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0133 ;APPLICANT TO FILL-IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY 'SBO I LOI NG PROJECT I DENT[FICATION - PERMIT NUMBER e BUILDING APPLICATION & PERMIT 0133 ADORE6s OO SCEN)G /SC�/!) 4a BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S NAME PLAN CHECK VALIDATION QTY. ELECTRIC PERMIT FEE •C' PRONE 739 sHV6 .3 CONTRgC DR'S Name gp UTLETS-SWITCHES-RECEP 5.00/1.00 en c6a;t. uC.ND. 7/•S�iLIGHTING FIXTURES 5.00/1.00 aODRE65 °f•V6 APPLIANCES-RESIDENTIAL^ 4.00 U Q, PHONE J �3 PANELS 5.00 DATE OF APPLICATION ARCHITECT - SIGNS 6.00 PLAN CHECK FEE P.C.NO. OR < / Lie NO ISIGNS TRANS4fTr7"PERTJN0 3.00 ADDRESS ENG, SPECIAL CIRCULI, 6.00 PERMIT VALIDATION VA AC I SC.00AZIP EMP.METER L I 15.00 APPLICANTS, MOTORS SEE FEE SCH. p SERVICE CHANGE 10.00 �- p' 00 LIC17NSED CONTRACTORS DECLARATION - L//a/p a IN u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE r z m (commencing with Se tion 7000)of Division 3 of the Business and Mr¢ ,^q n BLDG. ELECT. PLG. MECH. r Z Professions Code,s y license is in full fare t ' 'i o - License CI Lie. Number iw t w )am Contractor ar z w ss OWNER-BUILDER DRCLARA ON S• - BUILDING'PERMIT o A U INFORMATION w ; r I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD r u o v, Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 6.00 VALUATION $/FT. vs� Code:Any citycreounty which requires a permit to construct,alter, o N Q Q ¢ 0 LE improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR.. , LIC.NO. ELEC. O ? 0 6 e. D M requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO w$u, he is licensed pursuant to the provisions of the Contractor's License. r Law(Chapter9(commencing with Section 7000)of Division 3 ofthe .SFD{�. F i 40 Business and Professions Cade)or that he is exempt therefrom and GTY. PLUMBING PERMIT FEE ¢r the basis for the alleged exemption.Any violation of Section 7031,5 STORIES TYPE CONSTR. a ; - by any applicant for a permit subjects the applicant hoa civil penalty ALTER-DRAIN (EA.) 4.00 2 of not more than five hundred dollars(S500).): P ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 2.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not - - intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 4.00 Code:The Contractor's License Law does,not apply to an owner of property who builds or improves Iheraon,and who does such work FIXTURES loft4.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. rents are not intended or offered for sale.If,however,the building GAS-EA.ST S 4.00 /7Q 7 264 $f or improvement is sold within one year of completion,the owner- GAS•EAS ST O (E .1 1.00 builder will have the burden of proving that he did not build or im- . BUILDING USERES prove for purpose ofsar.). INDUSTRIA A EI 20.00 IND CON PB Omar ❑ I,as owner of the property,am exclusively contracting with ' licensed contractors to construct the project(Sec. 7044,BusinessLAWN SPRINKLERS-1 INC 5 VB500 ASSESSORS PARCEL No. and Professions Code:The Contractor's License Law does not apply V.B. . to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.I 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. SEWER-SANITARY-STORM EA.200ft/8.00 TRACT NO. PARCEL NO. ❑ lam exempt under Set..,B.&P.C.for this reason WATER HEATER W/VENT 4.00 7005 Dae Owner WATER SYSTEM 4.00 ACC.DATE - ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 4.00 I hereby affirm that I have a certificate of consent to self-insert, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.CJ. AJO Policy No. Company . 0 ❑ Certified copy is hereby fugh' . FIRE SPRINK ENERGY T 24 Z Z ❑ Cenified is Iled il6t le 'in7cuon division. p Applicant , y w � b v• MISC.