Loading...
2827 (2) POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO Y.Nx:Ii NUL:9EN INSPECTION DIVISION 2827 JOB INSPECTION RECORD k.Y PERMIT EXPIRATION _ JOB ADDR ESS ���Lt� ��MiSu •r• Lri UNIT# LOT# i 1 PERMIT EXPIRES IF WORK /• OWNER �� dy; /Y.� JM1•�7i, CONTRACTOR I.L�P}�;- ' ,'/+{-h._,j CIV IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR 100 DAYS OFPERMIT ISSU- INSPECTORS'NOTES ANCE OR 180 DAYS FROM I NOTE:A REINSP.FEE WILL BE ASSESS.UNDER LASTCALLED INSPECTION. �• FOUNDATION PROVISIONS OF SEC.305(8) PERLIII VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -• CONCRETE SLAB FLOOR ' GAS PIPING(Groundwork) r PLUMBING(Groundwork) ISSUANCE DATE ELECTRICAL(Groundwork) aLDf:. ELECT. PLO. NECK. FILL&REINFORCEMENT ❑ ❑ r ❑ DO NOT POUR FLOOR UNTIL IMAWING PERMIT ABOVE HAS BEEN SIGNED ORMA,T.ION WOOD FLOOR +•; n •, GAS PIPING(Groundwork) PLUMBING(Groundwork) •ty of Cu�Pe ►IITTO HEATING(Under Floor) iERIRQD�� ELECTRICAL(Groundwork) STORIES TYPECONerR. UNDERPINNING(Bldg Inspector) .GROYP RES.UNITe PLACE NO SUBFLOOR.UNTIL ABOVE HAS BEEN SIGNED - ROOF ro.Fr.PLODR AREA rorALAGewaL ELECTRICAL •1�. BUILDING USE DIAPHRAGM NAILING • RES IND CON Pe Othe. APPLY NO ROOFING UNTIL "—' ❑ ❑ ❑ ❑ ❑ ABOVE HAS SEEN SIGNED ROUGH GAS PIPING ROUGH PLUMBING TRACT NO. PARC LNO. ROUGH HEATING ROUGH ELECTRICAL ERG.DEFT. Aa.DATE A=.FIL'EN 6' FRAMING COVER NO WORK UNTIL ZONING ENG.SITE NO. ABOVE HAS BEEN SIGNED PLANNING DEPT. LATH FIRE SRRNK ENERGY T-N, SHEETROCK NAILING Y❑ NO, VO N❑ EXTERIOR LATH FIRE DEPT.ACCEPTANCE PLOOOZONE A.L.U.I:. NO TAPE OR PLASTER UNTIL N❑ ABOVE HAS BEEN SIGNED .FEE SUMMARY FI DATE INSP. PLUMBING TEMPORARY APPROVALS BUILDING HEATING PLAN CHECK ELECTRICAL GAS ❑ ELECTRIC ❑ OCC. ❑ FEE BUILDING FINAL SEISMIC FEE OCCUPANCY OF BUILDING IS NOERM( E NTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC • 6� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. APPLICANTS POSTING COPY J1569APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY " 5b9 BUILDING PROJECT IDENTI FICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 2827 O 2 7 ADDRESS/0-A/03 u�O [I Q /V'1 3 Ww- BUILDING-ELECTRICAL-PLUMBING -MECHANICAL dwNER'S �.-aS� PLAN CHECK VALIDATION NAME �c /�J//,,�,,-// CITY. ELECTRIC PERMIT FEE rtes eft CONTRACTORS 3OUTLETS-SWITCHES-RECEP 5.00/1.00 LIGHTING FIXTURES 5.00/1.00 CONTRACTOR'S C APPLIANCES-RESIDENTIAL 4.00 ADDRESS �/ // ��/�✓✓ ((�� w.4D V? �-C .FHONErJ/xJ�jz� PANELS 5.00 DATE OF APPLICATION ARCHITECT SA}QM OI '+ gyNn3 SIGNS 6.00 PLAN CHECK FEE P.C.NO. OR ENGINEER uc.No, SIGNS TRANS. 3.00 ARCH,OR ENG. PERMIT VALIDATION aooREss SPECIAL CIRCUIT 5.00 zlv EMP:METER OR POLE INS. 15.00 Ais ADDRESS CANTS - MOTORS SEE FEE SCH. '�(((fff411L„ccr!lhwww^^^=J SERVICE CHANGE 10.00 I (/ C o LICENSED CONTRACTORS DECLARATION ¢ 1 hereby.111 nn that 1 am licensed under provisions of CloquEr 9 ISSUAN/E DATE (commencing with Section 7000)of Division 3 of the Business and Q u r H i professions Code,and my license is in fut BLDG. ELECT. PLG. MECH.ll force and effect, El ❑ ® ElO O y License Class Lic.Nwnber, Oz Z o Date Contractor- ' ¢ m E BUILDING PERMIT ¢ ¢ OWNER-BUILDER DECLARATION "¢ w U -INFORMATION Ou MISC.- REFER TO ORD X u r 1 hereby affirm that 1 am exempt Iro.5 the Business and License VALUATION 5/FT. FLOj Law for the following reason(Sec.703L5.Businessand Professions PERMIT ISSUANCE 6.00 Code:Any city or county'which requires a permit to construct,alter, ¢ 2 ¢ FO improve,demolish,or repair any structure,prior to its issuance also ELEC.CONTR. LIC.N0. ELEC. ¢ requires the applicant for such permit to file a signed stacmm�l that TOTAL PERMIT TO w he is licensed pursuant to the provisions Of the Comrlctor's LicreA, • azi Law(Chapter,!)(commencing with Scction 7000)of Division 3 of the Q Business and Professions Code)or that he is exempt therefrom and, CITY. PLUMBING PERMIT FEE ¢ =$ the basis for the alleged cn'mplion.Any virdation of Section 7031.5 STORIES TYPE CONSTR. u � by any applicant for a permit subjects the applicant tea civil penalty ALTER-DRAIN& VENT-WATER (EA.) 4.00 of not more than five hundred dollars(S500).)= ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 2.00 DCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure Is not . . intended or offered for sale ISee. 7044. Business and Professions DRAIN$-FLOOR,ROOF,AREA,COND. 4.00 - Sode Tie,Con tractor's Licesssc law does not apply to un owner of property who bonds or improves the«on,and who doe,such work F IXTURES-PER TRAP 4.00 So.FT.FLOOR AREA TOTAL ACREAGE mentsllre not or offered for sale. If,however, the improve GAS-EA.SYSTEM-1 4.00 meals are not intended or offered for sale IC ed that q the building r improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 1.00 BUILDING USE builder will have the burden of proving that he did not build or im" RES IND CON PB other prove 1,as owner of low RES INDUSTRIAL WASTE INTER. 20.00 ❑ ❑ ❑ ❑ ❑ ❑ 1,as owner of the proper Y.run exclusively contracting with licensed contractors to construct the project(See. 7044,Bus icss LAWN SPRINKLERS-1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO: and Professions Coda.The Contractor's Liceew Law does not apply to an owner et p,ow,t, who builds or improve thereon.and collo LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contructor(sl Iicenned pursuunt to the Contractor's License Law. SEWER-SANITAR V-$TOR 200f1/g.00 TRACT NO. PARCEL NO. ❑-- taro excinpt under Sec. - .d.til'.C.tin this ' WATER HEATER W/VE 00 6-� reason Date 0,per WATER SYSTEM D yb 4.00 ACC.DATE ACC.FILE NO. WORKR RS'COMPI7 NSA'1'ION DECLARATION WATER TREATING EQ IPP 4.00 I hereby affirm that I have u certificate of consent to sell-instre. Q ZONING ENG.SITE NO. or a nerliLcllu al'Worked Ctnnpenantian psurm u,or a certific ropy thereotf 33$00, oh. .1 -- Policy ertifwd,mpy i 0 ❑ Cetified ropy is hcorby Filed will, Ed. FIRE SPRINK ENERGY T"24 Z 0 Certified copy is fdeJ with die city inspection Division. Fp Applicant IMISC.- REFER TO ORD. y ❑ N❑ ,v E] IN w PERMIT ISSUANCE LU CI7R'1'I I'IGOM E I Ai[O FINS FROM WORKERS' I®.00 /'(� FLOOD ZONE .. aL.UL. W COSIPENSATTON INSURANCE PLG.CONTR. LIC.NO.. PLG CL 0 ('Chu WClion heed not be cion,1 led if the permit i, far nnC TOTAL Y E] N❑ Y ❑' N❑,,r 2 hundred dollars IS 100)or Ic,,r U O 1 certify that in the performmlee of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY I- mit is issued. I shall not employ ally person in any...an ner so as In O W become subject to the Workers'Compensation Laws of California. a Date ApplicantALTER OR ADD TO MECH. 4,00 BUILDING >_ to NOTICE TO APPLICANT': If,after making this Certificmofe Ex- F 2 eruption,YOU should become subject to tho Workers*Compensation APPLIANCE 4.00 PLAN CHECK provisions of the Labor Cade, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10)000CF.M.) 3.00 CONSTRUCT ION LElq)[NO AG17NCY AIR HANDLING UNIT(OVER 10=C.F.M.) 5.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 2.00 III \1 the performance the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.L HEATING UNIT(TO 100,000 B.T.U.) 4.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)7.50 Lenders Address ELECTRIC 1 certify tine,I love rood this upplieat ion and stale that the xbove'� VENTILATION FAN (SINGLE) 3.00 Ind. linore. n csure I agree ti«imply with all city amt county PLUMBING ordinwtc-es and stmt lows rclwing us building l cityrociine, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 4.00 hereby authorise represenmlives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save indemnify and keep harmless the City of misc.- REFER TO ORD. Cupertino against liabilities,juit•omZP ts and ex eases which CONST.TAX may in any way accrue ag'"ns liconxe Ience of the PERMIT ISSUANCE 3.00 gra •of the,per Ii MECH.CONT. LIC.NO. -T ETCH, 7 TOTAL Signa merit Applicant/ on actor- Date OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT ADDRESS - BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 0rF 12753 OwNERS PLAN CHECK VALIDATION "A/M/E�� y_ 1 /� QTY. ELECTRIC PERMIT FEE 1 Y-L -LA PHONE croRs NAIVE UTLETS-SWITCHES-RECEP 10.00/1.00 NAME p' LIC.NO.Cid-"" LIGHTING FIXTURES 10.00/1.00 DDRE SS cro AR's - APPLIANCES-RESIDENTIAL 4.00 ooRE 7-/d Pnory ' e3 PANELS 10.00 GAT of PP TION ARCHITECT PLA C ECK E P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER y LIC.No. _ SIGNS TRANS. 