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15747 - i POST THIS CARD NEAR FRONT OF BUILDING - PERMIT NUMBER Y ' . CITY OF CUPERTINO 15747 INSPECTION DIVISION JOB INSPECTION RECORD •, S LpS PERMIT EXPIRATION + JOB ADDRESS4QO43^M/LL£x— 'UNNtTr�#� _LOT# - PERMIT EXPIRES IF WORK OWNER - U- / a [,fie - coNrRAcroa l,p��^><{. - - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION' - ANCE OR 180 DAYS'FROM NOTE: LAST CALLED INSPECTION. UFER - - - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED (. UNDERGROUND /SLAB PLUMBING . 7b, ✓lC•� I ' ELECTRICAL - ISSUANCE DATE . MECHANICAL BLUG F.LeCi, .PPLLO. MECH. ❑ r1L ❑ 1 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ol BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION"-. SIFT. PLUMBING - MECHANICAL ELECTRICAL - PERMIT TO FRAMING - `t1 6" INSULATION p STORIES' TYPE CONSTR. DOEGROUPRES.UNITS , PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED (],GT,FLOON AREA TOTAL ACREAGE ' . ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEne DIAPHRAGM, THE CONSTRUCTION TAX IS PAID G _ ROOF SHEATHING -RES IND ILUCON USEPB '• 00— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El. ' ED ElID UGH SAN.N ASSESSORS PARCEL NO, PLUMBING - - ELECT.ENERGY 'TRACT NO PARCEL NO TUBS 8'SHOVJER PAN PLUMBING ENERGY M - MECHANICAL..., _ MECH'ENERGY ACC DATE ACL,FILE NO. ELECTRICAL ' .I BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION - PLUMBINGGAS'TEST - GASMECHANICALFIRE SPRINK ENERGY T24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ N❑ YE] N❑ELECTRICAL RELEASEFLOOD ZONE ALUC. EXTERIOR SHEAR INTERIOR SHEAR,- . FIRE DEPT. r ❑ N❑ ;Y ❑ 'NSHEETROCK GRADEFEE SUMMARY ' EXTERIOR LATHE BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS . FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL i — SEE PERMIT FOR DATE EXPIRATION IMPORTANT! . • CONST TAX PLEASE READ REVERSE SIDE BEFORE TOTAL ! CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY. BUIL INGPROLIE IDENTIFICATION - - PERMIT NUMBER, BUILDING fT� Ips APPLICATION & PERMIT 15747 C�] A ^J . ADDRESS I J 1 4{ 1 10055 M1 Aur BUILDING—ELECTRICAL—PLUMBING—MECHANICAL OWNER'S PLAN CHECK VALIDATION /MB'TQ °L E DTV. ELECTRIC PERMIT FEE Q K I PHONE CONTNAMFRacrORs UTLETS-SWITCHES-RECEP 10,0011.00 - C!E2M LIC.NO, LIGHTING FIXTURES 10.00/1.00 CONTRACTORS APPLIANCES-RESIDENTIAL - 4.00 ADDRESS te, - 2�,/J I 2)I�IC•�( � v orve PANELS 10.00 - T r DATE OF APPLICATION ' ARCHITECT , - PLAN CHECK FEE .C:NO. OR PANELS (OVER 200 AMP) '20.00 s' , - ENGINEER LIC,NO SIGNS•TRANS. .3.00 - - ADDREOR SS ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS.' APPLICANT ADDRESS MOTORS SEE FEE SCH. ' , l -201j I /NGW0w'J^^ . AVe ISERVICE CHANGE 20.00 - p 7111-09 LICENSED CONTRACTORS DECLARATION a u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE s- w (commencing with Section 7000)of Division 3 of the Business and y< n 'BLDG. ELECT, PLG. " MECH. 0 i Professions Code,and my license is in full force and effect. ❑ ❑ ❑ a i n W License Class Lie.Number Date Contractor a m E -Ji BUILDING PERMIT. ¢ ¢ ¢ ¢ OWNER-BUILDER DECLARATION dodo - INFORMATION w ; I hereby affirm that I aril exempt from the Contractor's License MISC- REFER TO ORD rn VALUATION $/FT. E u_ 0 ¢ Law to Any Cit Or iountyreason,(Seequire.5,eito andcon Professions PERMIT ISSUANCE- 10.00 -' Code. e,dem y or co,repan icy structur e permit prioto construct,alter,also - ¢ rt ¢ improve,demolish)or repair any structure,prim to its issuance,also ELEC.CONTR, a, LIC.NO. ELEC. i D ¢ requires the applicant for such permit to file a signed shoemeol that TOTAL PERMIT TO - w $ he is licensed pursuant to the provisions of the Contractor's License ri >w Law(Chapter 9(commencing with Section 7000)of Division 3 of the E 4 o Business and Professions Cade)or that lie is exempt therefrom and OTY• PLUMBING PERMIT ¢ t-$ the basis for the alleged exemption.Any violation of Section 7031.5 1 ES TYPE CONSTR. a ; by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5. �j of not more than five hundred dollars(SS00),I: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OC[GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. Code:'rise Contractor's License Law does not apply to an owner of properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 30.