Loading...
HomeMy WebLinkAbout5660 A15PL•ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY - BU6LDING PROJECT IDENTIFICATION - IT NUMBER BUILDING Lot 6 APPLICATION & PERMIT 1024 � ) // BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 660 OWNER'S J� / b����` PLAN CHECK VALIDATION 'NAME `. li/� OTY. ELECTRIC PERMIT- FEE L.P- CON AGTaIi'a OUTLETS-SWITCHES-RECEP 5.00/1.00 NAME LIC.NO, LIGHTING FIXTURES 5.00/1.00 , ADTRARESS oR's APPLIANCES-RESIDENTIAL 4.00 COND 1HOsE PANELS 5.00 DATE OF APPLICATION ARCHITECT SIGNS 6.00 PLAN CHECK FEE P.C.NO. OR ENGINEER �Qn� SIGNS TRANS. 3.00 ' ADDRESS ENO 4� S � 014 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ARCH OR L ZI EMP.METER OR POLE INS. 15.00 APPmcgrvrsss � Hyl *n_ -_'R, MOTORS SEE FEE SCH. AooRE #l�W 9 SERVICE CHANGE 10.00 o o LICENSED CONTRACTORS DECLARATION a U U I hereby affirm that 1 am licensed under provisions of Chapter') JS.ANCE DATE w a m (cnmmancing with Section 7000)of Division 3 of the Business and a G. ELECT, PLG. MECH. r y z Professions Code.and my license is in full force and effect ® ❑ ❑ O z o m - License Class Lia Number 9 - w Dam Contractor a y E BUILDING PERMIT a wa OWNER-BUILDER DECLARATION INFORMATION dodo MISC- REFER TO ORD w 3 LL r I hemby affirm (but I am exempt from the Contractor's License VALUATION S/FT. F LL o j Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 6.00 I �>f Code:Any city or comfy which requiresa permit tocomtnmLalter, ELEC.CONTR. LIG.NO. y 431,000 a O improve,demolish,or repair any structure,prior to its issuance,also ELEC. - O M requires the applicant for such permit to file a signed statement that TO, PERMIT TO a w m he is licensed pursuant to the provisions of the Contractor's License FiQ Law(Chapter 9(eommencingwith Section 70000of Division Sof the Condos. 8 Units 4 O Business and Professions Code)or(bat he is exempt therefrom and OTY. PLUMBING PERMIT FEE H o the basis for the alleged exemption.Any violation ol'Scetion 7031.5 STORIES TYPE CONSTR. a ;m by any applicant for a pemtit subjects(be applicant toacivilpenalty ALTER-DRAIN&VENT-WATER (EA.) 4.00 ol'not more than five hundred dollars(E500).) 2 5 N. Hr. ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 2.00 OCC.GROUP RES.UNITS Their sole r offered for will(S tm work,and the and ctmeProf is not intended or offered for sale(Sec. doe Business and Professions DRAINS-FLOOR,ROOF,AREA, 4.00 R-1 8 Code:Thp Contractor's Lipase Law docs not apply to,l owner of property who buildsis improves(hes,pr and who does such work FIXTURES-PER TRAP 4.00 so.FT aDOR AREA TorAL ACREAGE himself re through his own employees,provided that such improve. men..pro ...car endedwittinoneVeiroIf,however,the building GAS-EA.SV STEM-11NC.40UTLETS 4.00 14,000 or lder will have is wd within one your of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 1.00 BUILDING USE builder will have the burden of proving that he did not build or int- RES IND CON PB Omer �mvc for Purpose nl's'alc.). INDUSTRIAL WASTE INTER. 20.00 ® ❑ ❑ ❑ ❑ as owner of the property.am exclusively contracting with - li ed ca nlmmors to construct the project(Sec.7044,Business LAWN SPRINKLERS-I INC 5 V.B. 5.00 ASSESSORS PARCEL NO. and Professions Code:The C.... or's License Law dues not apply N un owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 269-2-2 contracts for such projects with a contmerods)licensed pursuant 1. the Contractor License lav SEWER-SANITARY-STORM EA.2001t/8.00 TRACT NO, PARCEL NO. ❑ lam exen Pt under ,B.