3.00 I r moo ESS Frvc. SPECIALCIRCUIT 5.00 I PERMIT VALIDATION ZIP rEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 Ale o o LICENSED CONTRACTORS DECLARATION R2 3 1987 ¢u v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE N to N (commencing with Section erxe)i in Division 3 of thef LECT PLG. EC F N z Professions Code. J y license is in full forego s�yJ ❑ z o m - License Class - (, Lie.Number R( �/d r w Uate Contractor ce Ys BUILDING PERMIT ¢ ¢ w OWNER-BUILDER DECLARATION INFORMATION w3 LL I- I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION 5 FT. FuoJ Law for the following•mason.(Sec.7031.5,BGsHessamd FN,bcSsmm, PERMIT ISSUANCE 10.00 Code:Any city or county which requiresu permit to construct,alter, ISQ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELED. D¢ requires the applicant for such permit to file a signed statement that TOTAL T TO to $m he is licensed pursuant to the provisions of the Contractor's License FZQ Law(Chapter 9(Commencing with Section 7000)of-Division 3 ofthe E 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE IS r o the basis for the alleged exemption.Any violation of Section 7031.5 POCC.GROUP TYPE CONSTR. La A � � bY:my applicant faro permit suMccts the applicant toacivil Penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(5500).): - ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 RES.UNITS their sole compensation,will do the work,and the structure is notintended 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 FIXTURES-PER TRAP 5.00 A TOTAL ACREAGE himself or through his own employees,provided that such improve- mcutsarenotintendedoroffendforSHE,lf,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 IEA) 200 builder will have the burden of proving that h - . . . e did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ES IND CON Pa Omer ❑ 1,as o rer of the property,am exclusively contracting with 0 0 licensed contractors 10 Construct the project(Sec. 7044,Business ILAWN SPRINKLERS- 1 INC 5 V.B. 6.00 SSESSORS PARCEL NO. and Professions Code:The Contractor's License Law dues not apply EA to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor s)licensed poo shut to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00 Owncr Dat, WATER SYSTEM 5.00 - ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. ProlicylNo00 oup ny )-/n/(Zc{5�lRL O ❑ Certified copy is hereby furnished. FIRESPRINK ENERGY T-24 Z Z }Y CC, fic�y5yj cup fil h the city inspection division. O Ai 2& lj MISC.: REFER TO ORD. Y [] N❑ I Y ❑ NC] CC T CERTIFICA'I'li OF EXEMPFION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE a1..U.C. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG, v N� v NEI Z (This section need not be completed if the permit is for one TOTAL hundred dollars IS 100)or less.) U O I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to U w become subject to the Workers'Compensation Laws of California. o. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } W NOTIC17 TO APPLICANT: If,atter making this Certificate of hx- Z emption,you should become subject to the Workeri Compensation APPLIANCE 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 10MC.F.M.) 4.00 CONSTRUCTION L17NDING AGENCY AIR HANDLING UNITIOVER 10=C.F.M.) 6.00 SEISMIC FEE I 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. O 4� MICROFILM 3097,CN.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 O Lender's Name H EATI NG UN IT(OV ER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC ,. I Certify that I have read this application and state that the above 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-COUP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorise representatives of this city to enter upon the above-mentioned property for inspection purpows. BOILER-COMP IOver 100,0008TUl SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep hurnless life City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 �Q a CONST.TAX may((((((��PIIm any way ac ageinst•said City in consequence of the �anl+ngofthis'perm MECH.CONT. LIC.NO. MECH, f/2 uA - rt.a,1 /-a3�8 JIT �l TOTAL 0.6 TOTAL �uturo of Appliemil/Co r:cor Date �Vo L OFFICE COPY