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13400 POST THIS CARD'NEAR FRONT OF. BUILDINGPrRMIT NUMBER CITY OF .CUPERTINO. . -� INSPECTION DIVISION" p+ 00, JOB INSPECTION RECORD . • PERMIT EXPIRATION JOB ADDRESS10171 AMELIA COURT - UNIT# . - PERMIT EXPIRES IF WORK OWNER DARYL FAZEKAS' CONTRACTOR BARNARD POOL IS ,NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180DAYS OFPERMIT ISSU- ANCE,OR 180 DAYS FROM i. LASTCALLED INSPECTION: - LIFER _ PREGUNITE - , - PERMIT.VALIDATION, POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB . " r,a1 1 •�`;, ��3/ PLUMBING - ELECTRICAL .1,y_� ISSUANCE DATE - MECHANICAL " r' E„#!";;a ^ RLD ELECT. PLG MECH. tJ Q Lin DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED LTi '. * � BUILDING PERMIT INFORMATION WOOD FLOOR VA unnoN s/PT. . PLUMBING - ' 'MECHANICAL.- ELECTRICAL MECHANICAL ELECTRICAL - - - A,PE,RM,IATTTo FRAMING ��1"l!`7�f'IE�(- CY71�..r. INSULATION STORIES- TYPE CDNSTR.' ' - ;',;; � � -'GCC.GROUP RES.UNITS _ PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF , TL - SOFFOOR APEA TOTALACREAGE DIAPHRAGM - BUILDING USE RES IND CON. PB 00" APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 'r `-© '❑ ❑ , ❑ ❑ ROUGH - ASSESSORS PARCEL N O. PLUMBING - _ Ag - GAS TEST - TRACT NO - PARCEL NO. '+ " • MECHANICAL • "' - ACC.DATE ..,ACC FILE NO., ELECTRICAL FINALS - d,DATEINSP. FRAMING - SAN #' „ ZONING ENG.SITE NO.INSUIATION •' PLUMBI NG:' - 00GASFIRE SPRINK, ENERGY T.24 MECHANICAL COVER NO'WORK UNTIL ABOVE HAS BEEN SIGNED HEATING', ` ❑ '.' ND9 "❑FLOOD ZONE A.L:uc . LATH—INTERIOR - ".i - ELECTRICA _ j LATH— FIRE FIRE'DEPT. Y❑ ,�N❑ v ❑ ,ry❑ SHEETROCK - GRADE - . �FEE'SUMMARY SHEAR INTERIOR • "' BUILDING - . SHEAR EXTERIOR T PORARY APPROVALS BUILDING FIREWALLS 'o ELECTRIC' ' PLAN CHECK - GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY, SEISMIC FEE ' OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM 'r ARRANGE.FOR INSPECTION'BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE-JOB ADDRESS WHEN'PHONING. -.SEE PERMIT FOR EXPIRATION DATE - MECHANICAL d CONST.TAX IMPORT-ANT! PLEASE READ REVERSE SIDE'BEFORE TOTAL CALLING FOR'FINAL INSPECTION. OFFICE COPY ' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT AD ss -1 A ED A 13400 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 13 4 O O CANER,'s PLAN CHECK VALIDATION "A QTY'. ELECTRIC PERMIT. FEE Ff'� uw CONTRACTOR 5 NAyq '7 OUTLETS-SWITCHES-RECEP 10.00/1.00 Q `J i"t e uc.rvo. 3S_ .LIGHTING FIXTURES 10.00/1.00 _ rorvrRAcroR's r +APPLIANCES-RESIDENTIAL 4.00 PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. on PANELS (OVER 200 AMPI 20.00 SIGNS TRANS. 3.00 ' ARCH. ENG. PERMIT VALIDATION ACED RCILL 1//.J/ �-SPECIAL CIRCUIT 5.00 Q 'zlP EMP.METER OR POLE INS. 20.00 �' ', j�„1D nv LI ADORES" - MOTORS SEE FEE SCH. SERVICE CHANGE 1 o o LICENSED ONTRACTORS DECLARATION �f/ ci I hereb affirm that I am IicensCd under rovisions of Cha ter9 1 .) . n'�np+1190 M ¢y' (commencing with Section 7000)of Division 3 of the ninnies C' J �' PIS$uA:4 EIDATE. � BLDG, ELECT. PLG. MECH. H w z Professions Co license is in full for a 16�a. UL ❑ ❑ ❑ ❑ oz m W Licens ^ss _ Lic.Number City Psi IUOh.•'. w F Date Contrncmr V Q y C J m a OWNER-BUILDER DECLARATION BUILDING PERMIT o a O INFORMATION' E ; u �, I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD E. 0< Law forthe following reason.