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15534 POST THIS RD NEAR FRONT OF BUILDING PERMIT NUMBER .CIOF CUPERTINO l 15534 INSPECTION DIVISION JOB INSPECTION RECORD . • 1 9 I', S' �OO 6 A' ' PERMIT EXPIRATION JOB ADDRESS /�/a.] �r WJ'L FC' 7�1� r UNIT# # - ^- L - i PERMIT EXPIRES IF WORK OWNER lJN- (/ CONTRnCTOR /i-'S' Lj'7aIIS NOT STARTED WITHIN INSPECTION DAT INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180-DAYS FROM NOTE: - LAST CALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE-SHALL BE INSTALLED PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS, GARAGE SLABS -POUR NO NOCONCRETE UNTIL ABOVE HAS BEEN SIGNED .Z[.� SV.. ILO D ='mow _�, �,.. ', ' - •""� UNDERGROUND/SLAB PLUMBING ELECTRICAL - - - ISSUANCE DATE MECHANICAL . - BLDG- ELPCT I PLG. MECH. ❑ ❑ . ❑. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT I N FORMATI ON WOOD FLOOR - ' . ALUATtON SIFT, PLUMBING _ - ` MECHANICAL ELECTRICAL Or _%/0,0 PERMITT FRAMING 1AjT �c;'!4m-- BTORIF.S TYPE CONSTR, INSULATION ' _ i OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO FT.FLOOR P EA TOTAL ACREAElE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2 4 BUILDING USE ROOF SHEATHING' ' RES IND AN ,PB Oma, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 0 0 0 0 ROUGH - - SANA _ ASSESSFIRSPARCELNO -+ PLUMBING ELECT.ENERGY TRACT NO. PARCELNO TUBS 8 SHOWER PAN PLUMBING ENERGY - MECHANICAL ' , MECH.ENERGY ELECTRICALBUILDING ENERGY ACC DATE ACC-FILE NO , FRAMING -( - ELECT.FINAL TEST, INSULATION NJ PLUMBINGZONING ENG.SITE NO. -2 GAS TEST GAS MECHANICAL FIRE$PRINK ENERGY h2< COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING _� ❑ ' "❑' ❑ "❑ . - EXTERIOR SHEAR .' - ELECTRICAL FLOOD ZONE: A.L.U.0 -.RELEASE INTERIOR SHEAR FIRE DEPT. - " ❑ "❑ ❑ N❑ SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING -2- BUILDING INTERIOR LATH TEMPORARY APPROVAL SCRATCH COAT ELECTRIC PLAN CHECK . GAS - - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE L. OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUI LDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 00 PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE IMPORTANT! coNsr.rnz PLEASE READ REVERSE SIDE BEFORE 5 CALLING FOR FINAL INSPECTION. TOTAL lo�fU OFFICE COPY APPLICANT TO FILL IN INFO MATION WITHIN RED LINES - USE q 'LL POINT PEN ONLY BU LD1 NG PROJECT I DENTI IC .PERMIT NUMBER BADDRESS UDDING APPLICATION & PE T 15534 �0 /23 _ BUILDING - ELECTRICAL-PLUMBING-MECHANICAL- , OWNER'S \' NAME PLAN CHECK VALIDATI x �1��/r4 �&PN / ,y/ 1� OTS'- ELECTRIC PERMIT .' FEE corvr TOP's W UTLETS-SWITCHES-RECEP 10.00/1.00 �0� 7`f NAME Cr. sY - �.^ -w- eIC JY r�W LIc.rvFo.NLW LIGHTING FIXTU RES 10.00/1.00 C NTRACTOP'$ ' `� ' ADORESs ! �S S-.SCAJ,L,1�ynws tyrq.ahp PPLIANCES-RESIDENTIAL 4.00 PRONE PANELS 10.00 GATE OF APPLICATION O . - 0RCHITEGr� ,S "�S ti f PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.,NO. Vl\ R r-lq-^�f ENGINEER / - uc.ry SIGNS TRANS. 3.00 ARCH.OR ENG. ADDRESS PERMIT VALIDATION - 832 p _N _^ SPECIAL CIRCUIT 5.00 a-} (�L( TEMP.METER-OR POLE INS. 20.00 �n..'�'• ; APPLICANTS ADDRESS MOTORS SEE FEE SCH. oREss � SERVICE CHANGE 20.00 w ¢ z /2 Hoo LICENSED CON'T'RACTORS DECLARATION �7 1/• a z w I hereby affirm that I am licensed under provisions of Clapler 9 ISSUANCE DATE _ ¢ vAi (commencing with Senion 7000)of Division3 0l the Business and BLDG. ELECT. PLG. MECH. H o z Professions Code d my license is in full fort f - o i" License Cha Lic.Number ❑ ❑ ❑ . r u� Date Controctor ¢_ ¢ a OWNER-BUILDER UFCLA RATION ING PERMIT U er ORMATION w ;' y I hereby affirm that I am exempt from [he Contractor's License MISC.- REFER TO ORD. u o j Law Ibr the fWlnwing reason.