&P.C.for this WATER HEATER W/VENT 4.00 lc,pim1 7575 Owner ate WATER SYSTEM 4.00 ACC.DATE ACC.FILE NO. WORKERS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 4.00 I hereby affirm that 1 have a certificate of consent to sell-insure. ZONING ENG,SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.). - Policy No. Company ❑ Certified mpy is hcreM1y tarnished. FIRESPRINK ENERGY T 24 Z Z ❑ Certified copy is fled with the city inspection division. MISC.- REFER TO ORD. Y❑ No Y ❑ N❑ o Applicant Fm PERMIT ISSUANCE 6.00 FLOOD ZONE A.L.u.c. LU - CIiRI'IIICCOI PE I AX I PI'INS FROM WORKERS' W >_ COMPENSATION INSURANCE: PLG.CONTR. LIC.NO. PLG. EL O (This Avelino Decd not be completed if the permit is for one TOTAL Y❑ N❑ Y❑ N❑ Z) Z hundred callun($100)or less.) U O I certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE'SUMMARV, LL I- mit is issued,I shall not employ any person in any manner so as to OW become subject to the Workers'Compensation Laws of California. BUILDING n Dale Applicant ALTER OR ADD TO MECH. 4.00 1,260.50 } rn NOTICE TO APPLICANT: If,after making this Certificate of Ex- F. Z empliou,you should become subject to the Workrrs'Compensation APPLIANCE 4.00 PLAN CHECK - provisions of the Labor Cade, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10.000CF.M.) 3.00 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 5.00 SEISMIC FEE 30.17 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 2.00 the prairtmance of the work for which this permit is issued(Sec. MICROFILM 3097 Civc) _IAI�� v� HEATING UNIT(TO 100,000 B.T.U.) 4.00 bender's Nanhe- . HEATING UNIT(OVER 100,000 B.T.U.17.50 ' Lenderily fia,s�" ELECTRIC ounatiy tmt l have rcaagree application and all c that d county VENTILATION FAN (SINGLE) 3.00 and r loSel a uState. I agree m comply with all city and county BOILER-ODMP(3 H.P.or 100,000 B.T. 4.00 PLUMBING oNiwnces and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP (0ver100,00o BTUISEEFEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree m Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Copertino against liabilities,judgmexpenses which CONST.TAX bfay inb an accru aya ,�nd equen c ol'/he ERMIT ISSUANCE 3.00 a cant ///, / MECH.CONT. LIC.NO. MECH. TOTAL TOTAL290.67 �aturc of ApplicaaUal� OFFICE COPY 'l. =R CITY OF CDPERTINO INSPECTION RECORD (OFFICE COPY) R7- UWNh lig C� PERMIT ISSUED DATE ELECTRICAL DATE INSP. SU-1-Tri-ng Elect Plunbing Power Pole anica rg:oun P as ec ough Wiring O ar 4a s ire rin c er P6, r� 6- bign 1=res Int/Ext otors � Misc. roan in e ower Uther FINAL INSPECTIONS DATE INSP. Not Approved Gas G_y �s yLf ectric ote- um in - PUMBING DATE IId5P. Mechanical - Solar Backflow 0o run dt-3a-Fs— ra in oor anning Partialu - l- ire Dept. No V RouMlete health Dept. Solar � uoh ui in water ' i->a-Ys- er ain 7 _ao-Ps- o ain Gas Other BUILDING DATE INSP. Not Approved Pad Certification oun ation v e- - ELECTRICAL DATE INSP. 7r-e---=n1 -te Slab-Yembrane Underfloor S.M. eam DUE-t-s-T=nsulation Undeftloor Girders Fire 5ampers Steel i ace - s ie ownsrease Duct o0 i a rams a our eismecracin nate Drain al s- ane s Equipment Anchorage tame Flues 0 Uomb. Air Lath ter �71Rl1boards Int/Ext. Not Approved .