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17392POSTaTHIS CARD NEAR FRONT,OF BUILDING PEPAUIT NUMBER CITY OF - CUPERTINO ,,.'. 173f ' • INSPECTION DIVISION" , . JOB JOB INSPECTION RECORD ~ PERMIT EXPIRATION JOB ADDRESS Z -Z? yj tlAj•�UNIT# E.- •_LOT PERMIT EXPIRES IF WORK owrvER 0 L f-' '�Ap rRACTOH; '. '•'r y<: IS NOT STARTED. WITHIN 160 DAYS OF' PERMIT ISSU- ANCE OR 160 DAYS FROM ,. - LAST,CALLED INSPECTION. INSPECTION - DATE INSPECTOR • INSPECTION RECORD - FOUN DATION �C, ,, NOTE:, " + �s. LIFER � - AG ALL GRADING AND DRAINAGE SHALL BE INSTALLED' TO COMPLY WITH THE APPROVED PLANS AND CITY, OF - ' 4. PREGUNITE- - •,APE LIMIT VALIDATION' - , CUPERTINO STANDARDS. ; ' • -" ..C"' ,�tg(...� '' GARAGE SLABS' ' - '' ,.POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ ., uAD'� ���J _ MAR ' •'. UNDERGROUND /SLAB _- / T �•:,J.0 C VV�A vv& ,r PLUMBING - - - ELECTRICAL - .� , . sf' TE MECHANICAL •. .. BLUE„ ELECT. ,. LG. m[cH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ry UI' - BUILDING PERMIT INFORMATION .VALUATION FLOOR $JFT. ' PLUMBING MECHANICAL ELECTRICAL FRAMING '�. INSULATION STORIES TYPE CONSITO • - 1 ,, OCC G11DDP ES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' .,ROOF - NOTE: NO FINAL INSP: SHALL BE MADE BEFORE, - THE CONSTRUCTION ?AX IS PAID • • _ _ -�.' ••, '.,( • SO IT.FLOORPREP TOTAL ACREAGE • . .' DIAPHRAGM • ROOFSHEATHING •' •4 '' �,F`' BUILDING USE - HE IND CON PB Do— • 0 ❑ ❑ ' ❑" L ,APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS- DATE ANSP.• . ROUGH' SAN.N' 'ASSESSOHs PARCEL NO PLUMBING ELECT. ENERGY, TUBS 8 SHOWER PAN � � PLUMBING ENERGY � � . . TRACT NO — PARCEL NO.'. MECHANICAL - MECH. ENERGY•'. j r, ELECTRICAL. - BUILDING ENERGY ACC DATE :ACC. FILE NO ' 'FRAMING - "- - ELECT. FINAL - TEST -,. INSULATION PLUMBING. ZONING •" ENG. SITE NO. GAS TEST.' GAS - MECHANICAL 'EIRESPRINK ENERGY Tao COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING•, EXTERIOR SHEAR ELECTRICAL RELEASE - FLUUULONE 'v.Q. ,m❑ A.L.U.C. , v (� N❑ INTERIOR, SHEAR - ( FIRE DEPT.. - SHEETROCK' _ .GRADE FEE SUMMARY EXTERIOR LATH. BUILDING - BUILDING INTERIOR LATH,', - ,'TEMPORARY APP VALS - SCRATCH COAT - ELECTRIC. PLAN CHECK FEE Y•�!• • GAS A. .. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY, SEISMIC FEE.h_ .,i OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAEISSIGNED BY BUILDING INSPECTOR. . ,MICROFILM •�^ -•�.,� ARRANGE FOR INSPECTION.BY PHONING -252 -4505, s ELECTRIC , Lu — ONE WORKING DAY BEFORE REQUIRED INSPECTION.: PLUMBING 00 PLEASE GIVE-JOB.ADDRESS WHEN PHONING. MECHANICAL ,..,' —• ` • —SEE PERMIT FOR EXPIRATION DATE-- . -. I• - CONST'TAX --- :IMPORTANT.! TOTAL PLEAS E'READ REVERSE 'SIDE BEFORE CALLING FOR FINAL INSPECTION: OF.FICE'COPY APPLLCANT TO FILL IN INFORMATION WITHIN REDLINES - USE.BALL•POINT PEN ONLY l LDING PROJECT,(DENTI F.ICATION - PERMIT NUMBER ". APPLICATION &PERMIT _ •. '' f" BUILDING:— ELECTRICAL— PLUMBING — MECHANICAL , 17 /'S1 Q I' /') . -• ', 1 "I V 92 - m LOING „ ADNESG AooRESS .j' OZ� (, 9NAME _ /MS�S� • TV. .. ELECTRIC PERMIT " FEE 1 PLAN CHECKVALIDATION ." r. - s t OUTLETS - SWITCHES - RECEP 10.00/1.60 - •uc: No ". LIGHTING FIXTURES ,.10.00/1.00 , .