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM•I INC,4 OUTLETS 6.0 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM•OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or int. BUILDING USE ' prove for purpose of sale.). RES. IND CON Pe Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS•1 INC 6 V.B. 8.00 - 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 for such'projects with a contractot(s)licensed pumuunl to SEWS -SANITARY- TORM EA.200ft/70.00 "yam the Contractors License Law, s„A TRACT NO. - PARCEL NO. ❑ I un,exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM '£r.00 pJ ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to set-insure, - ZONING ENG.SITE NO. Or a cerlificale of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab,CJ, Policy No. Company p ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z DY Certified copy is fled wit t..the city hsPection division. MISC.- REFER TO ORD. O Applicant Y ❑ Np y N� ~ rn PERMIT ISSUANCE •}8:08 LU — CIi RTIFICCO SATIO TINS FROM E CCR$' la` FLOOD ZONE a.L.U.C. W � COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. 'CL 0 _ ('This section need not be completed if the permil is for one - TOTAL Y F] NE] Y❑ N[] hundred dollars(S 100)or Ess.) U O' 1 certify that in the performance of the work for which this per- OTY, MECHANICAL PERMIT FEE FEE SUMMARY U. F' mit is issued, I shall,not employ any person in any manner sous to O become subject to the Workers'Compensulion Laws of California. ' p i Date-- Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NO]ICE '1'0 APPLICANT: If,after making thus Cerlh'Icxle of fix. Z 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 10,000OF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 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 permil is issued(Sec. - MICROFILM 3097,Civ.C.L - HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that I have read this application and one Ihat the shove VENTILATION FAN (SINGLE) 4.00 information is correct.1 agree to comply with all city and couilly PLUMBING • ordinances and state,laws relatirig to building construction, and BOILER-WMPI3H,P.or 100,000 B.T.U.) 6.00 hereby authorize represenfatives.'o( this city to enter upon [he BOILER-COMP (Over 100,000 BTU)SEE FEE SCH, MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE' 10.00 CONST.TAX may-in any way accrueagainst said City in consequence of the ranting orthfs perm' MECH,CONT, LIC.NO. .MECH, _ TOTAL TOTAL sgnature pplicant Contractor Date OFFICE COPY - i POST THIS CARD NEAR FRONT OF BUILDING - PERMIT NUMBER Y ' . CITY OF CUPERTINO 15747 INSPECTION DIVISION JOB INSPECTION RECORD •, S LpS PERMIT EXPIRATION + JOB ADDRESS4QO43^M/LL£x— 'UNNtTr�#� _LOT# - PERMIT EXPIRES IF WORK OWNER - U- / a [,fie - coNrRAcroa l,p��^><{. - - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION' - ANCE OR 180 DAYS'FROM NOTE: LAST CALLED INSPECTION. UFER - - - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED (. UNDERGROUND /SLAB PLUMBING . 7b, ✓lC•� I ' ELECTRICAL - ISSUANCE DATE . MECHANICAL BLUG F.LeCi, .PPLLO. MECH. ❑ r1L ❑ 1 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ol BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION"-. SIFT. PLUMBING - MECHANICAL ELECTRICAL - PERMIT TO FRAMING - `t1 6" INSULATION p STORIES' TYPE CONSTR. DOEGROUPRES.UNITS , PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED (],GT,FLOON AREA TOTAL ACREAGE ' . ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEne DIAPHRAGM, THE CONSTRUCTION TAX IS PAID G _ ROOF SHEATHING -RES IND ILUCON USEPB '• 00— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El. ' ED ElID UGH SAN.N ASSESSORS PARCEL NO, PLUMBING - - ELECT.ENERGY 'TRACT NO PARCEL NO TUBS 8'SHOVJER PAN PLUMBING ENERGY M - MECHANICAL..., _ MECH'ENERGY ACC DATE ACL,FILE NO. ELECTRICAL ' .I BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION - PLUMBINGGAS'TEST - GASMECHANICALFIRE SPRINK ENERGY T24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ N❑ YE] N❑ELECTRICAL RELEASEFLOOD ZONE ALUC. EXTERIOR SHEAR INTERIOR SHEAR,- . FIRE DEPT. r ❑ N❑ ;Y ❑ 'NSHEETROCK GRADEFEE SUMMARY ' EXTERIOR LATHE BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS . FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL i — SEE PERMIT FOR DATE EXPIRATION IMPORTANT! . • CONST TAX PLEASE READ REVERSE SIDE BEFORE TOTAL ! CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY. BUIL INGPROLIE IDENTIFICATION - - PERMIT NUMBER, BUILDING fT� Ips APPLICATION & PERMIT 15747 C�] A ^J . ADDRESS I J 1 4{ 1 10055 M1 Aur BUILDING—ELECTRICAL—PLUMBING—MECHANICAL OWNER'S PLAN CHECK VALIDATION /MB'TQ °L E DTV. ELECTRIC PERMIT FEE Q K I PHONE CONTNAMFRacrORs UTLETS-SWITCHES-RECEP 10,0011.00 - C!E2M LIC.NO, LIGHTING