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18589 POST THIS CARON EAR FRONT`OF BUILDING RM;TNUMRER CITY 01 " CUPERTINO 1$5$9 INSPECTION DIVISION JOB INSPECTION RECORD ' I �- PERMIT EXPIRATION l JOB ADDRESS 6 t,7'l`f p lau F—``L' UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR L 'K IS NOT STARTED WITHIN INSP C ION DATE INSPECTOR INSPECTION RECORD 180 Dnvs OF PERMIT Issu" FOUNDATION ANCE,OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAL BE INSTALLED PR EGUNITE• TO COMPLY WITH THE APPR�S AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABSto 1989 - --'� POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED " UNDERGROUND /SLAB , ff PLUMBING at - ELECTRICAL ISSUANCE-DATE MECHANICAL eLDc. ELECT. • PE MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING /j-/vinwanoN IT SIFT. - MECHANICAL PEHMIT TO ELECTRICAL r. -/ FRAMING - •' - 1A-'T IC"' :I• VC Cr STORIES TYPE CONSTH. INSULATION OCC GROUP . RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - SO.FL FLOOP AREA 10LaL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE' DIAPHRAGM THE CONSTRUCTION TAX IS PAID - eulLDwc USE ROOF SHEATHING RES IND CON PB Om- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH SANA PLUMBING • ELECT,ENERGY- TRACT-NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY '3 MECHANICAL MECH.ENERGY ' PCL DATE ACC.FILE NO ELECTRICAL - BUILDING ENERGY FRAMING ELECT,FINAL TEST, ZONING ENG,SITE NO. • INSULATION PLUMBING • GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T2 . (] N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 'HEATING `' N❑ FLOOD ZONE A L U.C. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. v0 ND YL N❑ SHEETROCK GRADE FEE_SUMMARY EXTERIOR LATH BUILDING m-77-TT BUILDING PU� INTERIOR LATH - 'TEMPORARY APPROVALS SCRATCH COAT ELECTRIC - PLAN CHECK `r GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �_aU F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING., — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX r PLEASE READ REVERSE SIDE BEFORE TOTACr CALLING FOR FINAL INSPECTION. I OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING ADORES APPLICATION & PERMIT PO Q _D BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 1 8589_ [ on OWNER'S PLAN CHECK VALIDATION NAME E 7 L.6-% 7,/BaM QTY. ELECTRICPERMIT FEE PHON NAME en's UTLETS-SWITCHES-RECEP 10.00/1.00 ,D L_ iczQ LIC.NO. 1n. LIGHTING FIXTURES 10.00/1.00 ,O CONTRACTOR'S PPLIANCES-RESIDENTIAL 4.00 ADDRESS pp p SI L_Otirz lriii PHON p V8 PANELS 10.00 DATE OF APPLICATION ARCRITECT PANELS (OVER 200 AMP) 20.00 GINEE� PLAN CHECK FEE PC ; .NO. , OR p.1 � ENM Q,(J C.NO. 1 1 5 SIGNS TRANS. 3.00 ADDRESS ENG _ SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 ADDDRESSDRESS AMOTORS SEE FEE SCH. �1 SERVICE CHANGE 20.00 `' T IA w 00 LICENSED CONTRACTORS DECLARATION V' ` V`J PMD < u w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE y< N (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. �. y z Professions Code,and my license is in full force and effect. ❑ ❑ oi w o License Class Lie.Number ,U F ,A H J Date Contractor a x , BUILDING PERMIT ¢ ¢w OWNER-BUILDER DECLARATION INFORMATION wO e r I hereby affirm that 1 am exempt from the Contractor's License MISC.- ETrTcr ORD �+ u w VALUATION $/FT. rn.o J Law for the following mason.(Sec.7031.5,Business and Professions -PERMIT ISSUANCE 10.00 44 - m 0 Code:Any city or county which requires permit to construct,alter, /s OD a2Q40 improve, or repair structure,prior to its issuance.also ELEC.CONTR. LID,NO. ELEC. /� ob 6� O ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO n w m a. he is licensed pursuant to the provisions of the Contractor's License i Law(Chapter 9(commencingwlth Section 700()o'Division3oflhe �]` r 2 a Business mud Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE LT � `C�' �1 'Q- ¢ H the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. s ;R by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN -WATER IEA:) 5.00 of not more than five hundred dollar(S500)J: ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEV ICE 4.00 OCC GROUP RES.UNITS their Sole compensation,will do the work,and the structure is not intended or offered for sale (See. 7044, Business mud Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACREAGE Horns are of ugh intends own employees, ered forspmIf,ho hbsuch improve. GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 mems ore not intended or offered for sale.If.however,the building ar improvement is sob within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving Thus he did not build or int RES IND CON PB Omer Prove for purpose of sale). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property.am exclusively contracting with ED ❑ 11 1:1 ❑ 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 contracts forsuch Pfojectswith a contraclols)licensed pursuant to SEWER-SANITAR V-STORM EA.200ft/70.00 the Contractor's License Law. - TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 reason - Owner [)ate WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconsenl to sel4insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sea 3800,Lab.C.). - Policy No. ' Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z a[Certi�fSi d� copy is filed with the city invectom division. O Applicant G:..r( l� I MISC.- REFER TO ORD, y❑ N❑ Y ❑ N❑ ~ w� PERMIT ISSUANCE , 10.00 FLOOD ZONE A.L.uc. LU CERTIFICATE OI'EXEMPTION FROM WORKERS' W COMPENSATION INSURANCE, PLG.CONTR. CIL.NO. OLD. V❑ N❑ Y❑ N❑ Z (This section need not be completed if the permit is for one _ TOTAL hundred dollars IS 100)or less.) U O 1 certify that in the performunce of the work for which this per. QTY MECHANICAL PERMIT FEE FEE SUMMARY 1L, F mil is issued.I shall,not employ any person in any manner so as to Ubecome subject to the Workers'Compensation Laws of California. 0. Date BUILDING //Applicant ALTER OR ADD TO MECH. 5.00 E } m NOTICE TO APPLICANT: If,alter making this Certificate of Ex- emption,you should became subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with i U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 FEE � 6 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 3097 performance MICROFILM )Ace of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's No Lender's Address 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 information is correct.I agree to comply with all city and county PLUMBING ordinances and stale laws relating to building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 6.00 - hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU(SEE FEE BCH. MECHANICAL shove-mentioned property for inspection purposes. (We) agree to save, indemnify and keep hamuless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments,costs and expenses which ,PERMIT ISSUANCE 10.00 CONST.TAX ay in any way accrue against said Cityin consequence of the rooting Of this permit MECH.CONT. LIC.NO. MECH. TOTAL TOTAL 4 / Signelure of Applicant/Contractor OFFICE COPY