• _ ADDRESSTOR's y - - PPLIANCES - RESIDENTIAL' 4.00 PANELS 'A 1 10.00 - PHONE 'DATE OF APPLICATION 1 ARCHITECT - oR ENGINEER ' LIG Na, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.0 "NO. . _ - SIGNS TRANS. 3.00 ARCH, OR ADDRESS ENG. ' '^ SPECIAL CIRCUIT 5,OD � PERMIT VALIDATION ' MP. METER OR•POLE INS. - +20.00 • I nP �� `. APPLICANT jQLS/Q S ai SEE FEE SCH: ' .'20.00' " LICENSEDCONTRACTORSDLCLARATION iy I herchy affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Ilse Business'aa,] Professions Cci and my license is in full force and effect I-i,c, Class Conract.,r Date Contractor RRRVIC�CHANGIE�' + - UL:J ISSUANCE GATE BLDG.- ELECT, PLG. ' MECH. EJ �f� �.4i.� ^ity oVYAR {I L01lIY OWNIi R- RUILDER DECLn ItAT10N I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason. (Sec. 703 1.5, Buseress:ud Professions C county which structur e permit construct, alter, BUILDING PERMIT INFORMATION REFER TO ORD PERMIT ISSUANCE ,• ip,00 r VALUATION UA 0 $ /FT. ELEC. CONTR, _IC. N0. - - -- ELEG TOTAL prove, d mulish improve, demolish, or repair any structure, prior to its issuance, also o Sho requires the applicant for such perm l,tn file a signed statement that he Is licensed Pursuant to the provisions ofthe Contractor's License I.aw,(Clmpter9(comm(ncingwilh Seetion7000)of Uivision3ofthe': Business and Professions Code) or that he is exempt therefrom and _ � - , 11C. 1� 0, D W`V V - OTV. "' - PLUMBING PERMIT FEE file basis for the alleged exenrptinn. Any violation of Section 703L5 by any applicant for a permit subjects the applicant to a civil penalty, of not more than five hundred duple, (5500).): .'. - .,f ;- STORIES ; ".;TYPE CONSTR. ' gLTER- DRAIN &VENT -WATER (EA.) 5.00 ❑ 1, as owner of the properly, F my employees with wages as their sole compensation, will do the work, and the structure is not ggCK FLOW PROTECT. DEVICE 4,00 " . OCC. GROUP 'v RES. UNITS DRAINS- FLOOR, ROOF, AREA,COND. '5,00 _ intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor License Law does not apply to an owner of I FIXTURES %PER TRAP 5.00 ' GAS - EA. SYSTEM „I INC. 4 OUTLETS' 6.00 _ SQ. PT. FLOOR AREA TOTAL ACREAGE property who builds m improves fhercon; and who does such work himself or ' through his own employees, provided that such improve- ments are not intended or offered fnrsale. If, however, file building or improvement is sod within one year of'complelimr, the owner- builder will have the burden of proving teal he diet not build or am. GAS - EA. SYSTEM - OVER 4 (EA.) -' 2.00 � n BUILDING USE pr a for purpose of sale.).' . • 1; as owner of the property, mn.oxclusively contracting with RES ENO CON, Pa Other E] o ❑ � ❑ INDUSTRIAL WASTE INTER. v 30.00 Y LAWN SPRINKLERS - 1 INC 5 V.B. • 6.00 " lice std contractors to construct the I'T"I (Sce. 7044, Business Slid