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18887.4 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO " INSPECTION DIVISION `-• '. I C� JOB INSPECTION RECORD JOB ADDRESS _% U O( SD ��FF�/ /7 UNIT# _LOT# OWNER - f `� (7 -e CONTRACTOR PERMIT NUMBER 1 8887 PERMIT EXPIRATION i• PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION I DATE INSPECTOR INSPECTION RECORD FOUNDATION - - NOTE: ALL'GRAND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPER7INO1N0 S STANDARDS. UFER - PR EGUNITE PERMIT VALIDATION ! �, •-v `� 411 4 1 1 ISSUANCE DATE ✓ GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - PAW UNDERGROUND/SLABNt)V*1999 PLUMBING ELECTRICAL'!��'� MECHANICAL - .. BLOC I ELECT PLG, MECR. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION MECHANICAL ELECTRICAL - - PERMIT TO r FRAMING INSULATION STORI0t3 r PE CONSTR. PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED OCC GROUP RES UNITS ' ROOF NOTE: NO FINAL INSP. SHAIL'BE MADE BEFORE THE CONSTRUCTION TAX IS PAID SO. FT. FLOOR AREA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING BuaomN USE 'RES INo-, BCONUILDING PB GO— ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNEDFINALS DATE INSP. ROUGH SAND! 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 ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG. SITE NO. GAS TEST GAS MEC H A N IGAL - FIRE SPRINK V ❑ N❑ ENERGY LZe ` ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE Y❑ N❑ AL UC. v❑ N❑ INTERIOR SHEAR - FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC - i- PLAN CHECK . FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ~o�ONE WORKING DAY BEFORE REQUIRED INSPECTION, Z PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - Ra,`' "` ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL.,Ua OFFICE COPY • O Z_z P N CC- W CL 0 D z Uo LL U Ow } n I" ? �. - .., hhl, / MRA A-rinAt WITUINI RFn 1 IKIFS _ I IRF BALL POINT PEN ONLY Hrr LiuF im 1 I V rrLL nxl nor v...... -.._.- .-- -- - - T NUMBER BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT PLUMBING -MECHANICAL I U IPLANIHECKVALIDATION am LD ING o Ress 1 1. BUILDING-ELECTRigAL- �k& • r ��„ NAMER'S p u�3_EyYq C GANT / �-U " ! QTY. ' `oo Krl PHONE ELECTRIC PERMIT FEE DATE OF APPLICATION CHECK FEE CONTRACTOR'S NAME LIC, NO. OUTLETS - SWITCHES -RECEP 10.00/1,00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S ADDRESS PHONE ARCHITECTPLAN OR ENGINEERu PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 PANELS (OVER 200 AMP) 20.00 SIGNS TRANS. 3,OD c.No. ARCH. OR ENG.6.00 ADDRESS ZIP SPECIAL CIRCUIT PERMIT VALIOAT I ON l �%AUCL, ' EMP. METER OR POLE INS. 20.00 p, see APPLICANT ICT.. SL o/JT D T '7 y ADDRESS p /) S LVA N V e? O MOTORS SEE FEESCH. SERVICE CHANGE 20.00 PAMW LICENSED CONTRACTORS DECLARATIONU I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business anti Professions Code, and my license is in full force and effect. License Class Lt.. Number ISSUANCE DATE BLDG. ELECT. PLG. MECH. ❑ Date Contractor. cit" rill?'PF runo BUILDING PERMIT INFORMATION OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Business and Professions Code: Any city orcounty whiChrtquiresapermilloconstntcLaller, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions 01 the Contrlcmr's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty .Feet more than five hundred dollars (5500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is net intended or offered for sale (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 does such work himself or through his own employees, provided that such improve- meats are not intended or offered for sale. IL however, the building MISC. - REFER TO ORD VALUATION $/FT. PERMIT ISSUANCE 10.00 ZD ELEG CONTR. LIC. NO. ELEC. TOTAL �Z. 0 PERMIT TO _e, G3/ OTY. PLUMBING PERMIT FEE STORI S TYPE CONSTR. ALTER-DRAIN&VENT-WATER (EA.) 5.00 BACK F LOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND- 5.00 FIXTURES - PER TRAP 6.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 SO, FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM - OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PS Other Q El 11 or improvement is sold within one year of cheIP a'lon, the owner builder will hove the burden of proving that he did not build c r int- prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See. 7044, Business INDUSTRIALWASTE INTER. - 30.00 LAWN SPR INKLERS - 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 contracts far such projects with a contnmtorls) licensed Pursuant to lhC Contractor's License La . ❑ lam exempt ode ec. .B.&I'.C. ortl LAWN SPRINKLERS -OVER 5 IEA.) 1.00 SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL N0. WATER HEATER W/VENT 6.00 mason Own D' )/ - WATER SYSTEM 5.00 ACC DATE ALC. FILE NO. WATER TREATING EQUIP. 5.00 wo KERMMPeNSATION DECLARATI N ZONING ENG. SITE NO. I hereby affirm that I have u certificate of Consent to self-iasure, or a certificate of Workers' Compensation Insurance, or a certified Copy thereof (Sec. 3800, Lab C). Policy No. C....pony ❑ Cetlifiedcopyishembyfgrnished. ❑ Certified copy is fled with the city inspection division. - FIRESPRINK Y N❑y ENERGY T 24 N� MISC.- REFER TO ORD. Applicant C1iRTIFICATEOP EXEMPTION PROM WORKERS' COMPENSATION INSURANC17 (This section need not be completed if the permit is for one hundred dollars IS 100) or less.) I Certify that in the performance of the work for which this per- Init is issued, I shall not employ any person in ,tiny mennerso as to become subject to the Workers'Compensation Laws of Colifgrnia' Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- emption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this Permit shall be deemed revoked. '' CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the pertixmance of 'ilia work for which this permit is issued IScc. 3097, Civ.C.). Lender's Name PERMIT ISSUANCE 10.00 FLOOD ZONEA. Y ❑ N [:]t L u. C. Y � 'N ❑ PLG. CONTR. _ ❑c. NO. - PI -G. TOTAL QTY. MECHANICAL PERMIT FEE FEE SUMMARY ALTER OR ADD TO MECH. 5.00 APPLIANCE - 5.00 AIR HANDLING UNIT (TO IOPIXIC.F.M.) 4.00 AIR HANDLING UNIT(OVER IOAOOO.EM.)6.00 M EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000 B.T.U.)9.50 Lender's Address - f certify that l have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and VENTILATION FAN (SINGLE) 4,00 'PLUMBING gO1LER-CONP I3 H.P. Or 100,000 B.T.U.) 6.00 - hereby au lmrize representatives of this city to enter upon the BOILER -COMP lose, 100,000 BTU) SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmles's the City of uperlino against Ii abilities, judg nis, costs un expens which 1 ay in an wa ace agal said City in ase ucn of the 'n th' mr MISC. - REFER TO ORD. CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL,DD Ignalureo pplicamiContractor e P731Ifl410-11I