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15353POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD 1196 Elmsford Drive JOB ADDRESS UNIT# _LOT# OWNER Ral h/Ra na Mann CONTRACTOR PERMIT NUMBER 15353 \\ 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 I INSPECTION RECORD FOUNDATIONNOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS i4O.Q OF CUPERTINO STANDARDS. 1 rr/l UFER PREGUNITE PERnvr VALIDATION O I •'•rr--% ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED MAY 1 9 UNDERGROUND/SLAB PLUMBING City Of CDpertl ELECTRICAL - MECHANICAL - BLOCELEcr PLC. MecH" © j� DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING ,�_�� VALUATION -. SIFT. MECHANICAL ELECTRICAL PERnnt ro - - FRAMING INSULATION sTORi ES TYPECONSTH PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED OCC GROUP RES UNITS ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID s" FT FLODR AREA - ^ TorAL ACR EACE DIAPHRAGM ROOF SHEATHING BUILDING use RES WO ONPB Ong•+ ❑ ❑ ❑ ❑ ❑ ASSESSORS vARCEL NO APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED=TEST LS DATE INSP. ROUGH PLUMBING •A0,•b GY TUBS 8 SHOWER PAN .(y NERGY TRACT No ­O PARCEL NO MECHANICAL GY ELECTRICAL -:iI• ERGY ACC ATE FILE NO FRAMING TEST INSULATION PLUMBING ZONING ENG.SITENO. " GAS TEST znwGAS MECHANICAL FIRE SPRINK Y ❑ N'❑ ENERGY T 2G ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLooD ZONE Y ❑ N❑ ALUc Y L N❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH -TA BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS - SCRATCH COAT ELECTRIC PLAN CHECK FEE SEISMIC FEE MICROFILM GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. UJ ARRANGE FOR INSPECTION BY PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. z — SEE PERMIT FOR EXPIRATION DATE — ELECTRIC ,. PLUMBING I y MECHANICAL IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. CONST. TAX TOTAL I.CU OFFICE COPY �;' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ` WILDING PROJECT IDENTIFICATION APPLICATION&PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIN53 5 3 '- �53 BUILDING ADDRESS C OWNER S q N E 'H1 2'�J5�2% PHONEG�y)` QTY. ELECTRIC PERMIT FEE e Q PLAN CHECK VALID N /s g O /�__f,\y/\) - DATE OF APPLICATION NAE uc. ND. rUTLETS- SWITCHES -RECEP 18:00/1.00 ,00 LIGHTING FIXTURES .66.10,00/1.00 1,06 ADDRESSiORs PHONE PPLIANCES- RESIDENTIAL 4.00 PANELS 10,00 ARCHITECT OR EN I c.No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNSTRANS. 3.0 ARCH, OR ENG. _7,WZIP //,O nooeS CANT ) SPECIAL CIRCUIT 5.00 PERMIT VALIDATION 8 1 0ITEL S/ I J� ISSUANCE DATE TEMP. METER OR POLE INS. M219P1-94 MOTORS SEE FE CH. SERVICE CHANGELCURd LICENSED CONTRACTORS DECLARATION 1 hereby affirm thal I am hvc used under provisions of Chapter 9 (COnnne,cing with Section ]000) of Division 3 of the Rusiaese:md Professions Code, and license is in full force td ffe t. License Class Lin. Tactor -1 � Date Contractor OWNER -BUILDER xem DECLARATION I hereby affirm That I am exempt from the Contractor's License Law lorry city or countywhihc.103LS.Businessand Professions Code: An cit or amm which ret uirsa Y Y Y 1 Pororto its improve, demolish, or repair any permit toff prior m its issuance, also permit fo file a sigma statement that requires isic the applicant t t the he is licensed pursuam to the ng with Secti of the CmufacHo's License Law (Chang Ptoc0sion, Code) with than ie "1s 00) cscru Dtherem3 of the Business and Professionsxempt or that he is exmnpt therefrom and the basis for the alleged exemption. Any applicant t ofSeetion malty by any applicant for permit dolla,s the 00.)i am macivil pcimlty of not more than five hundred dollars f5500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves thereon, and who docs such