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14836POST•THIS CARD NEAR FRONT OF -BUILDING PERMIT NUMBER ' CITY OF CUPERTINO 14836 INSPECTION DIVISION JOB INSPFCTION RECORD ; PERMIT EXPIRATION JOB ADDRESS 10951 .Santa .Teresa Drive UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER C. Elfving - - CONTRACTOR IS NOT STARTED WITHIN - 180 DAYS OF PERMIT ISSU- ' ANCE, OR 180 DAYS FROM INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION_ NOTE: LASTCALLED INSPECTION.' LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PREGUNITE PERMIT VALIDATION. CUPERTINO STANDARDS. "I I r -._ / , ISSUUA�NCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - UNDERGROUND/SLAB PLUMBING P ELECTRICAL MECHANICAL - Luc =FEE 0 MEr,R •. El 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED '- •^„ AlouW auaowc PERMIT - INFORMATION VALUATION SIFT. WOOD FLOOR PLUMBING � � - ' MECHANICAL ELECTRICAL PERMIT TO� - f�^ FRAMING INSULATION STORIES TY PL CONSTR, OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID - SO FT. FLOOR AREA TOTAL ACREAGE - • ' DIAPHRAGM ROOF SHEATHING BUILDING USE RES IND CON PB O"", ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.1:1' ROUGH _SAN tf.- ASSESSORS PARCEL NO, PLUMBING - ELECT. ENERGY TUBS & SHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO ' MECHANICAL - MECH. ENERGY ELECTRICAL BUILDING ENERGY ACC:DATE ACC FILE NO FRAMING ELECT.FINALTEST _/l) INSULATION - - PLUMBING ZONING ' ENG. SITE NO. , GAS TEST GAS MECHANICAL FIRESPRINA ❑ ENERGY T-4 Y 1:1 NE], COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED' HEATING EXTERIOR SHEAR ELECTRICAL RELEASE 'r LDDu;GNE y ❑ N ❑ A.L U,c ❑- i,, El INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH - BUILDING" BUILDING .INTERIOR LATH TEMPORARYAPPROVALS SCRATCH COAT ELECTRIC - - PLAN CHECK 'FEE' GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE ;-u OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F� ONE WORKING DAY BEFORE REQUIRED INSPECTION. O PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING Z - SEE PERMIT FOR EXPIRATION "'DATE — MECHANICAL CONST. TAX, IMPORTANT!, PLEASE READ REVERSE SIDE -BEFORE CALLING FOR FINAL INSPECTION. TOTAL. j .r OFFICE COPY !7 w¢z Foo QUU FzOw m a a oH- ozr0 in X 3 n I_ F u 0 my 2 6 O p LL F z a Sia I -m prm 40 A W 0 APP.rLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BLALDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING — ELECTRICAL— PLUMBING —MECHANICAL - PERMIT NUMBER ' 4836 BUILDING ADD ESS S C` '��. y •M• OWNER' - - PLAN CHECK VALIDATION NAME r V Iin PHONE 1_)J a- M OTY. ELECTRIC PERMIT FEE NAMERACToms_J UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00' LIC, NO, CONTRASDDRESS DRs A APPLIANCES-RESIDENTIAL 4.00 PANELS .10.00 PHONE DATE OF APPLICATION ARCHITECT - ENGINEER LIc, No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. ISIGNS TRANS. 3,00 ADDRESS ENa SPECIAL CIRCUIT 5.00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP APPLICANTMOTORS ADMDRESS ESESEE FEE SCH. SERVICE CHANGE 20.00�� - LICENSED CONTRACTORS DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) Of Division 3 of the Business antiBLDG. Professions Code, and my license is in full force and effect. License Class Lic. Number IS LIANCE DATE - BLDG. ELECT. PLG. MECH. F-1 , Date Contract., - BUILDING PERMIT INFORMATION VALUATION $/FT. .� OWNER-BUILDFR DECLARATION 1 hos til o ho that I sm exempt from the ContraH,,,a d I'l- License Law l'orlheity oririg ounty whichequire .a eLut to construct, alter, Code: Any mol or county which structur e p riot T o coil an e,also improve, ireapplic,nt for su any stNCtofile,t ort. its issuance, also for such permit to flea signed actor's i that thedp pursuant License he is licensed he is licensed pursuant to The provisions of the ) of Division Law(ChapterdPolfommencing Cde)orStation7000ulpttherefoof(he Business and Professionsxempt or that he is exempt therefrom and MISC.