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15281 POST THIS CARD NEIR FRONT OF BUILDING PERMITNUMBER CITY OFUPERTINO 15281 INSPECTION DIVISION JOB INSPECTION-RECORD /'' r({ �o/J PERMIT EXPIRATION JOB ADDRESS I) N, W04r- GI �/ UNIT# _LOT#. ' • /.'• - '.PERMIT EXPIRES IF WORK OWNER E[.� RDNf r- u f oa: CONTRACTOR E, ,� Ve IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: `; LASTCALLEDINSPECTION. UFER - ALL GRADING AND,DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLR%RT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - - - ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED : UNDERGROUND /SLAB . PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL - -767TELECT, PLG" MECH - . . ❑: ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED �U` - BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING' city 01 UuvorIR/D' VALUATION $IFT. to C90 t� MECHANICAL / ELECTRICAL PERMIT TO FRAMING " /v c5<1 1,0C INSULATION STORIES Tv ECONSTR. „ - UCC,GROUP RES:UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.IT,FLOOR AREA TOTAL ACREAGE . ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID �F ROOF SHEATHING RES INBDwIOWNusp8 ,--Gm.. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED' FINALS DATE INSP. El ED ❑ ROUGH SAN.N - ,ASSESS ORSPARCEL NO PLUMBING - ELECT.ENERGY " TUBS&SHOWER PAN PLUMBING ENERGY- - ' TRACT NO PARCELNO. MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE ACC,RILE No FRAMING �a0'ffg6ld ELECT.FINAL TEST ' - ' ZONING ENG.SITE NO, INSULATION - �' PLUMBING GAS TEST GAS xv MECHANICALFIRE SPRINK ENERGY 12 . y [:] N❑ y 1:1 No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A.LUC/ INTERIOR SHEAR FIRE DEPT. . -ILI-� IL v❑ "❑ Y ❑ N❑. SHEETROCK" GRADE - FEE SUMMARY EXTERIOR LATH BUILDING -/f,'_ INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT - ELECTRIC PLAN CHECK ' GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM w ARRANGE FOR INSPECTION BY PHONING 252-4505, �', ELECTRIC H-� ONE WORKING DAY BEFORE REQUIRED INSPECTION. '- PLUMBING, z l PLEASE GIVE JOB ADDRESS WHEN PHONING. "` •' R ."s — SEE PERMIT FOR EXPIRATION DATE —. s �a' MECHANICAL IMPORTANT!- , . ;;' ;;; CONST.TAX ' PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATIQN WITHIN RED LINES - USE BALL POINT PEN ONLY .. ieUILOING PROJECT IDENTIFICATION - PERMITNUMBER °'`DING2020 AOCO Al APPLICATION & PERMIT 1 C 0 . • ADDRESS I J 0 IIZ BUILDING = ELECTRICAL-,PLUMBING-MECHANICAL OWNER'Sj_� / I L.�TR�LC6�`�,^ PLAN CHECK VALIDATION NAME I Q�Lr'f SWI C.AXATLIYVV0l OTY. . ELECTRIC PERMIT FEE . 'TM MA 00kA) PHON I NTA NA.L S .�I�f�� UTLETS-SWITCHES-RECEP 10.00/1.00 (, UC.NZ431 LIGHTING FIXTURES 10.00/1.00 . nooREsW as TORE/sx?. N� W�sy APPLIANCES-RESIDENTIAL• 4.00 + Iv.'!&w PHONE PANELS 10.00 DATE OF APPLICATIOF ARCHITE�,i.,rPLAN CHECK FEE P.C.NO. ORAlzk PANELS (OVER 200 AMP) 20.00 ENGINEER -�c�--- LIC.N 1. SIGNS TRANS. 3.00 ARCH.OR ENG' GA aY1 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS( e<�16�A� � �L, A�1./NR W3 S�TAN�OJI L* FEMP.METER OR POLE INS. 20.00 APPucaNr' - MOTORS SEE FEE SCH. l/AUL,\ ADDRE55 1s ale SliMf_ 4F� w�w�ry�CS) SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION �`�� Hz W I hereby affirm that 1 am licensed under provisions of Chapter I) ! ISSUANCE DATE w aly (commencing with Section 7000)of Division 3 of the Businessand BLp�,p ELECT. -PLG. MECH. H D 2 Professions Code, my license is in full for c BL ❑ PL i= G License la. L1u: Numb w�liC1 1ID� ,A H j Datc�C R To DE `\ a x �e LDIN G PERMIT ¢ a a OWNER-BUILDER DECLARATION ¢ w u NFORMATION ce;' N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD F u o J Law for the following reason.