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17572's - POST THIS CARD NEAR FRONT OF BUILDING ' CITY OF CUPERTINO INSPECTION DIVISION JOB, INSPECTION RECORD JOB ADDRESS — LL/..i�t� UNIT#i _LOT# L D 0 J T, OWNER � �A/L_ CONTRACTOR Qr` `AGI✓ PERMIT NUMBER 17572 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. I LIFER PR EGUNITE PERMIT VALFDA NON �J - '�• �"�/ U'—I, ISSUANCE DA 111 GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED SEP 271989 UNDERGROUND/SLAB PLUMBING^^. Gl�L,, CRY Of WtjPO C ELECTRICAL MECHANICAL .. BLDG ❑ ELECT ❑ PLO ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION ' WOOD FLOOR VALUATION SIFT. PLUMBING /,z— .—ELECTRICAL MECHANICAL ELECTRICAL � + FRAMING INSULATION STORIES TYPE CONSTR. UCC 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 SO FT FLOOR AREA TOIAL ACREAGE DIAPHRAGM ROOF SHEATHING BURUM USE Res IND CON ve 00— Q E ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT. ENERGY TUBS & SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO MECHANICAL MECH.ENERGY ACC DATE ACC. FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT, FINAL TEST ZONING ENG. SITE NO. INSULATION PLUMBING GAS TEST GAS. FIRE SPRINK YF] No ENERGY T 24 I Q NEI MECHANICAL — — COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED . HEATING vuwO ZONE N[]❑ ALuc No 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 FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0PLEASE GIVE JOB ADDRESS WHEN PHONING. Z -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX `aO IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL-; -Da 'OFFICE COPY r O Zz _ 0 X LU - ao z 00 LL U 0 a } rn F Z APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION IPERMIT APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL NUMBER 7[ I JJ 172 BUILDINGy�j] o/� Al aoo�7V Imo.(/. OWrvOWNERSPLAN NAME �NIDF_.(/I COIj?P OTY-ELECTRIC PERMIT FEE CHECK VALIDATION DATE OF APPLICATION PLANCHECK FEE P.C. NO. CONTRACTORS NAME L LIc. ND OUTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 roqqrvqqT�f1R1Acrors �f ry(/f/ vHONE ARCHITECT OR ENGINEER LIC. NO. APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PANELS (OVER 200 AMP) 20.00 SIGNS TRANS. 3.00 ARC H. OR ENG ADDRESS SPECIAL CIRCUIT 5.00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 ZIP q�- ��-- APPLICANTS aOORESS MOTORS SEE FEE SCH, SERVICE CHANGE 0.00 1TI-' LICENSLD CON "f RACTORS DECLARATION 1 hereby off nn That 1 am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business uric 1'rofessinns Codrg�Mart1 license is in lull lore ff License Class CC.•iL`(((,// Lie. Number_ f ;p Contract.,- iG_ [)al -f-;p /' G. ❑ ELECT. ❑ PLG. M CH. ❑ �r/ �/�r ay. of cu�u BUILDING PERMIT OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor s License Law for the following reason. (sec. 7031.5, BUsineSa3nd PP tCs Ions INFORMATION MISC.- REFER TO ORD VALUATION 4/FT. PERMIT ISSUANCE 10.00 Code: Any cityor county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its Issuance, alsoELEF CONTR. LIC. N0. ELEC. requires the applicant for such permit to file a signed Melemenl that he is licensed pursuant to the provision of till Contractor's License LawI(Chapter 9(commencing with Section 70001.(Division 3 of tat BBusiness and Profession Code) or that he is exempt therefrom and usiness basis for the alleged exemp lion. Any violation of Section 7031.5 TOTAL PERMIT TO '^ ec_• l GTY. 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 of not more than five hundred dollars 155001.1: ❑ I, as owner of me property, or my employees with wages as their sole conhpehaation, will du the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 DCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code: The Contractor's License Law does not apply to all owner of properly who builds or improves thereon, and who does such work F IXTUR E$ - PER TRAP 5.00 sO. FT. FLOOR AREA TOTAL ACREAGE himself or through his own employees, provided That such innprrreg ments are not intended or offend for sale. If, however, the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within line year of completion, the owner- builder will have the burden of proving that Ile did not build or int- prove for purpose of sale.)_ O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project IS,,. 7044, Business GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Omer INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code: 'fhe Contrac(or's License Law does not apply to an owner of properly who builds or improves thereon, and who LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts 1'or such projects with it contructods) licensed pursuant to the Contractors License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 --TRACT No. PARCEL No. WATER HEATER W/VENT 6.00 ❑ I am exempt under Sec... BAP.C. for this reason Owner Datc WATER SYSTEM 5.00 ACC.OATE ACC. FILE NO. WORKF' PS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm thin I have a certificate of consant Rh SLIFlnxure. or a certificate of Workers' Compensation Insu once, of a certified copy thcrcy�7 17 Lab.y /a.�yJ7j. �.i//1� v�s� ZONING ENG, SITE NO. Policy N, (mpany ❑ Certified copy m Hereby furnished. ❑ CertifjP9�¢cy/�y jhleh(yl�lion division. nnplicam iIGI"�T/V a FIRESPRINK Y 0 N � ENERGYT24 Yo NEI MISC. - REFER TO ORD. CI"RT11'ICA1'17OI' IiXI:MPTION 1'ROM WORK[?RS' PERMIT ISSUANCE 10.00 PLOOD ZONE A.L.0 C. PLG. CONTfl. LIC. NO. PLG. TOTAL COMITNSATION INSURANCIi (Phis section need not be completed if the permit is lir one Y� N� Y� N� OTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 1001 or less. ) 1 certify that in the performance of the work for which this per- mit is issued, I shall n01 employ any person in any manner so as to become subject to the Workers Conhperoation Laws ol'Culifnr. Dale Applicant'ALTER NOTICI! TO APPLICANT: If, after making this Certificate of Ex- emption, you Should become subject to the Worker Compensation provisions of the Labor Code, you must RothwM1h comply wit such provisions or this permit shall be deemed revoked. BUILDING OR ADD TO MECH. 5'.M -fiiir� APPLIANCE PLAN CHECK FEE AIR HANDLING UNIT (TO 10,0MCF.M.) AIR HANDLING UNIT (OVER 10,0MC.F.M.)6.00 SEISMIC FEE CONSTRUC'f10N LE NDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 1 hereby affirm that there is a construction lending agency for the performance of the work lir which this permit is issued (Sec. 3097, Cis ,C. ). HEATING UNIT (TO 100,000 B.T.U.) B.00_MICROFILM HEATING UNIT (OV ER ECTRIC - Lender's Name Lendcr's Address 1 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 uuthonie representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of upertino against liabilities, judgments, costs and expenses which nay in any way accrue ago' st said City in consequence of the VENTILATION FA (SINGLE) 4.0Cr BOILER-CUMP(3 H. or 100,000 B.T. .) 6.00 MBING BOILER -COMP 214100,000 BTU( SEE - ME ANICAL ONST, TAX 7 MISC. - , REFS PERMIT ISSUANCE 10.00 CZQU ECH.CONT. I NO. TOTAL 2 TOTAL �-p0 anti this permit. Signa arc of Applicant/Contractor Date - OFFICE COPY' ✓v