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16290 PPLICANT 1-0 FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY a BUI LDI NG PROJECT I DENTI FICATION PERMIT NUMBER naRGINc APPLICATION & PERMIT 16290 L7"' OUILDING - ELECTRICAL-PLUMBING-MECHANICAL OWNEH'S • N/q/�MJA //�) //00 ( ) / CITV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION Nn /��Y' 1`0H J....../7,/ Z3Er '7��- Q�� NAMERAciosrs OUTLETS-SWITCHES-RECEP 10.00/1.00 Ti � l/ TON /Zv/H/ SCi L10.NO.i:Sx j IS - LIGHTING FIXTURES 10.00/1.00 ADDRESS TOHs PPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION UR PANELS PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE PA,NO. E NGINEEH ADLIC.ENG. C.NO. SIGNS TRANS. 3.00 ADDDRESSRESS SPECIAL CIRCUIT S.QQ PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S 1 ADDRESS n MOTORS SEE FEE SCH. Zr 700 „ �w "`+� Ci y /, SERVICE CHANGE 20,00 v a i r o O LICIiNSI[D CON'I'IIACTORS DECLARATION a v w I hereby ath"Ll that I an, Iicenivil under pruvisi.....ul'Chaph, 9 a n Iembnte'neing with Seelinn 70001 of Division 3 01 the business and IN AQ9QU4CE DATE r i 1'rufessions Code,and on,license is in lull lure,and cl lerl, LECT. PLG. MECH. Zo i:O License Class Lic.Number N f DYte C....tracm, O - E ; 11 Ix OWNER-BUILDER DECLARATION 'BUILDING PERMIT 'xa ;n w I hereby apical that I an,exempt fruit, the Contractor's License MISC.- REFER TO ORD INFORMATION �. O a Law for file following reason.(See.7031.5,Oosinessand Pmov,mor VALUATION t - i PERMIT ISSUANCE s/pr. ._ nom Code Any chsY or county which rcquirasuluvnuttuconstnn'I,ahety A ' - ^ Q K ¢ improve,demolish,or repair any structure,prior to its issuance,alw ELEC.CONTR. LIC.NO. ELEC. '�AAaa /` OC-ClV i iL m u requires the applicant I'or such permit to lite n signed statement Ilial TOTAL "L� he is licensed Pursuant to the provisions.1 tile Comr:retor,License �/ 7-AZ��••''I''T TO/' z a Law(Chapter 9lconmenCnd )Witt,Section 70001u1'DivisionJot Dm FEE Say Li K/ I�Pr^ it the basis and he alleged eCole)or That he is Bion or a crion 70 mal DTV. PLUMBING PERMIT rt r o by basis for the alleged exemption.Any violation t in ac civil malty STORIE TYPE CONSTR. v by any applicant fora hundred subjects tire applicant luucivil penally of not marc than five hundred dollars 11: ALTER-DRAIN& VENT-WATER (EA.) 5.00 ❑ I,as owner of the Property, myem y,or my employees with wages as BACK FLOW PROTECTDEVICE 4.00 (heir sale cohnpenvfion,will Jo the work,and the structure is not . OCC.GROUP RES.UNITS intended or offered for sale(Sec. 7044, limitless and PolfieWmts DRAINS-FLOOR,ROOF,AREA,COND. 5.00 . _ Cone:Pusycluent dhe Contractor's License Law doesnut apply m an owner ofroperwho builds or improves thereon,and who does such work FIXTURES-PER TRAP 50.FT.FLOORAREA TOTALACREAGE orelor through his own employes,provided that such improve- ensrenolintendedorollered l'or sale.It,however,Nle building GAS-EA.SYSTEM-11NC.4 OUTLETS,&,W is sold within one year III conspletion,the owner- builder will hove the burden of proving that he did not build or int- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for 1,as owner of stile.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Dmn ❑ d as owner of the properly,lint exclusively contract ins wish 0 Ind Prd contractors to iv Contra the project(Sec. 7044,0usinns LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 and Profwsirnv Code:'I'he Contractor'$License Law docs nut apply ASSESSORS PARCEL N0. to an owner of property who builds or improves Iheremt.and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 COnlraels for such projects With a epnlractods)licensed pursuant to tile Contractor,Lice, L SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCEL NO. O l it c ul r a._ ,O.dtP.C.sur His --�� reasonWATER HEATER W/VENT -6+90 Cj'2- _ _ Owner_ _ Date - WATER SYSTEM 5.00 ACC.GATE ACC FILE N0. Olt Ii HSI('OMI'.N.' 'PION I11iCIARAI'ION WATER TREATING EQUIP. 5.00 1 hereby Minn that I h vo a cenilicale of consent la wlHins'ne, or'a certificate of Workers'Compensation lu'unnce,lir a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.), Valley No. Company 0 ❑ Certified copy is hereby furnished. z Z ❑ Cenilied copy is Ii1,d will, the city impeclimt division. FIRE SPRINK ENERGY T-24 � O Applicanl MISC.