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17905 i POST THIS CARD NEAR FRONT OF BUILDING . w •'=—•V.:. PERMIT NUMBER ' CITY OF CUPERTINO 17.95 �- INSPECTION DIVISION ti.' \ �7(� JOB INSPECTION RECORD l ���ZpUG �� 6� UNIT LOT PERMIT EXPIRATION JOB ADDRESS PERMIT EXPIRES IF.WORK n f OWNER c�, YV\e$ L a CONTRACTOR e - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD X180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE:• ' LIFER � � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. ? ,,,Y GARAGE SLABS 1 f POUR NO CONCRETE UNTIL ABOVE HAS BEENSIGNED - - UNDERGROUND /SLAB � ` •'O 2' v.• 'I,1 ✓C4_ PLUMBINGml wr ELECTRICAL 1.. ISSUANCE DATE MECHANICAL .BLDG ELEcr. Pu; MECH. w Gl. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED _'ZZ— Mf1-�'IZ<'Z'R J�'T BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING - vnwn STET. MECHANICAL - 5 e ELECTRICAL FRAMING INSULATION' �A��WA 2 STORIES TYPE CONSTR y �6�4 -5- 9-2R"l7erlo SRQAloy T1,a.:-,�ous x-ra>_,s cc. ' 5'Z 6' F�E1"H'G'T.C.. occ cNouP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED S 30 4 s eaTczoJc4G ROOF NOTE:NOLFI NAL INSP.SHALL BE MADE BEFORE 50-Pr FLOOR AREA roraL ACREAGE DIAPHRAGM' 'THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING ' RCS IND CON PB Dmf, APPLY NO ROOFING UNTIL ABOVE HAS'BEEN SIGNED FINALSDATE INSP. D ❑ ❑ El El / ASSESS095 PARCEL NO. ROUGH SAN.# PLUMBING ELECT.ENERGY TRACrNO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL. - MECWENERGY ELECTRICAL BUILDING ENERGY ACC.DATE ACC FILE NO FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION - - - PLUMBING � � - .. , GAS TEST, GAS MECHANICAL IR SPRINK ENERGY T.2a COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y "[:] Y ❑ "� EXTERIOR SHEAR ELECTRICALS RELEASE EL ZONE A.Luc. (/Y N❑ Y L NO: INTERIOR SHEAR FIRE DEPT. L SHEETROCK — .11 GRADE - FEE SUMMARY EXTERIOR LATH, BUILDING . INTERIOR ,. BUILDING TEMPORARY PROVALS SCRATCH COAT - - ELECTRIC PLAN CHECK GAS FEE NO'FAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM. T � LU ARRANGE:FOR.INSPECTION BY PHONING 252-4505, ELECTRIC I— ONE WORKING DAY BEFORE, REQUIRED INSPECTION. PLUMBING O� PLEASE GIVE JOB ADDRESS WHEN PHONING: . `t ' LL z MECHANICAL -_SEE PERMIT FPR EXPIRATION DATE - IMPORTANT! coNsr.TAx PLEASE READ REVERSE SIDE BEFORE TOTAL 1 1 5 (X CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN.ONLY BQI LDI NO PROJECT I DENTI FICATION I PERMIT NUMBER _ BUILDING 46t APPLICATION & PERMIT 17905 aD RESS�/ .1. /_J/ BUILDING —ELECTRICAL—PLUMBING—MECHANICAL JO FR'S PLAN CHECK VALIDATION N ME QTY. ELECTRIC PERMIT (FEE J7 I PRONE 1 NArNlk1RAc�Rs �` UTLETS-SWITCHES-RECEP 10.00/1.00 f 10 L- Jq3 LIGHTING FIXTURES 10.00/1.00 ADOR cions PPLIANCES-RESIDENTIAL 4.00 AOORE�ys PHONE - PANELS 10.00 DATE OF APPLICATION - ARCHITECT PLAN CHECK FEE P.C.NO. OR - PANELS (OVER 200 AMP) 20.00 ENGINEER LIC.NO, SIGNS TRANS. 3.00 ADDRRiSS ENG. SPECIAL CIRCUIT 5.00 PERMIT VA(L�ICATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS ASEE FEE SCH. ooREss ISERVICE CHANGE ' =20.00 .A ^ 4��k�CL( a c z Foo LICENSED CONTRAC'T'ORS DECLARATION ^ a i w I hereby affirm that I am licensed under provisions of Chapter 9 ) ISSUANCE DATE (commencing with Section 7000)of Division 3 of the Business and 1"9BLDG. ELECT. PLG. MECH. DO Professions Code,and my license is in full force and effect. u ❑ ❑ ❑ Dale License Class Lia Number IY1y/1 9 Contract., y - ¢ a OWNER-BUILDER DF.CLARA'PION City of Cupertino BUILDING PERMIT — o a O INFORMATION w3:u H 1 hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO ORD Fuoa Law for tlta following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE VALUATION $/FT. y w Code:Any city or county whichrequiresa permit l0constneLalter, 10'00 (_6 a 2 Q Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR, LIC.NO. ELEC. D u requires the applicant for such permit to file a signed statement that TOTAL PE w m u he is licensed pursuant to the provisions of the Contractor's License F > Law IT 9(commencingwith Suction 7000)of Division 3 of 0e s i o• Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE a r— e $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYqE CONSTR. by any applicant for a permit subjects the applicant toacivil penalty gLTER-DRAIN -WATER (EA.) E.00 of not more than five hundred dollurs($500L): ❑ I,as owner or 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,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of properly who builds'or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SG.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- memsarenotintended or offered for sale.If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA:SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove for purpose of sale.). RES IND CON PS Orher ❑ I,as owner of the property,um exciomycly contracting with INDUSTRIAL WASTE INTER. 30.00 El ❑ ❑ ❑ 11 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 builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 ,on Cants for such projects with a coneracmgs)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License is w. TRACT NO. PARCEL N0. ❑ I am exempt under Sec,.,B.T.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPF.NSA"I']ON DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconsent to sell'-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800 ab.C.). Policy No. in any - Cqf,�CC tilled op hs hereby unis}I Z Z Seticd y i- wth he speClinn Division. FIRE SPRINK ENERGY TQ4 p: O Applicant MISC.- REFER TO ORD. y C] N y [:JNr rnPERMIT ISSUANCE 10,00 � CIiRTIPICATEOFEX . ION FROM WORKERS' FLOOD ZONE q.LU.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O (This section need not be completed if the permit is for one TOTAL y❑ N❑ V E] NC] LD Z hlmd,ed'dollars(S100)orlcssJ U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any perum in any manner so as to ` O W hecome subject to the Workers'Compensation Laws of California. _ 6 Date A licant BUILDING } W NOTICE 'f0 APPLICANT: IL after making this Certificate of Ex- 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 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE �D I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the petl'onmance of the work for which this permit is issued(Sec. MICROFILM t� 3097,Civ.C.L HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name HEAT]NG UNIT(OV ER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct t I agree o comply with all city and county PLUMBING ordinances and slate laws relating to to building construction, and BOILER-COMP(3 H.P.Or 100,0008.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. Cupertino against liabilities,judgmen costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in u way accrue ages; sj City in consequence of the anting this per IL MECH.CONT, LIC.NO. MECH. TOTAL TOTAL . Btu of pf mctor Date OFFICE COPY