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88354. POST THIS.CARD NEAR FRONT OF BUILDING CI -6 OF .CUPERTINO • ,8635 INSPECTION DIVISION JOB INSPP/ECTIONNRECORD JOB ADDRESS /Q5�5 S•' _be oozo, Nyd. UNIT# LOT# ' L / - OWNER 1 Y CONTRACTOR ,O, S �I�. �PERA9 pM9EN • PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM ,LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION [r S •G� 1L7 peV LA( a"'(-r 4'TT UFER PREGUNITE _ PERMIT VALIDATION - - / 7J/?f ISSUANCE DATE .Ls%. �v,t.Los o-1-Flb J POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 'UNDERGROUND/SLAB _PLUMBING — ./j I dd ELECTRICAL •` �� MECHANICAL '-/�"- o �' ut�• /�., BLDG. ELECT:' PLG. MECR. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 2- 5'6 GiL'G' i[zC BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION I•.' PLUMBING MECHANICAL - ELECTRICAL - PERMIr ro .' PH, -s FRAMING INSULATION ', STORIES TVPECONSTR- 'OCC. GROUP RES, UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF 37 SO, FT. FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE RES IND CON PB OIM1Nf ❑ •• ❑ ❑ ❑ APPLY NO ROOFING UNYIL ABOVE HAS BE GNED(]' ROUGH ASSESSORS PARCEL NO, '"f.`'"-�''✓/ PLUMBING GAS TEST''} - - � - TRACT NO. ' �'PARCELNO. MECHANICAL ELECTRICAL/vo s FINALS DATE INSP. ACC. GATE ACC. FILE NO. FRAMING - b, SAN # - INSULATION„�✓-ff6 PLUMBING •- •L zoNlNc "ENG. SITE No, GAS MECHANICAL % F IR E'SPIT INK ENERGY T 2 E] "� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING • LATH -INTERIOR ELECTRICAL 1-2,$-- S-7 FLOOD ZONE NE Y C] , N� aL.u.c Y ❑ NO LATH -EXTERIOR FIRE DEPT. I,I SHEETROCK.GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING - BUILDING - SHEAR EXTERIOR }%mob' TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE ` ' - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z 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 f I f OFFICE COPY Z°= R!6 .RLQ 2.6YJVGTxv VF ccE`ftttWNc.E!5 �Y CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE ,:. CITY OF CUPERTINO �y m DATE �--- �- 19'RZ BLDG. PERMIT NO. a g 3r E THE BLDG. LOCATED AT Si7 NP / r Lk Zfa a OWNED BY _t` (MPLETE ,}7(, miE I, HAS BEEN FOR USE AS )b f�'� C� U 1-y� g .o (AETERED) I :i Ca LL' cm Cn 'T.:,, r' o CERgTIFIpCNAGTE OF CO COMPLETION FICE CITY OF CUPERTINO �y DATE Z--- 2— 19� BLDG. PERMIT NO. a K :S'S— THE TTHE BLDG. LOCATED AT -S OWNED BY --4L; 1,AI P jr= HAS BEEN ( MPLETED FOR USE AS I C'P U `�' _� ER EDI ,tVPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LDIRIG PROJECT 1 DENTI FI ION APPLICATION & IT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 8835 .mJ IL NG 'oOrFs � �� 4. .L OVINERS NAME OTT�Y. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION NAME CON1Ac R's UTLETS-SWITCHES -RECEP 10.00/1.00 . (�, _C.NO. LIGHTING FIXTURES 10.00/1.00 ADDRESS'ons PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPLICATION AARRCHITECT O ENGINEER ry^A IArPsec. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECKFEE P.C. NO. SIGNS TRANS. 3.00 V ARCH OR ENG.PIn A ZIP SI SPECIAL CIRCUIT 5,00 PERMIT VALIDATION PAID JL Lf1.d EMP. METER OR POLE INS. 20.00 ARE ADDDDRESSSS D MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION TEMP. POLE 30.00 1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) Of Division 3 of the Business and Professions Co an my license is in full forccgg �fac Licens......�•PPPPPP1Ias P Lie. Number •� of C11gyp( COE DATE LO ELECT. PLG. MECH. ❑ ❑ ❑ DateConlractor OWNER -BUILDER DECLARATION 1 hereby affirm that I so exempt from the Contractor'sPrLicense Code:Law rthe Anycitylowingreywhichec.uires a perminess t tocodProfessions Code: Any curer counpair any structurep riot ttoconsuance,heq improve, demolish, or sepals any structure, prior to IIS ISrnallCe, aI50 requires the applicant for such permit to file a signed statement that he is licensed pursuantto the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000)ofDivision 3 ofthe Business and Professions Code) or that he is exempt therefrom and BUILDING PERMIT INFORMATION MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION Sol ^IOr 00. d`{0, �/ $/FT. ELEC CONTR. LIC. NO. ELEC TOTAL PERMIT TO Q •C%�..� � -470 �---ff�" "� DTV. PLUMBING PERMIT - FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant tee civil penalty or not more than five hundred dollars ($500),): : I 5 o/C_. ALTER -DRAIN IEA.) 5.00 AL - ❑ I, as owner of the property, Or my employees with wages as their sole Compensation, will do the work, and the structure is not 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 and Professions n a� Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mems are not intended or offered for sale. If, however, the building O- FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE GAS•EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that h e did not build or im- prove for purpose of sale.).INDUSTRIAL ❑ I, as owner of the property, am exclusively contracting with . -.. GAS - EASYSTEM OVER 4 IEA) 200 BUILDING USE RES IND CON PB Omer ❑ ❑ 0 ❑ ❑ WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business 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 - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORSPARCEL NO. Q contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ I em exempt under Sec. ,B.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORK ERS'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. copy thereof (Sec. 3800, Lab.C.). E ,-s Y Policy No. Company [1_ FIRE SPRINK Y F -1N ❑ ENERGY T-24 Y E] NC] ❑ Certified copy is hereby furnished. African t-/ ❑ Certifl�co�y qhs hbl�ed Sail thity ins n Division. pp MISC. - REFER TO ORD. t CERTIFICATE OE EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A. L. UC. PLG. CONTR. LIC. NO. PLG. TOTAL COMPENSATION INSURANCE (This section need not be completed if the permit is for one Y ❑ N Y ❑ No OTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or le..) I certify that in the performance of the work for which this per- Mit is issued. I shall not employ any person in any manner so as to BUILDING Qty 7 �i' become subject to the Workers' Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE. TO APPLICANT: If, after making this Certificate of Ex- emption, you should become subject to the Workers' Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked FEE AIR HANDLING UNIT (TO 10=11F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT (OVER 10=C.RM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 theperformance of the work for which this permit is issued (Sec. e3097, oC MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UN IT (OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Name Lender's Address 1 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 ordinances and state laws relating to building construction, and PLUMBING BOILER- CDNP(3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100.01BOBTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned property for inspectinn purposes. MISC. - REFER TO ORD. CONST. TAX (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the gra gofthis prmit./It-2?_86MECH.CONT. PERMIT ISSUANCE 10.00 LIQ NO. TOTAL TOTAL Signatumof pplicant/Contractor Date OFFICE COPY