-irewa s other Net Approved ^1 3 6- z- 1 BUILDING ` ELECTRICAL PLUMBING • MEmANICAL MISCELLANEOUS e I BUILDING INSPECTOR'S OFFICE I t CITY OF-CUPEKTINO Bldg.Dept. ' Olfice Copy Backflow Device Sanitary Permit No. /1,/o t r❑x Sewer Connection Plumbing Permit No. ,19' Plumbing Final Lot No. Owner or Tenant f/� til i„�7- "Z i At tirL p s I Tract t Date Connected 19_Date Final �' Y 19 II &” PLUMBING INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO 19�7 f To You are hereby authorized to Connect electrical service for Owner or Tenant ✓!7�7- a w' '�- At,& /0 2. 41 /102 /, / /r,- 2 S 12A No.o4 Wires Size of Wires Size of Switch Motor Load Voltage Phase Heating Load K.W. Voltage Light 110_N.Service Reconnect No.of Meters Heat 120-Throe Wlre More Service No.04 Add.Meters Power Three p� I Move Meter- ELECTRICAL erer ELECTRICAL INSPECTOR - I ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTORS NOTICE /^� //�( C CITY OF CUPERTINO To V r/ 4 C F_ ' 19 You are hereby authorized to Connect elecinco1 service for Owner or Tenant T At Ali a Y� . C� B•, 13 " 6 +I h < No.of Wires Size of WiresR Size of Switch /Od .4- Motor Load Voltage Phase Heating Load K.W. Voltage No.of Meters Light 110_New Service x Reconnect Heal 120_Three Wire More Service No.of Add.Meters Power M a Phase Move Meter ELECTRICAL INSPECTOR // a.rne v ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERDNO V To You are hereby authorized to C��on''n''ecct�t electrical service for 'Owner ar Tenant At No.of Wires Size of Wires Size of Switch Motor Load Voltage Phase Heating Load K.W. Voltage / Light 110_New Service Reconnect N0.04 Meters Heat 120Three Wire More Service No.of Add.Meters Power TT)hrpe Rho osse� Moo ve Meter Qw ELECTRICAL INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTORS NOTICE CITY OF CUPERTINO � To P C ; , °/ — / 1" Vou are hereby'\whorized to Connect electrical service for I 'Owner or Te—, At /o Y7-/0 2 6 No.of Wires—� Size of Wires �/ G Size of Switch —_ Motor Load / /,IL, n Voltage—� phase Heotinq Load"I r lr Y'V"/y /'� / 1 f K.�W / 1 Voltage � J i v / / No.of Meters ( L'9ht 110 -New Service x OJ Hem Recoo nnect No.of Add.Me ZCihree W, More Service ters Power Three�Phase Move Meert O� ELECTRICAL INSPECTOR V CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO DATE %"�1'_ S`, Iq__ BLDG. PERMIT NO. 7 6 (9 D THE BLDG. LOCATED AT OWNED BYn7- HAS BEENCOMPLETE (ALTERED) FOR USE AS Rls d�/2��• ,� I r Ow BUILD GINSPECTOR f BUILDING INSPECTOR'S OFFICE I CITY OF CUPERTINO Bldg.Dept. f--�_L Office Copy : Backflow Device Sanitary permit No. /=_Sewer Connection Plumbing Permit No. / Plumbing FinalLot No._r;-Z4== Owner or Tenant ! iC�t�/'.o STM_ 0 C- At in S'% 71 c�'e. d�P Tract U Date Connected :7 - ]9" Date Final �'� �-19 ©M I PLUMBING INSPECTOR BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg.Dept, Office Copy t _0-Backflow Device / Sanitary Permit No. '©. Sewer Connection Plumbing Permit No, I Oma. Plumbing Final Lor No. I Owner or Tenant C .1'1.0 n_ Yi O-ul'r, SC !L V q ti At Tract f Date Connected 2 —19 YDate Final 79 PLUMBING INSPECTOR l v