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C 8234 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY 0_F, CUPERTINO ,, . / INSPECTION'DIVISION : • JOB INSPECTION RECORD "'PERMIT EXPIRATION JOB ADDRESS PERMIT EXPIRES IF WORK OWNER - CONTRACTOR S NOT STARTED WITHIN INE ION DATE INSPECTOR SPEC ION RECOR ' 180 DAYS OF PERMIT ISSU-' FOUNDATION ANC. OR 180 DAYS FROM LIFER LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ` 1 PLUMBING f ' ELECTRICAL - ISSUANCE DATE MECHANICAL BLDG. ELECT, PLG. MECH. 1[:]/ ❑J ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED r BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION PLUMBING f < MECHANICAL ELECTRICAL 'PE MIT TO FRAMING INSULATION , BTORIESTYPE CONSTR. L_ Wrkl�l OCC:GROUP RES. PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF SO,FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING usE RES -IND CON PB Olnr APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSEsssPAHceL NOL ROUGH PLUMBING GAS TEST TRACT NO. PARCEL NC.-" MECHANICAL - ELECTRICAL FINALS DATE INSP. ACC.DATE ACC;FILE NO. FRAMING I SAN # - ZONING ENG.SITE No. INSULATION PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY T-24 `' ❑ NY ❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ .N❑ LATH—INTERIOR ELECTRICAL FLOOD ZONE aL.u,c. ❑ LATH—EXTERIOR � � FIRE DEPT. IN E:) Y'❑ N❑ , SHEETROCK -. GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALSI BUILDING FIREWALLS - ELECTRIC ' PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE , OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ' Z ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL IIS CALLING FOR FINAL INSPECTION. ' OFFICE COPY . . , APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENTIFICATIONPERMIT NUMBER BUILDING.rO 672 APPLICATION & PERMIT �� G^ A BODREs (� 1 4__ BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER' PLAN CHECK VALIDATION 7 rvamE r ELECTRIC PERMIT FEE Q PHONE coMERAc oRS OUTLETS-SWITCHES-RECEP 70,00/1.00(!, sec.NG. LIGHTING FIXTURES 10,00/1.00 ADDRESCroR's +( APPLIANCES-RESIDENTIAL 4.00 ADOREaS (('/JJQ PHDNE �� PANELS 70.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER UC.NO. SIGNS TRANS. 3.00 ADDRESSs ErvG' SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION as 1,L TEMP.METER OR POLE INS. 20.00 / APPLICANT L MOTORS SEE FEE SCH. /(f/� ADDRESS e SERVICE CHANGE 20.00 /� wMai LICENSI 'D CONTRAC RS DECLARA sY� TEMP.POLE 30.00 Fi W I hereby affirm that I am lianud under provisions of Chapter 9 1SSUA GE DATE a h (Commencing with Section 7000)of Division 3 of the Business and LDG. ELECT. PLG. MECH. F y Professions Cod and my license is in full foLie,Num at rjj11C__aryryd� -�ejjfggY ❑ ❑ ❑ Z r�- UateLite�S_Contractor r^^i" "..- a BUILDING PERMIT ¢ Ica OWNER-BUILDER DECLARATION A o to u INFORMATION X ; LL w I hereby collo that I am exempt from Ole Contractor's License MISC.- REFER TO ORD u 0¢ Law for the following reason.(Sec.7031.5,Business and Professions / VALUATION E/FT. _ PERMIT ISSUANCE 10.00 4T' Cade:Any city or county which requires permit to construct,aper, 2 ¢ improve,Demolish,Or repair any structure,prior l0 its issuance,also ELEC.CONTE. LIC.NO. ELEC. D0� n wO LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO Pam he is licensed pursuant to the provisions of the Contractor's License rZ � Law(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe S 4 o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE It r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES VPE C STE. by any applicant fora permitsubjectsthe applicant toacivilpenalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of nal more than five hundred dollars(5500).) ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 DCC.GROUP RES.urvlTs their sole'compensation,will Jo 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 TOTAL ACREAGE • himself or through his own employees,Provided that such'in poor. menu are not intended or offered for sale If,however,tire ud building GAS-EA.SYSTEM-1 INCA OUTLETS 8.00 or improvement is sold within one year of Completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.1 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND D PB Omer wilt prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ I,as owner of the property,am exclusively contracting w licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSE5S 5 ARCEL 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 MA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO, PARCEL NO. ❑ I am 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. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to SCIF-I mire' ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance, r a certified copy th¢Egp�(Se Policy N6.Tr6mpany O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T24 Z ❑ Cc Iifie .o,y s fled ithe city inspection division. - REFER TO ORD. b Applicant_ MISC. Y [3N❑ V ❑ N[]� N CERTIFICATE 01:EXE MPTI01 -ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.O. LLI > COMPENSATION INSURANCE PLG.CONTE, ❑C.NO. PLC. CL Z (This section need not be completed if the permit is for one TOTAL Y[:] NC]N❑ Y❑ N hundred dollars(S 100)or less.) L) O I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY Ly f mit is issued.I shall not employ any person in any manner so as to Become subject to the Workers'Compensation Laws of California. ED Date-Applicant BUILDING .� a ALTER OR ADD TO MECH. 5.00 �- m NOTICE TO should If,after making this Certificate of Ex Z em vision you should become subject to the Workers'Compensation APPLIANCE' 5.00 PLAN CHECK provisions io the Labor Code, you must forthwith comply with FEE C� such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 1Op00QF.M) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER IOl000C.F.M.) 6.00 SEISMIC FEE `�f7 I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the perfor7,Cia mance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's ddreddy HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that I have read this application andstate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and slate laws relating to building Construction, and BOILER-COMP(3H.P..rlOO,000B.T.U.) 6.00 hereby authorise representatives of this city to enter upon the BOILER-COMP Inver 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indenmify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in conuq seance of the •\ granting of this permit. MECH.CONT. LIC.NO. MECAH. \x/ TDTL TOTAL 5 �- Signature of Applicant I Datf OFFICE COPY -