFEE P.C. NO. TRANS. 3.00 ARCH, OR ENG.PERMIT AS Es �♦ _� ♦ qVJIfib_IP[ SPECIAL CIRCUIT 5.00 VALIDATION EMP. METER OR POLE INS. 20.00 APPLICANT'S 7A \ _I MOTORS SEE FEE SCH. CHANGE 20.0 NAopaEss IV•of)SERVICE V LICENSED CON I'R CfORS DECLARATION is1 hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Professions Code, , it my license is in full force and effect. License CI¢' Lie, Number `V • BLDG Q ELECT. PLG, MECH. nU Uate-I /J Cnlltmctor `r BUILDING PERMIT OWNER-BUILDI:R DECLARATION I hereby collo that I and exempt from the Contractor's License Low 1: Athefollowingreason.ISee. B.,iucss tocand Professions Code: Anycity county whiny structure permittoconstrud,a0eq improve, demolish, Of repair any StNGtull', prior l0 IIS issuance, aIW requires the applicant for such peTtait 10 lite a Signed statement that be 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 Professions Code) or that he is exempt therefrom and INFORMATION MISC.- REFER TO ORD VALUATION 1�l p2 �Q PERMIT ISSUANCE 1 7 ELEC. CONTR. LIC. N0. ELEC. Xn�u 77 TOTAL V �Lz PERMIT TO - / QTY, - PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant toa Civil penalty of no, more than five hundred Aollars (S500).): ALTER -DRAIN -WATER IEA.) 5.00 'y ❑ I, as owner of the property, or my employees with wages as their Sale compensation, will do the work. and the structure is not intended or offered for sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP R-3 RES. UNITS 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 50. FT. FLOOR AREA TOTALACREAGE himself Or through his own employees, provided that such improve- ments are not inlended or offered for sale. It, however, the budding �74� GAS- EA.SVSTEM-11NC.4OUTLETS 8.00 wner- r improvement is sold within One year of completion, the owner- builde}r�will have the burden of proving that hu did not build or im- builder rove r ser lou of sale.). p Y purpose [ as owner of tom property, exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 9ua01NG USE RES IND CON PB Ome. ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 A$$EssoRS PARCEL No. he Business licensed contractors to construct the project ISec d fees and n owner its Code Thu Con trader's 1iccus,improv Law docs not apply to an owner o1 property who builds or improves thereon. and who , LAWN SPRINKLERS -OVER 5 (EA.) 1.00 contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under See_ ,BAP.C. lilt 0 is WATER HEATER W/VENT 6.00 reasy on _ Owner Date b WATER SYSTEM 5.00 ACC. DATE ACC FILE NO. WATER TREATING EQUIP. 5.00 WORK ISRS'COMPENSAIION DECLARATION I hereby affirm that I have a certificate ofconsent to self -insure, Or a Certificate of Workers Com ensat ion Insurance, or a certified ZONING ENG. SITE NO. em 00 Li 380QLah.C.) \�Al policy Nrcol'(Scc. policy Compny_ tlL FIRE SPRINK v N ❑ ❑ ENERGY T44 V N ❑ ❑ ❑ S.e lift opy Is hereby furnis a Caroli Lc- ' Iik;"Ilb �y 'm cdiun division. Applicant ♦- MISC.- REFER TO ORD. CIi R'I'IFICA'FI:OP EXEMWI'ION 17ROM WORKIiRS' PERMIT ISSUANCE a - FLOODZONE A.L.0 C. PLG. CONTR. LIC. NO. PLG. TOTAL COMPENSATION INSURANCE (I In, section nevi not be completed if the permit is for one v❑ N❑ v❑ N❑ OTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollms (S 100) or I,,,) I certify that In the performance of the work I'or which this per- mit is issued, I shall not employ any person in any inner so as to BUILDING 010-01 become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE '10 APPI-ICAN'1': If, 'after making this Certificate of E.- enlption, you should become subject to the Workers Conlpensatiou ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY FEE AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIR HANDLING UNIT (OVER I0,000C.F.M.) 6.00 SEISMIC FEE /<-,Yo EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM 1 hereby affirm flat there is a construction lending agency for the performance of the work for which this permit is issued (See 3097, Civ,CJ. Lender's Name HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (O VER 100,000B.T.U.0.50 ELECTRIC OG7 Lender's Address I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby uuthorice representatives of this city to enter upon DIC above-mentioned property for inspection purposes. VENTILATION FAN (SINGLE) 4.00 PLUMBING ,0 WI Ll BOILER -COMP (3 H.P. Or 100,0006.T.U.) 6.00 BOILER -COMP Over 100,000 BTU) SEE FEE SCH. MECHANICAL MISC. - REFER TO ORD. �• CONST. TAX 03 (We) agree to save, indemnify and keep harmless the City of upertino against liabilities, judgments, costs and expenses which ay i any way accrue agai st slid City in consequence of the PERMIT ISSUANCE H) -.ft MECH. CONT. LIC. NO. MECH. TOTAL TOTAL (p�3 ran 1 g of this permit . �•yl IAlt") �I Signature of Applicantt Co tr ct, Talc OFFICE COPY