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15416 POST THIS CARD NEAR FRONT OF BUILDING �� PERMIT NUMBER I -CITY OF CUPERTINO 15416 INSPECTION DIVISION JOB INSPECTION RECORD " PERMIT EXPIRATION -JOB ADDRESS 6652 Clifford Court _UNI T# _LOT# PERMIT EXPIRES IF WORK OWNER,- Gill CONTRACTOR - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF-PERMIT ISSU- FOUNDATION NOTE: ANCE OR 180 DAYS;FROM LAST CALLED INSPECTION'. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - I POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ` // ,✓/ PLUMBING ELECTRICAL' ISSUANCE DATE MECHANICAL. - - BLDG. ELECTPLc. MECR El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR.' - +, INFORMATION VALUATION SIFT. PLUMBING ► ' p MECHANICAL ELECTRICAL `��'`�� , �:vNRMIT ro FRAMING . . - T STORIES TYPE CONSTR. INSULATION - G1•� OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF. NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so IT FLooR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND - CON PR On... APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALSDATE INSP. ❑ E3 El L ED ASSESSORS PARCEL NO ROUGH SAN.R ' PLUMBING ELECT.ENERGY TRACT NO PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY r MECHANICAL MECRENERGY AT . ACC.DATE ACC.FILE No ELECTRICAL, BUILDING ENERGY I FRAMING ELECT.FINALTEST INSULATION _ ZONING ENG.SITE NO. - - - PLUMBING . GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T;24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 'ND Y .L N� EXTERIOR SHEAR ELECTRICAL: RELEASE' FLoOD zorvE A.Luc.. .. 'N❑ INTERIOR SHEAR FIRE DEPT. - YO NO YL ' SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING i INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC - PLAN CHECK, GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR-INSPECTION BY PHONING 252-4505, ELECTRIC FW ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING • z� ' '.PLEASE'GIVE JOB ADDRESS'WHEN PHONING. 1 - SEE PERMIT FOR EXPIRATION DATE = MECHANICAL /( :« iMRORTANTI CONST.TAX 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 •' ` BUILDING PROJECT IDENTIFICATION •' h PERMIT NUMBER APPLICATION & PERMIT BDILGING gU1LDING-ELECTRICAL-PLUMBING-MEMECHANIC C ADDRESS 66V CLIFF. o [ q OwNER'S PLAN CHECK VALIDATION L.A.0 \ I [��/III��`//E' U/ TY. ELECTRIC PERMIT FEE • � S ONE WI - lv NOrRj,ERAcrOR's �UTLETS-SWITCHES-RECEP' 10.00/1.00 e T ' ILIGHTING FIXTURES 10,00/1.00 CONTRTRADDRESCrOR's A " APPLIANCES-RESIDENTIAL- 4.00 A O T U P...E299 `L PANELS 10.00 DATE OF APPLICATION . ARCHITECT - PLAN CHECK FEE P.C.NO. oR PANELS (OVER 200 AMP) 20.00 ; • ENGINILH LIC.No, SIGNS TRANS. 3.00 ADDRESS ENC. - SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zip TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESS fin:/` r ` _ SERVICE CHANGE 20.00i' D ac o LICENSED CONTRACTORS DECLARATION �/" < u I hereby affirm that 1 am licensed under provisions of Chapter 9 - ISS ANCE DATE H a y (commencing with Section 7000)of Division 3 Of the Business and BLDG. ELECT. 1 PLG. MECH. H N i Professions Co Y�n I 1 license is in full fu e n e} ❑ ❑ ❑ z O m. Licen as Lic.Number Is z w Da[c � Contractor Er Y s em, BUILDING PERMIT ¢ ¢ w ¢ OWNER-BUILDER DECLARATION INFORMATION AD¢U MISC.- REFER TO ORD w ; u y I hereby affirm that I am exempt from the Contractor's License VALUATION S/FT. v .. O¢ Law for the following reason.(Sec.703 L5,Business and Professions PERMIT ISSUANCE - 10.00 Code:Any city.,county which requires a permit toconslruct,alter: Q Q Q O Improve,demolish,or repair any structure,Ore,prior to Its Issuance.also ELEC.CONTR. LIC.NO. ELEC. OLL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO K $ he is licensed pursuant to the provisions of the Contractor's License = Za Law(Chapter 9(commencing with Section 7000)of Division 3 oftlm Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE ce the basis for the alleged exemption.Any violation of Section 7031.5 - STORIES TYPE CONSTR. a ; by any applicantmr a permit subjects the applicantto a civil penalty ALTER-DRAIN -WATER (EA.15.00 of not mora than five hundred dollars($5001k): ❑ 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. 7144, 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 does such work FIXTURES-PER TRAP 5.00 4: SO,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. menus 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 (EA) 200 Bu1LDING USE builder will have the burden;of proving that h - . . . e did not build or on- prove forpurposeofame.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(See.7044,Business LAWN SPRINKLERS-1 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 contmetons)licensed pu n am to the Contractor's License Law. . SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO. PARCELING. ❑ I am exempt under Sec. ,B.&P.C.for this WATER,HEATER W/VENT 6.00 reason Owner Data WATER SYSTEM 5.00 ACL.DATE ACC.FILE N0. WORKE-RS'COMPENSAT'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofemsent to self-insure, ZONING ENG.SITE N0. ora certificate of Workers'Compensation Insurance,or a certified . copy Ih 00,Lab.C.7.f+�� .-E��z ' Policyn ImPanyl±nD ffIr9 wL - 0 ❑ Cerliie co sity��rr�rby urnishedr �yl/fj2p'LnI FIRESPRINK ENERGY T-24 Z Z ❑ Certified p hs//Ble /ith the city mspectmn Jnrsiun. MISC.- REFER TO ORD. ❑ ❑ ❑ O ApplicantYt C_ V N Y N ~ vi CL CER'1'IPICATE OF TIPROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. - 1 W � COMPENSATION INSURANCE PLG.CONTR. LIC.NO. �"�. Bile. " IL O (This section need not be completed if the permit is for one ♦ C TOTAL h Y❑ N❑ Y ❑ No Z) Z hundreddollars($100)or less I tt U O 1 certify that in the erformance of the work frir which this e'r, •,'} FEE SUMMARY y p s TV. MECHANICAL PERMIT$ d FEE i LL F mit is issued,I shall not employ any person in any manner s.as to H t1"ss ,n0 U become subject to the Workers''Compensation Lawsof CSltatute. U i Dme Applicant - ALTER OR ADD TO MECH. wF 5.00 BUILDING } m NOTICE.TO APPLICANT: If,after making this Certificate of Ex. Fz emplion,you'should become subject to the Workers Compensation APPLIANCE C��'� 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 101000C.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,Civ.C.). HEATING UNIT(TO 100,000B:T.U.) 8.00 Lender's Nana Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city andcounty PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.Ror100i000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP IOvar 100,000 BTUI SEE FEE SCH. MECHANICAL GA7 above-mentioned property for inspection purposes. - (We)"'agree 10 save, indemnify and keep Iharmlcss the City of _ MISC.- ' - h REFER TO ORD. Cape,.Ban against liabilities,judgments, cost,and expenses which CONST.TAX may in y wa ace a against said City in consequence of the PERMIT ISSUANCE 10.00 d rand it is ml - MECH.CONT. LIC.NO. MECH. TOTAL /�1 TOTAL Signature o Applicant/Contractor Date OFFICE COPY ;