Loading...
11243 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO I•PR„ITNUMBER{ INSPECTION DIVISION 11243 JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS �7�ay Free k I1Vl& UNIT# LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR<ICJ Q, (]I S IS NOT STARTED WITHIN INSPECTIO DATE INSPECTOR U INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM UFER LAST CALLED INSPECTION. PREGUNn_IT _ PERMIT VALIDATION 11_ -Yb FOUR NO CONCRETE UNTIL ABOVE HAS FAGNEO UNDERGROUND /SLAB PLUMBING S ELECTRICAL nL'b% ISSUANCE DATE MECHANICAL 31_04. ELECT. PLG. A`LclR - . ©• 1_,q DO NOT POUR.FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION PLUMBING -- VALUATION MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION STDR ES Q TYPE CONSTR. OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF $O FT,FLOOR AREA TOTAL ACREAC'. DIAPHRAGM BUILDING USE HES: IN CON PB 01,,.,APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑. ❑ ❑ ❑ ❑ ROUGH ASSESSORS PAHCE L N0, PLUMBING GAS TEST TRACT NO. PARCEL NO. MECHANICAL ELECTRICAL FINALS - DATE INSP. ACC DATE ACC.FILE NO. FRAMING SAN # INSULATION PLUM ING zaNlrvc ENG.SITE NO. GAS _ �( MECH NICAL FIRE SPRINK ENERGY T 24 z COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATI G Y ❑ N❑ r ❑ N❑ LATH—INTERIOR ELECTkQAj — y,Y'7 FLOOD ZONE A.L.U.C. LATH—EXTERIOR FIRE DEPT. Y❑ IN C) 10 N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING POO(— SHEAR OO SHEAR EXTERIOR TEMPORARY APPROVABUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC • F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING ;+ z PLEASE GIVE JOB ADDRESS WHEN PHONING. 1 - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL .4 Orp:ZE COPY .APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY PERMIT NUMBER BU I LDING PROJECT IDENTIFICATION APPLICATION & PERMIT ADDRESS 11243 y ADDRESS / BUILDING-ELECTRICAL-PLUMBING-MECHANICAL i 5kdfs t 1T''a." '•.,.y _;; ,:• PLAN CHECK VALIDATION "AME / GTYu na'il.••'. ELECTRIC PERMIT" FEE a' ` PHONE 99�-�b - -- ' - ��i•/ •• CO RgCTOR'b NAME OUTLETS-SWITCHES-RECEP 10.00!100 S N S LIc.N � - LIGHTING FIXTURES 10.00/1.00 \_ roNT croR's e4w�AM/0/? APPLIANCES-RESIDENTIAL 4.00 ADDREbb Ip' 18;0S; PHDNE 7 PANELS t0.D0 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINE SIGNS TRANS. 3.00 agiell ARCH.OR ENG. 5.00 PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT '� ZIP EMP.METER OR POLE INS. 20.00 APPLICANT'S MOTORS SEE FEE SCH. n f I •, �ry�,� ADDRESS ✓ , l!.6yy SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION M,u 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE H,w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. M y i Professions Cod a Qmy license is in full for<e�n 0 L � License Clas Lic.Number !� o LF w Date Contractor -- BU DING ERMI . 15 X w 40 OWNER-BUILDER DECLARATION '$`'k.--� REFER INFORMATION �rs.,t; w;LL m 1 hereby affirm that 1 am exempt from the Contractor's License MISC.- VALUATION SIFT. _ w0 < Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.0 Code:Anycilyorcounty which requires a permit to construct,alter, r��•1 Q Q Q Q improve,demolish,or repair any Structure,prior to its Issuance,also ELEG CONTR. LIC.NO. TE DEC C LL requires the applicant for such permit to file a signed statement that IOTA PERMIT TO KCI $ he 6 licensed pursuant to the provisions of the Contractor's License r r Lew(Chapler9(commencing with Section 7000)0(Division 3 of the t t{� ID^ha'ai t- .M t }v.' E ?< r"Y "g4' PLUMBING PERMIT *x Business and Professions Code)or that he is exempt therefrom and DTV.u ; ti-a the basis for the alleged exemption.Any violation of Section 7031.5 r'" .i:. .I:'S,xx•.-6.:: ',. e': :i., TO IES TYPE CONSTR. a ; m by any applicant for a permit subjects the applicant to a Civil penalty gLTER-DRAIN IEA.) 5.00 rot 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 Dec.GROUP RES.UNITS their sole 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 does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE •SC himself or through his own employees,provided that such improve- mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is mid within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im RE IN CON P8 Orne, prove for purpose of sale.). I N D USTR I AL W ASTE INTER. 30.00 ❑ 1,as owner of the property,am 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts forsuch projects with a conlractons)licensed pursuant to SEWER-SAN ITAR V-STORM EA.200ft/10.00 TRACT NO. PARCEL N0. the Contractor's License Law. ❑ lam exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.001 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a Certificate of Consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800.Lab.CJ. Policy No. Company 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certif c srrled wit he c' ins c I n division. 2/, Applicant g '/r/A t �- Flu MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ CLy CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.c. IL 7 COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y❑ N❑ V❑ N C O (This section need not be completed if the permit is for one TOTAL Z hundred dollars(SIDE)or less.) , U O 1 certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT, _ FEE ,FEE SUMMARY, Iy F mit is issued,1 shall not employ any person in any manner so as to • O W become subject to the Workers'Compensation Laws of California. BUILDING y Date Applicant ALTER OR ADD TO MECH. 5.00 } W NOTICE TO APPLICANT: If,after making this Certificate of Ex- t.. ? emplion,you should become subject to the Workers'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 10=11F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=O.EM.).6.00 SEISMIC FEE 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,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender s Address 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 countyPLUMBING 01 ordinances and state laws relating to building construction. and BOILER-DOMP(3H.P.Or100,000B.T.U.) 6.00 -Z! hereby authorize representatives of this city to enter upon the 801 LER- P IOver 100, 00 BTU)SEE FEE SCH. EC HANICAL above-mentioned property for inspection purposes. REFER TO ORD. / (We) agree to save. indemnify and keep harmless the City of MISC.- ` -CONST.TAX Cupertino against liabilities,judgments, costs and expenses which PERMIT 10.00 may in any way accrue against said City in consequence of the grant t is pegni r / MECH.CONT. LIC.NO, MECH. TOTAL-, Signature of Applicant ontracfor Date If OFFICE COPY