FIXTURES 10.00/1.00 CONTRACTORS APPLIANCES-RESIDENTIAL - 4.00 ADDRESS te, - 2�,/J I 2)I�IC•�( � v orve PANELS 10.00 - T r DATE OF APPLICATION ' ARCHITECT , - PLAN CHECK FEE .C:NO. OR PANELS (OVER 200 AMP) '20.00 s' , - ENGINEER LIC,NO SIGNS•TRANS. .3.00 - - ADDREOR SS ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS.' APPLICANT ADDRESS MOTORS SEE FEE SCH. ' , l -201j I /NGW0w'J^^ . AVe ISERVICE CHANGE 20.00 - p 7111-09 LICENSED CONTRACTORS DECLARATION a u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE s- w (commencing with Section 7000)of Division 3 of the Business and y< n 'BLDG. ELECT, PLG. " MECH. 0 i Professions Code,and my license is in full force and effect. ❑ ❑ ❑ a i n W License Class Lie.Number Date Contractor a m E -Ji BUILDING PERMIT. ¢ ¢ ¢ ¢ OWNER-BUILDER DECLARATION dodo - INFORMATION w ; I hereby affirm that I aril exempt from the Contractor's License MISC- REFER TO ORD rn VALUATION $/FT. E u_ 0 ¢ Law to Any Cit Or iountyreason,(Seequire.5,eito andcon Professions PERMIT ISSUANCE- 10.00 -' Code. e,dem y or co,repan icy structur e permit prioto construct,alter,also - ¢ rt ¢ improve,demolish)or repair any structure,prim to its issuance,also ELEC.CONTR, a, LIC.NO. ELEC. i D ¢ requires the applicant for such permit to file a signed shoemeol that TOTAL PERMIT TO - w $ he is licensed pursuant to the provisions of the Contractor's License ri >w Law(Chapter 9(commencing with Section 7000)of Division 3 of the E 4 o Business and Professions Cade)or that lie is exempt therefrom and OTY• PLUMBING PERMIT ¢ t-$ the basis for the alleged exemption.Any violation of Section 7031.5 1 ES TYPE CONSTR. a ; by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5. �j of not more than five hundred dollars(SS00),I: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OC[GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. Code:'rise Contractor's License Law does not apply to an owner of properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 30.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM•I INC,4 OUTLETS 6.0 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM•OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or int. BUILDING USE ' prove for purpose of sale.). RES. IND CON Pe Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS•1 INC 6 V.B. 8.00 - 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 for such'projects with a contractot(s)licensed pumuunl to SEWS -SANITARY- TORM EA.200ft/70.00 "yam the Contractors License Law, s„A TRACT NO. - PARCEL NO. ❑ I un,exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM '£r.00 pJ ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to set-insure, - ZONING ENG.SITE NO. Or a cerlificale of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab,CJ, Policy No. Company p ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z DY Certified copy is fled wit t..the city hsPection division. MISC.- REFER TO ORD. O Applicant Y ❑ Np y N� ~ rn PERMIT ISSUANCE •}8:08 LU — CIi RTIFICCO SATIO TINS FROM E CCR$' la` FLOOD ZONE a.L.U.C. W � COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. 'CL 0 _ ('This section need not be completed if the permil is for one - TOTAL Y F] NE] Y❑ N[] hundred dollars(S 100)or Ess.) U O' 1 certify that in the performance of the work for which this per- OTY, MECHANICAL PERMIT FEE FEE SUMMARY U. F' mit is issued, I shall,not employ any person in any manner sous to O become subject to the Workers'Compensulion Laws of California. ' p i Date-- Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NO]ICE '1'0 APPLICANT: If,after making thus Cerlh'Icxle of fix. Z 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 10,000OF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 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 permil is issued(Sec. - MICROFILM 3097,Civ.C.L - HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that I have read this application and one Ihat the shove VENTILATION FAN (SINGLE) 4.00 information is correct.1 agree to comply with all city and couilly PLUMBING • ordinances and state,laws relatirig to building construction, and BOILER-WMPI3H,P.or 100,000 B.T.U.) 6.00 hereby authorize represenfatives.'o( this city to enter upon [he BOILER-COMP (Over 100,000 BTU)SEE FEE SCH, MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE' 10.00 CONST.TAX may-in any way accrueagainst said City in consequence of the ranting orthfs perm' MECH,CONT, LIC.NO. .MECH, _ TOTAL TOTAL sgnature pplicant Contractor Date OFFICE COPY