- REFER TO ORD. Y[:] N v ® N[ i= CERT ATI: PE%IiMI'TION FROM WORKERS' PERMIT ISSUANCE 6.00 FLOOD ZONE A.LU c. LUL COMPENSATION INSURANCE PLG.CONTR. - LID.NO. PLG. Z (This section need not be completed it' the permit is for one TOTAL Y[:] NC] Y [3 No U O hundred dollars IS 100)or less.) I certify that in the performance of the work for which this per. PTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mitis issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. U y Date Applicant ALTER OR ADD TO MECH. 4.00 BUILDING qs�� } 0 NOTICE;TO APPLICANT: If,after making this Certificate of Ex. Gs emption,you should become subject to the Workers'Compensation APPLIANCE 4.00 PLAN CHECK provisions of the,Labor Code, you must forthwith comply will, FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000CF.M.) 3,00 CONSTRUCTION L17NDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 5.00 SEISMIC FEE s8� I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 2.00 the performance of the work for which this permit is issued(Sec. Lender's MICROFILM Lr'iv.C.). �nwa HEATING UNIT 170 100,000 B.T.U.) 4.00 Lender's Name Lender's Addreee 1171 HEATING UNIT(OVER 100,000 B.T.U.)7,50 ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE). . 3.00 information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 4.00 PLUMBING ordinances and state laws relating to building construction, and J hereby authorize mi,mientatives of this city It) ender upon the - 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. Cupertino against liabilities„judgments, costs and expenses which PERMIT ISSUANCE 3.00 CONST.TAX may in any way accrue aiiansteAjid City in consequence of the grannhis pC mit. - MECH.CONT. LIC.NO. MECH. 440 TOTAL TOTAL !Q Si pp cant/Contractor Date I OFFICE COPY N lk 10300 Tor phone 252-4505 INSPECTION • BUILDING DIVISION DATE ADDRESS TIME DAILY REPORT ■ ■ VIOLATION ■ ,G ELEC. PLOG. ■ MECH. ■ CITY OF CUPERTINO INSPECTION • BUILDING DIVISION DATEi ADDRESS % Cl2 DAILY REPORT ■ CORRECTION NOTICEE] VIOLATION Cl TYP : . . ■ ELEc. ■ PL13G. ■ MECH. ■ eoll ar i/i/y / 111 -_I A/19 _ 1�!-- l/� i WEATHER INSP. i� CITY OF CUPERTINO 10300 Torre Avenue Telephone 252-4505 INSPECTION • BUILDING DIVISION - ._ ADDRESS TIME DAILY REPORT D- ■ CORRECTION NOTICE5a .� ■ a4a 6o CITY OF CUPERTINO 10300 Torre Avenue Telephone 252-4605 INSPECTION • BUILDING DIVISION JOB DATE J ADDRESS D \ • • 1TIME GLY REPORT 0 CORRECTION NOTICE VIOLATION ■ ■ ELEC. ■ PLSG. . ■ k . A a1r.� �� ' `• • �^ 10 d J-fit 1 ctL WEATHER INSP. //V� CITY OF CUPERTINO 10300 Torre Avenue Telephone 252-4505 INSPECTION NOTICE BUILDING DIVISION JOB DATE ADDRESS ` V �7 C�P L O TIMEAf'N K�^ &Y REPORT ❑ CORRECTION NOTICE ❑ VIOLATION❑ TYPE INSP.: BLDG. ❑ ELEC. ❑ PLBG.❑ MECH. ❑ gzLz rly Q-r -r U NmT bL Ft-0-a&. ralzq , 2. gja2ay I-fig A w Q cQat"erb c r S N Ig Spec UROIH 63 �s�►Z Jzu,c mfr WEATHER INSP. CITY OF CUPERTINO 10300 Torre Avenue Telephone 252-4505 ' INSPECTION NOTICE BUILDING DIVISION 1 JOB DATE ADDRESS U C fW-C cPYI TIME• . SLY REPORT F-) CORRECTIONNOTICE❑ VIOLATION❑ TYPE INSP.: BLDG. ❑ ELEC. ❑ PLBG.❑ MECH. ❑ CS WEATHER INSP. CITY 01' CUPERT'INO INSPECTIOL' RECORD (Office Copy) N . 0Li3 _2 10047 Scenic Blvd....... ._... PIMUT NO. SANITARY DIST. I10. LOT NO. A1)1)RFSS �• Single Family Thaelling M_c_ lim, partnership PROJECT OI•ir]ER JOB SITE PHONE N0. PERMIT ISSUED Date ELECTRICAL Building 5-13-81 Date Insp. Electrical Power Pole Plumbing - - Underground Mcchnnical -S-rl P.ou ,h WiringJ-1 _ Temp. Cas/Elect. Waal�s Solar y_S _/ Ceiling Fire Sprinkler Fixtures Int/Ext , Sign Notors Grounding Hisc. Temp. Power Other _ FINAL. I14SIlECTIONS Not Approved D to Insp. r,F.s Electric .a_yy PLUMBING , r Plumbin , _,Z_�j_ Date Insp. Backflow Mechanical 9-1- of Underground _ Solar Underfloor Pool 6af Partial P.ou h GradingRough Complete F ire Det. Solar Rough �- -- Firs De [dater & Insulation /gtic�o� w/d�v�-20- health Dept. :gain Drain �— Buildin R/of/S Drain Other Gas 8 Other ,W BUILDING Not Approved Date Insp. Pad Certification A MECHANICAL Foundation ).1Z ( Date knsp. Pre-Gunite. Underfloor S.M. Slab-Membrane Ducts & Insulation Bond Beam Fire Dampers Underfloor Girders Fireplace Floor Steel Grease Duct & hood _ Tiedoums One (lour Shaft Diaphrams Condensate Drain Seismic ]tracing Equipment Anchorage halls-Panels Flues & Comb. Air Frame Other Lath Not Approved Uallboards n /Ext. -/ Firewalls Other Not Approved Ell 6* BUILDING ELECTRICAL PLUMBING w MECHANICAL MISCELLANEOUS