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14880 POSTTHISCARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 148$0, INSPECTION DIVISION JOB INSPECTION RECORD ' PE RMITEXPIRATION JOB ADDRESS �_ / ' L '•✓/jGt UI001� UNIT#' '_LOT# t , . 'PERMIT"E XPIRES IF.WORK' OWNER ll CONTRACTOR _ IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD ieo Days oF,PERMIT Issu FOUNDATION - ANCE OR 18DAYS FROM :NOTE: LAST CALLED INSPECTION. LIFER - ALL GRADING.AND DRAINAGE SHALL BEINSTALLED ' TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERM1nr VALIDATION PREGUNITECUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I ^' ' UNDERGROUND /SLAB - - ,'- PLUMBING ELECTRICAL _ - ISSUANCE DATE MECHANICAL - BLDG. ELECT Plc_ •mECR. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED `D BUILDING PERMIT WOOD FLOOR - pA INFORMATION PLUMBING "" VALUATION SIFT. MECHANICAL PERMIT To ELECTRICAL FRAMING INSULATION srDRIEs TYPE coNSTR. '< DCG GROUP FRES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF - NOTE:NO FINAL INSP:SHALL BE MADE BEFORE sa FT-FLOOR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION,TAX IS PAID N BUILDING USE ROOF SHEATHING' - - - - RES INC CON PR 00", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS " ' DATE , INSP. �El L L 0 ASSESSORS PARCEL NO, ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO?, PARCEL NO. TUBS&SHOWER PAN - PLUMBING ENERGY ' MECHANICAL 'MECR ENERGY ELECTRICAL' . -/ BUILDING ENERGY " . ACC.DATE ACC,FILE No. FRAMING ELECT.FINAL TEST ZONINGENGf sIrE No, E, INSULATION PLUMBING" `� r GAS TEST - - GAS ' ' FIRE SPRINK ENERGY T 24 ' MECHANICAL.- ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' N[] FLOOD ZONE A.L.U.C. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. ' v L L,N' . r L, NL . SHEETROCK ' GRADE " FEE SUMMARY - EXTERIOR LATH _ . BUILDING - 6 \ " FFEE - INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT, ELECTRIC w'GAS'NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED. OCCUPANCY OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.ARRANGE FOR INSPECTION BY PHONING 252-4505, Lu ONE WORKING DAY.BEFORE REQUIRED INSPECTION. PILOMBING !v;; • O� PLEASE GIVE JOB ADDRESS WHEN PHONING.. z - MECHANICAL — SEE PERMIT-FOR EXPIRATION DATE — " , IMPORTANT!. covsT.TA PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION: TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY 8UI LDI NO PROJECT IDENTIFICATION - PERMIT NUMBER MIMINt APPLICATION & PERMIT �� 0 ADDRESS BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OW E 'S PLAN CHECK VALIDATION NAME % I9a?I� J.��"'w TV. ELECTRIC PERMIT FEE /GL InCte&411NS2- CONTRACTORS /d OUTLETS-SWITCHES-RECEP 10.00/1.00NAME I S� uc,rv0. LIGHTING FIXTURES_ '10.00/1.00 , CONTRACTORS - '� RESIDENTIAL 4.00 ADDRESS PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT 1 PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. oR ENGINEER _ L.C.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. 5.00 PERMIT VALIDATION ADDRESS - SPECIAL CIRCUIT zIP EMP.METER OR POLE INS. 20.00 APPLICANT'S / MOTORS SEE FEE SCH. — (1 . ADDRESS �J SERVICE CHANGE 20.00 / /GO woo LICENSED CONTRACTORS DECLARATION ! f (U 1 a U u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE vHi Q w (Commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. o Z Prafessions Code,and my license is in full force and effect. IK IFyv o.z� , W License Class Lic.Number ElIK IIvL`f- Date Contractor a m - BUILDING PERMIT rc w u OWNER-BUILDER DECLARATION INFORMATION le ;LL H I hereby affirm that I am exempt from the Contmclor's License MISC.- REFER TO ORD VALUATION u0� Law for the following reason.(See.703 1.5,ffiumassund Professions PERMIT ISSUANCE - vnLUOS/FT. HyW Code:Any citym county which requires a permit to construct,alter, - —� X100" SE aa Q Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. O u requires the applicant Cur such permit to file a signed statement that TOTAL 3 PERMIT TO whe is licensed pursuant to the provisions of the Contractor's License - Law(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe a Business and Professions Code)or that ha is exempt therefnun and OTV. PLUMBING PERMIT F� . Oo the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a3,: _ by any applicant for a permit subjects the applicant to a Civil penalty gLTER-DRAIN&VENT-WATER (EA.) 5.00 OCR arc than five hundred dollars($500).1: I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 DCC.GHOUP RES.UNITS t Cir sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Prolicomns DRAINS-FLOOR,ROOF,AR EA,CON D. 5.00 Code:The Contractor's License Law does not apply to an owner of 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 improve- memsarenotintendedorOfferedforsale.If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 4AO or improvement is sold within one year of completion,the owner. GAS-EA.SYSTEM-OVER IEA.) 2.00 BUILDING USE builder will have the burden of proving that hu did not built)or in, - RES IND CON PB Other prove for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensedcontractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V:B. 6.00 ASSESSORS PARCEL NO. and Prafessions 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 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 under Ser.—,B&P.C.for this . WATER HEATER W/VENT reason Gwn('k v - D' ' / WATER SYSTEM - 5.00 ACC.DATE ACC.FILE NO. WORKBRS'COMPENSATION DECI,ARA'I'[ON WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofconsent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers Compensation Insurance,or a certified - - copy thereof(Sec.3800,Lab.CJ. - Policy No. Company O ❑ Certified Copy is hereby fumished FIRE SPRINK ENERGY T-24' Z Z ❑ Certified copy is filed with the city inspection division. MISC- REFER TO ORD. y N Y N O Applicant E] ❑ ❑ ❑ PERMIT ISSUANCE 71600 a-� FLOOD ZONE A.L.U.C. LU CERTI FICATEPE EXEMPTION FROM WORKERS' W � COMPENSATION INSURANCE PLG.CONTR. LIC.NO. - PLG, y❑ N❑ Y ❑ .N❑ d O (Phis section need not be Completed if the permit is for one TOTAL 0 Z hundred dollars IS 100)or less.) V O I certify that in the Performance of the work for which this per- DTV MECHANICAL PER FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to OW become subject to the Workers'Compensation Laws of California. d Date Applicam ALTER OR ADD TO MECH. 5.00 BUILDING } to NOTICE TO APPLICANT''. If,after making this Certificate Of Ex- - ? saltation,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 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=CF.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) - the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.001MICROFILM 3097,Civ.C.). . , Lender's Name HEATING UNIT(EVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) information is correct. I agree to comply with all city and county PLUMBING /(Q 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 100,000BTU)SEE FE E SCH. 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 any way accrue against said City in consequence of the PERMIT ISSUANCE 18:86 /a ra of this permit. MECH.CONT. LIC.NO. MECH. s TOTAL OCJ ] na ore of APPliaant/C [roc 4-` Cafe 'D TOTAL 7J L� ' OFFICE COPY