(Sec,7031.5,Business and Professions VALUATION ,$/FT. H - PERMIT ISSUANCE '10.00 0 �' Eco Code:Any city or county which requires a permit toconstrud,alter, EE 2 Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTIT LIC.NO. ELEC. q�, O u PERMIT TO requires the applicant for such permit to file a signed statement that TOTAL 6CV n w es m he is licensed pursuant to the provisions of the Contractor's License t Law(Chapter 9(wmmenoing with Section 7000)ofDivision 3 of the io Business and Professions Code)or that he is exempt therefrom and QTY: 'PLUMBING'PERMIT` .FEE'. V R H$ the basis for the alleged exemption Any violation of Section 7031.5 { x t 4 [ w. ` STORIES TYPE CONSTR. w. by any applicant for a permit subjects the applicant to a civil penalty - ALTER-DRAIN -WATER (EA.) 5,00 of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS 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 5Q.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- '`, mems 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.). . RES IND CON PB Other ❑'1,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.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?)7 1.00 contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA:200ft//10.00 TRACT No. PARCEL No. ❑ lam exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT '� .J 1'6:00 reason' p1(: Owner Date WATER SYSTEM f"' - 5.00 x .. ACC.DATE ACC,FILE N0. WORKERTCOMPHNSATION DECLARATION WATER TREATING EQUIP.,;y,l 0l v,%j5'00 ' I hereby affirm that I have a certificate of consent to self-pan, vim-+ or a certificate of Workers'Comp ri' ion Insnr or a certifi ZONING ENG.SITE NO. copy theromf(Sec.3800,Lab.0 L , Policy No. Company - _ O ❑ Certified y sI reby u ish 'FIRE SPRINK ENERGYT24 Z Z ❑ Cerlifiell c with I city inspection ion. F„ O Applicant MISC.- REFER TO ORD. ' . Y❑ N Y ❑ N❑ CC to CERTI FICA FF.OF :XFMP7ION FROM WORKERS' PERMIT ISSUANCE 10.00FLOOD ZONE - A.LU.C. LU > - COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG, CL Z (This section need Lou be completed if the permit is for one TOTAL �- Y❑ NoV [-] NC] hundred dollars(S 100)or lexa) U O 1 certify that in the performance of the work for which this per- QTY, _ 'MECHANICAL PERMIT FEE FEE SUMMARY LL F mil is issued,I shall not employ any person in any manner so as to QW become subject to the WorkeriCompensationLaws ofC.lifornia. BUILDING y Date Applicant ALTER OR ADD TO MECH. 5.00 >_ W NOTICE'TO APPLICANT: If,after making this Certificate of Ex- Z emption,you should became subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with U FEE such provisions or this permit shall be deemed revoked, AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 - CONSTRUCTIONLENDINGAGENCY AIRHANDLING UNIT(OVER 10MC.EM.) 6.00 SEISMIC FEE 1 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 Wissued(Sec. MICROFILM , 3097,Civ.C.L - HEATING UNIT(TO 100,000 B.T.U.) 8.00 'Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9,50 ELECTRIC >110 I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 / hereby authorize representatives of this city to enter Upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE - 10.00 granting of this permit, MECH.CONT. LIC.NO. MECH. TOTAL TOTAL ��0 0 6. Signature of Applicant/Contractor � Date '.OFFICE COPY - -