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18881 ..POST THIS'CARD NEAR FRONT OF BUILDING PERMIT NUMBER " CITY OF CUPERTINO ` 188$1 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRE S / U Z i - N Ob ��E- 'UNIT# -_L'OT# .I`. PERMIT EXPIRES IF WORK, OWNER !e (✓p yy� CONTRACTOR © �( IS NOT STARTED WITHIN INSPEPATON DATEI INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSu- FOUNDATION NOTE: ANCE OR 180 DAYS FROM � UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE - ' - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAL DATION CUPERTINO STANDARDS, GARAGE SLABS • jl POUR NO CONCRETE UNTIL'ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ti �- PLUMBING 'JAI'll ,L 17:3 \�., ..�,.•; 1!, 1 C! b .-,, ELECTRICAL � IssuANCE DATE - MECHANICAL ("!T"mirtiRn BLDG ELECT. PLG. MEC.. ❑ ❑ X ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION , .SIFT. PLUMBING MECHANICAL - ELECTRICAL �,/(/Ti 1,P,E.RMI�I TO - FRAMING, - f STORIES TYPE NSTH, INSULATION / - t OCC.GNOUP RES.UNITS -PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' SO.FT FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAININSP.SHALL BE MADE BEFORE 'DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOFSHEATHING HES SND - CON PB Do— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ' ❑ ❑ ❑ ❑ ASSESSORS PAHCE L N0. ROUGH SAN.N PLUMBING- ELECT,,ENERGY - • TUBS 8 SHOWER PAN � PLUMBING ENERGY TRACT NO. PARCEL NO, MECHANICAL MECH.ENERGY ELECTRICAL ACC DATE, ACC.FILE NO. BUILDING ENERGY FRAMING ELECT.FINAL TEST INSULATION r - PLUMBING ZONING ENG,SITE NO. GAS TEST - GAS MECHANICAL FIRE SPRINK• ENERGY LZG �^ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ Y [:] "❑ FLOOD ZONE A.L UC EXTERIOR SHEAR ELECTRICAL RELEASE ' INTERIOR SHEAR FIRE DEPT. Y❑ N❑ . Y ❑ No SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH IBUILDING . - INTERIOR LATH- - TEMPORARY APPROVALS BUILDING . SCRATCH COAT - ELECTRIC PLAN CHECK GAS. .. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE, FOR INSPECTION BY P=DATE - T ELECTRIC I`J ONE WORKING DAY BEFORE RE I- i PLUMBING -V a 0 p WHEPHONING'.Z� LEASE GIVE JOB ADDRESS - SEE PERMIT FOR EXPIRMECHANICAL IMPORTAN ! CONST. TAX 1� PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY +BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT ADDRESS' BUILDING—ELECTRICAL—PLUMBINGMCHANICAL ' q p p p E OWNE PLAN CHECK VALIDATION rvAME A�Ol�GoN�uw� OTY. ELECTRIC PERMIT FEE ' r'ROW PRONE NAAMERACTORs UTLETS-SWITCHES-RECEP 10.00/1.00 - .No. LIGHTING FIXTURES 10.00/1.00 CDDRESS TOR A "p4� off- PPLIANCES-RESIDENTIAL 4.00 NTRAC ,6%Z0 sr. 714N PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP[ 20.00 PLAN CHECK FEE P.C.NO. ENGINEER uc.No. SIGNS TRANS. 3.00 ADDRRESS ENO. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT SMOTORS SEE FEE SCH. ADDRESS Z7_ SERVICE CHANGE 20.00 -\\''� r, ��f '09 o LICENSf:U CONTRACTORS DECLARATION l I/T4 r" u w I hereby affirm that I am licensed under provisions of Chapter 9 [ISSUANCE DATE N< n (commencing with Section 7000)of Division 3 of the Businessand _ �y BLDG. ELECT. PLG. MECH, F N i Professions Code ,n m license is in full force an— fee 1JAN ❑ ❑ m Q Z Z N 0 License Class Lic.Number f w H w Date Q_Contractor ¢sc s BUILDING PERMIT ¢ a ¢ QWNISR-BUILDER DEC L ATION I of rI nn 60 a v INFORMATION Ax g: L Ha I hereby affirm that I am exempt from the Contractor's License MISC.— -REFER TO ORD . w VALUATION $/FT. .. o J Law for the following reason.(Sec.703L5,Businessand Professions _ PERMIT ISSUANCE 10.00 Q rQn� Code:Anycounlywhiy structurepermit toconsaalter, improve,demolish,D!repair any structure,prior IV Its issuance,aISO ELEC.CONTR. LIC.N0.