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17675 POST THIS CARD NEAR FRONT OF BUILDING �+R NUMBER CITY .OF, CUPERTINO 17675 INSPECTION DIVISION JOB INSPECTION RECORD, PERMIT EXPIRATION JOB ADDRESS �� I �d VI/l C l( / '• UNIT# _LOT# OWN- r PERMIT EXPIRES IF WORK OWNER ck- S CONTRACTOR 0 lA dSD IS NOT STARTED WITHIN" INSPECTION - D E INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - - ANCE'OR 180 DAYS FROM NOTE: 'LASTCALLED INSPECTION. UFER' ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EG UNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF -PERMIT VALIDATION CUPERTINO STANDARDS: -PAID GARAGE SLABS - _(, `• 1 „�S / POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED (] UNDERGROUND /SLAB • • AeK 2 6 1989 ' o v - ' PLUMBING Coperfm ELECTRICAL ISSUANCE DATE MECHANICAL BLDG ELECT. PLG. MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION '. WOOD FLOOR vgwgnoNlDr.• siPT. PLUMBING - - C�s�0g _ - MECHANICAL ELECTRICAL PERM/T TO.•• _' p FRAMING 11 ffT STORIE9 #TYPE CONST R, INSULATION , OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED .� ROOF NOTE:NO FINAL INSP.SHALL SE MADE BEFORE SO,FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID- . BUILDING USE ROOF SHEATHING RES' IND - CONPS Om", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ,gSBES50RSiPgRCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO. PARCEL NO. TUBS 8 SHOWER PAN - PLUMBING ENERGY• - , . MECHANICAL . MECH.ENERGY - ELECTRICALBUILDING ENERGY ACC DATE ACC.PILE NO . FRAMING ELECT FINAL TEST ZONING ENG.SITE NO, INSULATION PLUMBING GASTEST GAS ' .. MECHANICAL - FIRE SPRINa' ENERGY T.aa COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y E] _'N❑ '• Y'❑ N� - EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD zoNE AL.0 c, INTERIOR SHEAR FIRE DEPT. - yp No Y ❑ NO SHEETROCK. GRADE ' ,FEE SUMMARY �L EXTERIOR ,LATH BUILDING BUILDING Q(/ .INTERIOR LATH TEMPORARY APPROVALS SCRATCH COATELECTRIC - PLAN CHECK - GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE I OCCUPANCYOFBUILD ING IS NOT PERMITTEDUNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LU ONE WORKING DAY BEFORE REQUIRED INSPECTION. ' F PLUMBING' ' I z PLEASE GIVE'JOB ADDRESS WHEN PHONING. SEE PERMIT.FOR EXPIRATION DATE - MECHANICAL IMPORTANT! coNsr.rnx PLEASE READ REVERSE SIDE'BEFORE TOTAL CALLING FORTINAL INSPECTION. S OFFICE COPY 4APPLI'CANT-TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY [Ulf LDI PIP PROJECT I DENTI FICATION ��F'.R MIT NUMBER I 5 -APPLICATION & PERMIT 1767,5/ BUILDING —ELECTRICAL—PLUMBING—MECHANICALI (7 J'sPLAN CHECK VALIDATION TY. ELECTRIC PERMIT FEE Nacro 'sOUTLETS-SWITCHES-RECEP 10.00/1.00 ' 2 LIGHTING FIXTURES 10.00/1.00 ,- LIC.NO..CTOR' - APPLIANCES-RESIDENTIAL - 4.00 .Ss /��ry�`pF`/ PHONE 1 PANELS 10.00 DATE OF APPLICATION ECT ,PLANCHECKFEE P.C.NOPANELS (OVER 200 AMPI 20.00ER, uc.No. SIGNS TRANS. 3.00 OR ENG. PERMIT VALIDATION SSSPECIAL CIRCUIT5.00N ZIv EMP.METER OR POLE INS. 20.0ANT's 0 //� MOTORS SEE FEE SCHss• s-4� �/� SERVICE CHANGE 0.00 I ��Q �V`L' o o LICENSED CON"TRACT RS DECLARATION _ ¢U U I hereby affirm that I am licensed under provisions of Chapter 9 t ISSUANCE DATE H U.H (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. ,_w z Professions C9 a d y lice se,is in fall for •a d cff cl ❑ ❑ OOR w o Lice.e l ss ¢.Numb r - Uate Contactor City Of CUpeno a Y s L7 BUILDING PERMIT E ¢ w OWNER-BUILDER DECLARATION INFORMATION E ;LL y I hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO ORD '�C VALUATION $/FT. u O ¢ Law for the following reason.