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18586POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 8586 INSPECTION DIVISION ' JOB INSPECTION RECORD PERM17 EXPIRATION, T//TI//I��)1 JOB ADDRES5�1!`� UNIT# _ OT# 'll�jl�•- ''` // PLERMIT EPIR851F WORK OWNER CONTRACTOR IS, NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- INSPECTION DATE INSPECTOR INSPECTION RECORD ANCE OR 180 DAYS FROM FOUNDATION - NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CIN OF LASTCALLED INSPECTION. b' UFER PR EGUNITE 'PERMIT VAI.m ATION I CUPERTINO STANDARDS. "" N jj} yt,. . \.`�t g211 GARAGE SLABS BEEN SIGNED POUR NO CONCRETEUNDERGROUND `@@'�ggO'ee - /SLAB PLUMBING TIFF' .N 1170.7 ISSUANCE DATE ELECTRICAL MECHANICAL' r ww BLDG ELER T ❑ ❑ PLG, MECH ❑. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED A. BUILDING PERMIT INFORMATION " WOOD FLOOR VALUATION $IFT.' PLUMBING - MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION STORIES, TYPE CONSTR. • /O2� . RES. UNITS" , 7..P_- PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID" SOFT. FLOOR AREA ' TOTAL ACREAGE DIAPHRAGM BUILDING USE ROOF SHEATHING REs IND co PB O,n,, . El APPLY NO ROOFING UNTIL -ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PAHCE L NO_ ROUGH SAN.# PLUMBING ELECT. ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO ' .PARCEL NP MECHANICAL - MECH..ENERGY _ ELECTRICAL - BUILDING ENERGY ACC.DATE ACCFILENO FRAMING ELECT. FINAL TEST INSULATION "PLUMBING i zoNlNc ENG, SITE No. " GAS TEST' - GAS - FIRE SPRINK ENERGY TZ4 - MECHANICAL . ❑ N❑ Y El NEI COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE YE] No AX U.C. Y L _ NE3 INTERIOR SHEAR FIRE DEPT. _ SHEETROCK •- GRADE-' -�. FEESUMMARY EXTERIOR LATH BUILDING BUILDING ._.--•-- INTERIOR LATH - TEMPORARY APPROVALS SCRATIGHCOAT. ELECTRIC - PLAN CHECK . FEE ' �''"•� - - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE" _ z OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL 19SIGNED BY BUILDING INSPECTOR. • MICROFILM : ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC PLUMBING` FIN ONE WORKLNG DAY BEFORE REQUIRED' INSPECTION. o PLEASE GIVE JOB ADDRESS WHEN PHONING. ZI -SEE PERMIT FOR EXPIRATION DATE - MECHANICAL CONST. TAX . IMPORTANT! TOTAL, � ,; PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. OFFICE COPY :, L 0. Z 2 N cc T LU _ D. 0 Uo LL U 0a I"' 2 `i. 10 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER p [ [� O J o BUILDING Aoo E // / �0 2D• LJL7 NAMER'S _ "AME GOND f(�LI PHONE QTV. ELECTRIC PERMIT FEE AN CHECK VALIDATION /7 CONTRACTOR - ME - OUTLETS -SWITCHES-RECEP 10.00/1.00 I a 1 /./ rZ/l/ IC Llc.N4/,J-7 '�1\ DATE OF APPLICATION LIGHTING FIXTURES .10.00/1.00 7DR DRESS k4ja DREss p TJ B /til NE PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 /R Hlracr OR ENGINEER • uc.No. PANELS (OVER 200AMP) 20.00 PLAN CHECK FEE P.C. NO. •SIGNS TRANS. 3.00 ADDRESS era SPECIALCIRCUIT 5.00 PERMIT VALIDATION rrEMP. METER OR POLE INS. 20.00 ' ZIP APPLICANTS AD DRESS, . - ' - MOTORS SEE FEE SCH. SERVICE CHANGE20.00 LICENSED CONTRACTORS DECLARATION - I hereby SMITH that I San licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Professions Cod • an license is in full fo-r�er� a 4C(� License Class - Lie. Nwnbefi( "7 0 BLDG. ELECT. PLG. MECH. ❑ ❑ ❑ Da[ene=� Cont roc tot MR - �of BUILDING PERMIT - OWNER -BUILDER DECLARATION I hereby oollo ing I am exempt from the Contractor's License Law forthefollowingreeson.ch(See. Professions a Business to requires Code: Any city or coo my which structure permit consuance, also improve, demolish, or repair any structure, prior n its issuance, also requires else applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of theceor s License INFORMATION A MISC. - REFER TO ORD VALUATION PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ET ' TOTAL PERMIT TO QTV. PLUMBING PERMIT FEE Law (Chapter 9 ( commencing with Section 7ofDiDivision 3 ol'the ofDivision exempt therefrom and Business and Professions Code) or that he iss exempt the basis for the alleged exemption. Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant toacivil penalty of not more Ilion five hundred dollars (5500).): / ALTER -DRAIN & VENT -WATER (EA.) 5.00 ❑ I, as owner of the property or my employees with wageses their Sale compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4,00 C. CUP REB. UNITS 'Z DRAINS -FLOOR, ROOF, AREA,COND. 5.00 Code. The Contmetor'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- mentsare not intended orOfferedfor sale. If, however, the building FIXTURES - PER TRAP 5.00 s T. FLOOR AREA TOTAL CREASE GAS-EA.SYSTEM-11NC.4OUTLETS 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- prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with GAS - EASYSTEM -OVER 4 (EA.) 2.00 . BUILDING u RES IND CO PR Oshe, El 11 ❑ ❑ INDUSTRIAL WASTE I LATER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESS RS PARCEL NO. licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who huRds or improves thereon. and who con tracts for such projects with a contractor(s) licensed pursuant to the Contrucenl s License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-. B.&P.C, for this WATER HEATER WIVENT 6.00 Noun Owner Date WATER SYSTEM 5.00 ACC. DATE . ALC. FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconsent to self -insure. or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE.NO. copy thereof (Sec. 3800, Lab.C.). Policy No.Company ❑ Certified copy is hereby furnished FIRE SPRINK ENERGY T-24 'Certified copy i fed will}}, the city 'inspection division. APPlicanl1(1MN-pA.'�i Y❑ :N❑ Y❑ N❑ MISC.-. REFER TO ORD. CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE '9(101 FLOOD ZONE A.L.U.C. PLG.CONTF. LIC. NO.PLG. TOTAL COMPENSATION INSURANCE (This section need not be completed if the permit is for one V ❑ N❑ Y ❑ N❑ OTY. MECHANICAL PERMIT FEE - FEE SUMMARY hundred dollars (SIGH or less. ) 1 -certify that in the performance of the work for which this per. mil is issued. I shall not employ any person in any manner so m to BUILDING �- become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- ALTER OR ADD TO MECH. - 5.00 APPLIANCE 5.00 PLAN CHECK FEE 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. AIR HANDLING UNIT (TO 10MC.F.M.) 4.00 AIR HANDLING UNIT (OVER 10,000C.FM.) 6.00 SEISMIC FEE ri� CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Dae work for which this Permit is issued (Sea 3097, CN.C.). EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00. MICROFILM HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC Lender's Name Lenders Address I certify that l have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER-CC1A1P (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC.'- REFER TO ORD. CONST. TAXt (We) agree to save, indennu and keep harmless the City of avegmtnls, costs and expenses which said City in consequence of the .PERMIT ISSUANCE 10.00MECH. CONT. LIC. NO. MECH.TOTAL TOTor - BAZ Date OFFICE COPY