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15626 POST THIS CAR D'NEAR FRONT OF BUILDING PERMIT NUMBER 6 CITY OF CUPERTINO 15626 INSPECTION DIVISION JOB INSPECTION,RECORD q `A3 2 /��`�. PERMIT EXPIRATION JOB ADDRESS 6 ` 3 � T �4TO'U�✓G: UNIT,4 P_LOT It PERMIT EXPIRES IF.WORK•I OWNER EQ,(6-47 .CONTRACTOR /7 76-- IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM NOTE: CASTCALLEDINSPECTION. UFER ALL.GRADING AND DRAINAGE SHALL BE INSTALLED ' PR EGUNITE ,TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUP ERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -- •,,,•' t:...�`�^�_, L'•'""'" `� UNDERGROUND /SLAB - ' '- ' PLUMBING ELECTRICAL - - . ' - ISSUANCE DATE MECHANICAL - - - BLDG ELECT. PLG. MECH ❑ ❑ ❑ Q DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING UI IIRMAT OMIT . WOOD FLOOR VALUATION $TFT. PLUMBING - MECHANICAL PEH M1III D I ELECTRICAL FRAMING INSULATION STORIES ., TVPECONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOFNOTE:NO FINAL INSP.SHALL BE MADE BFiF(Z! SO FT,FLOOR AREA TOTAL ACReAGc - DIAPHRAGM THE CONSTRUCTION TAXIS PAID Q BUILDING USE ROOF SHEATHING BS INO CON Pe OL" APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS UDATTE ❑ ❑ 1:1 1-1A SSEBSORS PAR CEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY , TRACT NO. PARCEL NOTUBS 8 SHOWER PAN PLUMBING ENERGYMECHANICAL MECH.ENERGY.'ELECTRICAL - BUILDING ENERGY ACC.DATE Acc FILE No FRAMING ELECT.FINAL TESTZONING ENG.SITE NO. INSULATION PLUMBING GAS TEST GAS E S MECHANICAL ' FIRPO INK ENERG L24 6 " ❑ N • [-] N❑ COVER NO WORK UNTIL ABOVE-HAS BEEN SIGNED HEATING EXTERIOR SHEAR, ELECTRICAL RELEASE FLOOD ZONE T !.L U,C. INTERIOR SHEAR FIRE DEPT. - V❑ N[j v 0 N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDINGAI BUILDING INTERIOR LATH - TEMPORARY APPROVALS SCRATCH COAT ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY" SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL - SEE PERMIT FOR EXPIRATION.DATE IMPORTANT! CONST.TAX PLEASE.READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY -' BUILDING PROJECT IDENTIFICATION PERMIT NUMBER APPLICATION 1 c� �C BaoUq.ovaI I iJ v oREss !) 6�3 Tj •�' BUILDING-ELECTRICAL-PLUMBING-MECHANICAL „. OWNER'S /_E D PLAN CHECK VALIDATION A NWNE(//Qf�,y'' //,. -53 'L TV• ELECTRIC PERMIT FEE • V I��V V 5 PHONF,,f ' [ CgMTRacroR's !/'� UTLETS-SWITCHES-RECEP 10.00/1.00 lT-lN C.No. t/T LIGHTING FIXTURES 10.00/1.00 CONTRACTORS croR's- APPLIANCES-RESIDENTIAL 4.00 HONE © PANELS 10.00 GATE OF APPLICATION ARCHITECT - PLAN CHECK FEE P.C.NO. oR PANELS (OVER 200 AMPh 20.00 ENGINEER LIC.NO. iSIGNS TRANS. 3.00 AARCH.OR DDRESS ENG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 - n APPLICANTS - MOTORS 6 SEE FEE SCH. �(rf"•••�- aoOREss , SERVICE CHANGE 20.00 /�//j��/•. w 00 LICENSED CONTRACTORS DECLARATION //- a C,w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE GATE y a (commencing with Section 7000)of Division 3 of the Business and BLDG. ELEC7. PLG. MECH. r w'^ Professions Cod- an license is in full fosrj.alG pit '-fel Z O N,- License Class Lic.Number 7�Z Y f z Dote Commclorl a x f� BUILDING PERMIT o a V OWNER-BUILDER DECLARATION - INFORMATION w ; m I hereby uffrm that I am exempt from the Contractor's License MISC.- ,REFER TO ORD F a o sc Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION S/FT. � T E Code:Any city or county which requires a permit to construct,alter, rt ca ¢ D improve,demolish,or repair any Structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. O u requires the applicant for such permit to file a signed statement that TOTAL pERMIT E 'm he is licensed pursuant to the provisions of the Contractor's License M FZQ Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe x o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE H$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.- by any applicant fora permit subjects the applicant toacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of mol more than five hundred dollars(E500).): ❑ 1,as owner of the property,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,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply to un owner of property who builds or inmroves thereon,and who does such work FIXTURES-PER TRAP 5.00 SQ FT.FLOOR AREA TOTALACREAGE • himself or through his own employees,provided that such improve. mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving(hat he did not build or im- RES -IND CON PB Other prove for purpose of sale.). INDUSTRIAL W ASTE INTER. 30.00 ❑ I,as owner of the properly,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec 7044,Business LAWN SPRINKLERS-I 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 for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.2001t/10.00 the Contractors License Law. TRACT NO. PARCEL NO. ❑ lam exempt under Sea ,BAP.C.for this reason WATER HEATER W/VENT 6.00 Owner Data - WATER SYSTEM 5.00 ACC.DATE ACG FILE NO., WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 1 hereby affirm that I have a certificate of consent to selfainxure, or a certificate of Workers'Compensation Insurance,ur a certified ZONING ENG.SITE NO. copy Hem,~00,Lah.C.I Policy N rt here yf A/✓lu d. Q ❑ Certified copy is hereby umishthe FIRE BPRINK ENERGY T40 Z Z ❑ Certi(i}{) py is fi eQ..y'ith the y�tygjns ecti�pt 'visi MISC.- REFER ❑ ❑ ❑ ❑ OrV ppcanv N V N ~ in'."- PERMIT ISSUANCE 10.0 LUY„ CFR11FICATEOF EXEMPTION FROM WORKERS' FLOOD ZONE A.L.U:C. W - COMPENSATION INSURANCE PLG:CONTR. LIC.NO. ccpps� 0. 0 -tThis.scnion need not he completed if the permit is for one T011�L Y C] NO V 1:1N❑ hundred dollars(E 100)or less.) U 0 I certify that in the performance of the work for which this per QTY. MECHANICAL PERMIT FEE FEE SUMMARY IL H mil is issued,I shall not employ any person in any manner so as to O L) become subject to the Workers'Compensation Laws of California. Dace Applicant BUILDING IL - ALTER OR ADD TO MECH. 5.00 } 0 NOTICE TO APPLICANT: If,after making this Certificate of Ex- / ? empliom,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 he deemed revoked. AIR HANDLING UNIT(TO l0=CF.M) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 SEISMIC FEE' I hereby affirm that (here 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.f HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 x Lender's Address ELECTRIC - 'T� I certify that I have read this application and state that lite 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-COMP(31-I.P.or 100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over100,000BTUISEE FEESCH. MECHANICAL • �Sv above-mentioned property for inspection purposes. (We) agree to save, indemnify'anll keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE •-19•B0 a CONST.TAX ay in any way accrue against said City in consequence of the ' ,an gof thispenn' A ME NT. LIC.NO. MECH. 6 ' -u^� �t 30 4 TOTAL TOTAL Signature of Applicant/Contmc r :Uate .. 'OFFICE COPY