(Sec.7031.5,Business and Professions VALVA p $/FT. � Code:Any city or county which requiresupermit toconNn¢Lal(eq PERMIT ISSUANCE - 10.00JEE x, �tb er ce ¢ improve,demolish,or repair any structure,prior 41 its issuance,also ELEG CONTR. LIC.NO. (_W/ 0 LL rcyuires thea titan[for such ELEC. PERMIT TO w hisBuw(Cha nd Procosions Code)th Section is Isem(D therefoof the / / ��•/ Fe /.O� • E 4 0 Business and Professions Code)or that vi diexempt action 70 and DTV. PLUMBING PERMIT rc H the basis for the alleged exemption.Any violation nl,(Section inn 7031.5 La ; by any applicant for a permit subjects the upplicant to a civil penalty STORIES TYPE CONSTR. Of not more plan five hundred dollars(5500).): ALTER-DRAIN& VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wa . .00 Side ges as BACK FLOW PROTECTDEVICE 4 Their e compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale(Seca 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of 11OP111Y who build,or Improves lllereoll,and who does Such work FIXTURES-PER TRAP 5.00• 50.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,the building GAS EA.SYSTEM-1 INC.4 OUTLETS 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 im. GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB. Othe, ❑ 1,as owner of the property,am exclusively contracting with licensed contactors to construct the project ISec.7044,Business LAWN'SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. 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-OVER 5(EA.) 1.00 contracts for such pmjeets with o contactorls)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10,00 TRACT NO, PARCEL NO. ❑ I um exempt under Sec. ,B.&P.C.for Chia reason WATER HEATER W/VENT 6.00 Owner Dote WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKIiRS'COMPC:NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy Nok,f(S�ec. _"r,111W,2m Policy NoGFd copy is hereby F fd. $Q$111I` S fiA 0 61"Cenified copy isherebyriled furnish cd. FIRESPRINK ENERGY T-24 Z Z -(�I Certified copy is filed with the airy inspection division. � - Applicant MISC.- REFER TO ORD. YE] NE] Y ❑ N� � T CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W COh/P17NSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O (This section need not be completed if the permit is for one TOTAL Y 0 N Y [] NE :) Z hundred dollars($100)or less.) U O 1 LL1 iry that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued,I shall not employ any person in any manner so as to O w become subject to the Workers'Compensulion Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5.001BUILDING t� } 0. NOTICE TO APPLICANT: If,alter making this Certificate of lix- F ? emotion,you should become subject to the Workers'Compemsalton APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith.comply with FEE C.1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000GF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 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. 'MICROFILM ' 3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name- Len der'sAddress HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read(his application and slate that the above VENTILATION FAN (SINGLE) 4.00 • information is correct.1 agree to comply with all city and county PLUMBING - ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,0008.T.U.) 6.00 hereby authon" representatives of this city to enter upon the 801 LER-COMP Over 100,000 BTU)SEE FEE SCH. - above-mentioned property for inspection purposes. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC:- REFER TO ORD. upertino against liabilities,judgments, costa and expenses which CONST.TAX ay i any way accrue against said City in consequence of the - PERMIT ISSUANCE 10.00 Nan o (hi ermil. ! MECH.CONT, LIC.NO. MECH. lR� TOTAL TOTAL T�p4 S nature AppbcaN/ 'onlractor Date OFFICE COPY