The URL can be used to link to this page

17587.. , 10 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION ./�J JOB, I`NSPEC/TION RECORD JOB ADDRESS % / i S STI NS C.k„ C '�-1/�/1�U�NIIT.#� _LOT# OWNER burl: Ai) S d*/�"-AM C)4Lf� PERMIT NUMBER 17587 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- OR 180 DAYS FROM LASTCALLEDI SPfCTION.dt INSPECTION DATE. INSPECTOR INSPECTION RECORD FOUNDATIONANCE' NOTE: ALL.GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY_OF CUPERTINO STANDARDS. - UFER - PREGUNITE PERMIT VALIDATION, - 5�}`" �. F t`` iL�V Issunrvcs unrtt GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PAID UNDERGROUND/SLAB PLUMBING mAy9 ELECTRICAL MECHANICAL cityof Cupeil -I . ELECT. I PUL MEGR DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. �t PLUMBING MECHANICAL ELECTRICAL Per�nuT rO - FRAMING INSULATION STORIES - TYPE CONSTR. -- UCC. GROUP TIES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID 50 IT, FLOORAREATOTAL, - ACREAGE DIAPHRAGM ROOF SHEATHING BUILDING use REs IND CON Pe our.. 0 ❑ El ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.N SSESSORS PARCEL NO --75—ACT PLUMBING ELECT. ENERGY TUBS & SHOWER PAN PLUMBING ENERGY NO. -- ' PARCEL NO MECHANICAL, MECH. ENERGY ELECTRICAL BUILDING ENERGY - ncc OnrE ACE FILE NO FRAMING • – ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG. SITE No. GAS TEST GAS -- ' MECHANICAL .FIRE SPRINK " .ENERGY T 24 "[j COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE clooO ZONE Y ❑ NEl .AIL c. v ❑ No INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEESUMMARY EXTERIOR LATH- BUILDING 5'—ZL'�" O BUILDING - 7r1� INTERIOR LATH..' TEMPO RARY• APP ROVALS SCRATCH COAT ELECTRIC PLAN CHECK' FEE } sC �t }•� - GAS - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252.4505, FONE WORKING DAY BEFORE REQUIRED INSPECTION. O� PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL — SEE PERMIT FOR EXPIRATION'DATE — ELECTRIC PLUMBING coNsr. rnx IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL 11ISPECTION. TOTAL f U!I �— OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL - PERMIT NUMBER 17581 BURPINGAPPLICATION ADDRESS 1s SN/� C OWNER'S / % rr�� /% NAME G % /7! �� r PHONE QTY. ELECTRIC PERMIT.- FEE PLAN CHECK VALIDATION CONTRACTORS AME AcrORs S% UTLETS- SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1'ONT.00 r uc. No. .f' ' Acro ADOREss ADDRESS APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPL ICATION _ ARRCHITECT ENGINEER LIC. No.SIGNS PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. TRANS. 3.00 ADD ESS ENG' SPECIAL CIRCUIT . 5.00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 ZIP 1 . IA T-D� `3 f' k J Y'11 ILS Y G ) Qq C3 I ADDRESS ADDRESS ' MOTORS SEE FEE SCH. SERVICE CHANGE 20.00, LICENSED CONTRACTORS DECLARATION MAY I I IDG. I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr lessions Cotte, and my license is in full force and effect. 'iL License Class Lie. Number ISSUANCE DATE ' ELECT. PLG. MECH. ❑ ❑ ❑ Date Contractor CIq� f Cu OWNER -BUILDER DECLARATION hereby affirm that I am exempt from Um Conlrnc[or's License Law for the following reason. (Sec. 7031.5, Business and Professions Code: Any city or county which tell Ci res a permit to construct, alter, improve,demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contrew or's License pe P BUILDINGPERMIT INFORMATION MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 - VALUATION O $/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO OTY. PLUMBING PERMIT FEE Law (Chapter 9 (commencing with Secl ion 7000) o' Division 3 of the Business and Professions Code) or that he is exempt therefrom and t q�. the basis for theolluged exemption. Any violation of Sectio 17031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): STORIE7 TYPE