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18380 POST,THIS CARD.NEAR FRONT OF BUILDING PEadlrmuMBER 'CITY OF. 'CUPERTINO INSPECTION DIVISION • 18380 JOB INSPECTION RECORD q p� D 1 1 _ PERMIT EXPIRATION JOB ADDRESS PIC/ .0/\C hVa./ - ` UNIT# _LOT# i ,Z PERMIT.EXPIRES IF WORK' OWNER b coNTRAcrod C_D IS, NOT STARTED WITHIN INSPECTION t DATE I INSPECTOR INSPECTION RECORD - 180 DAYS OF PERMIT ISSU-, FOUNDATION " ANCE OR,180 DAYS FROM • _ NOTE: LASTCALLED INSPECTION. LIFER - ALL GRADING AND DRAINAGE SHALL BEINSTALLED ±.' PR EGUNITE' r - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT vALmn noN , CUPERTINO STANDARDS. G - ' GARAGE.SLABS r ' 2 T POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED r UNDERGROUND /SLAB 1 PLUMBING ELECTRICAL - - ISSUANCE unrEr MECHANICAL _ BLDG. E�LECIT. , PLc.,' MECH . .DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - BUILDING PE1:1RMIT -WOOD FLOOR - INFORMATION PLUMBING VALUATION $/FT. " - ' MECHANICAL � - � � '�.. ` 1� 3", �,D 0 ERMII TO ELECTRICAL- - FRAMING "� .,, '. . INSULATION RIES RNS TR. , - OCC GROUP RES.UNITS i PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED- ROOF. 'R NOTE: IGNEDROOFNOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa,Fr.FLooR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAXIS PAID .� ROOF SHEATHING � t Res '-INO ILD `ON uI PB omr, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 7 0` 0 0 ASSESSORS PARCEI,.NO. ROUGH SANA' . PLUMBING - ELECT.ENERGY - P - TUBS SHOWER PAN . � .PLUMBING ENERGYTACT NO ARCELNo. ' - " ' MECHANICAL MECH.ENERGY. - ELECTRICAL BUILDING ENERGY ACC.DATE ACC FILE NO. FRAMING ELECT'FINALTEST ,' r ZONING -ENG.SITE N0. INSULATION PLUMBING - - GAS TEST .. GAS. MECHANICAL FIRE SPRINKENERGY L24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "'❑ ,�.[] N❑ ZONE A _'U C. EXTERIOR SHEAR ELECTRICAL RELEASE . EELINTERIOR,SHEAR FIR6DEPT. , 'N❑ Y NO SHEETROCK GRADE FEE SUMMARY YY11 EXTERIOR LATH - BUILDING ± BUILDING INTERIOR "LATH - TEMPORARY APPROVALS SCRATCH COAT - ELECTRIC - "P.LAN CHECK' GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY 7 SEISMIC FEE 4 Ni OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BLIILDING FINAL ISSIGNED BY.BUILDING INSPECTOR. MICROFILM t ARRANGE FO,R.INSPECTION•BY PHONING 252-4505, 'ELECTR'IC ,OD• o� ONE WORKING DAY BEFORE`REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. --SEE PERMIT FOR EXPIRATION DATE — 'MECHAwcaL CONST.TAX, IMPORTANT! . PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY `. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY 7� BU I LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT AO oDREss BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S C- PLAN CHECK VALIDATION " QTV. ELECTRIC PERMIT FEE L- PHONE CONTRACTOR NAME UTLETS-SWITCHES-RECEP 10.00/1.00 NAME B e LIC.NC.�j�I LIGHTING FIXTURES -10.00/1.00 2.06 CONTRACTOR PPLIANCES-RESIDENTIAL 4.00' _ ADDRESS �Op� � pq�/s- - �Y//Ap1/ {//IP ! PHOrve C>,S- PANELS 18.00 DATE OF APPLICATION ARcmTECT -09 PANELS (OVER 200 AMP), 20.00 PLAN CHECK FEE P.C.NO. ENGINEER - 1 LIC.Nb, SIGNS TRANS. 3.00 AARCH.OR DDRESS ENG. -. , SPECIAL CIRCUIT .5.00 PERMIT VALIDATION t, ZIP EMP.METER OR POLE INS. 20.00 7 7 ADDREoREsS AS - MOTORS SEE FEE SCH. _� _ Q SERVICE CHANGE.: - 20.00 /AI. g O o1 �LICENSED CON TRACTORS DECLARATION w ��-( ir U p I hereby storm that I um licensed under provisions of Chapter 9 - ISSUANCE DATE GZ w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. 0 i Professions Code,a It m icense is in full fare eaL El E)O 0 In License ss Lic.Numb Date contract o IIRl r s BUILDING PERMIT w .OWNER-BUILDER DECLARATION INFORMATION w; v r 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD .. oa Law for the following reason.