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14653 7-7 POST THIS CARD NEAR-FRONT OF BUILDING ' PERMIT NUMBER ' `CITY OF CUPERTINO 14653 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION' JOB ADDRESS ��.�� •-S ��A '7 Z Ct_, UNIT# '_LOT# - - \_- - PERMIT EXPIRES IF WORK OWNER 6.4GQ.Z .Gl.l QS �2.,+=IL . CONTRACTOR U0. •�vL �G6 IS NOT, STARTED WITHIN I INSPECTION DATE INSPECTOR SPECTION RECORD 180 ANCE OR 180 PERMITFROM FOUNDATION - ,- LAST AL 180 DSPEAYS FROM NOTE: - - LASTCALLED INSPECTION. LIFER ��, ALL GRADING AND DRAINAGE SHALL BE INSTALLED' PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. , GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING; - -- J+r�/° ( i• ELECTRICAL ISSUANCE DATE MECHANICAL - BLDG ELECT PLO MECH. El . ❑ Q- ❑ . . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT - INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING- , MECHANICAL - - p r,Mrt TO ELECTRICAL p. 1 FRAMING INSULATION • RIES TYPE CONSTE, 1 6 UCC GROUP RES UNITS, II [PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 90.FT„FLOOR AREA TOTAL,Aca SAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - � � Res ]NO, 'CON va OR”,/ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El ❑ El ElASSESSORS PARCEL No. ROUGH SAN.N PLUMBING - ELECT.ENERGY , TUBS&SHOWER PAN PLUMBING ENERGY .1. TRACT Nor PARCEL No. MECHANICAL' - MECH,ENERGY. ^�.r ACC ATE ACC,FILE NO ELECTRICAL. BUILDING ENERGY FRAMING- ELECT.FINAL TEST ^ ZONING ENG.SITE NO. INSULATION PLUMBING � 0111 �GAS TEST, GAS MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' - - Y ❑ "❑ Y ❑ N❑ . EXTERIOR SHEAR - - ELECTRICAL RELEASE f LOO ZONE A.L.0C. ❑ N❑ Y ❑' N❑ INTERIOR SHEAR - - FIRE DEPT. SHEETROCK - GRADE ' FEE SUMMARY EXTERIOR LATH - BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING i� SCRATCH COAT ELECTRICPLAN CHECK GAS FEE a NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED, OCCUPANCY 'sElsMlc FEE I OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC " z ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLEASE GIVE JOB ADDRESS WHEN PHONING: PLUMBING f.- =a- - SEE PERMIT FOR EXPIRATION DATE,— CONST. MECHANICAL IMPORTANT! covsr.rax 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 PER MIT NUMBER ' - BUILDING PROJECT I DENTIFICATI ON APPLICATION & PERMIT - - EI A �+ C� TeoaolNc - - I L}v�J ADDRESS /) O �� _0 rf ILDING-ELECTRICAL-PLUMBING-MECHANICAL c OWNER'S - PLAN CHECK VALIDATION f' NPM ieQl1T( $'fQTY. ELECT RIC PERMIT FEE' xl b iOl.t/�HDNE�3 J//.04 CONTRACTORS NAME UTLETS-SWITCHES-RECEP 10,00/1.00 A No;;?�///9J JILIGHTING FIXTURES 10.00!1.00 CONTRACTOR'S - • j AOORESSwaR Cd'�p PPLIANCES-RESIDENTIAL 4.00 . •�-64x ,� vHONEJ�/�.�,� PANELS 10.00 DATE OF APPLICATION-- Oqc«Irecr '+ .PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE - .c.No. ENGINEER " - uc.No. SIGNS TRANS. 3.00 ARCH.OR ENG. + PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT . 5.00 ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S MOTORS BEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 0 o O LICENSED CONTRACTORS DECLARATION a u u l hereby affirm [hat I am licensed under provisions of Chapter 9 IS4UANCE DATE y a a- (commencing with Section 7000)of Division 3 of the Busit ess and BLDG. ELECT. PLG. MECH. r 0 i Professions Code,and my license is in full fosa}I d�14e65 - •❑ ❑ ❑ Z,o=-- LicenseLl�ss Lic.Number�'s7 0 N r uy D'atc 77 Contraemr/� - L f - BUILDING PERMIT rt wu OWNER-BUILDER DECLARATION INFORMATION Aoa - MISC.