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184171 ?,. POST THIS CARD NEAR •FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 18417 INSPECTION DIVISION JOB INSPECTION RECORD. I O� ' /Q ,�A JOBAODRESS_/o4 7 r !!J� z- UNIT#. !{-wE IT EXgIRA - _LOT# ' OWNER - ( IJ CONTRACTOR �-1 ER 1 lxPIRES I3WO1) IS ST1I C WITHIN Teo AY OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPEC ON DATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF UFER - PREGUNITE PERMIT VALIDATION CUPERTINO STANDARDS. • PAID /--"�' C� 11)1 6 ; ISSUANCE DATE / �l GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED JAN. o2 lqqnr* UNDERGROUND/SLAB PLUMBING ColyRf rilrarfina ELECTRICAL MECHANICAL - BLUG ELECT. PLG. MECH. ❑ 0 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION D, SIFT. PLUMBING - - - MECHANICAL ELECTRICAL �¢fPER IIT TO- `'ev�u•d . FRAMING INSULATION - STORIES TYPE CONSTR. OCC, GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAXIS PAID-: SO, Fr. FLOUR AREA TOTAL ACREAGE, DIAPHRAGM BUILDING USE ROOF SHEATHING RES IND CON PB omr, 0 El ElC] 1-1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PAHCEL NO, ROUGH SAN.q PLUMBING ELE .ENERGY - TUBS TUBS $SHOWER PAN PL BINGE R TRACT NO. PARCEL NO, MECHANICAL - - M IL IN �i ACC oarE ACC FILE No , FRAMING - ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG. SITE NO. - � � GAS TEST GAS - .FIRE MECHANICAL - SPRINK Y ❑ N❑ ENERGY T 24 .❑ No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - EXTERIOR SHEAR, ELECTRICAL RELEASE - - O FLOOD ZONE v� N� ALUC , v ❑ No INTERIOR, SHEAR FIRE DEPT. „ "o9/-9OAw SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOLATH R TEMPORARY APPRO AL SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ' ARRANGE FOR INSPECTION BY PHONING 252-4505 ELECTRIC, .......�^ ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. . Z —SEE PERMIT FOR EXPIRATION DATE — MECHANICAL --- �' CONST. TAX IMPORTANT! TOTAL PLEASE READ REVERSE.SIDE BEFORE CALLING FOR FINAL INSPECTION. OFFICE COPY 10 0 CC LU - D. 0 D z 00 LL 00 } m F � 7 E] APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECTlDENTIFICATION APPLICATION & PERMIT BUILDING -ELECTRICAL -PLUMBING -MECHANICAL PERMIT NUMBER ' 18417 CY . BUILDING BUILDING1 AODREaa 11 �lf� S. OL -2 L- OWNER'S rvAME ^ bA uSTHONE QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATIO t -7 a CONTRACTORS COME NAME �ifJ!✓..i/MAN G ST. seta ND.y 73 OUTLETS -SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 ADDRESS APPLIANCES'- RESIDENTIAL 4.00 PANELS 10.00TE PHONE OF APPLICATION ogcercecr EN I/C'L fit/ U�� ,r/ seta No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE - P.C. NO. SIGNS TRANS. 3.00 ARCH. OR ENG. ADDRESS L^�- SPECIALCIRCUIT 5.00 PERMIT VALIDATION n/i6 �=� Lf�YoS zlP 9sasa C • ` �T lv �L L� �//�(��'// EMP. METER OR POLE INS. • 20.00 ARPucANTS ADDRE - -5a ///,o C4P(,Tl.,O C • S- MOTORS SEE FEE SCH. SERVICE CHANGE 2000. LICENSED CONTRACTORS DECLARATION PAID�� I berehy affirm that I am licensed underprcoisionsof0wpter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Class Lic. Number UANCE DATE / �. - BLDG. ELECT. El PLG. MECH. El El - Datu Contractor ' OWNER -BUILDER DECLARA'T'ION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Businessand Professions Code: Any city oramnty which requiresa permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed acm is Li (hal be is licensed 9pursuant to the provisions of the Contractor's Loathe of Division 3 of the Low (Chapter 9 (commencing with Section is exempt Business and Professions Code) or that he is exempt therefrom and City flf CR119((IRD - BUILDING PERMIT INFORMATION MISC. - REFER TO ORD VALUATION ®� $/FT. PERMIT ISSUANCE. 10.00 ELEC. CONTR. LIC. N0. ELEC. TOTAL NjtT, TU PERNJ Cal �/ -�--ry QTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for lite alleged exemption. Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil penalty of not more than five hundred dollars (8500}): ' ALTER;DRAIN&VENT-WATER IEA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do lite work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 . DeeGROUP RESurvtTS . DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to on owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve' tents are not intended or offered for sale. IL however. the building . FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 SD. FT. FLOOR AREA TOTAL ACREAGE or.improvereent is sold within one year of completion, the owner- builder will have the burden of proving that h e did not build or im- prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with GAS - EASYSTEM -OVER 4 (EA.) 2.00 . BUILDING USE RES IND CDN PB Omer ❑ ❑ "❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business 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 -I INC 5 V.B. 6.00 LAWN SPRINKLERS -OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a emdmesor(s) licensed pursuant to Be Contractor's License Low. - SEWER -SANITARY -STORM EA. 200ftI10.00 TRACT NO. - PARCEL NO. ❑ I um exempt under Sec.-, BAP.C. for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM - 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00' WORK FRS'COMPENSATION DECLARATION I hereby affirm that I If ertif¢ate ofconsent to self -insure. or a certificate of Wor Con ensa'fee Insurance, certified ZONING ENG. SITE NO. r copy thereof (Sec. 840, Lab. .. Policy No. Com y ❑ Cerlilic rehy fumishe Certif op belt t ,ylivrsion. )vfpscant -FIRE SPRINK Y❑ NQ. ENERGY T.24 Y❑ NE) MISC.-, REFER TO ORD. CERTIFICATE 017 EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A. L. U. C. PLG.CONTR. LIC. NO. PLG. TOTAL COMPENSATION INSURANCE (This section need not be completed if Ole permit is far one Y [DN,❑ Y ❑ N ❑ hundred dollars (S 100) or less.) I certify that in lire performance of the work for which this per- mit is issued• I Shull not employ any person in any trimmer so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workeri Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: If, after making this Certificate of fix - APPLIANCE5.00 PLAN CHECK enation, you should become subject to the Workers Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 1oAaOC.F.NL) 4.00 FEE AIR HANDLING UNIT(OVER 10 C. M.) 6.00 SEISMIC FEE 2�? CONST'RUCT'ION LENDING AGENCY I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH D T 5.00 the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). MICROFILM HEATING UNIT (TO 100,0 B. .) 8.00 HEATING UNIT IOVER }L ELECTRIC , Lender's Name Lender's Address I certify that I have read this application and stale Ilt41 the above VENTILATION FAN ISLE 4. 0 - information is correct I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER-COMP(3H.P. or 100,000B.T.U.) 6.00 BOILER -COMP (Over l 00,000BTU)SEEFEE SCH MECHANICAL hereby out re r s,n,.,ives of this city to enter upon the above -mention oper for inaectinn purposes. MISC. - REFER TO ORD _ - (We) e to seeIndemnify P formless the City of uperl' u'.a'sl ililies, ' S, osis and expenses which mo n accrue SaiY2t con) qu ce of the CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL m 1 is permit. Ignature of Applicant/Contractor a OFFICE COPY