(Sec.7031.5.Business and Professions H _ PERMIT ISSUANCE T0:90 D Code:Any city or county which requirese permit toconsuanc ,also K 2¢ p improve,demolish,or repair any structure,prior 10 its issuance,also ELEC.LONTR. LIC NO. ELEC. ? ,�/� i O LL requires the applicant for such permit to file a signed statement that TOTAL 13 1✓y. PERM TO w 2 he is licensed pursuant to the provisions of the Contractor's License I— F z Q Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe Tl 2 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE l ¢ H the basis for the alleged exemption.Any violation of Section 7031.5 STORIES YPE CONSTR. d; by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars[$500T): ALTER-DRAIN III VENT-WATER (EA.) 5.00 ❑ L as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sale 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 p,.Perry who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.IT,FLOOR AREA TOTAL ACREAGE himself Or through his own employees,provided that such improve.. mems are not intended or offered for sale.IL however.the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6,00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE RES IND CON PB CO., prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licclised contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1.INC 5 V.8. 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 contractions)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO. PARCEL NO. ❑ .Iamexemptunder Sec. ,B.&P.C.far this WATER HEATER VV/VENT 6.00 reason Owner - Date WATER SYSTEM 5.00 ACC:DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 1 hereby affirm that I have a certificate of consent to self-insure. ZONING ENG,SITE NO. or a cerlil'icate of Workeri Compensat run Insurance,or a cerlil'ierl copy thereof(Sec.3800,Lab.C.). Policy No. Company 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T44 Z 2 ❑ Certified copy is filed with the city inspection division. MISC- - REFER TO ORD. O Applicant Y ❑ N❑ Y❑ N❑ ~ vl PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Lu CIiRTI EIC ATE F. gATI PTINS FROM WORKERS' DJ COMPENSATION INSURANCE PLG.CONTR. LIC.NO, PLG. Y❑ N❑ Y❑ N❑ 1 O re section need not be completed if the permit is for one TOTAL 0 2 hundred dollars(41001 or lcssJ U O I certify that in the performanc". k r which N per QTY- t PERMIT 'FEE FEE SUMMARY U. F mit is issued,I shall not employ amanner as mOuup�cl�p�he Workers' s o a m.ia. 0D0y OTICE— �d-LAppl'C°nl ALTER OR.ADD TO MECH. 5.00 BUILDING N - NOTICETO APPLICANT: If,aftertificate of Ex. L.. ? emption,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=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000 C.EM.) 6.00 SEISMICFEE 1 ' � Ihereby 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.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Address /J 0V I certify thm I have read this application and state 11,31 the above VENTILATION FAN (SINGLE) 4.00 information is correct.I 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 low,100,000 BTU)SEE FEE SCH. 'MECHANICAL above-mentioned property for inspection purposes. (We) agree to save,'indemnify an keep harmless the City of. MISC.- REFER TO ORD. Capetian gains[ liabilities,judgme costs and expenses which CONST.TAX m in way accrue agains s City in consequence of the PERMIT ISSUANCE 10.00 nil [his permi MECH.CONT. LIC.NO. MECN. W4--- � TOTAL TOTAL 3 i nature of Appli ant Contractor Ua[e f OFFICE COPY ROVEDv µ 7 `NGE WITH THE�.T�O; Com" ".� SCK ,06 SET w 7 TE _ Z GNED ' ( v%�o V v Cc This sot of.pians and <pectlrati,ns MUST �'�� ' r �j} JJ. � Kept on the jnh at a'lhmes and it is un• i � rfed, 1 a ful to"mate any c,:an!;os or al e,atipns �. a APR 2 61969 L�hi� mewtih:u w wi n pe missionund ng.Uepl C i, .t Cup trio. F W fxk.G ta%mg ci hi< p A .n;' -pecii cations BLDG. INSPECTION DEPARTMERL O uys/.>> HALL N01,pe lieu t p, ma „r L. he an CITY. OE CUPERTIR approval of the m•.ia:i.n %�i an,F ,piuvisions W/1 LlLf any Co, 0'd nan,:e .:r S!aie law. P440 'aorsT OFFICE CQP F I at �; � // rryye� /)♦ //�� t� �3 f I�f ;� �� . Z X, Hic I 71 . n?o�Jthc.�? o'�J �'AL' Fi2A� 1 �klJ ns . 2X� Z `fa o,c; c:s 4r 7-0 ell • �Gl�Q��'' � ��',��°/tom' �/US?��L!t/.r,�'�?��. �t�. , ..'. - 44,7