¢ ELEQ wm u req Vires the applicant for such permit to file a signed statement that - - TOTAL PERMIT TO he is licensed pursuant to the provisions of the Contractor's License H i i Law(Chapter 9(commeneingwith Section 7000)of Division 3 ofthe (/v J ¢ Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE 111 M o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE C NSTR. by any applicant for a permit subjects the plicunt too civil penalty ALTER-DRAIN&VENT-WATER (EA.)JiCO of not more than five hundred dollars($5 0)J: ❑ I,as owner of the property,or employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC,GROUP RES.urvlTS their sole compensation,will d0 the ark,and the structure is not intended of offered for sale (Sec. 44, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License L does not apply to an owner of Property who builds or improve hereon,and who docs such work FIXTURES-PER TRAP .L6B pa so.PT.PLooR AREA TOTAL ACREAGE himself or through his own em oyees,provided that such improve- ments ore not intended or off ed for sale.If,however,the building GAS-EA.SYSTEM-I1NC.4'OUTLETS 66B ,ez or improvement is Sold witf' one year of completion,We owner- GAS-EA,SYSTEM-OVER 4 (EA.) 2.00 builder will have the burd of proving that he did not build or im- BUILDING USE - prove for purpose of sale. RES IND CON PB Omer ❑ I,as owner of th property,am exclusively contracting with INDUSTRIAL WASTE INTER, 30.00 ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORSPARCEL NO. and Professions Code: he Contractor's License Law does not apply to an owner of prop sty who builds of improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such ojects with a conlractoos)licensed pursuant to the Contractor's L' ensu Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. _ PARCEL NO. ❑ lame xt I under Sec. ,B.&P.C.for this WATER HEATER W/VENT reason Owner Date WATER SVSTEMjpBO ACC.GATE 'ACL.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 " 1 hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy Ihereo f ro. BOQ p.my-. Policy No. mpany_u_F(/ c/r— O ❑ Certified copy iS l eby All i"J. FIRE SPRINK ENERGY T-24 Z Z Certified c py filed with rIhe pity inspection division. MISC.- REFER TO ORD. O ApKcant 7frr Y ❑ N❑ Y ❑ N❑ Fy PERMIT ISSUANCE IW FLOOD ZONE A.L.U.C. Cr CER FICATE COMPENSATION FROM WORKERS, W � COMPIiNSATION INSURANCIi PLG.CONTR. - LIC.NO. PLG. ' CL Z (This rection ed not be completed if the Pernod is for cine TOTAL Y Z�• V d ❑ N❑ Y❑ N❑ hundred dollars(S 100)or Icss.) U O 1 certify that in the performance of the work For which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY W F mit is issued,1 shall not employ any person' 'any mannerw as to U become subject t0 Bre Workers'Compensa n Laws of Culiforniu. O y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } In NOTICE TO APPLICANT: If,after eking this Certificate of Ex- ? emption,you should become subjec o the Workers'Compensation APPLIANCE -5.00 PLAN CHECK - .. provisions of the Labor Code, a must forthwith comply with FEE U such provisions or this permit sh he deemed revoked. AIR HANDLING UNIT(TO 10MCF.M.) 4.00 CONSTRUCT[ LENDING AGENCY AIR HANDLING UNIT(OVER I0=C.FVL) 6.00 SEISMIC FEE I hereby affirm that th a is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the309 ,C'mCrance of tire MICROFILM e s rk for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UN IT(OVER100,000 B.T.U.)9:50 ELECTRIC Lender's Address . 1 certify that I he real this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.1 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 to enter upon the BOILER-COMP(Over 100000 BTU)SEE FEE$CH. MECHANICAL ubove-meutioned property firinspection purposes, - - (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way ccrue against said City in consequence of the PERMIT ISSUANCE 10,00 ranting of this r�rit. MECH.CONT. LIC.NO. MECH. �. A TOTAL TOTAL V t re App cit/Contractor Date - OFFICE COPY