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16483 POST THIS CARD NEAR FRONT OF BUILDING - PERMIT NUMBER CITY-. OF CUPERTINO 6483 INSPECTION DIVISION JOB-INSPECTION'RECORD . ^PERMIT EXPIRATION. JOB ADDRESS -� ""'�V �� 7 UNIT# LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION • DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMITISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: - I LAST CALLED INSPECTION. ' LIFER ' -ALL GRADING`AND DRAINAGE SHALL BE INSTALLED - PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL - ISSUAN MECHANICAL - BLOC Ecec T. PLG. . MECR 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED S BUILDING PERMIT INFORMATION ' WOOD FLOOR - VALUATION - $/FT, i PLUMBING - - I MECHANICAL - ELECTRICAL - PERMIT �TTO�µ I FRAMING STORIES TYPE CONSTR, 1 INSULATION - Ly - OCCGROUP RES UNITS I■Ilf �' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED •' _ $O.FT.FLOOR AREA TOTAL ACREAGE .ROOF NOTE:NO FINAL INSP:SHALL BE MADE BEFORE DIAPHRAGM - THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES No CON PB OMI,, ; APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE ' INSP.' ASSESSORS PARCEL NO ROUGH SANA PLUMBING - - ELECT.ENERGY I S TUBS&SHOWER PAN PLUMBING ENERGY ` � TRACT NOPARCELNO. ' MECHANICAL MECH.ENERGY - ELECTRICAL - BUILDING ENERGY Acc. o onrE A FRAMING ELECT.FINAL TEST ZONING. ENG.SITE NO. INSULATION PLUMBING GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T;24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "o "o FLOOD ZONE ALUC. - I EXTERIOR SHEAR ELECTRICAL RELEASE v N� v ❑ No' INTERIOR SHEAR FIRE DEPT. SHEETROCK• GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS , BJ)ILOwG�_ r SCRATCH COAT ELECTRIC - PLAN CHECK - GAS FEE NOTAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE �r OCCUPANCY OF BUICDIN G IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM. ARRANGE FOR INSPECTION-BY PHONING 252-4505, ELECTRIC UJ � ONE WORKING DAY BEFORE REQUIRED..INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING.` I . SEE PERMIT FOR.EXPIRATIONI DATE - MECHANICAL- IMPORTANT! coNST..rAx PLEASEREAD REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL! ' . " OFFICE COPY OL"Tirlr S I�n�'�' 40 ✓ APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL Pt7fNT PEN. L r " ' BUILDING PROJECT IDENTIFICATION PERMIT NUMBER N,LEANG APPLICATION & PERMIT q C A Q3 OR s Dis _ (51 I U`F U �• K BUILDING -ELECTRICAL-PLUMBING-MECHANICAL Ly,•.e� PLAN CHECK VALIDATION ` ", 4 E OTY. ELECTRIC PERMIT FEE •Wf CONTRACTORS N ME. OUTLETS-SWITCHES-RECEP 10.00/1.00 moffilIc.No LIGHTING FIXTURES _ 10.00/1.00 GONYTIACTOR's APPLIANCES-RESIDENTIAL 4.00 A�E FHON PANELS10.00 DATE OF APPLICATION d4 RCNrtECT - PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) O 20.00 ENGINEER - - • - uc,No. ISIGNS TRANS. 3.00 ADDRESS ENO SPECIAL CIRCUIT 5.00 PE MITVALIDATION -ZIP TEMP.METER OR POLE INS.' 20.00 APPLICANT sMOTORS SEE'FEE SCH. / MDOREs '. SERVICE CHANGE 20.00 S o LICENSED CON'FACTORS DECLARATION 0o 1 hereby affirm that 1 am licensed under provisions of Chapter9 ISSUANCE E - y z"' (cam me nein with Section 7000)of Division 3 of the Business and 10 N g BLDG. ELECT. PLG. MECH D i Pmfeseians Code m 1 license is in full to n ❑ ❑ ❑ Z o`,%,- License .la Lie..Natn¢er - D w w Date - Craumctnr ► SEP 13199 a Y E BUILDING PERMIT OWNER-BUILDER DECLARATION a wU INFORMATION w ;v vHi 1 hereby a(Onn that I am exempt from the Contractors License MISC.- _ uoa Law for the following reason.