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16972 I 'POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY .OF 'CUPERTINO 16972 INSPECTION.DIVISION• ' JOB INSPECTION RECORD Q� PERMIT EXPIRATION 1 C JOB ADDRESS .�02�1 C `am Jt UNIT# LOT# �� PERMIT EXPIRES IF WORK OWNER ``�\ - CONTRACTOR .. IS NOT STARTED,;WITHIN INSPECTION DAYE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-: FOUNDATION. ANCE OR 180 DAYS FROM "NOTE: LAST CALLED INSPECTION. _ UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED - PREGUNITE TO COMPLY WITH,THE APPROVED PLANS AND CITY OF PERMIT VALIDATION 1 CUPERTINO STANDARDS. GARAGE SLABS, - I '' ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ' ELECTRICAL' - ISSUANCE DATE MECHANICAL BLDG ELECT, PLG. MECH, 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT • - INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING - MECHANICAL 8 �/�� PERMIT TO ELECTRICAL., s FRAMING I STORIES TYPE CONSTR.INSULATION OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ $tl,fi FLOOR ANEA TOTAL ACREAGE•• ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM • THE CONSTRUCTION TAXIS PAID • RUILDING USE " ROOF SHEATHING RES IND CON PB 0 E , APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El • ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.# - PLUMBING .". ELECT.ENERGY TUBS B SHOWER PAN PLUMBING ENERGY - TRACT No. PARCEL NO MECHANICAL MECH.ENERGY' ' ELEDTRCAL ' _ ACC.DATE ACC.FILE NO BUILDING ENERGY FRAMINGELECT.FINAL TEST - 20NING ENG,SITE NO. INSULATION PLUMBING GAS TEST GAS - - - MECHANICAL FIRE SPRINK ENERGY T 2 COVER NO WORK'UNTIL ABOVE HAS BEEN,SIGNED9, HEATING v N� Y ❑ NE] F LOOO ZONE A.L U,0. . EXTERIOR SHEAR ELECTRICAL RELEASE .INTERIOR-SHEAR FIRE DEPT. _ v N� v ❑ N� SHEETROCK ' GRADE ZkFEE SUMMARY ' EXTERIOR LATH, BUILDING INTERIOR LATH - - TE PORARY APP OVAL$ VIE .FQ{a. SCRATCH COAT •' ELECTRIC - �CF SGy GAS' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINA L ISSIGNED BYBUILDING INSPECTOR. ARRANGE FOR INSPECTION BY PHONING 252-4505,' , 12, 0; ONE WORKING'DAY BEFORE REQUIRED INSPECTION. ' PLUMBING z PLEASE GIVE JOB ADDRESS WHEN.PHONING: - SEE PERMIT FOR EXPIRATION'DATE• MECHANICAL . IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL f tJ yl� CALLING FOR FINAL INSPECTION. OFFICE COPY' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY ' BUILDING PROJECT IDENTIFICATION - .PERMIT NUMBER mat-OINGc - APPLICATION " :16972 AOS _l? I J r ' BUILDING —ELECTRICAL—PLUMBING—MECHANICAL x, OWNER'5 PLAN CHECK VALIDATION ' N QTY. ELECTRIC PERMIT FEE L PHONE �� - �/ NAME s UTLETS-SWITCHES-PIECED 10.00/1.00 tr -UG.NO. LIGHTING FIXTURES 10.00/1.00 ' Dns ADDRESS PPLIANCES-RESIDENTIAL 4.00 ADDRESS - PHONE PANELS 10.00 DATE OF APPLICATION ORPLAN—CHECK FEE P.C.NO. OR PANELS PANELS (OVER 200 AMP( 20,00 ENGINEER LIC NO, ISIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION, zap TEMP.METER OR POLE INS. 20.00 ` Z i'Q I ADDRESS s MOTORS SEE FEE SCH. ADDRESS �J, SERVICE CHANGE 20.00 av_ I k,�lrp�,, woo LICENSED CONTRACTORS DECLARATION �'�M'1I��r�r�-i a i u I hereby affirm that I an,licensed under provisions of Chu ur,9 ISSUANCE DATE a,a a- (commencing with Section 7000)of Division 3 of the Business and elt BLDGELECT. PLG. MECH. H w i .Professions Code,and my license is in full force and effect. ❑ ❑ z o w — License ClassLic.Number o w L o Date Contractor H _ J a y f J Ono BUILDING PERMIT ¢ ¢ a OWNIiRBUILD1iR DECLARATION o s ° MISC.- REFER TO ORD INFORMATION w ; H 1 hereby affirm that 1 am exempt from the Contractor's License m e o VALUATION 5/FT. LL 0 a Law for the following reason.(See.7031.5,permit to co d Professions � _ J PERMIT ISSUANCE �•�, e?999 12 Q m> Code: e,demolish, countywhichreqStruturema p prior its issuance, also Q G a improve,demolish,ur repair any MNetUm,prior to its issuance,also ELEC.CONTR. LIC NO. ELEC. PERMIT TO i —y 0 u requires the applicant for such permit to file a signed statement that TOTAL (I w m m he is licensed pursuant to the provisions of the Contractor's License - .c ra a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe i O Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE - OF I- m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a;_ by any applicant for a permit subjects the applicant ma civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(S500).): O I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS 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 - - propertywhObuildsorimprovesthereon,and who does such work FIXTURES-PER TR AD 5.00 so.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- stents are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 or improvement is Sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2,00 BUILDING use builder will have the burden of proving that he did not build or am. RES IND CDN PB Omer prove 1,aso neeose of sole.). INDUSTRIAL WASTE INTER. 30.00 .El ❑ D O ❑ ❑ d as owner of the property,he exclusively contracting with licensed contractors : construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law Anes not apply. to antr owner of property who builds tr improves rased uand who LAWN SPRINKLERS-OVER 5(EA.) 1.00con - theCoctsfor ctor'shcenects Lwithacontractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. - TRACT NO. " PARCEL NO.. ❑ lam exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT - 6.00 reams Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP.- 5.00 I hereby affirm that I have a certificate of consent to set&insure' ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy lhereof(Sec.3800,Lab.C.). Policy No. Company O ❑ Certified copy ishereby furnished. FIRESPRINK ENERGYT24 Z Z ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. O Applicant V N� Y N� ~ iCE RI'IFICATE OP EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.UU.c. � LU COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y 0 Al D Y C] IN CD CL Z( This section need not be completed if the permit is for one TOTAL' ' hundred dollars IS 100)or less.) U 01-1 1 certify that in the performance of 11te work which this per. QTY MECHANICAL PERMIT FEE FEE SUMMARY LL I— mit is issued,I shall not employ any person in y anner so as to becmpp sub I he Workers ompen atlas aws aliforma. Ud Dmc15.'ITApplicant L\QF2� A LTER OR ADD TO MECH. 5.00 BUILDING ��O } N - NOTICE TO APPLICANT: If,a r making this Cer t is a of - F... Z emption,you should become subject to the Workers Com ns' t APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forth vo cam y w t FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10P=WC.F.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) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,CmC.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 ' Lender's Name HEATING UNIT 1TU )9 E ( 00,000 B. . . .50 ELECTRIC n Lender's Address H � Cr 1 certify that I have read this application and state that 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 to.,100,000 BTU7 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. upertme against liabilities 'o gmenis, costs and expenses which CONST.TAX may in any way accrue ains said City in consequence of the PERMIT ISSUANCE 10.001. ranting of this permit. MECH.CONT. LIC.NO. MECH. 1A1 G TOTAL t TOTAL Signa reo p anl hcCo Data_ D OFFICE COPY