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17546 r 1 POST THIS CARD NEAR FRONT OF BUILDING pERMRNUMRER CITY OF CUPERTINO INSPECTION DIVISION �� JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS wYc1r SD - � .Zdd _UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER 1 L CONTRACTOR Ae -f IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - T NOTE: - ANCE OR 180 DAYS.F•ROM UFER, — ' ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. .TO COMPLY WITH THE APPROVED PLANS AND CITY OF. PERM1UT VALIDATION PREGUNITE CUPERTINO STANDARDS. _ GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - APR p pU a UNDERGROUND- /SLAB lata. PLUMBING city Of Cup81RQ.' f� ��dyi VCc-f ELECTRICAL ISSUANCEOATE MECHANICAL - RLUc• ELE11 I PLG. MecH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION $/F I. - PLUMBING � - - � , MECHANICAL ELECTRICAL PERMIT TO Y FRAMING A ' 'TORIES IVPE CONS R. INSULATION - - - OCC,GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' � ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO 4'i ILOOIi RHEA TUTALACREIAGE ' DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHINGa RCS NO a"u`N usepe Om APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSPPx'*t �O El I] 0 11 ROUGH SAN.a ASSESSORS_ PARCEL NO PLUMBING ELECT.ENERGY TRACT NO. PARCEL NO, TUBS BSHOWER PAN PLUMBING ENERGY MECHANICAL - MECH.ENERGY ' ELECTRICAL BUILDING ENERGY ACC.'DATE ACC FILE NO FRAMING ELECT.FINAL TEST, ZONING- ENGf SITE NO. INSULATION PLUMBING - .. GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y "� Y "� P LOUR ZUNL EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR'SHEARFIRE DEPT. Y "❑ ` ❑ "❑ SHEETROCK GRADE - , FEE SUMMARY EXTERIOR LATH BUILDING 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 NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252.4505, . ELECTRICQp H ONE WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING O� PLEASE GIVE JOB ADDRESS WHEN PHONING. I ZPTOTAL ICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT!PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. j ,,j pe COPY . APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU1 I'.ANG PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT A ADDRESS r BUILDING-ELECTRICAL-PLUMBING-MECHANICAL n5 4 OWNER'S PLAN CHECK VALIDATION NAME • 1 ,�; CITY. ELECTRIC PERMIT FEE CPHONE CONTRACTORS R'S NA" 14- 1OUTLETS-SWITCHES-RECEP 10.00/1.00 .rD L No, -Z%-Lt/(D LIGHTING FIXTURES 10.00/1.00 �jt rb CNTRAC DNTRAGTORs APPLIANCES-RESIDENTIAL 4.00 ��qp1 WI W PHONE _4• I PANELS 10.00 Ab DATE OF APPLICATION ARCHITECTPLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP)sI�Q�Kl-t 20.00or ENGINEER - uc.No. •�� SIGNS TRANS. 3.00 _AARCH.OR DDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 ('�/' APPLICANTS MOTORS '. SEE FEE SCH. Ot01 c 'Q ADDRESS _ f� 5OC:% , ,C01%JV'A `sJ AON S-3 SERVICE CHANGE 20.00 'ep F o o LICENSED CONTRACTORS DECLARATION 12, � IK- '�`1 2ys d O C--4v:P � a o Cp 1 hereby nfl'Inn that 1 am licensed antler provisions of Chapter 9 I It- 01. T. ,`a p ISSUANCE DATE y<t (commencing with Section 7000)of Divisiun 3 of the Business and BLDG. ELECT. PLG. MECH. H w z Professions Code,and my license is in full force and effect. Zp} '• p aO El �-�• ❑ ❑ o z m W License Class Lic.Number Mr 4 r w Date Contractor _ st a 2 BUILDING PERMIT Is: ¢ OWNER-BUILDER DECLARATION w v MISC.- RD INFORMATION W,;LL F I hereby affirm that 1 am exempt from the Contractor's License y Z�1) VALUATION SIFT. a- Law Law for the following reason.(Sec.7031.5,Bwinessand Pmfessimss PERMIT ISSUANCE - 10.00 us Code:Any city or county which rcquiresa permit toconstrucL ulteo a ¢ o improve,demolish,Or repair any structure,prior to its issuance,also ELEC. . LI CONTRC.NO. - E LEC. yn1 0 ¢ requires the applicant for such permit to file a signed statement that - TOTAL 0 V PERMIT TO w Cs m he is licensed pursuant to the provisions of the Coutrmtor's License Fz > Law(Chapter 9(commencing with Section 7000)of Division 3 ofthc ¢ Business and Professions Cade)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE L� It =$ the basis for the alleged exemption.Any violation of Section 7031.5 TrTOPINES TYPE CONS R. by any applicant for a permit subjects the applicant-Ino civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500)J: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not _ intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTALACREAGE • himself or through his own employees,provided that such improve- ments are not intended or offered for sale.IL however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA) 200 BUILDING USE builder will have the burden of proving that h . . . e did not build or im- RES IND CON PB Omar prove for purpose of sale.h INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am,exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the"Twee,(Sec.7044.Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's Lyase Law does not apply to an owner of property who builds or improves Thereon,and who LAWN SPRINKLERS-OV ER 5(EA.) 1.00 corI for such projects with a contracliu(x)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STO RM EA.200ft/10.00 TRACT NO. PARCEL NO. 0 lam exempt under Sec.-.B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM' 5.00 ACC.DATE ACC.FILE NO. WORKERS•COMPRNSATION DECLARATION - WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certifieuln of consent In self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Ins.rm r a certified copy Thereof t$ec. I/'(x r-ne•-A�cc�-.fx e Policy N 'mm O ❑ Certif copy S ler by furBifhed. t7jVr FIRE SPR INK ENERGY T2 Z Z 0 Cert if•d o 7aI vitt IL.city-iwpeninn division. MISC.- REFER TO ORD. O Applicant Y ❑ N❑ Y ❑ N❑ N CERI&CZE OF EXEMPTION('ROM WORKERS' .PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. LU >_ COMPFNSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CLO (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y❑ N❑ Z) Z hundred dollms0100)or leas.) U O 1 certify that in the performance of the work Joe which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any mannerso as to U become subject to The Workers'Compensation Laws of California. O y DoT° ApplicantALTER OR ADD TO MECH500 BUILDING >. to NOTICE 1'0 APPLICANT: II',after making This Certificate of Ex . . � ? London,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply will FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.RM.) 6.00SEISMIC FEE I hereby affirm that (here is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 re MICROFILM performance of the work for which this permit is issued(See. HEATING UNIT(TO 100,000 B.T.U.) 8.00 a Lender's An HEATING UNIT 100,000 B.T.U.)9.50 1 p11 Lender's Address ELECTRIC I certify that 1.have read tisis application andstore Ilia,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(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon tlm BOILER-COMP IGVer 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep lannless the City of MISC.- REFER TO ORD. upeNino against liabilities,judgments, costs and expenses which - CONST.TAX may in any ay o against said City in consequ n • of the PERMIT ISSUANCE 10.00 mating Of t is e n n89 MECH.CONT. LIC.NO. MECH. `17 TDTAL TOTAL Signature o Af diem / o Date (�(J OFFICE COPY