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17803 POST THIS CARD NEAR FRONT OF BUILDING. • PERMIT NUMBER CITY OF CUPERTINO 17803 INSPECTION DIVISION JOB INSPECTION RECORD �J PERMIT EXPIRATION JOB ADDRESS_}h`' 6R-c �'� D� UNIT# LOT# PERMOWNER S- a` "I tS �'OV k r CONTRALTOR S NOIT STARTED WT EXPIRES IF ITHIN i SPECTION 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 CUPERTINO STANDARDS. GARAGESLABS k POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB /� G� L; PLUMBING - tV A '/� ' . ELECTRICAL ;SSU ;• IssunmcE DATe MECHANICAL PLOT; ELECT. VLG. MEC. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING ALUATION S/FT. MECHANICAL V o 0 ELECTRICALPj11 11 TO FRAMING ��'L"oo �".swa INSULATION Si O.IES TYPE CONSTR. - � , OCC.GROUP RES UNITS,,o PLACE NO SUBFLOOR-UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 50 FT FLOOR G.EA TOTALACREAGE IP DIAPHRAGM I I THE CONSTRUCTION TAX IS PAID' BUILpING USE ROOF SHEATHING I 1 1 REs INDcoN Pe om.. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.k_ ASSESSORSPARCEL NO PLUMBING - ELECT.ENERGY . ;O TUBS 8 SHOWER PAN , PLUMBING ENERGY TRACT NOPARCEL MECHANICAL MECH.ENERGY ELECTRICAL ACC.DATE ACC.FILE NO _ BUILDING ENERGY - FRAMING ELECT FINAL TEST ' -ZONING ENG.SITE NO. INSULATION - PLUMBING GAS TEST GAS ` MECHANICAL Fi.ESPaINK ENE[-] T-74 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v Cj "� � EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A.L U C� INTERIOR SHEAR FIRE DEPT. Y❑ NE] Yo NE] SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING p^ INTERIOR LATH - TEMPORARY APPROVALS BUILDING jT,a1 SCRATCH COAT ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE v I OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC � 3, sv o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING (J(1 Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - 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 BUILDING PROJECT I DENTIFICATI ON PERMIT NUMBER 7u .- APPLICATION & PERMIT - a� 7803 ADDRESS 1 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL S: OWNER'S PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE - osw rrareHGNE NOME"ACTORS4fi7-1 is UTLETS-SWITCHES-RECEP 10.00/1.00 dim LIC.No. LIGHTING FIXTURES 10.00/1.00 NTRAAOTOFs AUDREPPLIANCES-RESIDENTIAL 4.00 CO PHONE PANELS 10.00 DATE OF APPLICATION ' OR RcmTECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGINEER - Llc.No, SIGNS TRANS. 3.00 PRCH.OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION e,00rZIP TEMP.METER OR POLE INS. 20.00 Q APPLICANTS MOTORS SEE FEE SCH. 7 ADDRESS ESS SERVICE CHANGE , 20.00 �{ �VCC./ wo O LICENSED CONTRACTORS DECLARATION \(11-V` ¢ ¢ U 1 hereby aflirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE' z eu (commencing with Section 7010)of Division 3 of the Business and r4¢ PM - BLDG. ELECT. PLG. MECH. D- Professions Code,and my license is in lull force and effect. ❑ 0 ' Ovs-- License Closs Lin.Number /�.�,,,�7� 9 z H ° Date r CoNractor a Y a wi!w BUILDING PERMIT ¢ Or T o OWNER-BUILDER DECLARATION INFORMATION ww 1 hereby affirm tlt at I um exempt from the Contractors License MISC.- REFER TO ORD u O et Law for the fullowing reason.(Sec.7031.5.Bmacsxand Prafadons VALUATION S/FT. H._ PERMIT ISSUANCE 10.00 D D ^ m� Code Anycity orcounty which requiresahermit to construct,alter, (J or ¢ improve,demolish,or repair any structure,prior to its Lssuantt,also ELEC.DDNTR. LIC.NO. ELEC. .