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16605 POST THISD NEAR-FRONT OF BUILDING PERMIT NUMBER CITTOF CUPERTINO + 16605 'INSPECTION DIVISION . JOB INSPECTION RECORD . loo4 PERMIT EXPIRATION' JOB ADDRESS V_)CnArn -( -5 UNIT# _LOT# '� PERMIT EXPIRESAF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSu' • FOUNDATIONNOTE: LASTCALLED INSPECTION.. ANCE OR 180 DAYS FROM ' LIFER - � ALL GRADING AND DRAINAGE SHALL BE INSTALLED - PREGUNIT•E TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VA1.17noN CUPERTINO STANDARDS. _ GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I UNDERGROUND /SLAB o +' PLUMBING - OCT i 3 19 v ELECTRICAL ISSUANCE DATE - MECHANICAL Upol LI L G ELECT, PEC. MECH. ❑ ❑ ❑ .. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED euaowc PERMIT WOOD FLOOR INFORMATION ' .PLUMBING v �uAIII ,' SIFT. MECHANICAL _- aw 1 co ELECTRICALPERMIT TO ' � � � - tt FRAMING • -I`.it'i INSULATION STORIES TYPE CONSTR, OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn.ET FLooRARPA TOTAL ACREAGE .- DIAPHRAGM' THE CONSTRUCTION TAX IS PAID " BUi CLING USE ROOF SHEATHING - REs IND CON PB on,�� APPLY NO RO61 OFING UNTIL ABOVE HAS BEEN SIGNED FINALS FDATEINSP. E:l 11 ASSESSORS YARCEL NO/E'ROUGH SANJI PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT No. PARCEL NO MECHANICAL MECRENERGYELECTRICAL BUILDING ENERGYAcc.DnrE Acc.wLE No FRAMING ELECT,FINALTESTzow"cENCsire No. INSULATION PLUMBING GAS TEST GAS FIRE SPRINK ENERGY T 24 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y NE ND Y IN[D EXTERIOR SHEAR ELECTRICAL RELEASE - FLooD zoA,L U.Cr INTERIOR SHEAR FIRE DEPT. v NEI ° 0 NQI SHEETROCK GRADE - FEESUMMARY EXTERIOR LATH BUILDING INTERIOR LATH - TEMPORARY APPROVAL tlBUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY,OF BUILDING IS NOT PERMITTED UNTIL BUI LI)MG.FINAL IS SIGNED BV BUILDING INSPECTOR: ' MICROFILM . _ T� ELECTRIC ARRANGE FOR INSPECTION BY PHONING 252-4505, Q F� ONE WORKING DAY BEFORE REQUIRED INSPECTION. ; PLUMBING o PLEASE GIVE JOB ADDRESS WHEN PHONING. �I ."" Z - SEE PERMIT FOR EXPIRATION DATE'= Y:,= MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE A+ z " 1'" CALLING FOR FINAL INSPECTION. P ,k TOTAL ✓r ,-�,�i OFFICE COPY. APPLICANT TO FILL IN INF MATION WITHIN RED LINES = USE LL POINT PEN ONLY BUILDING PROJECT IDENTIFAWN - _ PERMIT NUMBER. BUILDING APPLICATION & P IT 1 C(; O ADDRESS. ,/ If+ I U U i Z A D , .d'/O BUILDING -ELECTRICAL-PLUMBING-MECHANICAL ` WNER��T6� Q l y I PLAN CHECK VALIDATION rvaMI I�I�//f�,...rr.��//Q-{'�// CITY. ELECTRIC PERMIT FEE . (.40&77 PHONE ; CONTRACTOR'S NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 ' S� c.No ,7, Z LIGHTING FIXTURES 10.00/1.00 DDTRAGrogs 8(/ APPLIANCES-RESIDENTIAL 4.00 ADDRESS /y �' CY PHON / 8 rya PANELS 10.00 DATE OF APPLICATION - ARCMTEC OR PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.!NO. i ENGINEER ARCH.OR ENG. LIC,NO ISIGNS TRANS. 3.00 ADDRESS SPECIAL CIRCUIT . 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S �/ 'J�� AOD.ESit /PJ �GfEL Z,6 MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION u iv I.hereby affirm that I am licensed under provisions of Chapter 9 , ISSUANCE DATE - < (commencing with d my l ]0ew i of Division 3 of the Business and B,LO ELECT. PLG. MECH. r-w i Professions Code,andmy license is in lull force and effect. Z i m 0 License Close r_y5. Lie.Number - Date ❑, ❑ ❑ J ye �g---Canlraeler City of C airtime a W ei OWNER-BUILDER DECLARATION H D BUILDING PERMIT eLo a O INFORMATION X ; m I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD LL 0 0 Law for the following reason.