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1746910 LT POST THIS CARD NEAR FRONT OF BUILDING CITY .OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD /.� �� . JOB ADDRESS MT EG_S r --1T ALT-�Iti UNIT# _LOT# OWNER CONTRACTOR /L o_ PERMIT NUMBER 17469 PERMIT, EXPIRATION PERMIT EXPIRES IF .WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PR EG UNITE PERNnT VALIDATION ; � .� G�>~ /' ✓1�(.'��t.4/ ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED MAR 2i WT., Z A UNDERGROUND/SLAB PLUMBING - City Of Cepow ELECTRICAL MECHANICAL - BLD(;ELECL o PLG MLCH ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION • WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL - ELECTRICAL � - PERMIT TO _ - Ged FRAMING INSULATION STORIES TYPE NSTR OCC GROUP - RES UNITS PLACE'NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID . 5p'FL FLOOR (•HEA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING . BUILDING use Res IND CON PB U.", 0 ❑ El ❑ El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT. ENERGY rRncT No PARCEL No TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC. RLE NO ELECTRICAL BUILDING ENERGY FRAMING . ELECT. FINAL TEST. ZONING ENG SITE NO. INSULATION - - PLUMBING GASTEST GAS FIRE $PRINK ENERGY T 24 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE v NE] ALUC v ❑ NQ EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH - TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK F EE GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ELI ARRANGE FOR INSPECTION BY PHONING 252=4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. �� PLEASE GIVE JOB ADDRESS WHEN PHONING. —SEE PERMIT FOR EXPIRATION DATE — ELECTRIC ' I PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTALm,SS(a OFFICE COPY O Z z�O LU CL Z) z Uo LL F- 0 Ow F z A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY a Bhll &DI NG PROJECT I DENTI FICATION APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 1 �] [� (� !i' I 1 U J BDILo1Nc AODREbs , 1 r „^o, r OWNER'S NAMECITY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION ti PHONE 'ANTRAcrons NAME ` \ I OUTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 Vt`-'l�C sec No. DATE OF APPLICATION CTRAcioR's ADDRESS S",4, PHONE PPLIANCES- RESIDENTIAL 4.00 PANELS 10,00 RLHITELi OR O ENGINEER LIc. NO, PANELS(OVER 200 AMP) 20,00 PLA N CNECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH. OR ENcSPECIAL ADDRESS CIRCUIT 5,00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 ZIP t� A ADDRESS ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 O� /( V�PRK � !�^'Y LICENSED CON'I'RAC'EORS DECLARATION }1.. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and I'rofussmus Code. and my license is in full force and effect. License Class Lic. Number Date Contractor ISSUANCE DATE BLDG. 1:1 ELECT. PLG. MECH. ❑ ❑ �� BUILDING PERMIT OWNER -BUILDER DECLARATION I hereby affirm thot 1 um exempt Gone the Contractor's License Low l:Any INFORMATION MISC. - REFER TO ORD VALUATION PERMIT ISSUANCE 10.00 v!J LOD mash(See.703L5,Businessandfucl,ssloms Cityfioll.wmemory countywhiny Structurep prior Code: e, demolish, in is uoumuLaalo improve, demolish, or repair any rtr¢torfi prior to its ateme t also for the rovisi t0 file a signedractor's statement that he is tic elle licensed the provisions of the Licenm he is licensed ELEC. CONTR. LIC NO. ELEC. TOTAL . � PERMIT TO CITY. PLUMBING PERMIT FEE 9 (comm en ) ofDivision Law (Chapter 9l commencing with Section is exe of Division 3 of nd Business and Professions Code) or that he is tion to therefrom and the basis for the alleged exemption. Any violation ofSection 7031.5 QL �L1 STORIES TYPE CONSTR. ALTER -DRAIN & VENT -WATER (EA.) 5.00 by any applicant for a permit subjects the applicant toa civil penalty of not more than five hundred dollars (S500f) ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sc,. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code: 'I'hc Contractor's License Law docs not apply to an owner of property who builds or improves flimcom and who docs such work FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTALAOREAGE himself or through his own employees. provided that such improvu- mentsam of intended or offemd for sale. ll', however, the building GAS -EA -SYSTEM -1 INC.46UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im- prove for purpose of sale.).RES ❑ as owner of the property, exclusively contracting with dd contractors to construct the project (Sec. 7044, Business GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE IND CON P8 Other ❑ ❑ El El INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code: Theo u's License Law docs not apply o builds or improves thereon, and who to an owner of property whhbuilds LAWN SPRINKLERS -OVER 5 IEA.) 1.00 contracts for such projects with it contractor(s) licensed Pursuant to the Contmdor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 ❑ I am exempt unser S«. . B.SP,G. tor this Owner Dme WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORK E.RS'COMPENSA'I' ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to sel -incom. or a certificate of Workers' Compensation Insurance, or a ceHified copy thereof(Sec. 3800, Lab.C.). ZONING ENG. SITE NO, Policy No._ Company- ❑ Ceti 'opy is mby turns ed. c FIRE SPRINK ENERGY T-24 ❑ CeNi ropy Iledwim a dry inspection di'ision. Applicant `-.- -Y It MISC.- REFER TO ORD. ❑ N ❑ Y ❑ N❑ PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 C. CE -R ' CA'l 1: 01 I %IPI ION FROM WORKERS' PLG. CONTR. LIC. NO.PLG. TOTAL COMPENS "ION INSURANCE IThis section need not he conlpluted if the permit is I'or one Y ❑ N ❑ Y C] N ❑ CITY. MECHANICAL PERMIT FEE FEE SUMMARY Ilnlldrud dollars 1$100) or less.) I certify that in the performance of the work for which this per' nit is issued, I shall not employ any person in any manner so as to BUILDING become subject to the Workers' Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICAN"E: If. after making this Certificate of E.- APPLIANCE 5.00 PLAN CHECK FEE enlption, you should become subject to the Workers' Compensation provisions of the' Labor Code, you most forthwith comply with such provisions or this permit shall be Jecmed revoked. AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIRHANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMICFEE- CONSTRUCT ION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 I HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sea 3097, Civ.C,). HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC }+ IJ 1) Lender's Name Lender's Address 1 certify that 1 have read this application and state chat the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER-COMP(3 H.P, or 100,000 B.T.U.) 6.00 BOILER -COMP Over 100,000BTUI SEE FEESCH. MECHANICAL hereby au0lorin representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. CONST. TAX OVc) agree to save, milenmify and keep haroless the City of upetlin against liabilities, judg ls, costs and expenses which may y way accfue coni nin 1 City in consequence of the PERMIT ISSUANCE 10.00 MECH.CONT. LIC. NO. MECH. TOTAL TOTAL 0. mol 1 this peri6 \1 SignaRivfAFP1ffAVC.Rti7rcbm Date OFFICE COPY