CONSTR. ALTER -DRAIN -WATER (EA.) 5.00 ❑ 1, as Owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP • RES. UNITS intended or offered for sale (Sec. 7044, Business and Professions Code Code: The Contractor's License Law does not apply to an owner of ROOF, AREA, CON D. 5.00 FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -11PIC. 4 OUTLETS 6.00 property who builds or improves thereon, and who does such work himself or through his Own employees, provided that such improve- mentsare not intended Orofferedfor sale. If, however, the huilding SO. FT. FLOOR AREA TOTAL ACREAGE or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or int- GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE prove o sale.). ❑ I,, aas s owner wner of the property, am exclusively contracting with RES . IND CON PS Other ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS- 1 INC 5 V . 6.00 licensed contractors to construct the project (Sec. 7044, Busine» and Professions Code: The Contractor's License Law does not apply ASSESSORS PARCEL NO. 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 conlractorlsl licensed pursuant to lite Contractors License Law. ❑ I am exempt order SC,.-, B,&P.C, for thio reason SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO, WATER TREATING EQUIP, 5.00 WORKERS'COMPENSATIONDECI.ARA'r(ON, 1 hereby affirm that I hove u vicHificme of consent toschGjhmum, ZONING ENG. SITE NO. or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 31400, Lab.C.). Policy No. Company ❑ Certified copy is hereby furnished.• copy is filed with lite city inspection division. Applicant MISC. - - REFER TO ORD. FIRE SPRINK Y ❑ N❑ ENERGY T-24Curlified ' Y [:DN[:] CER'I'IFICA'LIZ OP EXEMPT ION FROM WORKERS' C014ENSATION INSURANCE (This section need not he completed if (he permit is for one PERMIT ISSUANCE 10.00 FLOOD ZONE Y ❑ N❑ A.L.U.C. Y ❑ No PLG. CONTR. LIC. NO. PLG. ' TOTAL hundred dollars IS 100) or les.) I Certify that in the performance of the work for which this per- mit is issued, 1 shall not employ any person in any manner+o us m CITY. MECHANICAL PERMIT FEE FEE SUMMARY become subject to the Workers' Compensation Laws of California. ALTER OR ADD TO MECH. 5.00 Date Applicant BUILDING ��' NO'1'IC17 TO APPLICANT: If, aIle, making Ihis Certificate of lix- APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=11F.M.) 4.00 PLAN CHECK FEE '� /� ICV l Emptied, you should become subject to the Workers' Compensation provisions OI' the Labor Code, you must forthwith cont ply with such provisions o, this permit shall be deemed revoked. AIR HANDLING UNIT (OVER 10=C.EM.) 6.00 SEISMIC FEE Ay1 F�v CONST' RUC'I' ION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 I hereby affirm that there is a construction lending agency for tilen pero onee of the work for which this permit is issued (Sec. 3097, Civ.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 benders Name lender's Add,- ss HEATING UN IT (OVER 100,000 B.T.U.) 9.50 ELECTRIC VENTILATION FAN (SINGLE) 4.00 I Certify that 1 have read this application and stale that the above Information is correct. I agree to comply with all city and county ordinances and stale laws relating to building construction, and PLUMBING BOILER -COMP (3 H.P. of 100,000 B.T.U.) 6.00 ' authorize herebhereby authorize representatives ec this City to enter upon the y eritimeed property I'orinsp oftion purposes. BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL (We) agree to save, ind unify and keep harmles the City of Cupertino against liuhilitic, udgments, costs :md expenses•whidl ay in any way accrue met said City in e.ma, ten of the ranting fthis ,nit --t �� / Signatu IA can[/Co tact r to MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX MECH.CONT. LIC. NO. MECH. TOTAL TOTAL 4� OFFICE COPY