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18901 POST THIS.CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO % 18901 INSPECTION DIVISION JOB INSPECTION RECORD :. '�0/ -2 �., PERMIT EXPIRATION - JOB ADDRESS LKS ` IT# _LOT# / �/I''�� '' PERMIT EXPIRES IF WORK OWNER 1-11 �l/, 'CONTRACTOR �OL�LGJ� 0 IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD TUB RAYS-OF PERMIT.ISSU. FOUNDATIONANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. ' UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAUDA TION CUPERTINO STANDARDS. GARAGE SLABS• POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB - - i i /� ;'•• PLUMBING C ELECTRICAL - - ISSDANCE DATE MECHANICAL - BLDG ELECT- PEc MECR El 11 ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION WOOD FLOORI T n-Ino VAI. TION s/FT. PLUMBING - - ` "" � � ©© MECHANICAL R. PENS .r ELECTRICAL pi" - FRAMING - - ' INSULATION STOPIES TYPEcorvsTR •. F OCC,GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF - NOTE:NO INAL 114SP.'SfIALLBE MADE BEFORE- sO.IT;F-00"AREA TOTAL ACREAce DIAPHRAGM THE CONSTRUCTION TAX IS PAID B REDING USE ROOF SHEATHING. RES IND CON PB Om., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. �' nSSES50R5PAHCE L NO ROUGH SANA - PLUMBING - ELECT.ENERGY TRACT NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY - - MECHANICAL MECH.ENERGY ACD DATE ADC.FILE NO, ! ELECTRICAL BUILDING ENERGY 'FRAMING ELECT.FINAL TEST IzoNlNc . ENC.SITE.No. INSULATION PLUMBING GAS TEST - GAS MECHANICAL FIRE SPRINK ENERGY L24 COVER NO WORK UNTIL ABOVE HAS BEEWS10.1i HEATING Y ❑ N❑ ' . ❑ N[] FLoou.zONe EXTERIOR SHEAR ELECTRICAL RELEASE aL uc INTERIOR SHEAR - FIRE DEPT. .v ❑ N❑ Y Y ❑ N SHEETROCK - GRADE E FEE SUMMARY EXTERIOR LATH IBUILDING INTERIOR LATH- TEMPORARY APPROVALS BUILDING SCRATCH COAT JELECTRIC PLAN CHECK GAS FEE . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANC,YOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z� ' PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL I IMPORTANT'! CONST.TAX, PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION.' TOTAL QQ OFFICE COPY . T ti-'a APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY j3Ul LDI NG PROJECT I DENT]FICATION - PERMIT NUMBER AnBLRD�Nss APPLICATION & PERMIT 8901 BUILDING- ELECTRICAL-PLUMBING-MECHANICAL i Oao6ag oebarsefl 1)11 011 6, 6 - PLAN CHECK VALIDATION t NAME QTY,' ELECTRIC PERMIT FEE ` ONE NOAMERAC OR< OUTLETS-SWITCHES-RECEP 10.00/1.00 uC.No. LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S SS PPLIANCES-RESIDENTIAL 4.00 ` Ja iJ� PHONE PANELS ' ' 10.00 DATE OF APPLICATION -• ARCHITECTPLAN CHECK FEE 'P.Q N0. OR PANELS (OVER 200 AMP) '20,00 ENGINEER UC.No. SIGNS TRANS. 3.00 ARCH,OR ENG. ERMIT VALIDATION ADDRESS - SPECIAL CIRCUIT 5.00 /1 ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT MOTORS, SEE FEE SCH. SERVICE CHANGE 2000. '02 0o LICENSED CON'PRACTORS DECLARATION av u I hereby affirm that I on licensed under provisions of Chapter 9 n� ISSUANCE DATE e. "' (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT: PLG. MECH. n i Professions Code,and my license is in full force and effect. . ❑ Z 0 w License Class Lie.Number - +r1r ❑ ❑ 9 r Date Contractor ¢ s,s ��\ Q BUILDING PERMIT ¢ ¢w ¢ • OWNER-BUILDER DECLARATION o a " MISC.- REFER TO ORD INFORMATION w ; u w 1 hereby affirm that 1 am exempt from the Contractor's License - VALUATION $/FT. F =m J Law for the following reason.