Professions Code: The Contractor's License Law does not apply ASSESSORS PARCEL NO. to an owner of properly who buflds'or improves Ihercon: and who LAWN SPRINKLERS - OVER 5,(EA.) 1.00 contracts forsuch mejecls,eifh'a contractor(s) licensed pursuant to the Contractor's License Law. ❑ lam exempt under Sec. ,U. &P.C. Ibr this maSOn S EWER- SANITARY -STORM EA. 200ft /10.00 TRACT NO. PARCELING. WATER HEATER W /VENT 6.00 - Owner /J ��(�_ D:ne / WATER SYSTEM 5.00 ' ACC. DATE ACC. FILE NO. - WATER TREATING EQUIP. 5,00 woRKERS'COMPENSATION DECLARA.TION I herchy affirm that 1 have a Celt ifcate of consent to sell-insure, ZONING ENG. SITE NO. or a certificate of Workers' Compensation Insurance, or a certified copy thereat (Sce. 3800, Lab.C.l: - policy No - CamPany _ - - ❑ Certified ' copy Is hereby furnished. - ❑ Certified opy, is filed vith the city Inspe.UOn •division, Applicant _ t, _ . / MISC. - REFER TO ORD. FIRE,SPRINK - Y N� ENERGY.T.24 Y�'NQ', ., CERTIFICAT' Ii OF EXEMPTION FROM WORKERS' - COMITNSA'fION INSURANCE not (This section need not he complcled if the permit is foe one I PERMIT ISSUANCE 10.00 FLOOD ZONE Y N� A. L. U.C. - YE] No PLO. CONTE. LIC. NO. ,PLG. TOTAL hu(This dollars (need , 1 certify that in the perl'onnance of the work for which fills re, mit is issued, 1 shall.not employ any person in any manner so as to CITY _ MECHANICAL PERMIT FEE FEE SUMMARY BUILDING D dA become subject to fire Workers' Compensation Laws of C,.1:1ornla. Datc Applicant ' - ALTER OR ADD TO MECH. 5.00 NOTICE: TO APPLICANT: If, aftv,awking This Ccrf ificatc of fix APPLIANCE '5.00 PLAN CHECK FEE - f emption; you should become subject to the Workers' Compensation provisions of thc,LOboi Code, you must ItHiliwith comely will( such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10,000C.F.M.) ' 4.00 - ' CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT (OVER 10OW C. F.M.) 6.00 SEISMIC FEE 4 ✓' I hereby 'affirm thul'there is 'a construction lending agency for EXHAUST HOOD (WITH DUCT)' 5.00 ' file performance of file work for which this permit is issued (Sec. 3097, Civ.CA -- ± ' MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name der's LenaJress HEATING UNIT (OVER'100,000 B.T.U.)9:50 ELECTRIC I rertil'y' that I have R,mi this application and stale that lhcabovc' , VENTILATION FAN (SINGLE)- ' s 4.00 ormaf ion is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby atiliontd property for inspection purposes. • - above- ,authorize roperty fo eves ec Phis sty to enter upon the PLUMBING BOILER - COMP (3 H.P. or 100,000 B.T.U.). 6.00 - - BOILER -COMP (Over 160,000 BTU) SEE FEE SCH: MECHANICAL ' (We) agree to save, indemnify and keep harmlcss the City of MISC. - REFER TO ORD. upertino aganst liabilities, judgments, ants and expenses which- ay in any way accrue against said City in consequence of the m • of this r if. PERMIT ISSUANCE ;10.00 CONST. TAX - " MECH. CONT. LIC: N0. MECH. DTAL TOTAL - Signature of Applicant /Contractor U OFFICE COPY '