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18704 _ POST THIS CARD NEAR FRONT OF BUILDING "' PERMIT NUMBER CITY. OF CUPERTINO INSPECTION JINSPECTION DIVISION `, n, JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 2- �[ V' U,� �� UNIT# _LOT# ,PERMIT EXPIRESIFWORK OWNER CID Y ,_ CONTRACTOR CL! IS NOT STARTED WITHIN INSPEiCVION DA INSPECTOR INSPECTION RECORD 100 DAYS OF PERMIT ISSU- FOUNDATIONANCE OR 100 DAYS FROM NOTE ' LAS TCAL LED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERPUT VALMArION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ( / UNDERGROUND /SLAB PLUMBING - - y, d RN II•��'" 4�,/ ELECTRICAL - A:,,, nf.rar!Tflo ISSUANCE DATE MECHANICAL -• BLuc, ELeeTr PLG. MECR [ED] .. ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR - VALUATION T. PLUMBING - MECHANICAL ' PERMIT To ELECTRICAL " ' FRAMING `� q-.c INSULATION sr RIES TYPECONSTR. OCC,GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.FT.FLOOR AREA"TOTAL ACREAGE l� ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE - - DIAPHRAGM THE CONSTRUCTION TAXIS PAID BUILDING USE ROOF SHEATHING - ARES IND . CON PB O'l- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ Ej' 0 . ❑W ❑ ASSESSORS PARCEL NO ROUGH - SAN.# ' PLUMBING ELECT.ENERGY ' TRACT NO. r PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY ' ' MECHANICAL MECH.ENERGY " ELECTRICAL -ACC.DATE ACC.FILE NO BUILDING ENERGY " FRAMING ELECT.FINAL TEST INSULATION PLUMBING _ ZONING ENG.SITE NO. . � � GAS TEST GAS FIRE SPRINK ENERGY'T 2a . MECHANICAL YE] IN Y [:] NE COVER NO WORK UNTIL ABOVE HAS BEEN.SIGNED HEATING EXTERIOR SHEAR" _ ELECTRICAL RELEASE FL000 zUNE AL u.c. . - INTERIOR SHEAR FIRE DEPT. 'v NE] v N❑ SHEETROCK' GRADE - FEESUMMARY EXTERIOR LATH BUILDING INTERIOR LATH' - TEMPORARY APPROVALS` BUILDING; . SCRATCH COAT JELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. '.MICROFILM- ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC. tlP' �� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING ' o PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE = IMPORTANT! CONST.TAX 1 PLEASE READ REVERSE SIDE BEFORE TOTAL UD CALLING FOR FINAL INSPECTION. OFFICE COPY. APPLICANT'T 'FILUIN INFORMATION.WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER., Ooiiass APPLICATION &.PERMITne WBUILDING-ELECTRICAL-PLUMBING-MECHANICAL 18704 x7O4 PLANCHECKVALIDATION NAME OTY. ELECTRIC PERMIT FEE • PHONE NooN ORS' - UTLETS-SWITCHES-RECEP 10,00/1.00 LIONO. S.1]. _'J-'LIGHTING FIXTURES 10,00/1.00 sQ r-DNTRACTOR's APPLIANCES-RESIDENTIAL 4.00 - n9ooRlE,ss PANELS 10.00 - DATE OF APPLICATION ' RcwrscT PLAN CHECK FEE - - PANELS (OVER 200 AMP) 20.00 OR P,L NO. O ENGINEER LIC.NO. SIGNS TRANS. 3.00 moo,OR ENG' SPECIAL CIRCUIT " 1 5.00 PERMIT VALIDATION ESS" ZIP TEMP..METER OR POLE INS... . 20,00 ff �C APPLICANTSMO • ,Y 'l ADDRESS TORS ?O iO.ts: SEE FEE SCH. � n 3 //( �! ,�� %i➢.S SERVICE CHANGE' 20,00 '�T� o o LICENSED CONTRACTORS DECLARATION l g' <u u. I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE H¢U. (commencing with Section 7000)of Division 3 of the Business and - - BLDG. PLG. MECH. r N i Professions Code,and my license is in full force and effect. n R N 1QCII I ❑ ELEC ,❑ O z0 n - License Class Lic.Number. Q Z L ra w Date Contctor P: ,s-i - n BUILDING PERMIT X ¢w < OWNER-BUILDER DECLARATION ♦ ._ INFORMATION w3 LL y 1 hereby affirm that 1 am exempt'from the Contractor's License MISC.- REFER TO ORD VALUATION $/FT. Law for the following reason.(Sec 7031.5,Business and Professions PERMIT ISSUANCE IUO /.2,00 Code:Any city or county which requiresapermit to construct,alter, re ¢ ¢Q improve,demolish,or'repair any structure,prior to its issuance,also ELE .CONTR./ LIC.NO. ELEC. i m m u requires the applicant for such permit to file a signed slalemenl that F ry r / �� TOTAL �� PERMIT TO he is licensed pursuant to the provisions of the Contractor's License F z a Law(Chapter 9(commencingwith Section 7000)of Division 3 offle 4 0 Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ 1- the basis for tlhe alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. t by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(4500).)'. ❑ 1,as owner of the properly,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 property who builds or improves thereon,and who docs such workF IXTUR ES-PER TRAP 5.00 - SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. - mems a no not intended or offered for sale.IL however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner. GAS-EA.SV STEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or int RES IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,um 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:The Contractors 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 contractorts)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT N0. PARCEL NO. the CommcRlr's License Law. ❑ tum exempt under Sec.' .B.&P.C.Icor this WATER HEATER W/VENT 6.00 reason Owner Data WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COAIPENSAT ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofconsent to self-insure, - ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance;or a certified copy thereof{S v.3800,Lab.C.). q ^^ 1'olicY No.;O-AAC n pant-L�L�9"�/O if/' Q ❑ Certified copy' ereb islhed. FIRE SPR INK ENERGYT24 .e�Cenif is hl• t cit speclion division. ZZO Applicant W11 MISC.- REFER TO ORD. Y❑ N❑ v ❑ NE] CERTIFICATE OP EXEMPTION FROM WORKERS' PERMIT ISSUANCE - 10.00 FLOOD ZONE A,L.U.C. LU > COMPENSA'E10N INSURANCE - PLG.CONTR. - LIC.NO. eLG.' CL 0 (Phis section need not be completed If the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ D Z hundred dollars($100)or less.) U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE PEE SUMMARY LL H mit is issued.Lshall not employ any person in any manner so as to U become subject to the Workers Compensation Laws of California. '0 y DareApplicant ALTER OR ADD TO MECH. 5.00 BUILDING } W NOTICE TO APPLICANT: If,after making this Certificate of fix- F ? emption,you should become subject to the Workers'Compeasut ion APPLIANCE 5,00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE V such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,00011F.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(Sec. MICROFILM 3097,Civ.C.). - HEATING UNIT(TO.100,000 B.T.U.) 8.00 Lender's Name Lender's AddreName HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 ,Ile BOILER-COMP(3 H.P.Of 100,000 B.T.U.) 6.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000BTU1 SEEFEESCH. MECHANICAL above-mentioned properly for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in aKApaillmif. ce ainst said City in consequence of the PERMIT ISSUANCE 10.00 !an ltMECH.CONT. LIC.NO. MECH. yW�. `C �✓,Ll�it/ TOTAL TOTAL V U gnat re ntractor Date T- -7- OFFICE COPY