(Sec.7031.5,Business and Professions , VALUATION $/FT. - PERMIT ISSUANCE Le Code:Any city orcounty which requires a permit to construct,alter, �'� .n ^ M Ie 2 Q 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. L 0 or requires the applicant for such permit to file a signed statement that TOTAL a w$m EC he is licensed pursuant m the provisions of the Contractor's License _ r PERMIT To r,i a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe - s 4 0 Business and Professions Code)or that he is exempt therefrom and pTV. PLUMBING PERMIT FEE JIkA M H 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 to a civil penully ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner at the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will property, the work,andemployees the slwith w is not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5,00 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 SO.FT.FLOOR AREA TOTAL ACREAGE e himself or through his own employees,provided that such improv ments are not intended or offered fo..rle.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner GAS EASYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of proving that he did not build or im - . BUILDING USE prove for purpose of Sala). INDUSTRIAL WASTE INTER. 30.00 RES E] El ON EPR l0❑ 1 ❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sea 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and ProfessionsCode:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who ILAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contrantmia)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00TRACT NO, PARCEL NO. O 1 um exempt under Sec. ,B.&P.C.for This - - ' reason WATER HEATER W/VENT 6.00 '. Owner .Dale WATER SYSTEM 5.00 ACC.OATS ACC.FILE NO. WORKE-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 - 1 hereby affirm that 1 have a certificate of consent to sel&insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.thereof(Sec.3800,Lab.CJ- - i Policy No. Company ' 0 ❑ C 1iif I,d copyist famished. FIRE BPRINK ENERGY T-24 .Z'Z ❑_C1 C r[ified cry i � itly.,the ci inspection division. - � p Applicant ( i MISC.- REFERTOORD. r,❑ IN Y ❑ No N CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U,C. 11J > (ibis section need noCOMPENSATION be com INSURANCE letedlif B eFpermit is for one PLG.CONTR. LIC.NO. TOTAL Y❑ N❑ Y ❑ --N ao 7) Z hundred dollars($100)or lL.,)' U O I certify that in the performance of the work for which this per. CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued,1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ' W Date Applicant - BUILDING } W NOTICE TO APPLICANT: If,after making this Certificate of F:x- ALTER OR ADD TO MECH. 5.00 F Z eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with /\ U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10JMC-F.M.) 4.00 FEE 150 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.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 - r Lender's Name - HEATING UNIT 100,000B.T.U.)9.50 ELECTRIC Lender's Addre` IR IOb 1 certify that 1 have read this appliemion and state that the above VENTILATION FAN (SINGLE) 4.00 information n correct. I agree to comply with all,city and county BOILER-ODMP(3 H.P.or 100;000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to comply with 1.city action,nd co and hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTUI SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, ' it If and keep harmless the City of MISC.• REFER TO ORD. upertino against Nabi t' s,judgments, costs and expenses which pERM1T ISSUANCE 10.00 CONST.TAX may in any way a against Bald C'y in.cunsegmence of the tamtin his pe LL. MECH.CONT. - LIC.NO. MECH.'s /D I3-�U '� TOTAL TOTAL Si lure of Applicant FfContractor Date OFFICE COPY g �P-