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17880 r POST THIS CARD NEAR FRONT OF BUILDING - PERMIT NUMBER CITY OF CUPERTINO 17880 INSPECTION DIVISION JOB INSPECTION RECORD " JOB ADDRESS ' ©� "� 1)1C� YL_�1� /7��PUNIT# _LOT# PERMIT EXPIRATION .✓ PERMIT EXPIRES IF WORK OWNER .Je� P CD . CONTRACTORQL- G, IS NOT STARTED WITHIN INSPECTION DA E INSPECTOR I SPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION NOTEANCE OR 180 DAYS FROM - R UFER• � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE ` TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALUATION CUPERTINO STANDARDS. " . i fj GARAGE SLABS • - - �i1,J, 4 —� '1 '• ��"'.t POUR NO.CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB MAY.12 1989- PLUMBING - - ELECTRICAL . ' City of CUpergRO ISSUANCE DATE - MECHANICAL - BLOU ELECT PLG. MECR ❑ ,� El ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT • WOOD FLOOR - i INFORMATION PLUMBING t VALUATION S/BT. - MECHANICAL ' I 'ELECTRICAL - t PERMIT To FRAMING _ 1 �y[„r�t C& INSULATION . STORIES -TYPE CONSTR. . • - OCG GROUP RES UNITS _ PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE ' SO ET.FLOOR AREA TOTALACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID. ROOF,SHEATHING BUILDING USE RES IND - CON PB pmei APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH ' SANH ASSESSORS PARCEL ND PLUMBING' - - - ELECT.ENERGY - TUBS&SHOWER PAN- PLUMBING ENERGY TRACT NO. PAecEL NO MECHANICAL MECR ENERGY ELECTRICAL BUILDING ENERGY - .Acc.DATE ncC BILE No. FRAMING - ELECT.FINAL TEST - INSULATION - - PLUMBING zpNING ENG.SITE No. GAS TEST - - - GAS MECHANICAL EIRE SPRINK ENERGY T.}4 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED .HEATING Y'❑ N❑ ❑ NL EXTERIOR,SH EAR .ELECTRICAL RELEASE - PLDODZONE ALUs. INTERIOR SHEAR FIRE DEPT. Y E] NL Y L NL SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC - PLAN CHECK GAS - FEE - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SWIMoccuPANcv sElsnnlc FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY 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 TOTAL C CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUPERMIT NUMBERILDING PROJECT IDENTIFICATION BUILDINGAPPLICATION & PERMIT - ^ I I (7 OWNER'S I ADDRESS BUILDING -ELECTRICAL-PLUMBING-MECHANICAL O C�S O L Gran,G !/C PLAN CHECK VALIDATION NAME . QTY.. ELECTRIC PERMIT FEE GwJ' ✓� PRONE CONTRACTORR5'S NAME / OUTLETS-SWITCHES-RECEP 10.00/1.00 r L,Lue.No. yy2J C1 _ZaLIGHTING FIXTURES 10.00/1.00 I ADDRESS TOR's - f l' APPLIANCES-RESIDENTIAL 4.00 /6Q90 ron.[aw PRONEy" � PANELS( 10.00 - DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMPI .20.00 ENGINEER LIC.NO. SIGNS TRANS. 3.00 ACOR ES ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 ADDRESrvrs MOTORS z- L_ SEE FEE SCH. 40 SERVICE CHANGE 20.00 / /I x -PywoG D ¢ z i tZ r o D LICENSED CONTRACTORS DECLARATION - _ - I n " < i w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE y¢ m (commencing with Section 7000)of Division 3 of Itte Business and BLDG. ELECT. I PLG- ECM. f y z Professions Code,and my license is in fall fore and eft�ct. Z O w License Class C-/& Lic.Number If 198 ry V D z- Dw Date.S-/2- Contractor ' i F H �y ,(9tn/J/cc G a Y BUILDING PERMIT ¢ ¢w OWNER-BUILDER DECLARATION INFORMATION w3 > 1 I hereby affirm that 1 am exempt thorn the Contractor's License MISC:- FER T ORD H u 0 4 Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 zr Ud , VALUATION Code:Any city or county which requires a permit to construct,alter, S ¢ improve,demolish,or repair any structure,prior to its issuance,Also ELEC.CONTR. LIC.NO. ELEC. - ac 0u requires the applicant for such permit to file a signed statement that TOTAL �ga -D PERMIT TO A w m he is licensed pursuant en the provisions of the Contractors License - �• �l�d H z > Law(Chapterand Professions Code)orth is 00)exempt the en 3 andflic !Y�-ll X 4 o Business and Professions Code)or that he is exempt therefrom and GTV. PLUMBING PERMIT FEE ¢ I $ the basis for the alleged exemption.Any violation of Section 7031.5 _ STORIES TYPE CONSTR. w. by any applicant for a permit subjects the applicant tou civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 .four more than five hundred dollars IS500)J ❑ I,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 smucrm re is ol intended or offered for sale(Sec. 7044, Business and ProfessionsDRAINS-FLOOR,ROOF,AR EA,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 SD.FT.FLOOR AREA TOTAL ACREAGE himselforthrough his own employees,provided that such improve. - mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-i 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.(sale.). RES ' IND CON PB Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30:00 El El ❑ ❑ ❑ 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 huilds or improves thereon,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. ❑ lam exempt under See.-,B.&P.C.for this WATER HEATER W/VENT •6.00 reason Owner Date WATER SYSTEM - 5.00 ACC:GATE ACG FILE NO. WORKE.RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 \I I hereby affirm that I have a certificate of consent to self-insure, I ZONING or a certificate of Workers Compensation Insurance,or a cc rtificd ENG.SITE NO.- copy thereof(Seo 3800,Lab.G)- Policy No Company O ❑ Cetiied copy ishereby furor d - FIRESPRINK ENERGYT-Z4 ' Z Z r Cell d' copy is filed wit city m�L tion division. O Applica ry' /�Z 6 MISC.-- REFER TO ORD. V ❑;' N❑ Y ❑ No ~ PERMIT ISSUANCE 10.00 G: -rn RTIPICAT OF EXEMPTION FROM WORKERS' FLOOD ZONE A.L.U.C. 'LU 2 COMPENSATION INSURANCE PLG.CONTR.. LIC'.NO. PLG. CL Cl . (This section need not be completed if the permit is for one TOTAL - Y❑ (.N❑ Y ❑ N❑ hundred dollars IS 100)..less.) - U O 1 certify that in the performance of the work for which this per- GTY• ' MECHANICAL PERMIT FEE' _ FEE SUMMARY LL 1- mil is issued,I shall not employ any person in any manner so as to O,W become subject to the Workers'Compensation Laws of California- "' y Date Applicant BUILDING } N NOTICE: TO APPLICANT: If,after making this Certificate oFET, � ALTER OR ADD TO MECH:' '' 5.00 H 2 emption,you Should become subject to the Workers'Compensation 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 IOMOC.F.M.)• 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 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 permit is Issued(See MICROFILM 3097,Civ.0.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Q Lender's Name HEATING UN IT 100,000 B.T.U.)9.50ELECTRICf7 rib Lender's Address I certify that I 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 toenter 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,judg ents, costs and expenses which PERMIT ISSUANCE - 10.00 CONST.TAX may in any way accrue again said ity in consequence of the ran m of this permit. MECH.CONT. LIC:NO. MECH. -�•Z-�- - TOTAL TOTAL �I/13D S' afore of plicant/Contractor Date OFFICE COPY