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17065a T� - POST THIS CARD NEAR FRONT OF BUILDING ' - A -CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD /1 1I A 1,� JOB ADDRESS Z.. Sp.. �E'��l 7Y� UNIT# _ _LOT#,. _ J OWNER V 0, CONTRACTOR d L '- D D PERMIT NUMBER j 17066 PERMIT EXPIRATION PERMIT EXPIRES IF WORK 1�' 'IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- •' ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION - NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF OUPERTINO STANDARDS. LIFER PREGUNITE PERMIT VALIDATION •,� -, �.�iL I,YT4 " 11'1V`'j ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED q UNDERGROUND/SLAB PLUMBING ELECTRICAL _ MECHANICAL BLDG ELECT PLG. MECH'" j 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION - WOOD FLOOR- qR•• VALUATION I OD 0, SIFT. PLUMBING MECHANICAL ELECTRICAL, PERMIT TOf�••��'' SIE' L STORIES T PE CONSTR. FRAMING - INSULATION OCC. GROUP ,HES. UNITS " PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOFNOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID " sn. Fr. FLooR AREA ' TOTAL ACREAGE. DIAPHRAGM. ROOF SHE ATHING BUILDING USE - RES INO CON PB au... ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.# ASSEssORS PARCEL NO ' PLUMBING ELECT. ENERGY TUBS &SHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO " 1 MECHANICAL MECH ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACC FILE NO. , FRAMING ELECT. FINAL TEST INSULATION PLUMBING " ZONING ENG. SITE NO. GAS TEST - GAS ' MECHANICAL FIRE SPRINK Y NF] o ENERGY T.79 Y "� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOOZONE . Yo. NE)' AL U. C. L N❑ INTERIOR SHEAR FIRE DEPT, SHEETROCK GRADE • FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH - TEMPORARY APPROVALS SCRATCH COATELECTRIC PLAN CHECK FEE • GAS _ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC'FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. ARRANGE FOR INSPECTION BY PHONING 252-4505,ELECTRIC ONE WORKINGDAY BEFORE REQUIRED INSPECTION. z �. PLEASE GIVE JOB ADDRESS WHEN PHONING.. -SEE PERMIT'FOR EXPIRATION DATE - MICROFILMLu " PLUMBING 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 I DENTI FJCATION APPLICATION & PERMIT' PERMIT NUMBER A7 BUILDING - -, AooRess BUILDING --ELECTRICAL— PLUMBING—MECHANICAL 1706 �?" I 0 6 OWNER'S NAME G PNONE DTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION NAMERACTORs UTLETS-SWITCHES -RECEP 10.00/1.00 Oo LIC. No, LIGHTING FIXTURES 10.00/1.00 AONOREs9 oRs" APPLIANCES - RESIDENTIAL - 4.00' M Giv PHONE �$ PANELS 10.00 DATE OF APPLICATION -' ORcrsrt i ENGINEER '�' LIC. No. PANELS(OVER200 AMP) 20.00 PLAN CHECK FEE P.C. NO. - , SIGNS TRANS. 3.00ARCH. OR ADDRESS ENG SPECIALCIRCUIT 5.60 PERMIT VALIDATION ZIP EMP. METER OR POLE INS. 20,00 4 ADDRESSTs - MOTORS SEE FEE SCH. SERVICE CHANGE - - 20.00 LICENSED CONTRACTORS DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and, Professions Code and my license is in full forge and effect. License Class. -0_1 Lie. Number OV 5 6 -.4 Datelr�i/-a a ContmctGr Rs*,,�- OWNER -BUILDER DECLARATIONT oF' `V I hereby affirm that 1 son exempt from the Contractor's License Professions Low: the city or counlHit ason.(h require a perminess t to Code: Any city or county which Structure permit to consuanc alter, improve, demolish, or for sR any permit requires the d Pursues for such revisit to file a sContl statement that to Structure, PADS n IIS Iatement talsohat he is licensed pursuant to the provisions of Contractor's License AN 1 1989 ISSUANCE DATE BLDG. ELECT. PLG. MECH. ® ❑ ❑ ❑ , City. of Cupertino BUILDING PERMIT INFORMATION MISC. — REFER TO ORD PERMIT ISSUANCE - - 10.00 - VALUATION I (/�/(_) $/FT. ELEC. CONTR. LIC. N0. .. ELEC. TOTAL PERMIT TO 00 tlic Law(ChapterP,oco,i.n, Codeng with Section is exempt Business mW Professions and or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE L_4yLl L) :IE I i 1 exemption, the basis for the alleged exemption. Any applicant ofonclinn malty by any applicant fora permit subjects S500).licam toacivil penahY : oC not mom than five hundred dollars (my