- REFER TO ORD. YEl N� YE) N[] N CERTIFICATE OF EXEMPTION PROM WORKERS' PERMIT ISSUANCE L C'ONipl:NSATION INSURANCE PLG.CONTR. FLOOD ZONE A.L.U.C. d 0 LIC.NO. PLG. q Z (This acelion need not be completed it IIIc prrnis is for ooh TOTAL I�e a--� Y[3 N[3 Y 0 N[D U O hundred dollars CS l UO)or less.) I certify that in lire performance of the work In,which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY LL V mil is issued,I shall not employ any person in any runner sit as to O W become subject to the Wurkiers'Cuniprnkmimh Laws AI'Calilbrnia. S N01 Appli' BUILDING >- 0NOTICE TO AI'1 ICAN E: If,alter making this Certificate of lix- ALTER OR ADD TO MECH. 5.00 I" Z entption,you should become subject to the Workers'Compensation APPLIANCE 500 PLAN CHECK provisions of th . e Labor Code, you must forthwith emoply with U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 FEE CONSTRUCTION LENDING AGENCY AIRHANDLINGUNIT IO VERI0,000C.F.M.) 6.00 SEISMIC FEE hereby al'b'um Runfir Ilion is t nmstrthis p mit is agency Ibr EXHAUST HOOD(WITH DUCT) 5.00 the perlirmancr of the work Ibr which this permit is issued(Svc. 3097,Civ.C.). HEATING UNIT ITO 100,000 B.T.U.) 8.00 MICROFILM Lender's Nmme Lender's Address HEATINGUNIT(OVER100,000B.T.U.19.50 ELECTRIC a*ru . I certify that l have read this application and state Dol the above VENTILATION FAN (SINGLE) 4.00 information is correct I agree IG comply with all city and county PLUMBING ordinances and state laws relating to building conslnetion, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize reprusculatives of this city to enter upon IIIc above+nermioned property I'or inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (Wc) agree to save, indemnify and keep harmless the City ul MISC.- REFER TO ORD. upenino against liabilities,judgments, casts and expenses Which stay lin J h against salt City in consryucna'e of lI PERMIT ISSUANCE - 10.00 CONST.TAX LdoHng to /y MECH.CONT. LIC.NO. MECH. %%y � / _ , , TOTAL T�,� Signal real Applicnnl/Co ru or U OFFICE COPY POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER - l CITY OF CUPERTINO = 16290 INSPECTION DIVISION JOB INSPECTION RECORD - PERMIT EKPINATION JOB ADDRESS_ 700 ,14/nA/30 vIJC.7 UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER Q CONTRACTOR IS NOT STARTED WITHIN E E 180 DAYS OF PE�t MIT ISSU- a S -• - t ' E - ANCE OR 180 DAYS FROM FOUNDATION NOTE: LAST CALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PI RnaT VAL1UATION PREGUNITE CUPERTINO STANDARDS. GARAdE SLABS --� UNDERGROUND /SLAB PLUMBING ISSUANCE UAIL ELECTRICAL �1 G ELIX' 11.6 Mf Lrl MECHANICAL ❑ ❑ 7ffU-,W,P,UUNiF,LUUN(UNTILqABUYUiHAS;BEEN,'SIUN .1 ro WOOD FLOOR N SIFT, PLUMBING C\m Bt �' Tj-Q. MECHANICAL PN MR TO ELECTRICAL 1011464 : !E FRAMINGsRuu[5 TYPE CONSTR INSULATION ��- 0§w 0k 'Pop G, OCC GHDUP RES UNITS E� /y •ea> mt o Lcbr • � I �` EE. E I I %�'�1 S() FI.FLOONANEA IOIAL ACREACF ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID UILUINURES IND CON USE PR (1.1- ROOF SHEATHING Ey� p- - �(� 0 111. YI It � I IIIf + � Y� lf$ ^` "2T"' ASSESSOHS PARCEL NO ROUGH SANA PLUMBING 0 fj' ELECT.ENERGY TRACINO PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACG.DATF nCCFILENO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG,SITE.NO, INSULATION PLUMBING GAS TEST GAS FIRE SPRINT( ENERG'I T}a MECHANICAL 12-27 YE] NY 1] N❑ C OW T BD E ONE HEATING FLOOD 70NE AL UC EXTERIOR SHEAR rp/ _ ELECTRICAL RELEASE ;7 V-YX 10 N 10No INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE ' *'- ��'l EXTERIOR LATH BUILDING L'L7 BUILDING , INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS O TA E $ . OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC . LUONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING d�- O PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL IMPORTANT! — SEE PERMIT FOR EXPIRATION DATE — coNST.TAX . '. PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. OFFICE COPY CITY OF CUPERTINO 10300 Tolre Avenue Telephone 252-4505 INSPECTION NOTICE Pt7BLIa0RKSU ATE Z ADDRESS � / DAILY REPORT r-1CORRECTIONNOTICE VIOLATION ❑ TYPE INSP.: BLDG. ❑ ELEC. ❑ PLBG. MECH. ❑ �i r mAir Lv-L � u✓ � . tri lit 271 r� Q � viq �� Grrfv h e�ciY WEATHER INS - . : r � � � .3K, . _ . , . . . � «� � . � . . ff - \ ® : : s � �=c /� . ` ` \ :�.� y . � . . : \ . � �- a »� » � «} > � �\/{� \.2� � . . . � r�y;.«»« . � \ . . « �� > � « » � * � ��� \ \� ©