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HomeMy WebLinkAbout12778 (2) POST THIS CARD NEAR FRONT OF BUILDING ' CITY OF CUPERTINO ,►: I . PERMIT NUMaER INSPECTION DIVISION '12778 JOB INSPECTION RECORD ! PERMIT EXPIRATION' JOB ADDRESS 4'�:( �f OFJC iN-f'� ' LT - UNIT# LOT# . PERMIT EXPIRES IF WORK OWNER '�( :1 C. 'E,Q CONTRACTOR �1Q IS NOT STARTED WITHIN,, INSPECTION DATE IN ECTOR INSP CTI NR C D 180 DAYS OFPERMITISSU ANCE OR 180 DAYS FROM FOUNDATION - ^7�7 LASTCALLED INSPECTION. LIFER I - PREGUNITE I' _ - PERMIT,VAUDATIpN .. _S kA-lb POUR NO CONCRETE UNTIL ABOVE HAS BE SIGNED UNDERGROUND /SLAB y PLUMBING ELECTRICAL - - ISSUANCE DATE' MECHANICAL �EEf CT: PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED NG PERMIT -WOODC1ty INFORMATION FLO R VALUATION $/FT. PLUMBING . ` MECHANICAL 4 w. ELECTRICAL _ - �ERMIT,TO - - FRAMING INSU LATION STORIES TYPE CONSTR. - OCC GROUP 'RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED `` ROOF- n , SO,FT,F`OOR AREA :TOTALACREAGE Y' . DIAPHRAGM .BUILDING USE - RES IND CON Pa 6M., 'APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - '. - -❑ . ❑ : ❑ ❑ ❑• ROUGH " ASSESSORS PARCEL NO PLUMBING O ONE '�'� ' TRACT NO•. Pq RCEL NO. GAS TEST, _ZD ., MECHANICAL DATE ELECTRICAL 'FI,NALS ACC.DATE 'ACG FILE NO. ' ' INSP. FRAMING SAN PLUMBING.., GAS , - ZONING ENG.SITE NO. INSULATION . . t I _ - MECHANICAL I FIRE SPRINK ENERGY T24 i `,'COVER NO WORK UNTIL ABOVE HAS BEEN S ONEOrl HEATING _ Y ❑ , "❑ Y ❑' NF] 'LATH—INTERIOR': 1 k7 >1vELECTRICAL" ^ ,FLooD ZONEA.L.u•c. LATH-EXTERIOR FIRE DE T. I - Y❑ N❑ Y.❑ ,N❑ j SHEETROCK — GRADE FEE SUMMARY SHEAR INTERIOR ,: BUILDING,, _ SHEAR EXTERIOR - TEMPORA APPROVALS BUILDING FIREWALLS - ELECTRIC 'PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN.SIGNED_'' OCCUPANCY sISM16 FEE' 7'r , OCCUPANCYOF'BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BYBUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING�52=4505;.,•- :: - ELECTRIC, /// H ONE WORKING DAY BEFORE REQUIRED I,SPECTION;' PLUMBING' O PLEASE GIVE JOB ADDIEESS'WHEN PHONI,G. . 7.:1 Z SEE PERMIT FOR EXPIRATION DATEti MECHANICAL I IMPORTANT! CONST.TAX ,,PLEASE READ REVERSE SIDE BEFQRE LITOTAL ' °.15 I - CALL FOR FINAL INSPECTION. !l OFFICE COPYY . . t , APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN'ONLY .BU IILDING PROJECT I DENTI'FICATI ON < ` PERMIT NUMBER BUILDING- C3 APPLICATION & PERMIT . ^ n ADDRESS +�6'T G I BUILDING-ELECTRICAL-PLUMBING r MECHANICAL s7.*X S O 1`7•' �l OWrvER"{���,� ��y�� PLAN CHECK VALIDATION p NAME_�"rl "�`v•� • GTV. ELECTRIC PERMIT ~ FEE I " - , PHONE NAME ncrORs . UTLETS-SWITCHES-RECEP 10.00/1.00 �1Llt �t'f-Wl' GON�Lic.Net ir} LIGHTI NG FIXTU R ES 10.00/1.00 roNTRAa 's�1R1I 'L APPLIANCES-RESIDENTIAL 4.00 ADDRESS , A(/ PHON PANELS10.00 d' DATE OF APPLICATION ARCHITECT - PANELS(OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR E Ve'W r. C�. SF4.+"tr" uc:No. SIGNS TRANS. 3.00 ' ARCH.OR END. $'33' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS PETXn.S AUL, 4) CAzI . EMP.METER OR POLE INS. 20.00 . PAID ADDRESS - MOTORS SEE FEE SCH. APPLICA - " SERVICE CHANGE 20.00 /.'/ - J7 Q.O o LICENSEDCONTRACTORS DECLARATION Qu w 1 hereby affirm That 1 am licensed under provisions of Chapter9 - CLBAttp tln� N ¢ e. (commemm�g with Section 7000)of Division 3 of the Business and BLDG. EL CT. PLG. MECH. H o Z Professions Code, d n license is in full force and eff d. u- a.1 '1G. `, ®` ©\ 2 0,'^n License Class Liu Numher3 j..'Z_ o m� w Date �_7 ,-7_CoNmctor ¢ m s O BUILDING PERMIT Q ¢w ,OWNGR-BUILDF•R DECLARATION �L INFORMATION w3 u y 1 hereby affirm that I am exempt from the Contractor's License MISC.- R'TO ORD uoa Law for the following reason. 