work himselfor through his own employees, provided that such improve- mentsall net intendedor01hard for sale. If, how eve r, file building or improvement is sold within one year of c0mplefion, the owner- builder will have the burden of proving that he did not build or fill- prove for purpose of sale.). O 1, as owner of the property, um exclusively contracting with licensed contractors to construct the project (Sea 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner oI' property who builds or improves thereon. and who contracts for such projects with a eontractoos) licim,d pursuant to the Contractor's License Law. ❑ taro esempt under Sec ,N.&P.C. for this reason BLDG. © ELECT. © PLG. MECH. .1' 7I ® vLJ Y✓ BUILDING PERMIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE 12[�1g00 r� orl ELEC. CONTR. uC. NO. ELEC. TOTAL co VALUATION A3 SIFT. PERMIT TO ✓ O / J/ ] :1✓ Ti /�-t(J Ll v DTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN& VENT -WATER (EA.) 5.00 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA. CON D. 5.00 ,J FIXTURES - PER TRAP Q IedG80 ( GAS-EA.SYSTEM-11NC.40UTLETS 6.00 GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 So. FT FLOOR AREA e) TOTALACREAGE BUILDING USE RES IND CON PB Other INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 IEA.) 1.00 SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Dat, WORKERS'COMPENSATION DECLARATION 1 hereby affirm that I hall a certificut, ufe nwrit 4r sell -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof (Sec. 3500, Lab.C.), Policy No. Company WATER SYSTEM 5.00 ACC. DATE ACC. FILE N0. WATER TREATING EQUIP. 5.00 ZONING ENG. SITE NO. MISC.- REFER TO ORD. ❑ Certified copy is hereby furnished. e Certified op is filed iflt Ih�P, -ty Ittspectmu division. Applicant_T/a --_ FIRESPRINK Y[D NEI ENERGY T 24 Y[:] N[] CFRTIPIG7 EOTIFROM WORKERS' COMPENSATION INSURANCE (This section need not he completed if the permit is for one hundred dollars ($100) or Ins.) 1 certify that in the perfurmaace of the work for which this per- mit is issued, I shall nut employ any person in any manner sl as to become subject to the Workers' Compensation Laws of California. DaIL Apphcent NOTICE TO APPLICAN"I': If, after making this C,rt ifieate of Fs- emption, you should Recut,, subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I briefly affirm that there is a construction lending agency for the perfiunun" of the work for which this permit is issued (Sec. 3097, Cv.C.). Lender, Name Lender's Address PERMIT ISSUANCE .� FLOOD zorvE Y ❑ N ❑ A. L. U.C. Y ❑ N ❑ PLG. CONTR, LIC. NO, PLG. QQ Ce I TOTAL I[J -�' OTY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 3 JQ ALTER OR ADD TO MECH. 1IDPrs,90 9'M APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=r.F.M.) 4.00 PLAN CHECK FEE AIR HANDLING UNIT (OVER 10=C.EM.) 6.00 SEISMIC FEE EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATI NG UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC �C�IQO I Certify Iltal l have read this application and state that lire above information is correct, I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorise ropertyfor i s ec this city to enter upset the abovementioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of upetlino against liabilities, judgments, costs and expenses which lay in any way accrue against said City in consequence of the nan[ing of this permit. VENTILATION FAN (SINGLE) 4.00 BOILER- COMP (3 H.P. or 100,000 B.T.U.) 6.00 PLUMBING IM l..li BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL MISC.. REFER TO ORD. I ry I„ PERMIT ISSUANCE (� IOC18:80 i/I V CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL n^ q�I1W TOTAL &gnature of Appllcan[/Canhact0r Uu[c OFFICE COPYC, I