- REFER TO ORD X ;LL N I hereby affirm that 1 am exempt from the Contractor's License - - ,VALUATION $/FT. t-u_0 J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 - w Code:Any city or county which requires a permit to construct,after, ' 2 ¢ ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CORER. LIC.NO. ELEC. ' a- - G LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO $m he is licensed pursuant to the provisions of the Contractor's License na Law(Chapter 9(commencing with Section 7000)of Division 3ofthe - a Business and Professions Code)or that he is exempt therefrom and 123 PLUMBING PERMIT FEE H$ the basis for the alleged exemption.Any violation of Section 7031.5 / - STORIES TYPE CONSTR, u ; - by any applicant for S permit subjects lire applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500).): ❑ 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. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,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 SQ FT.FLOOR AREA TOTAL ACREAGE •� himself or through his own employees,provided that such improve GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 menus are not intended or offered for sale.If,however,the budding or improvement is sold within.onu year of completion,the owner. GAS-EASYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of pfovingdhm h .e did not build or im- - BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER3000 RES IND . CON PB Omer 13 . . 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ + licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSEESORSPARCELNO.- 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- 5(EA.)' 1.00 contracts for such projects with a contraetuns)licensed pursuant to BEWER-SANITARY- RM EA 1t/10.00' the Contractors License Law. TRACT NO. PARCEL NO. ❑ I ommxempt Order Sec.-,B.&P.C.for this WATER HEATER W/VE T 6.00 reason Owner Uute ' WATER SYSTE 5,00 ACC.GATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION � WATER TR EATI G EDU CQ 5.00 . I hereby affirm that 1 have a certificate of Consent to self-insure- or a certificate of Workers'Compensation Insurance,or a certified I ZONING ENG.SITE NO. 'opy thereof(Sec.3800,Lab.C.),f/� Policy N.. Company - O ❑ CCrt tied copy is IF eby Gro,hed. :FIRESPRINK ENERGY T-24 Z Z ❑ CL��t fl�et, �cop�y� ij�f �j'I�ll✓�sJa ty inspccCon division. - O ApplicanDda��`7.6�Z14't/''hJ- MISC.- REFER TO ORD. Y ❑' N❑ Y ❑ N❑ F-'. w WUw1JR� •' PERMIT ISSUANCE 10.00 U'-' 1 FLOODZONE A.L.u.C. LU UTIFICA F EAEIO TINS FROM WORKERS' W7 'COMPIiN$ATION INSURANCC PLG.CONTR. LIC.NO. PLG. Y❑ N❑ Y ❑ N❑ CL Z (This section need not be Completed if the permit is for one - TOTAL hundred dollars($100)or less.) V O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H- mit is issued,1 shall not employ any person in any mannerso as to O W become subject to the Workeri Compensation Laws of California. yy Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT: If,after making this Certificate of rix- Z emption,you should become subject to the Workers'Compensation APPLIANCE ,5.00 PLAN CHECK provisions of the Labor.Code, you must forthwith comply with FEE - V such provisions or this Perrot shall he deemed revoked.` AIR HANDLING UNIT(TO 1Op00 _F.M) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.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 issued(Sec. _ HEATING UNIT(TO 100,000 B.T.U.) 6.00 MICROFILM 3097,CIv.0.). - ' Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50 Lender's Names ELECTRIC I certify that I have read this applicationand state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.1 agree to comply with all city and county PLUMBING ordinances and state laws relating,to building construction, and BOILER-COMP(3H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP'IOver 100,000 BTU)SEE FEE SCH. MECHANICAL' above-mentioned property for inspection purposes. (WC) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino.ugainst liabilities,judgments, costs and expenses which .- PERMIT ISSUANCE10.00 CONST.TAX accrue may in any way against said City in consequence of the ranting of this er MECH.CONT. LIC,N7_7. L TOTAL rgiosture4of AppiatintlContractor Uaue' OFFICE COPY,