(Sec,7031.5,Businessi nd Professions PERMIT ISSUANCE 10.00 Z(-� Code:Any city or county which requires a permit t0 cmistruct,aller, U v 2 ¢ Q Q improve,demolish,or repair any Structure,prior to its issuance,also ELEC.CONTR. - LIC.NO. . ELEC. /�` requires the applicant for such permit to file a signed statement that TOTAL PERMIT O w2 m he is licensed pursuant to the provisions of the Contractor's License Fir Law(Chapter 9(commencingwith Section 7000)ofDivision 3 ofthe ¢ Business and Professions Code)or that he is exempt therefrom and OTTPLUMBING PERMIT FEE W = the basis for the alleged exemption.An g p AnyviolationofSection malty STO HE VPE CONSTR. by any more fore permit subjectstire($500plicant Loa civil penally , ALTER-DRAIN -WATER (EA.) 5.00 of`n9t more than five hundred dollars(8500).): I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS Ih tr sole 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 property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACR EAGE himself re through his own employers:provided that such improve-- mems are not intended his orofferedforsale.Ii,however,ded that inhcbuilding GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion;Ole owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES ' IND CON PB Omar rove . ,00 for purpose of sale.). INDUSTRIAL WASTE INTER30 ❑ I,as owner of the property,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 properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts forsueh projects with a contmetons)licensed pursuant to SEWER-SANITARY-STORM EA.200h/10.00 the Crintradoi s License Law. TRACT NO, PARCEL NO. ❑ lam exempt under Sea ,B.&P.C.fm Ibis WATER HEATER W/VENT 6.00 reason • caner ate WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. W iK1iRS'COMPENSATION DECLARATIo WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificme of consent to sell'-insure, ZONING, or a certificate of Workers'Compensation Insurance,or a certifiedENG.SITE N0. copy thereof(Sec.3800,Lab.C.). Policy No. Company - O ❑ Certified copy is hereby furnished FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is filed with lire city inspection division. MISC.- REFER TO ORO. Q Applicant Y❑ N❑ Y ❑ IN y CERTIFICATE OF Ii XEMPTION FROM WORKERS' PERMIT ISSUANCE FLOOOZONE A.L.U.C. LU > COMPENSAT'IONINSURANCE PLG.CONTR. LIC.NO. PLG I� OO Y❑ N❑ Y ❑ ❑ Q' O (This section need not be completed if the permit is for one TOTA N 0 Z hundred dollars IS 100)or ICS,.) - V O 1 certify that in the performance of the work for which this per, QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,1 shall not employ any person in any manner so as to U became subject to the WorkersCompensation Laws of California. y Datr Applicant - ALTER OR ADD TO MECH. 5.00 BUILDING } W NOTICE TO APPLICANT: If,after making this Certificate of Ex F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Cade, you must forthwith comply with FEE V such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.NL) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE I hereby 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`"Wil(SeC. MICROFILM - 3097,Cm.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I information t is I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 G ,/ In information n correct I agree to comply with all city and county PLUMBING / VO ordinances and state laivs relating to building construction, and BOILER-COMPl3 H.P.Dr 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 SCH. MECHANICAL above-mentioned property for inspection purposes. (we) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and ekpenses which CONST.TAX may in any way accrue against mid City in consequence of the PERMITISSUANCE10.00 - granting of,Otispermit. MECH.CONT. LIC.NO. MECH. '/eleinTOTAL TOTAL 4JAI Signatu (Applicant/Contractor Date / e •� OFFICE COPY: I I I I � Z V - I I 1�1�1�-i- •--� I I� I I , , I Co • � I I I �� `Q•��-lll . I I I I ' ' I I I I , �_ � I • I 1 I I -� 9Z80 fS i I I SZT56 V-0 �Sof - I�--!------' -- -- ' UARTQ 'Jq0 17,T1II ZSi,--- ----"- -�--` - - -- -`--j---i----*--�.,-1- �5inxaS 9-KTINT, CIUVO C[&V : * dVDsU-Njly ill X-�V G