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18809 POST THIS CARD NEAR FRONT OF BUILDING PERMIT 18809 . � CITY OF CUPERTINO ` INSPECTION DIVISION JOB INSPECTION RE ORD i (/�7` 4/J////�,/� I PERMIT EXPIRATION JOB ADDRESS*_7J!S/ I # _ _LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION NOTEANCE OR 180 DAYS FROM : UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERAu'VALIDATION GARAGE SLABS CUPERTINO STANDARDS. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING NDERGROUND /SLABPLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL 7E ELECT F PLG. MEC. ❑ ❑ 1 ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION AjLUATION S/F T. PLUMBING VVA MECHANICAL ELECTRICAL PERMIT TO FRAMING - if/^t�F 'T JY Ar •1.r INSULATION - s,OR iES TYPE CONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BqSIGNEDROOFNOTE:NO FINAL INSP.SHALL BE MADE BEFORE SL.FT n.00R ARBA ICTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING Res INowEOCON usE'a 0"'.1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ n55E5SOHs PAR CE I.NO ROUGH - SAN.q PLUMBING ELECT,ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY ' TRACT NO PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC LATE ACG.FILE-NO FRAMING ELECT,FINAL TEST INSULATION PLUMBING zawmc ENC SITE NO. GAS TEST GAS MECHANICAL FI RESPRi NK ENERGY T2 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N'❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE - FLOODSONE ALUC. INTERIOR SHEAR _ FIRE DEPT. Y❑ NE] v ❑ NE] SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH v 72 INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE G OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, MIMI ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE 1 CALLING FOR FINAL INSPECTION. TOTAL Z �- OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 18809 ^' ADDRESS BUILDING - ELECTRICAL_PLUMBING-MECHANICAL 2 O 6b W ARD OWNER'S PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE 1r�INS PNDNE 5'- NAMER cTORs UTLETS-SWITCHES-RECEP 10.00/1.00 S?CUE MISIFWICZLie NOSZ577q LIGHTING FIXTURES 10.00/1.00 CONTRACTORS MT V IGW APPLIANCES-RESIDENTIAL 4.00 ADDfl E55 $� i YDU Q•r PHory I5 9b949 PANELS 10.00 DATE OF APPLICATION OR ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGINEER LIC,NO. SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIALCIRCUIT 5.00 (� e ZIP EMP.METER OR POLE INS. 20.00 0-30 ^ O/ APPLICANTS ADDRESS MOTORS SEE FEE SCH. ' SERVICE CHANGE 20.00 o o LICENSED CON'T'RACTORS DECLARATION .. a 0 U I hereby affirm diol 1 on licens'e'd under provisions ol'Chapter 9 - ISSUANCE DATE ,o¢ m (commencing with Section 7000)of Division 3 of the Business and ^ BLDG. ELECT. PLG. MECH. , D Professions Codo n I my license is in full forU j4 ^Oft ❑ ❑ O ❑ a, 0 m - License Cl.s _ Lic.Number.�_L /`� - - vva o m row Date-_40(25-Commcmrs�c_M .I�I a x I j BUILDING PERMIT ¢ ¢ a OWNIi R-BUILUIiR DECLARATION 0"! 0 o u INFORMATION 0 m I hereby affirm Ihm I am exuntpl from lire Contractor's License MISC.- REFER' O ORD VALUATION F u 0¢ Law for the following reason.(Sec.7 ices 2 Business and Professions PERMIT ISSUANCE 10.00 SIFT. Code Any modish rarely which structure p riot t toconstruct,issuance. also O O ¢¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. - 0 LL requires the applicant for such permit to file a signed statement that TOTAL a w m m he is licensed pursuant to the provisions of the Contractors License PERMIT TO r a Law(Chapter 9(Commencing with Section 7000)of Division 3 ofthe io Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE fN'E"E'I ¢ r• o the basis for the alleged exemption.Any violation of Section 7031.$ I STORIES TYPE CONSTR. a ; m by any applicant for u permit abject,me applicant 1.a civil penalty ALTER-DRAIN& VENT-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 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (See, 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:Thu Contractor's License Law dues not apply to an owner of properly who builds or improves thereon,and who does such work FIXTURES;PER TRAP 5.00 SD,FT.FLDOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve mems are not intended or offered for sale.if.however,the building GAS-EA.SYSTEM-11NC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 build,,will have the burden of proving Wad he(lid net build or inn BUILDING USE 00 30. Prov,for purpose of sale.). RES IND CON PR 0 her ❑ L us owner of the property,ani exclusively contracting wish INDUSTRIAL WASTE INTER. ❑ 1:1 El .ad Pro contractors m construct the project(Sec. does Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS-PARCEL and Professions Code:The who buildsContractor's License Law docs not apply toan trowner property buildstr improvesthereon.nand who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 Contracts for such License L with a contmmorl sl licensed pursuant to the Contractors Liceme Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL No. ❑ IamexemptmedcrS e. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason_�?7 _ Owner Datel Q' WATER SYSTEM 5,00 ACO,DATE ACC.FILE NO. WORKERS'COMPENSAITON DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a ecrti0cac ofcensend to self-insure, or a eerdificale of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). Policy No. Company ❑ Certified Copy is hereby furnished. FIRE SPRINK ENERGY T44 Z z ❑ Certified copy is Bled with the city inspemiou division. H0 Applicant MISC.- REFER TO ORD. Y❑ NE] Y [D NE] y CERTIFICATIi OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > CONiPENSATION INSURANCI. PLG.CONTR. LIC.NO. PLG. C1. 0 1 Phis section need not be completed if the penuit is I'or one TOTAL Y E] NE] V E] N E]� Z hundred dollars(SIOo)orlessJ U 0 1 certify that in the performance of dire work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,1 shall not employ ny person in any manner so as to U w becomes t�hI�r to the workers' pensatipppp,�lay'-}p�f Calif omen Cd CL Uwe�Q.1Z.i/�Q_Apphcant - _!l[1 ClGlaLlC+� ALTER OR ADD TO MECH. 5.00 - BUILDING 7Z } N NOTICE TO!l1�11-PPALICANT: It,after making this CertiLcarci IN- Z emption,you should Lee oloc subject to dire Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with U such provisions or this permit shall be decnad revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 FEE CONSTRUCTION LENDING AG17NCY AIR HANDLING UNIT(OVER 10=11C.F.M.) 6.00 SEISMIC FEE , CO 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,Civ.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 1 have read thisapplication and nem that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,0006.T.U.) 6.00 PLUMBING ordinances and state laws relating to building Construction, and hereby entiori,e representatives of on city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL hereby above-mentioned property for inspection purposes. •(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertin"against liabilities,judgments, costs and expenses which CONST.TAX [ignat ay in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 i gofthis permit. MECH.CONT. LIC.NO. MECH. �0 ZS TOTAL TOTAL � -Sreof Applicant/Contractor Date Z OFFICE COPY