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14374
_ POST THIS CARD NEAR FRONT OF BUILDING 1 PERMIT NUMBER CITY OF ,CUPERTINO, . 14374 INSPECTION DIVISION JOB INSPECTION RECORD . PERMIT EXPIRATION JOB ADDRESS �O / 9 AI•�k. �/'V7�}' (�'^ UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER r}�(qn// �c t/ CONTRACTOR A-L� �LJ��- CO.v 7R-S 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 LASTCALLED INSPECTION. PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION . CUPERTINQ STANDARDS. - GARAGE SLABS �`• (, .....• ��+ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED .S of M- UNDERGROUND /SLAB PLUMBING Z/ ELECTRICAL 3o-3l.'pLQrsIXX L—Fi/;PIb "i T,c 1 ISSUANCE DATE MECHANICAL. SLUG. ELECT. PLG. MECH. 6'- i-b' P9 � ❑ El ❑ . 0 NO VPOUR FLOOR TILS88L ABOVE AS EEN BUILDING PERMIT SIGNE INFORMATION WOOD.FLOOR UN VALUATION STET. PLUMBING - '��{{S�EEEE �{pD mftrol Cd MECHANICAL Wq "' V ELECTRICAL PERMIT T/o FRAMING � T�(L a'•& STORIES TYPE CONSTH. INSULATION � � � hp ^ - UCG GROUP RESES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED N, �� dJ `g $O,GT.FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INS,.SHALL BE MADE BEFORE -� DIAPHRAGM THE CONSTRUCTION TAXIS PAID' BUILDING USE ROOF SHEATHING _ Hes IND CON Pe 0th..F El 0 D � ElQ APPLY"NO ROOFING UNTIL ABOVE HAS BEEN SIGNED �'rm6":;?'SII"FINALS DATE INSP. � ASSESSORS PARCEL NO ROUGH - SANl PLUMBING -- ELECT,ENERGY •.' a •�� - Cir n TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO T MECHANICAL MECR ENERGY ELECTRICAL' UILDING ENERGY ACC DATE ACC ELLE No - FRAMING LECT.FINAL TEST ZONING ENG.SITE NO. INSULATION �. Or LUMBING GAS TEST - GAS FIRE SP RINK ENERGY 120 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED"s' HEATINEU— G Y NF Y ❑ NEI EXTERIOR SHEAR 6 ELECTRICAL RELEASE -`jQ r iLooU ZONE ALuc. INTERIOR SHEAR �; FIRE DEPT. v N[] r ❑ N[] SHEETROCK p GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR'.LATH TEMPORARY'APPROVALS 13UILDING30�D ,• 'SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE ��a OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY SUI LDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC HONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING ISM o� PLEASE GIVE JOB ADDRESSWHEN PHONING. Z -'SEE PERMIT,FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX 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 q - PERMIT NUMBER I BUILDING PROJECT.I DENTI FICATION APPLICATION & PERMIT 6NLOING -�/ "Ill ' ADD;:j? Io { 1 14374 l (�� y ZA UILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME rA ' (•�4) 770 CITY. ELECTRIC PERMIT FEE cNE NOANERAc*Gas UTLETS-SWITCHES-RECEP 10.0011.00 (4/!u {� l 8/Y .No. 7� LIGHTING FIXTURES 10.00/1.00 A2RESCTOR s. APPLIANCES-RESIDENTIAL 4.00 PHONE ( / PANELS 10.00 DATE OF APPLICATION RCHR D PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE EN E �y Kv /�S�rti uc.N- 4,_-J28/,qSIGNS TRANS. 3.00 APC OR ENG. PERMIT VALIDATION ADDRESS (�Q �. � /PK� / SPECIALCIRCUIT 5.00 eJOS15 LPgJ TEMP.METER OR POLE INS. 20.00 - APPUCANTS MOTORS SEE FEE SCH. � l_ ADDRESS SERVICE CHANGE 20.00 o o LICENSED CONTRACTORS DECLARATION a I hereby affirm [hut I am licensed under provisions at Chapter 9 ISSUANCE DATE - "' (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. zProfessions Cole, a my license is in full force' ec4m ❑ ❑ z O_. License Class Lic.Number - VU UN O z H m Date- Contractor Lf _ _ a y UILDING PERMIT ¢ ¢ w ¢ OWNER-HUILUER DECLARATION INFORMATION- -BUILDER MISC.- REFER TO OARD E ;LL N 1 hereby affirm that I am exempt from the Contractor's License (pqV N $/FT. r ei a-o J Law for the following reason.(Sec.7031.5,Businessond Professions PERMIT ISSUANCE 10.00 Z soCode:Any city or county which requires a permit incur a0eq ,ti.A./l 2 2¢0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. ,V t/N DLL requires the applicant for such permit to file a signed statement[hal TOTAL yw..b IT TO wm he is licensed pursuant to the provisions of the Contractor's License (rQANWr/ /L r- za Law(Chapter 9(commencing with Section 7000)of0ivisim,3 of the CK✓ `o Business and Professions Code)or[hal he is exempt therefrom and OTY. PLUMBING PERMIT FEE �Fy the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE COPISTR. by any applicant for a permit subjects[heapplicanuoa civil penalty ALTER-DRAIN (EA.) sV/N of not more than five hundred dollars l S5000: ❑ 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 --ff intended or offered for salt (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,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 50.FT.FLOOR AREA TOTAL ACREAGE meats are not hrough ownemployees,for sale. If,ed that however, the improve- GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 7 Q3 © mems are not intended or offered for solo.If,however,the hui Wing or improvement is e b within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the burden of proving thus he did not build or im- BUILDING USE p g RES NO CON PB Orher prove for purpose of soled' INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑ ❑ d as owner of the property,he exclusively contracting lug with licensed scions tors to construct the pLijen (See.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law Joos not apply ^ l to an owner of Property who builds or improves 0mr,on,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00. { 0-0 o contracts for such projects with a contractions)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ Iamexemptunder Sec. .B.&P.C.for Olis WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Campe sat ion Insurance,or a certified copy thereof(See.3800,Lab.C.). .17�QN Policy No. Company ' O ❑ CeRiOedcopy is hereby furnished. FIRE SPRINK ENERGY T@4 Z ❑ Certified}�ry )he�ity�ns�iwYvdi djvisio°- MISC.- REFER TO ORD. Y N Y N O Applicant-N o Lf //ND- ❑ ❑ ❑ ❑ rn KERS' 1 PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Lu > CERTIFICATE F. kAX [OTINS FROM WORKERS' W _ COMPENSATION INSURANCE PLG.coNTR. _IC.NO. PLG. CL 0 This section need not be completed if the permit is for one - TOTAL Y❑ N❑ Y❑ N❑ 7) Z hundred dollars($100)or 1,1x.1 U O I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued,I shall not employ any person in any manner so as In - . O W become subject to the Workers Compensation Laws of California. BUILDING ?3 Date Applicant ALTER OR ADD TO MECH. 5.00 - J } y NOTIC17 "1`0 APPLICANT: If,after making this Certificate of E ♦- ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must lisrthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10PMC.F.M.) 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. MICROFILM 3097,CN.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT(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 oullmriee representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEESCH.1 MECHANICAL kit above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- .REFER TO OD. upertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way accrue against said City in consequence f the PERMIT ISSUANCE 1R0.00 vtn[iDg of this p,nn Ap" MECH.CONT. LIC.NO. MECH. ^^ w/ (o G TOTAL TOTAL .SSS //� Signature of pplicant/Contractor ate OFFICE COPY