(Sec.7031.5,BusinesslandPro@scions PERMIT ISSUANCE _ VALUATION $/FT. 3wCode:Anycily orcouity which requires a permit to construct,alter, Q Q Q D Improve,demolish,or repair any structure,prior to Its IssnallCe,aISO ELEC.CONTR. LIC.NO. ELEC. O u requires the applicant for such permit to file 3signed statement that TOTAL PERMIT TO e w m he is licensed pursuant to the provisions of the Contractor's License HiQ Law(Chapter9(commerciag with Section 7000)of Division 3 ofthe 4 D Business and Professions Code)of that he is exempt therefrom and OTY. PLUMBING PERMIT FEE X 1- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant toss civil penally ALTER-DRAIN -WATER (EA.) 5.00 n of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEVICE 4.00 ace.GROUP REB.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sea 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 T� Code:The Contractor's License Law does not apply to an owner of V property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 So.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such imp rove GAS-EA.SVSTEM-11NC.40UTLET$ 6.00 mems are not intended or offered for sale.If,however,the building - V;. =� or improvement is sold within one year of completion,Inc owner GAS-EASYSTEM-OVER 4 IEA.) 2.00 BUILDING USE •-,�• builder will have the burden .en of proving that he did not build or im- - RES IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the properly,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:'I'he 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 ' contracts for such projects with a contractor(S)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA,200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt no der Sec.-,BARC.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 i ACC.DATE ACC.FILE NO. WORKF.RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby atfirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copytiter- Lnb.Ct }���W 1'o1 Nr�,/•(ary'fyM(/$ mPanY-+�' r` O ❑ Ce tirt red co e by famished FIRE SPRINK ENERGY T-24 Z Z Certi�fied �co�.yy�ias filed'wi I ti y�'q�ec ryh div MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ O A hcant_ yir� Y N .Y N ~ rn PERMIT ISSUANCE 10.00 FwoD ZONE A.L.u.c.' LU CL j' CERTIFICATE OF EXEMPT'TION FROM WORKERS' COMPENSATION I NSURANCIi PLG.CONTR. LIC.NO. PLG. tl O (This section need not he completed if the permit is for one TOTAL V❑ N❑ Y❑ N❑ Z hundred dollars IS 100)or less.) G U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT 1.6 FEE FEE SUMMARY F iss U_ mit is ued,I shall not employ any person in any manner so as to U become subject to the Workers m Copensation Laws Rf California. 0 G.W UMe - Applicant ALTER OR ADD TO MECH. U DING } W NOTICE TO APPLICANT: If,after making this Certificate of F.x- ♦- Z eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN C ECK 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 IOPMC.F.M.) 6:00 SEISMIC FEE. �1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of hhe work(or which this permit i issued(Sec. MICROFILM 3097,Civ.C.l. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Nam 0 K' HEATING UNIT 100,000 B.T.U.)9.50 ' s-, Lender's Address - _ /•� ELECTRIC' Icertifylhsstlhavereadthis oat dTSIL• ea VENTILATIONFAN (SINGLE) 4.00 A+ S� information is correct. I agree to comply with,all city and county y 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 to enter upon the BOILER-COMP DJA68BTU)SEE FEE SCH. �• MECHANICAL o �• above-mentioned property for inspection purpoxs. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE CONST.TAX may in an way true against said City in consequence of the W mating is rut. MECH.CONT. LIG NO. "E"L TOTAL C �'y� 335 ignamr o ppl an[/Contractor 1 ate Diu rv- - • OFFICE COPY.