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14165�• POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO. INSPECTION DIVISION JOB INSPECTION RECORD ' JOB ADDRESS 10150 TORRE AVE UNIT# LOT# OWNER CHATEAU CUPERTINO CONTRACTOR JOHNS HEATING PERMIT NUMBER 14165 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION UFER PREGUNITE PERMIT VALIDATION ISSUANCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL BLOC. ❑ ELECT. 1 ❑ 1 PLG. I MECR. ❑ 13 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 2nak„loE ox, F UILDING PERMIT INFORMATION VALUATION $IFT. WOOD FLOOR PLUMBING ' MECHANICAL - ELECTRICAL .�, .t. PERMIr TO •:�rin STORIES TYPE CONSTR. FRAMING INSULATION .i1'y� - OCC.GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SQ FT. FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE PES IND CON PB OV", ❑ I] ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH ASSESSORS PARCEL No. PLUMBING GAS TEST TRACT NO. PARCEL NO, MECHANICAL ELECTRICAL?aei- FINALS DATE INSP. ACC.OATE ACC. FILE NO. FRAMING SAN tk INSULATION - PLUMBING ZONING ENG. SITE NO. GAS • MECHANICAL FIRESPRINK Y [j N[:] ENERGY T 10 Y ❑ NC] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH—INTERIOR ELECTRICAL FLOOD ZONE v rv� a. L.u.c. 'v �] N❑ LATH—EXTERIOR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING ' BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS - FIREWALLS ELECTRIC PLAN CHECK FEES GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEWySIGNEO OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, H ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z' —SEE PERMIT FOR EXPIRATION DATE — ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY .-�4 0L 0¢ z FOO QUU „ay 0?�0 H ~ ¢ ¢ ¢ V X 3c H Hu- O� Z ce in > i ¢¢stO u � z < Ei0 a 3 119 O P 0/7 CC T W CL Cl :)z UO LL U Oa >- y h ? 0 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING -ELECTRICAL- PLUMBING -MECHANICAL PERMIT NUMBER 14165 DYILDING ., ADDRESS OWNERS NAME 1 OTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION Name acrclas OUTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1,00 DATE OF APPLICATION CONTRACTORS ADDRESS ADDRESS G.et7s R APPLIANCES - RESIDENTIAL 4.00 PANELS 10,00 RRCHIrec OR ENGINEER ua No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.No. ISIGNS TRANS. 3.00 ARCH. Ess ENG. SPECIAL CIRCUIT S.DD PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP APPLICANTS ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 o LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE (Commencing with Section 7000) of Division 3 of the Business and Professions Code, a d m license is in full force an e st. , License Class S Lic. Number- �'_ BLDG. ❑ ELECT. I ❑ PLG. MECH. ❑ Date Contractor BUILDING PERMIT OWNER -BUILDER DECLARATION sacd P License r I so exempt from the ContraBusiness I hereby affirm fthatollowing Law for the ityowingreaeon.(hrequi3st, per sit tocnd Professions a tune permit toconsua c alter, Code: Any city or county which structure, 11s issuance, also improve, or repair any to fi pa INFORMATION MISC.- REFER TO OR VALUATION PERMIT ISSUANCE 10.00 ELEC. CONTR. LIG. NO. EOTA requires the applicant for such permit to file a signed statement that the permit sin he is licensed pursuant In the provisions o the700 Contractor's License of Division 3 a the Law (Chapter 9 (commencing with Section is exempt Business and Professions empt or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section TOTAL PER O 77rrrr'''''' C DTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. malty by any applicant fora permit subjects the 0).): ant toacivil penalty of not mom than five hundred dollars (EE00).1: ALTER-DRAIN&VENT-WATER(EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as (heir sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 intended or offered for Sale (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 does such work FIXTURES - PER TRAP 5.00 $D, FT. FLOOR AREA TOTAL ACREAGE himself or through his own employees, provided that such improve- ments arc not intended or offered for sale. If, however, the building GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or hit- prove for purpose ofsale.). ❑ I, as owner of the properly, ant exclusively contracting with GAS - EA. SYSTEM - OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PB Other ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. licensed contractors m construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law docs 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 it contmemRs) licensed pursuant to the Contmcmr's License Law. SEWER -SANITARY -STORM EA. 200tt/10,00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-, BAP.C. for this reason WATER HEATER W/VENT 6.00 Owner Date 5.00 WATER SYSTEM ACC.OATE ACC. FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificateof L.na.myni to self -insure, or a certificate of Workers' Compens' in or r/�tdied ZONING ENG. SITE NO. aor I O copy thereof(Sec. 3800, Lab.C.). 2�w Policy No. Cmnpito -� FIRE SPRINK ENERGY T 24 ❑ Certified copy is hereby f rmsm d. ❑ Cerlifi�d �'opy is til •d�wlth the city Hart Applicant -'it �rjF Y N ❑ ❑ V N ❑ ❑ MISC.- REFER TO ORD. CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. PLG.CONTR. LIC. NO. PLG. TOTAL COMPENSATION INSURANCE. (This section need not be completed if the permit is for one YE] N❑ Y❑ N❑ D V MECHANICAL PERMIT FEE .. FEE SUMMARY hundred dollars IS 100) or less.) I certify that in the performance of the work for which this or, mit is issued. I shall not employ any person in any manner so as to BUILDING become subject to the Workers' Compensation Laws of California. Dam Applicant NOTICE TO APPLICANT: If, after making this Cerlificate of Ex- ALTER OR ADD TO MECH, 5.00 APPLIANCE --0:5,00 PLAN CHECK emption, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked FEE ! AIR HANDLING UNIT (TO 1Q000,QRNU' 4.00 �p p AIR HANDLING UNIT (OVER 10=C.EM.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.CJ. EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC PLUMBING Lender's Name Lender's Address I certify That I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and stale laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 BOILER- CDMP(3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL -- hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Iii REFER TO ORD. CONST. TAX (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may iway Seem gainst said City in consequence of the PERMIT ISSUANCE 10.00 d MECH. CONT. LIC. NO. MECH. gra n th' per: 't r i TOTAL/3 Q- TOTAL I of Mpplic,DTCodfracfimD3K I OFFICE COPY