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18279POST THIS CARD NEAR FRONT OF BUILDING PLUMBING ENERGY CITY OF CUPERTINO PERMIT NUMBER 18279 148279 INSPECTION DIVISION MECH.ENERGY' ELECTRICALOl BUILDING ENERGY JOB INSPECTION R ORD I `�']� PERMIT•EXPI RATION JOBAD RESS_�1 • UNIT# _LOT# INSULATION I PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTI N RECORD FOUNDATIONANCE NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF UFER PR EGUNITE PERmn vnuunrloN HEATING CUPERTINO STANDARDS. ELECTRICAL RELEASE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED PLUMBING MECHANICAL ELECTRICAL FRAMING INSULATION PAW /AUG 2 41989 civ of Cupertino PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.tt JILDING PERMI INFORMATION TOTAL Rcs IND CON PR =VC TUBS &SHOWER PAN PLUMBING ENERGY CAC I NO, PARCEL NO MECHANICAL MECH.ENERGY' ELECTRICALOl BUILDING ENERGY ACC DATE Acc. ERE No FRAMING +�iC2� ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG SITE NO GAS TEST GAS MECHANICALS FWE SPRINI, Y E) N[] ENERGY T TE I [D "EI COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE ELOOD ZONE Y ❑ "❑ ALUC `" ❑ N INTERIOR SHEAR FIRE DEPT. SHEETROCK O GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING 4 , INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM 'ARRANGE FOR INSPECTION BY PHONING 252-4505, LEI ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE = ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING.FOR FINAL INSPECTION. TOTAL vrrwc ,GPPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY :. BUILDING PROJECT I DENTIF [CATION APPLICATION & PERMIT BUILDING -ELECTRICAL-PLUMBING-MECHANICAL PERMIT NUMBER 1 G ED LDING ADDRESS OWNE NAME I, ' y PHONE QTY. ELECTRIC PERMIT FEE PLAN CHC"I ATION IF^, �/ ( - ^� 1rvl- 51 9 O DATE OF APPLICATION C TRACTOR'S E ///� 1. Ic.No. L � OUTLETS -SWITCHES -RECEP 10.00/1.00 3 LIGHTING FIXTURES10.00/1.00 CONTRACTOR'S ADDRESS I'yam NONE {�� 0 APPLIANCES -RESIDENTIAL 4.0 PANELS 10,00 ORRCHITECT NGINEER uc. NO PANELS (OVER 200 AMP[ 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH . OR ADORERS ENG. ➢P SPECIAL CIRCUIT S.00 PERMIT VALIDATION L eR`� DATE - SLIGO, ELECT. PLG. MECIJ. ❑ TEMP. METER OR POLE INS. 20.00 APPucgrvrs AOOR�Esj, MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 _ LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (contmencing with Section 7000) of Division 3 of the Business and Pofessions Code,' 1 my license is in (ell force any effe License Class�y� Lic. Numbe - Date F� 4x_ o� CoITtmcIo _ ' OWNER -BUILDER DECLARATION 1 hereby aRinn that I am exempt from the Contractor's LicenseMISC. Law for the following reason. (See. 7031.5. Businessand Professions Code: Any city Or county which requires a permit m construct, alter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that lie is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (55001.1: ❑ 1, as owner Of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (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 does such work mentslare not hrough improve- ownemployees, for sale. mems ore not intended or offered for sale. If, mpleveq the bei Wing If, ed however, the .,,Improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im- prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with 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 contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. ❑ I am exempt under Sec.-, BAP.C. for this reason i:�ISSUANCE r 41 of J. - M BUILDING PERMIT INFORMATION - REFER TO ORD PERMIT ISSUANCE 10.00 O VALUATION �O 5 /�a•`J $/FT. ELEC. CONTE. LIC. NO. ELEC. ^'7.Oh TOTAL moi.] VV QTV. PLUMBING PERMIT FEE PERMIT TO Ary. -,IT 0" PV�V STORIES TYPE CONSTR. ALTER -DRAIN & VENT -WATER (EA.) 5.00 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 SO. Fr. FLoo A TOTAL ACREAGE GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES No CON PB Omer INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. u / - _ 1 J 60 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 SEWER -SAN V -STORM EA. 200ft /10.00 TRACT NO. Pq E NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 WORE; ERS'COSIPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -insure. or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab.C.). Policy No. Company ACC.DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 ZONING ENG. SITE NO. - ❑ Bed y s y�fu to art ified I tl aty inspection division. Ap leant GER' FICATEOE EXEMPTION FROM WORKERS' CONIPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars IS 100) or less.) 1 certify that in the performance of the work for which this per- Pont is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws Ella, ifornia. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- emption, 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097. Civ.C.L Lender's Name FIRE SPRINK Y [:]NEI ENERGY T-24 Y E] NEI MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 FLOODZONE Y ❑ N A.L.u.c. Y ❑ N PLG. CONTR. ❑C. NO. PLG. TOTAL QTY- MECHANICAL PERMIT FEE FEE SUMMARY BUILDING g ALTER OR ADD TO MECH. 5.00 00 . APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=C.F.M.1 4.00 PLAN CHECK FEE A AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE ar EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Address I certify that l have read this application and state that the chose information is nacorrect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby enthoed representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of (Cupertino against liabilities, judgments, costs and expenses which may 'n any ay accrue against said City in consequence of the kraof This perm HEATING UN IT (OVER 100,000 B.T.U.)9.50 ELECTRIC 3e(� VENTILATION FAN (SINGLE) 4.00 BOILER H.P. or 100,000 B.T.U.) 6.00 PLUMBING BOILER -COMP Over 100,000BTU)SEE FEE SCH. MECHANICAL (� 2J •SD MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 .OG CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL IM TOTAL Slgnatureof Applican l/Contractor US OFFICE COPY