7031.5,Businessand Professions PERMIT ISSUANCE t .1000 _ VALUATION $/FT. � w0 Code:Any city or county which requires a permit to construct,after, Q re ¢ ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. o ¢ requires the applicant for such permit to file a signed statement that TOTAL / - PERMIT TO a w mhe is licensed pursuant to the provisions of the Contractor's License ��U w H.? i Law(Chapter 9(commencing with Section 7000)of Division 3 of the U Q Business and Professions Code)or ihat he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢=$ the basis for the alleged exemption.Any violation of Section 7031.5 1 STORIES TYPE CONSTR, T by any applicant for a permit subjects the applicant ioacivilpenalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred d011ars(55D0).)> ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE - 4.00 OCC.GROUP ' RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Btsimn, 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 leas such work FIXTURES-PER TRAP 5.00 SOFT.FLOOR AREA TOTAL ACREAGE himself ar through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,the building GAS-1EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA.) 2:00 BUILDING USE builder will have the burden of proving that h .e did not build or am - RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE'INTER. 30.00 CI 1,as owner of the property,am exclusively contracting with z ❑ ❑ ❑ ❑ - 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) , 1.003 contracts for such projects with a contractods)licensed pursuant to SEWER-SAN V-S ORM F .200tt/10.00 the Contractor's License Law. �- T!-.,_.y-g 0 TRACT NO. PARCEL NO, ❑ lamezemptunderSec. ,B.&P.C.For'this I WATERHEATER'W/V NT 6.00 6 ^ ( 96 ' reason Owner - Dee WATER SYSTEM t)t. A „ C �,( , 5.00 ACC.DATE ACC.FILE NO,- WORK HRS'COMPENSATION O,-WORKERS'COMPENSATION DECLARATION WATER TREATING'EQIJIII. 5.00 ' 1 hereby affirm that 1 have a certificate of consent to self-insure, ' ora certificate of Workers'Compyyn?�1 LIo�h�h sur...cc,or a certified n ... In, ZONING ENG.SITE NO. copy thereof(Sec.3900,Lab:Cd.F11Csr�� Policy No. Company OS.S-�Q70.ryaZ0.��Q� A - O ❑ Certified copy ishereby furnished. FIRE SPRINK ENERGY LQ4' Z ❑ Certified copy is filed with the city inspection division. - - _ Z TO RD. O Applicant MISC.- REFER O v ❑ N❑ v❑ N❑ ~ H PERMIT ISSUANCE 10.00 0�' LU CERTIFICATE E EXEMPTION INS PROMWORKIiRS' FLOOD ZONE A.L.U.C. W � -COMPIiNSATION INSURANCE. PLG.CONTR. LIC.NO. PLG:' -s CL G (This section need not be completed if the permit is for one TOTAL 7-2 Y❑ N❑ Y❑ N❑ Z hundred do]]...($100)or IessJ - U O I certify that in the performance of the work for which this per GTY. MECHANlr� PE�v11T FEE FEE SUMMARY LL P mit is issued,I shall not employ any person in any manner w as to 5,,,3-yqy U become subject to the Workers'Compensation Laws of California. 1 y DaleApplicantALTER OR ADD TO5.00 BUILDING } w NOTICE TO APPLICANT: If,after making this Certificate of Ex' } L.. Z emption,you should become subject to the Workers'Compensation APPLIANCE �sl 1, 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 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT (84 GBM.) 6.00 SEISMIC FEE .7 I hereby a6um 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(Sea MICROFILM 3097,CRI.C.). - HEATING UNIT(TO 700,000 B.T.U.) . 8.00 Lender's Name Lender's AddELECTRIC H EATI NG UNIT[OV ER 100,000 B.T.U.)9.50 / ress • ( certify Thatl have read thm.pplication and state that Ihe.above ', VENTILATION FAN (SINGLE) 4.00 information is Correct. I agree to comply with all city and county PLUMBING a ordinances and state laws relating to building construction, and BOILER-COMP�3H.P.or100,0008,T.U.1 6.0o hereby authorize representatives of this city m enter upon the BOILER-COMP(D ver 100,DOOBTU)SEE FEE SCH. MECHANICAL above mentioned property far inspection purposes. - (We).agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which pERMIT.ISSUANCE 10.00 0 CONST.TAX s�7 3 wit / may in III wRce... agarn. said ity in consequence of the _ grant go d, i MECH.CONT. 'LIC.NO, MECH. TOTAL '7 O IS naureo plintr5miconitsector ^Dater r: J / r TOTAL OFFICE COPY