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18381.00 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION n/ JOB INSPECTION RECORDI JOB ADDRESS .I L'\'" WO_ 4� UNIT# _LOT# OWNER �Q CONTRACTOR G (� NUMBER 18381 /PERMIT EXPIRATION {F' PERJa EXiPfIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATIONANCE NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. RAM UFER PR EGUNITE PERMIT VALIDATION // _ ��f,!y, I= V'o4a ! ISSUANCE DATE GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ep S` Ri 1989 ' UNDERGROUND /SLAB PLUMBING - ELECTRICAL MECHANICAL BLD4. ELECT I PLG. MECM DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION ' WOOD FLOOR VALyyATI0 D S/FT. / 616' ' b PLUMBING MECHANICAL ELECTRICAL N,I TTO I 'd",-/ FRAMING INSULATION STOHIE' TYPE CONSTR. 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 sa IT FLOOR ARTA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING BUILDMG U5E Res IND .tcoN Pa ow., El ❑ 1:1 ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO - ROUGH SAND# PLUMBING ELECT. ENERGY TUBS & SHOWER PAN PLUMBING ENERGY TRAGI NO PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL j- BUILDING ENERGY ACC DATE ACCFILE NO . FRAMING ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG. SITE No. GAS TEST GAS FIRESPHINK v L] NEI ENERGYh2< ❑ N _ MECHANICAL - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ,`10pO ZONE Y� N� A.Luc v ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEESUMMARY EXTERIOR LATH BUILDING - BUILDING PLAN CHECK FEE INTERIOR LATH TEMPORARY AP ROVAL SCRATCH COAT ELECTRIC GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEEu:r, OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, H ONE WORKING DAY BEFORE REQUIRED INSPECTION. 00� PLEASE GIVE JOB ADDRESS WHEN PHONING. —SEE PERMIT FOR EXPIRATION DATE — ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL p{� OFFICE COPY A 0 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT I DENTIFICATI ON / (d APPLICATION & PERMIT DING -ELECTRICAL -PLUMBING -MECHANICAL PERMITNUMBER 1 /j�{ /'S� 1 5�ti I V V S 1 aDILwNG q /�y•� IwW ADDREBSt/q()k`1 , rf 1E aC-- /y�j - �� VYr OWNER'g NAME U I/_�V / TA,N % OTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE Op CONTRACTORS OP4 WiJ IG . FI LP- NC. NO. UTEM 10.00/1.00LfIij LIGHTI NG FIXTURES 10.00/1.00 CONTRACTORS �' • ADDRESS PPLIANCES- RESIDENTIAL 4.00 PANELS 10.06 PHONE DATE OF APPLICATION ARCHITECT on ENGINEER ,s .-•^� "t T/lV ^_ ■[1yry-'C `�/L TWOVC uc. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P. C. NO. SIGNS TRANS. 3.00 ARCH.OR ENc' )^ ADDRESS I�u(f . p , SPECIAL CIRCUIT SQQ PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 APPLICANT' �BO p�9�%e Lv ADDR E. Olt MOTORS SEE FEE SCH, SERVICE CHANGE 20.00 J,J/ LIC-NSIiD CONTRACTORS DECLARATION I hereby affirm that I con licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. License Class Lie, Number ISSUANCE DATE C BLDG. ELECT. ❑ PLG. MECH. ❑ ❑ Date Contractor �/111y�E4 w� ry��,��.��j,F.�11.� 1Myi YL WI!01SMIVI BUILDING PERMIT OWNER-BUILLFIL DFCLARA'I'ION I hereby alfirm ilia( 1 and exempt from the Contractor's License Law for the following rcason.ISee. 7031.5. Businessmtdl'rofcssions Code Any city or county which requiresapermit to construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such porn, it (O Zile a signed statement that he is licensed pursuant to the provisions of the Contractor's Licensc INFORMATION MISC.- REFER TO ORD va LUAnory / L D� 0 6 $/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO OTY. PLUMBING PERMIT FEE Law (Chapter 9 (commencing with Section 7000) of Division ofthe Business and Professions Code) or Iher he is exempt therefrom and Ylto TORIES TYPE ONST . the basis for the alleged exemption. Any violation ul Section 7031.5 by any applicant for a permit subjects the applicantto a civil penally of,, ofmore Chun five hundred dollars ($500).): ALTER -DRAIN -WATER IEA) 5.00 ❑ I, ns owner Of the property, or my employees with wages as their sole ann, pensalmn, will do the work, and the Storelure is mol BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044. Business :...d NoI'essio,s Code: 'fire COntracf or's Licrosc Law docs not apply to an owner ul' properly who builds or improves thereon, and who docs such work FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAVACREAGE himself or through his own employees, provided that such improve - merits are not intended oroffered tor sale. IL however, the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 oner- is d within one year OI completion, tire w r improvmnum sol builder will have the burden of proving that he did not build or im- prove for pmpusc of s:dcJ. ❑ I, as owner of fire property, un, exclo,deely contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:' Ihe C'ontractor's License Law does not apply to an owner of Property who huilds or improves Hereon. and who GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PS Other ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS -11 INC 5 V.B. 6.00 LAWN SPRINKLERS - OV ER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with o contractions) licensed pursumnt to the Contractor's License Law. SEWER -SAN ITARV-STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 WATER SYSTEM 5.66 ❑ lam ex pt under �e<. .B.&P.c. Rat ods Owre1011_ . • Owner ^ ,� Dulc ACC. DATE ACC. FILE NO. WORKERS'COMPENSA1'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby alfrm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thereof fSec. 3800, Lab.C.). Policy No. Company FIRE SPRINK Y ❑ N❑ ENERGY T-24 V C] No ❑ Certified copy is hereby furnished. Nr Cemfie lay 4i Ii with 1� city ins •tion livixion. Applicant-�•-�.LyI-I Z-'- MISC.- REFER TO ORD. PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. CERTIFICATEOF 17XIibI I'TION I°RO.V WOI KIiRS' PLG.CONTR. LIC NO. PLG. TOTAL COMM I'IiNSATIO-4 INSURANCE (This section need not be Completed if the permit is fix One Y ❑ N ❑ Y ❑ N ❑ FEE SUMMARY hundred dollars ($100) or less.) I certily that in the perfornsance of the work lox which this per -FEE mit is issued, I shall not employ any person in any frontier so as to become subject to the Workers' Compensalion Laws of California. Dam Applicunl NOTICE 1'0 APPLICANT: If, Her making this Certificate of Es.. BUILDING 4L'L!J ALTER OR ADD TO MECH. 5.00 - APPLIANCE 5.00 PLAN CHECK enlption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisionsor this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY FEE AIR HANDLING UNIT (TO 10,000C.F.M.) 4.00 AIR HANDLING UNIT (OVER 1000C.EM.)6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for the perform. rice of the �lot or which this pernhit is issued IS". 3097, Cie C.). ,• Lender's Name�pF 14 EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 6.00 HEATING UNIT (O VER 100,000B.T.U.)9.50 ELECTRIC Lenders Address I certify that l have read this application and state Dual the above inl'onuation is correct. I agree to comply with all city and county oNinanees and slate laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER-COMP(3 H. P. or 100,0008.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCM. MECHANICAL hereby aulhoriee representatives of this any to enter upon the above-n,enlion d! property for inspection purposes. MISC. - REFER TO ORD. (We) agree to save, indemnily and keep hannlass the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in roti sequence of the CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL •ran ing of lhi.v'PcrnmL Z' •n' ure of Applicunl/C.Uhn lar Dale / I OFFICE COPY