(See.7031.5,Business and Professions VALUATION 5/FT. w Cade:Any city or county which requiresu permit to construct,alter, 'PERMIT ISSUANCE 10.00 ¢ Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. Qe aa 0iL D LL requires theapplicant for such permit to file a signed statement that - - TOTAL w he is licensed pursuant to the provisions of the Con Dactor's License PERMIT TO wii Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe 7i o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE r ac H $ the basis for tire alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit Subjects the applicant too civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sale compensation,will do the work,and the structure is not - intended or offered for sale (Sec 7044, Business and Professions 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 docs such work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- meats are not intended oroffered for Side.If,however,the building GAS-EA.SVSTEM-l1NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4(EA.) 200 builder will have the burden of proving that he did not build or im- - . . BUILDING USE RES IND CON PB Osho' prove 1,aso nee of sale.)' INDUSTRIAL WASTE INTER." 30.00 ❑ d as owner of the property,he exclusively contracting with ❑. ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 _ ASSESSORS PARCEL NO. and Professions Code:The Contractors License s thereon, docs not apply to contracts owner of property who builds tr improves rased p,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 the Co is for such projects with a contracmr(s)licensed pursuant m SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. - TRACT NO. PARCEL NO. ❑ lam exempt under Sec..,B,&P.C.for this WATER HEATER W/VENT 6.00 reason ' Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERTCOMPFNSATION DECLARATION I ,WATER TREATING EOUt 5.00 1 hereby affirm that 1 have a certificate of consent«+self-insure, ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lah.CJ. Policy No. Company - ❑ Certified copy is h •by fur 'shed. FIRE SPRINK ENERGY T-20 Z ❑ Cerlif o t led w 1 he city inspection division. ���� MISC.- REFER TO ORD. OVA pplic:ut• G(c '� c Y"❑ N❑ V ❑ N❑' ~ w PERMIT ISSUANCE 10.00 PLOOD20NE A.L.U.C. CIiRTIFI E OF C%IiMP1'ION PROM WORKIiRS' - W COMPENSATION INSURANCE PLG.CONTR, LIC.NO. PLG. v❑ N❑ v ❑ N❑ C O (This section need not he completed if the permit is for one TOTAL Z hundred dollars IS IOD)or less.) - U O 1 certify that in the performance of the work for which this per- OTY. Il lNICAL PERMIT FEE FEE SUMMARY W F mit is issued,1 slhall not employ any person in any manner so as to I O W became subject to the Workers'Compensation Laws of California. CL Ualc APPlmanl ALTER OR ADD 1`6L MECH. 5.00 BUILDING rb } W NOTICE 1'O APPLICANT: II',after making this Certificate or Ex- F Z emption,you should become subject to the Workers'Compensation APPLIANCE r. 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,O QF.M.) 4.00 CONSTRUCTION L17NDING AGENCY AIR HANDLING UNIT(OVER 10,000C.F.M.) 6.00 SEISMIC FEE 474-t-_O 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 - the performance of the work for which this permit is issued(Sec. MICROFILM 3097,CivC.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name_--�� t� HEATING UN IT(OV ER.l 00,000 B.T.U.)9.50 ELECTRIC Lender's Address 1 certify that I have read this application and state That theabove VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COIvtP(3 H.P.or 100,000 B.T.U.1 6.00 hereby authorize representatives of this city Id enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL obovmmcntioned property for inspection purposes. p (We) agree t indemnif ep huntress the City of MISC.- REFER TO ORD. upertino ns abiliti`c !ftnts, sts and expenses which CONST.TAX may any against sai yin consequence of the PERMIT ISSUANCE 10.00 mg el MECH.CONT. LIG NO. MECH. , !' TOTAL TOTAL 3 . Signs re o ant Ommcln a OFFICE COPY '