� W0 ¢ requires the applicant for such permit to file a signed sialemenl that TOTAL PERMIT TO he is licensed Pursuant to the provisions of the Contractor's License Fii Law(Chapter 9(ememencingwith Section 7000)nf Division 3ofthc -yam 6 I ¢ et Business and professions Code)or that he is exempt Iheretiom and QTY. PLUMBING PERMIT FEE I C� I PQM ¢ r a the hosts for the alleged exemption.Any violation of Section 703LS STORIES TYPE CONSTR. A , by any applicant for a permit subjectstle applicant to,6,ilpenally ALTER-DRAIN -WATER IEA.15.00 of not more than five hundred Dollars(5500).): Q - ❑ I,as owner of the property,or my employees with wogcsas BACK FLOW PROTECT. DEVICE 4.00 their wk Compensation,will do the work,and the stmetere is not OCC.GROUP RES.UNITS intended or offend for sale (See. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Cade:The Contractor's License Law does not apply to an owner of property who huilds or improve,Lcrcun,and who docs such work FIXTURES,PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACHEAGE himself or through his own employees,provided that such improe- I meats are not in tended or offered for sale.If,however,the budding GAS-EA.SYSTEM-b INC.4 OUTLETS 6.00 or Improvement is sold within one year of completion, - . -OVER 4 (EA.)the owner- GAS EASYSTEM 200 - buddcr will have the burden of proving that he did not the Or im- . BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 3000 RES IND CON PB Other ❑ I,as owner of the property,am exclusively contracting with . ❑ ❑ Q ❑ ❑ licensed cntr.ctom to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Profession,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(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA,2Wft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.kP.C.for this WATER HEATER W/VENT 6.00 reusun Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, WORKE:RS'COMPFNSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby aflirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a cerlilied copy thereof(See,3800,Lob C.). - Policy No. Company O ❑ Certill• p hereby ish FIRE SPRINK ENERGY T-24 Z Z ❑ Certi ed is hh 1 iope aeon division. MISC- REFER TO ORD. APPlicunt_ _ - _ Y ❑ N❑ Y N� F w CIiRT119C 'I'I!OP .%li 'PION FROM WOR IiRS' PERMIT ISSUANCE 10.00 �Vd FLOOD ZONE A.LU.C. W > COMPEN ATION INSURANCE PLG.CONTR. LIC.NO. ,PLG. OD Y N Y N� d 0 (This weliun need lot be completed if the permit is for one TOTAL Z hundred dollars 15100)err Icn.1 U O 1 cerin, that in the paltcratarc,of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issed, 1 shall not employ any person in any manner so as to O W become subject to the Workeri Compensation laws of California. CL Date Applicant ALTER OR ADD TO MECH. 5.00 FS Dto NOTICE TO APPLICANI: If,after making this Certificate of fix- emption,you should become subject to the w'orkers'Comlwasatiun APPLIANCE 5.00 provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONS'fRUCr'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10)MOC.F.M.) 6.00 OI hereby affirm that there is a Cim,Rcstlon lending agency fur EXHAUST HOOD (WITH DUCT) 5.00the performance of the work for which this permit o issued(Sec.3097,Civ.C.c H EATING UN IT(TO 100,000 B.T.U.) 8.00 Lender's NameLender's Address HEATING UNIT(OVER i 00,000 B.T.U.)9.50. 1 certify that I have read this application aha slaw Ibt the above VENTI LATION FAN (SINGLE) 4.00 �n{ information is correct. 1 agree:10 comply with all city and county PLUMBING AD` ordinances and state lows totaling to building cons)ruct ion. and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 hereby authurirc reprcxnlalives of Ibis city m enter upon the BOILER-COMP IOWrr 100,000 BTU)SEE FEE SCH. MECHANICAL above mentioned property for inspection purpose. (we) agree to save, indemnify and keep hmmko the City of MISC.- REFER TO ORD. uperlino against liabilities,judgments, costs and expenses which CONST.TAX ;a any cru est 'id City a. consequence of the PERMIT ISSUANCE 10.00 innein f Ihi t MECH.CONT. LIC.N0. MECH. TOTAL TOTAL Staolittlif of A 4 n C a or Uat OFFICE COPY /