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17597 POST THIS CARD NEAR FRONT OF BUILDING t PERMIT NUMBER CITY OF CUPERTINO 7597 INSPECTION DIVISION JOB INSPECTION RECORD 7� PERMIT EXPIRATION JOB ADDRESS UNIT# _LOT# - PERMIT EXPIRES IF WORK OWNER dYe S .� v CONTRACTOR (y a IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION.' UFER ALL-GRAMNG AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PEHM11 VALIDATION PREGUNITE CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED �� r UNDERGROUND /SLAB APR 11 15U_ PLUMBING p `��,� l�`V' 1-' LI Ed.C./• ELECTRICAL of Of VQ ISSUANCE DATE MECHANICAL BLDG ELECT I PLG. MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION SIFT. MECHANICAL ELECTRICAL IFI PERMIT TD F RAM ING � r INSULATION STORIES TYPE CONSTH OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 5O Fr FLooH Avcq TOTAL gcvcgcF DIAPHRAGM _ - _ THE CONSTRUCTION TAXIS PAID BUILDING USE IND pa 0�11 ROOF SHEATHING El 1-1 ❑N El El NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PA HCEL NO ROUGH SAN.ft - PLUMBING ELECT.ENERGY TRACT NO. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACE FILE NO FRAMING ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION - PLUMBING GAS TEST - GAS FIRE SPRINK ENERGY 7 2 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y "� Y NEI EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE A.LUC INTERIOR SHEAR FIRE DEPT. Y❑ NE] Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLANCHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! covsT.TAX PLEASE READ REVERSE SIDE BEFORE -, y,4 v 'z TOTAL . CALLING FOR FINAL INSPECTION: OFFICE COPi APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION FPLAN R BUILDING APPLICATION & PERMIT 17597 ADDR 55 `�l - M K r/Tra.�r"' ,a Vc BUILDING -ELECTRICAL-PLUMBING-MECHANIC Owyn'B�,r j� � TO ATION NAL�A1eEd SlyQTY. ELECTRIC PERMIT FEE PHONE CONTRACTOR s "444* PANELS UTLETS-SWITCHES-RECEP 10.00/1.00 NAME vwx LPN LIC. IGHTING FIXTURES 10.00/1.00 CONTRACTOR'SPPLIANCES-RESIDENTIAL 4.00 , ADOREss D� C.€ O10.001.iDATE OF APPLICATION ARCHITECT ANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.No. SIGNS TRANS. 3.00 H.OR ENG, 5.08 ADDRESS PERMIT VALIDATION ARCSPECIAL CIRCUIT ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 'I H o O LICENSED CONTRACTORS D17CLARATION a u u I hereby affirm that I am licensed under provisions of Chapter 9APR ISSUANCE DATE t; 4 - (commencing with Section 7000)of Division 3 of the Business and _ BLOG.' ELECT. PLG. MECH. H viz Professions Code, d y license is N full Ibrce yn51 fp Ceel � y O pq• ❑ z O ro- License Class Lic.Number_-/L`ff 2Tl ^'Y O` .Sup.,.y' lLY Q r Date Conl Or In - V 1 y gy(IQ 1-i .- BUILDING PERMIT w u `b L -I ILDr:R I C IZ INFORMATION K H I hereby affirm that I am exempt rom )PTtn c MISC.- REFER TO OflD w �Y VALUATION 7"T LLp ¢ Law for the following reason. I umessandl' le si nsP PERMIT ISSUANCE' 10.00 p 15'> J Code:Any city or county whichrequi sapermil loconstnret.alteL rt ee Q g0 improve,demolish,or repair any slmelore,prior 10 Its issuance,also ELEC.CONTR. LIC.NO. ELEC. �{� DLL requires the applicant for such permit to file a signed 11a1enmm th al TOTAL .aD PERMIT TP X $ he is licensed pursuant to the provisions Of(be Cmurlctor's License r z i Law(Chapter9(commencingw'itll Section7000)ol Divisien3ofltle CL �� a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE f t O STORIES TYPE C NOR. cc H the basis for the alleged exemption.Any violation of Section 7031.5 d -;� by any applicant for a permit subjects the applicant loacivil penally ALTER-DRAIN& VENT-WATER (EA.) 5.00 ' of not more than five hundred dollars(55000.): ❑ I,as owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEV ICE 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,COND. 5.00 Code:The ConHunce's License Law does not apply to an owner of property who builds Or improve.,thereon;and who does Stich work FIXTURES-PER TRAP 5.00 50,FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 mems are not intended or offered for sale.If,however,the building or improvemennis sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im. RES IND CON PB Otte, prove for purpose clinic.). INDUSTRIALWASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with 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 docs not apply 10 an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 co o Vacls for such projects withu contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ lam exempt under Sec.-,TkP.C.for this WATER HEATER W/VENT 6.00 reason Owner - Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO, WORKERS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent 10 self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lid,C) A7iw_L19!Policy No. Company_ 0 M L - ❑ 1,: ied copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z Ccrti-ie cup y is with the 'try inspection division. MISC.- REFER TO ORD. y N� Y 0 N[] A Fenn 1- PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. CC Ch: I A 17ROM WORKERS' - W �_ COMPENSATION INSURANCE PLG,CONTR. LIC.NO. PLG, y[] N Y❑ N❑ LU O ('This section need not he completed if the permit is for one TOTAL D Z hundred dollars(SHOO)or less.) 0 O 1 certify that in the performance of the work for which'his per QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- Inil is issued,I Shall not employ ary person in any manner so as I- L) becoma subject to tire Workers'CompEumtien Laws of California. BUILDING Date Applicant ALTER OR ADD TO MECH. 5.00 } Do NOTICE TO APPLICANT: If,after making this Cer'ifierin of Ex- F. ? emption,you should become subject to Ole Workers'Conspensullun APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10PNIC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.EM.) 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 Penult is issued(See. 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 ELECTRIC s Lender's Address I certify that)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 BOILER-OOMP(3 H.P.Or 100,000 B.T.U.) 6.00 ordinances and state laws relating to building construction, and hereby aullmrive representatives of this city to enter upon the BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree 10 save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in consequence of lire r (ling of this Permit. MECH.CONT.' MECH. Z TOTAL TOTAL SI nature of )a(e If OFFICE COPY