STORIES TYPE CONSTR. ' ALTER-DRAIN&VENT-WATER(EA.) 5.00 ❑ I, as owner at the property, or my m employees their sole compensation, will and t e S with wages as the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS , intended or offered for sale (Sec. 7044, Business and Professions (S Code: The Contractor's License Law does not apply to an owner of DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP 5.00 GAS-EA.SVSTEM-l1NCAOUTLETS 6.00 property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- ments are not intended or offered fur sale. If, however, the building SQ FT. FLOOR AREA TOTALACREAGE 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 IEA.2.00 1 - BUILDING USE• prove for puipow of sale.). " ❑ I, as owner of the property, am exclusively contracting with RES .OND CON PB Other 0 ❑ ❑ ❑ 0 INDUSTRIAL WASTE INTER3000 . . licensed contractors to construct the project (Sec, 7044, Business 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- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a contmctoms) licensed pursuant to the Contractor's License' Law. ❑ lam exempt under Sec.., B.&P.C. for this reason SEWER -SANITARY -STORM EA. 20011/10.00 TRACT NO, PARCEL NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ADC. FILE No. WORKF.RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate of consent to sell' -insure, ZONING ENG. SITE NO. or a certificate of Workers' Compensation Insurance; or a certified copy thereof(See. 3800, Lab.C.). Policy No. . Company - ❑ Certified copy is hereby furnished. '• ❑ Certified copy is filed with the city inspection division. Applicant MISC.- REFER TO ORD. FIRE SPRINK Y N [3E]� ENERGY T2a V N ❑ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one PERMIT ISSUANCE 10.00 FLOOD ZONE - Y E] N ❑ A.L.u.c. V ❑ N PLG. CONTR. LIC. NO. PLG, ' TOTAL hundred dollars IS 100) or less.) - I certify that in the performance of the work for which this per- Hit is issued, I shall not employ any person in any Hunner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY - BUILDING /1G �� J become subject to the Workers' Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NO [CF. TO APPLICANT': If, after making this Certificate of six- APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 PLAN CHECK FEE h t`, h emption, you should become subject to the Workere ComPtnsatlon provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (OVER 10,000C.F.M.) 6.00 SEISMIC FEE 50 CONSTRUCTION LENDING AGENCY 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 is issued (Sec. 3097, CN.C.). HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Lender's Address HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC I certify that l have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER-COMP(3 H.P. Of 100,000 B.T.U.1 6.00 hereby authorize representatives of this city to enter, upon the above mentioned property for inspection purposes. 20'IER Over 100,000 BTU) SEE FEE SCH. MECHANICAL (We) agree. to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertinust liabilities, judgments, costs and expenses' which ay i any ay ace a most sail ty in consequence of the m ng his pe -PERMIT ISSUANCE 10,00 CONST. TAX MECH. CONT. - LIC. NO. MECH. TOTAL TOTAL r75 Si ture of App ice /Contract r Ddb, OFFICE COPY ` - r- V l 2- N 1= 14c r�r�,zs v_r.l 2^- F't'Ef•'rs �piSfS wI-r14 14-A�i6wCVou3Lf- Iz /A If ?b I $rm s 14le-e tTZ-47C. v APPROVED IN ACCORDANCE WITH THE CITY 1415, L.1 L/1 CUPERTINO CODES AND ORDINANCES DATE_ r—{/-�— $IGNE [�1 z i t o tt cAi I� as<. _n,) .;;r c ... cati ns PAUST m be ; '; a a I ti:r:-s nd it s un• lawful to m•:ae r;l, mzogcs o. vcfatiuns on same with p s, . -u'pe m:ssi^n irom (lie bui Cepa, ocp•., GJ) .tf 't:pe t'no. The siampS,t; it n W pcuaLaiions SHALL NL. iz ..c.6 t I,.. mA , r t , oe an approval .of tats m_tati_n .,j any prcvisian• . if any City 0 d,nance :.r S!a'e. Law. _ r> rN OFFICE COPY D JA1 � 19$ N 9 BLDG. INSPECTION DEPARTMERT,, CITY OF CUPERTINO, Tc 13.E Atop MFtm' tG�o4K'910 rN OFFICE COPY D JA1 � 19$ N 9 BLDG. INSPECTION DEPARTMERT,, CITY OF CUPERTINO,