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17445 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO . 17445 INSPECTION DIVISION , JOB INSPECTION REC�ORD / o,741 N b-ii 4A*z4 II�� PERMIT EXPIRgJI N JOB ADDRESS - UNIT4 _LOT# ({�-.I _1 i`` rPERM1T ESIPI ES IF ORK OWNER CONTRACTOR 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 OUPERTINO STANDARDS. GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED `J'' .I l `'lii _ UNDERGROUND /SLAB � �U PLUMBING . f1 ^U�U ELECTRICAL - MAR U IJ ISSUANCE DATE MECHANICAL. - - BLDG. ELECT.I PLO. MECR City Of [] ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR INFORMATION VALUAiI NSIFT. PLUMBING ,i7� ''��Y.a ' MECHANICAL ELECTRICAL - , PERn+IT TO FRAMING INSULATION STORIES TYPE CONSTR. OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 FT FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID eu ROOF SHEATHING uomN usE � D I CON - P' HES INOOrer APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ 1:1 ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING - - ELECT.ENERGY TRACT NO, PARCEL NO TUBS 8 SHOWER PAN . PLUMBING ENERGY MECHANICAL - MECH.ENERGY ELECTRICAL . BUILDING ENERGY - ACC DATE ACO.FILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING WRING ENG,SITE No. GAS TEST - - GAS MECHANICAL FIRE SPRINK' ENERGY T 2 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y N ° N[] EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE A.LUC INTERIOR'SHEAR FIRE DEPT. v❑ N❑- v ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING - _ ^ ,INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC - PLAN CHECK GAS' FEE ND TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC L ' ONE WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING } O PLEASE GIVE JOB ADDRESS WHEN PHONING.. L Z MECHANICAL— SEE PERMIT FOR EXPIRATION DATE = IMPORTANT! coNsr:rnx PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN.RED LINES — USE BALL POINT PEN ONLY • BUILDING PROJECT IDENTIFICATION PERMIT NUMBER APPLICATION& PERMIT ' 1c �] /� /� J B111LDING I �F`F Ao NG BUILDING—ELECTRICAL—PLUMBING—MECHANICAL OWN 'S - PLAN CHECK VALIDATION "A PTY. ELECTRIC PERMIT - FEE �I r 1, ABB Nory cTDRs UTLETS-SWITCHES-RECEP '10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR AO R 'a APPLIANCES-RESIDENTIAL' ,4.00 PANELS 10.00 DATE OF APPLICATION oqPANELS (OVER 200 AMP) - 20.00 PLAN CHECK FEE P.Q4N0. LIC.No. SIGNS TRANS. 3,0 ARCH,,,,��9Fr9glglc G. • PERMIT VALIDATION . ADo� SPECIALCIRCUIT 5.00 �/ ZIP TEMP.METER OR POLE INS. 20.00 APPLIc s MOTORS SEE FEE SCH, d'/IIY1 AD aI� ISI SERVICE CHANGE 20.00 F 00 LICENSED CONTRACTORS DECLARATION , <i w I hereby affirm that I m licensed under movisions of Chapter 9 ISSUANCE DATE vv,¢y (commenemg wiylr l' 0 00)of Division 3 of the Business and 1 ELECT. PLG. MECH. H D z Professions Co,✓Va iters,is in full f - .^,F z o b,— Liwns ss Lic.NumbL - 14VV1 ❑ 0 m�- Dale Contractor r _ ._ ¢ m s BUILDING PERMIT ac It ¢ OWNER-BUILDER DECLARATION - n o A. U MISC.— REFER TO ORD INFORMATION X ; H I hereby affirm that I am exempt from the Contractors License qEE VALUATION S/FT. o¢ Law for the followingreason.(Sec.703L5,Business and ProfessionspERM1T ISSUANCE— J Code:Any city or county which requires a permit to construct,alter, 7anQ0improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. - ELEC. (�O urequires the applicant for such permit to file a signed statement that TOTAL PERMITTO m he is licensed pursuant to the provisions of the Contractor's Licensei Law(Chapter 9(commencing with Section 7000)of Division 3 of theVBusiness and Professions Code)or Ihat he is exempt therefrom and PTV. PLUMBING PERMIT ICH$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by anyapplicant for a permit subjects the applicant toacivil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(5500)): ❑ 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 sate (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 ar improves thereon,and who docssueh work FIXTURES-PER TRAP 5,00 SO.FT.FLOORAREA TOTALACREAGE • himself or through his own employees,provided that such improve- h ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) '2.00 builder will have the burden of proving that he did not build or im- BUILDING USE Prove for purpose of colt.). INDUSTRIAL WASTE INTER. 30.00 . RES IND CON PB Orbe, ❑ I,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 ASSESSORS PARCEL 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(EA.) 1,00 contracts for such projects with a contractor(d)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/70.00 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 FRS'COMPENSAI'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to s,lf-insure, - ZONING ENG.SITE NO. or a certificate of Workers'Come anon Insuru/q��]s./y/rA•/fcel ytaific copy the r 'c Policy N Q CCrtifie yrs Amm aFIRE SPRINK ENERGY T2 Z Z A I ert ifi opy V N Y eniml division. MISC.-; REFER TO ORD. ❑ ❑ C] IN ❑ P Applicant cc L6 CERTIFICATEOFE iMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O (This section need not be completed if the permit is for ont TOTAL Y❑ N❑ Y ❑ N Z) 2 hundred dolims(SIOD)or less.) U O I certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY IL H mit is issued shall not employ any person in any manner so as ID U becotnect to the Workers'Compensal ion Laws of California. - 0O U y BUILDING Date Applicant - ALTER OR ADD TO MECH. 5.00 } to NO E TO APPLICANxr: If,after making this Certificate of Ex- Z an tion,you should become subject 10 the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 1provisions of the Labor Code, you must forthwith comply will FEE - U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000CF.M.) 4.00 CONSIRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10SWC.RM.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of 11 Lender's Nirk for which this permit is issued(Sec. MICROFILM 3097,CN.C.). HEATING UNIT(TO 700,000 B.T.U.) . 8.00 Lender's Nanme s HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 16,00 1 certify II at 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 aad xlate laws relating to building construction, and BOILER-COUP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon Be BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned properly for inspection purposes. (We gree o save, indemnify a keep harmless the City at MISC.- - REFER TO ORD. rpi a sl liabilities,judgm s, costs and expenses which CONST.TAX an a acee a 'nst City in consequence of Ola PERMIT ISSUANCE 10.00 t MECH.CONT. LIC.NO. MECH. TOTAL TOTAL -2� NrIfeatufl,oTK t/Comractor Data OFFICE COPY