— REFER TO ORD - PERMIT ISSUANCE 10.00 ELEC. CONTE LIC NO. F� qr. TOTAL ��I9999I1 TOTAL ' PERMIT TO� uenine9P'g-xi GTY. PLUMBING PERMIT coot STORIES TYPE GDN$TR, - the basis for the alleged exemption. Any violation of Section 7031.5 byanyapplicantforapermilsubjeclstheapplicant ON Civil penally of not more than five hundred ndlarx (5500).) ALTER-DRAIN&VENT-WATER(EA.) 5.00 ' ❑ 1, as owner of the property, or my employees with wages as sole compensation, will do the work, and the 111.111H, is not BACK FLOW PROTECT. DEVICE 4.00 - ocC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AR EA, COND. 5,00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properly who builds Of improve, thereon, and will) does such wink himself or through his own employees, provided that such improve- mentsare not intended or offered for sale..If, however, the building FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 SO. FT. FLOOR AREA TOTALACREAGE or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build of im- prove for purpose ofse. ❑ I, ass owner thp of the property, am exclusively contracting with GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON . PS Oma, 1:1 1:1 E] ❑ ❑ INDUSTRIAL WASTE INTER. 30,00 licensed contractors to construct the pinjecl (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 ASSESSORS PARCEL NO. . contracts for such projects with a c.OtHanorfs) licensed puromnt to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ lam cxcmpTuWtr Sec. ,B.&I'.C. for this reason WATER HEATER W/VENT 6.00 _ OwnerDate _ _ _ WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 W RKIiRS'COMPENSA lON LARATION D.. 1 hereby affirm that I have a cenif'iew, 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.). Policy No.—Co ... pony ❑ Certified copy is hereby furnished. ❑ Certified copy is filed wfth the city inspection division. Applicant FIRE SPRINK Y ❑ N❑ ENERGY T-24 Y ❑ N❑ MISC.- REFER TO ORD. CERTIFICATE 01' EXEMI'f1ON FRONT WORKERS' PERMIT ISSUANCE - 10.00 FLOODZONE A.L.UC. COMPENSA'T'ION INSURANCE - (This section need not be completed if the pernio is for one Y ❑ N ❑ Y ❑ N ❑ PLG. CONTE. LIC. NO. PLG. TOTAL hundred dollars IS 100) or less.) I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person inanym"nnersoas to QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING •�, become subject to the Workers' Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 APPLICANT: NOTICE TO APPLICANT: If, after making this Certificate of Ex- APPLIANCE 5.00 PLAN CHECK FEE emption, you should become subject In the Workers' Compensation provisions of the Labor Code, you most forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10=C.F.NL) 4.00 AIR HANDLING UNIT IOVER 10=C.F.M.)6.00 SEISMIC FEE CONSTRUCTION LENDING AC17NCY 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 permit is issued (Sec. 3097, CN,C.), MICROFILM ' - HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UN IT (OV ER 100,000 B.T.U.) ELECTRIC VENTILATION FAN (SINGLE) 4.00 I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING gO1LER-CUMP13 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Ovel 100,000BTU) SEE FEESCH. MECHANICAL hereby aulhoifm representatives of This city to enter upon the above-mentioned property for inspection purposes. (Mi agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. Cupertino against liabilities, judgments, coals and expenses which may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 ' CONST. TAX tap 'ng of this per L . y_/ MECH. CONT. LIC. NO. MECH. TOTAL .TOTAL S' aWre .fA licant/CO actor 17 Data OFFICE COPY