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14414 POST THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER CITY OF CUPERTINO , INSPEGTIONbIVISION 14414 JOB INSPECTION RECORD PERMIT EXPIRATION IJOB ADDRESS � O6 ZS CoR Q/D vL6. KOUN IT _4 LOT - - PERMIT EXPIRES IF WORK OWNER J G �7 /Y7 Z�, - CONTRACTOR 41E/113/4-7 IS NOT STARTED. WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION - ANCE OR 180 DAYS FROM NOTE: . 'LIFER •� ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITETO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED e a ce ,•,_, UNDERGROUND /SLAB PLUMBING •(d <; U_i(g1.•�-Z — u T �� 'r� -r (` ELECTRICAL - f'�L'B$ arc, [e C3S'8 ISiUANCE DATE MECHANICAL a U PLG. MECH El DO NOT POUR FLOOR UNTIL.ABOVE HAS BEEN SIGNED Ci y oYY, APTERMIT,,. FORM ION WOOD FLOOR VALUATION $IFT. PLUMBING` MECHANICAL " ELECTRICAL PERMIT TO_ FRAMING INSULATION - - STORIES r TYPE CONSTR. "^ OCC GROUP RES.UNITS r ' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED � ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.IT ELDDR AREA TOTAL ACREAGE - DIAPHRAGM THE CONSTRUCTION TAX IS PAID �C . � r ROOF SHEATHINGHES IND ILD`GusePe O 11 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. � ' - ASSESSORS PARCEL NO j. IROUGH SAN.N �' PLUMBING ELECT.ENERGY TRACING PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY - MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACE.DATE ACC.FILE NO FRAMINGELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION T ' PLUMBING .GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T.)4 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING NE] "� . ' EXTERIOR'SHEAR _ -}„- ° ELECTRICAL RELEASE FLOGO ZONE ALU.C. —•<'•"'""' 'INTERIOR SHEAR L_ FIRE DEPT. Y❑'. N0 Y ❑ No SHEETROCK .Q. GRADE FEE SUMMARY EXTERIOR LATH _ BUILDING ,INTERIOR LATH TEMPORARY APPROVALS BUILDINGII er6)✓ SCRATCH COAT" ELECTRIC PLAN CHECK vJ GAS FEE r: ^ rNO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE - •� y .r`OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM I ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC t1�r ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. SEE PERMIT FOR EXPIRATION DATE - MECHANICAL I IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL a CALLING FOR FINAL INSPECTION. OFFICE'COPY kPPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY °BU I LDING PROJECT IDENTIFICATION .PERMIT NUMBER au Im - -APPLICATION & PERMIT 14414 A �•� n AonREssJIL'DING-ELECTRICAL-PLUMBING-MECHANICAL 4F I `I' UN En PLAN CHECK VALIDATION NAME TV. ELECTRIC PERMIT FEE 5, CkM 4r- PHONE ' X. NAME Ac7oRs UTLETS-SWITCHES-RECEP 10.00/1.00 .5'.041 No. LIGHTING FIXTURES 10,00/1.00 'ACR's - ADDRESS APPLIANCES-RESIDENTIAL 4.00 - - Q 3 PHON PANELS 10.00 DATE OF APPLICATION ARCHITECT � oR PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.No. r SIGNS TRANS. 3.00 nooeE°ss ENG' SPECIAL CIRCUIT S.00 PERMIT VALIDATION _ ZIP TEMP.METER OR POLE INS. 20.00 - - AMOTORS .SEE FEE SCH. ADDDRESSDRESS SERVICE CHANGE 20.00 � //0 0 Woo LICENSED CONTRACTORS DECLARATION / G Q w 1 hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT.1 PLG. MECH. r D g' Professions Code, did license is in full force a f ❑ ❑ ❑ z o - License I,Ss Lie.Number_ 99 1 Dnte-S 3 Contractor ¢ y fes' p ILDING PERMIT ¢ ¢ w OWNER-BUILDER DECLARATION 919 NFORMATION E ;°' y I hereby affirm that 1 am exempt from the Conlracmr s License MISC.- REFER TO ORD LLo ¢ Law for the following mason.(See.7031.5,Business and Pmfessems PERMIT ISSUANCE 10.00 VA4U TION $/FT. � - -' Code:Any city orcounty which requiresa permit to construct,alter, �� ac 2¢p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. p Q C�Ve ' o u requires the applicant for such permit to file.signed statement that 'TOTAL C� PER TO w m m he is licensed pursuant to the provisions of the Contractor's License ��'� F- zrt Law(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe �e�8 i o Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE ¢ r $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. T by any applicant for a permit subjects the applicant to a civil penalty gLTER-DflA1N& VENT-WATER (EA.) 5.00 of not more than five hundred dollars($5001.)'. a1 ❑ I,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. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 �..-3 Code The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work ' F IXTUR ES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE •� himself am not hrough ownemployees,ors, le.If, ed however, b improve- GAS-EA.SYSTEM-11NC.40UTLETS 6.00 A� mems are not intended or offered far sale.If,mpleveq the building or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the harden of proving that he did nut build or im- RES IND CON PB Omer prove for purpose ofsthe p INDUSTRIAL WASTE INTER. 30.00 0 ❑ ❑ ❑ 'd as owner of the property,he exclusively contracting with licensed mums cod to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's limprov Law does not apply to tr owner of property who builds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 . a _ ]- -� contracts for such projects with a contracmr(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 - reason Owner Data WATER SYSTEM - 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure' ZONING ENG.SITE NO. or a certificate of Workers'1Cyofmpensation Insurance,or a certified COPY Ih re�1naR "). S'lATL� 7 Policy Q ❑ Nlfledoopyishereby Pros cd. - FIRESPRINK ENERGY T 24 Z Z ❑ Certified cop is d with a city inspection division. O Applicam�. - � MISC.- REFER TO ORD. y N Y N� ~ w - LU CERTII%C PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. " E ' W 2 - COMPENSATION EXEMPTION FROM WORKERS'INSURANCE PLG.CONTE. LIC.NO. PLG. CL a (This section need no[ be completed if the permit is for one TOTAL Y t N Y[:] N❑ =) Z hundred dollars(S 100)or Ic.J U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY H m IL it is issued,I shall not employ any person in any manner so as to g U become subject to the Workers'Compensation Laws of California. BUILDING L y Dide Applicant ALTER OR ADD TO MECH.. 5.00 BUILDINGRez } W NOTICE.TO APPLICANT: If,after making this Certificate of Fx- L.. ? emplion,you should Become subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Cade, you must forthwith comply with FEE U such provision s'or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M:) 4.00 coNsiRUCfloN LENDING AGENCY AIR HANDLING UNIT(OVER 10X0 C.EM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the rf3097, o Cance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Address Lender's Address HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC I 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(fiver 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We)•agroe to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperlino against liabilities,judgments, costs and expenses which CONST.TAX ay in any way accrue against Said City in consequence of the PERMIT ISSUANCE 10.00 n�ij!~s perrll, / MECH.LONT. UO.NO. MECH. mss(/ � � /Kiif-� .Z-3/- TDTgL TOTAL [ranti ,gTia(ure of App cmffiontractor Datc /// ` OFFICE COPY