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17980 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 17980 INSPECTION DIVISION JOBB INSPECTION RECORD JOB ADDRESS d-SJ W�//L 'J� PERMIT EXPIRATION q UNIT# _LOT# OWNER T��G/I/ C QL�J� PERMIT EXPIRES IF WORK CONTRACTOR IS NOT.STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 188 DAYS OF PERMIT ISSU- FOUNDATION ' ANCE OR 180 DAYS FROM LIFER NOTE: LASTCALLED INSPECTION. ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION GARAGE SLABS CUPERTINO STANDARDS. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB R ' PLUMBING J. Al ELECTRICAL ISSUANCE DATE- MECHANICAL BLDG El El 1:1ELECT PEG. MECH • DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR JUN INFORMATION PLUMBING - ) VALUATIOON7 S/FT. MECHANICAL - Cu 1/ o u�/ ELECTRICAL C4 of J // PERAfIT TO FRAMING .Z^) L�jl7 ` l:�'( (,./tr 1.�•j s INSULATIONT STORIES rvPE comsTR. U / V OCG GROUP RES UNITS PLACE NO SUBfL00R UNTIL ABOVE HAS BEEN SIGNED � ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE So FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING - B7LDIN OUSE HES IND CON PB Otlon APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE - INSP. ❑ ❑ ❑ 0 ROUGH SAN.N .ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO MECHANICAL . MECH. ENERGY ELECTRICAL BUILDING ENERGY' ACC.DATE ACC FILE NO FRAMING Z ELECT.FINAL TEST - INSULATION PLUMBING ZONING ENG.SITE No. GAS TEST - GAS - MECHANICAL FIRE SPRINK ENERGY T-za COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N _ . ❑ NEJ EXTERIOR SHEAR ELECTRICAL RELEASE FLOUD ZONE A.L U.C. INTERIOR SHEAR FIRE DEPT. Y N ❑ r o ' SHEETROCK GRADE - EXTERIOR LATH - BUILDING FEE SUMMARY INTERIOR LATH TEMPORARYA PROVALS BUILDING 4>"/ SCRATCH COAT ELECTRIC PLAN CHECK GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED loCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST,TAX PLEASE READ REVERSE SIDE BEFORE / CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL- IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT.IDENTIFICATION PERMIT NUMBER " ADD ADDRESS �.�.�. 5/ APPLICATION & PERMIT, e�(� O ALA O 9177SAZ OAK 1 I I J BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OwrvER'S PLAN CHECK VALIDATION NAME ' f(pp6N COO, ' DTV. ELECTRIC PERMIT FEE ONE?3v-�844 NAAM1ERAcrORS UTLETS-SWITCHES-RECEP 10.00/1.00 - e• SEJ 4.9)Z_r uc.ND.. 965** LIGHTING FIXTURES 10.00/1,00 CONTRACTOR'S ADDRESS Pf O• Bs�o APPLIANCES-RESIDENTIAL 4.00 SAN NIATLTO CA - PHONE':944317) PANELS - 10.00 . DATE OF APPLICATION " ARCHITECT PLAN CHECK FEE P.C.NO. on PANELS (OVER 200 AMP) 20.00 ENGINEER LIC.No. SIGNS TRANS. 3.00 ADDRREOR SS ENG' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 ADDRESS MOTORS SEE FEE SCH. ADDRESS � - ' 2357$/ /TYt3Y� C)/4J1C SERVICE CHANGE 20.00 J. A/7 oN&1_&J 0 o LICENSED CONTRACTORS DECLARATION _ U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE y z "' (commencing with,Sect{on 7000)of Division 3 of the Business and H H Z Professions Code nd Ihy, is s¢is in full force an effect. BLDG. ELECT. PLG. MECH. C m D License Claes Lie.Number - _ m r w DateCnntractor a >: f -' __9JUN' 91909 BUILDING PERMIT a w a OWNER-BUILDER UILDF.R DECLARATION INFORMATION MISC.- C' ORD P` ; . 1 I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. HuoJ Law for the following reason.(Sec.703L5,Businessland Professions PERMIT ISSUANCE 10.00 � � Code:Any city orcourty which requires a permit to construct,alter, 000 SE ¢ a improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. L, DLL requires the applicant for such permit to file a signed statement that TOTAL m Ile is licensed pursuant to PERMIT TO the provisions of the Contractor's License _ ' r z ¢ Law(Chapter 9(commencing with Section 7000)of Division 3 of the �• i a Business and Professions Code)Or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE the basis for the alleged exemption.Any violation or Section 7031.5 STORIES TYPE CONSTR. a3 _ by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN -WATEfl (EA.) 5.00 of not more than five hundred dollars($5001): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 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 himself or through his own employees,provided that such improves mena 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 or. GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PB 'Other prove IO,purpose of sale). INDUSTRIAL WASTE INTER. 30.00 IY d as owner of the property,he exclusively. 7044,contracting withss � ,El 0 ,o 11 licensed contractors to construct the project(Sec. ]044,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 thereom and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO, PARCEL NO. ❑ I um exempt under Sec,-,B.&P.C.for this casae WATER HEATER W/VENT 6.00 Overe 40 pDate . WATER SYSTEM 5.00 ACC.DATE ACC.FILE.NU WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 " I hereby affirm that I have a certificate ofcousent bowl Ginsure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.CJ. Policy No: Company - 0 ❑ Certified copy is hereby furnished. - ZZ mortified copy is filed with the city inspection division. 'FIRE SPRINK ENERGY T-24 )- O Applicant MISC.- REFER TO ORD. Y E] N Y ❑ N❑ CC L4 CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. 0- O (This section need not be completed if the permit is for one TOTAL Y❑ N❑ V Q N ::) Z hundred dollars($100)or less.) U O 1 certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any person in any manner so as to 0 W become subject to the Workers'Compensation Laws of California. y Date-Applicant BUILDING `?�•O0 >_ W NOTICE TO APPLICANT: If,after making this Certificate of lis-' ALTER OR ADD TO'MECH. 5.00 F;Z Caption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK .�•f 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=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10=C.EM.) 6.00 SEISM IC FEE tj Q 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 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that l haver dl4s'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 above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,j dgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX oy in any wa come ag' est said City in consequence of the ranting. f e i[. _ MECH.CONT. LIC.NO. MECH. TOTAL TOTAL �,75 tgnaN e o A moot/ ooh f ate OFFICE COPY