(Sec.7031.5,Businessand Professions - PERMIT ISSUANCE 10.00 VALUATION $/FT. r - Code:Any city or county which requiresa permit tnconstruct slier, ` 000 Q Q¢ Improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. TEL /T - m u requires the applicant for such permit to file a signed statement that TOTAL / .OD PERMIT TO whe is licensed pursuant to the provisions of the Contractor's Licenx5x l- r Z r Law(Chapter 9(commencing with Section 7000)ofDivision3of(he ` T` - a- Business and Professions Code)or that he is exempt therefrom and QTV. PLUMBING PERMIT FEE .J s r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES I TYPE CONSTS. by any applicant for a permit subjects the applicant toacivilpenalty ALTER-DRAIN -WATER (EA.) 5.00 - of not more than five hundred dollars(S5OOM: _ ❑ I,as owner of the properly,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 an owner of properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SD:FT.FLOOR AREA TOTALACREAGE .• himselfor throughhis awn employees,provided that such'improve' meats 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-EASYSTEM-OVER 4 IEA) 200 , BUILDING USE builder will have the burden of proving that be did not build or im . . . REB IND CON PB Other for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 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 property who builds or improves thereon..and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contmctorta)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCEL NO., ' ❑ I am exempl under Sec. .B.&P.C.for this WATER HEATER W/VENT 6.00 - mason Owner Date WATER SYSTEM 5.00 ACC.DATE - ACC.FILE NO. WORKERS'COMIFENSAT1ON DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that l have a certificate ofconsent to sell-insure, - - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sce.3800,Lab.C.). - Policy No. Company Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 ZZ ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. FO Applicant Y❑ N❑ Y ❑' ,N❑ InPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. CLQ CERTIFICATE OE h:%EMPTION PROM WORKERS' ELI _ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. O- O (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y❑ N❑ D Z hundred dollars IS 100)or less.) U O 1 certify that in the performance o Ilse work far which per- QTV MECHANICAL PERMIT FEE FEE SUMMARY LL P mit is issued, I shall not employ arson wink, e __ O been, Ob t orke a silt iol a If h1. O to Dam pplic t BUILDING �Q a ALTER OR ADD TO MECH. 5.00 Cli TO APPLI ANT: I after m' this Ce Irate ol'rix- ? emption,You should been object t the Workers on mutation APPLIANCE 5.00 PLAN CHECK p provisions of the Labor de, you must forthwith comply with (� such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 1Op00C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE D 'I hereby affirm that there is a construction landing agency for EXHAUST HOOD (WITH DUCT) 5.00 the 3097 performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM' Lender's Name HEATING UNIT(OV ER 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) 4.00 PLUMBING information is correct. I agree to comply with all city and county f Ordinances and state laws relating to building constrimtion,,and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 - f 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) ogre o save, indemnify a IIm less the City of MISC.- REFER TO ORD. uperlin mst bobilitie . nts, c d expenses which CONST.TAX ay i a way^a a ' st v' n consequence of the PERMIT ISSUANCE 10.00 tt Ili is p mil. MECH:CONT. LIC.NO. MECH. �� TOTAL TOTAL 2 Si store of ¢rint/Con act Date ^ .OFFICE COPY