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16270 POST.THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO - 16270 INSPECTION DIVISION JOB'INSPECTION RECORD • _ - PERMIT EXPIRATION 1 JOBADDRESS /Ok! Xl' 4�—S l� UNIT# _LOT# / PERMIT EXPIRES IF WORK OWNER E C°o0 ALN CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERmn VALIDATION CUPERTINO STANDARDS. - GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB - , PLUMBING ELECTRICAL - IssunrvCE DATE MECHANICAL BLDG ELecr PL -ECR ❑ I ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT, WOOD FLOOR INFORMATION r' PLUMBING VALUATION 5/FT, MECHANICAL ' ELECTRICAL - PeRMn ra FRAMING INSULATION STORIES TYPE CONSTR, OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP,SHALL BEFORE SO'rr.FLOOR Alien TOTAL ncREnee DIAPHRAGM THE CONSTRUCTION TAX IS P - ROOFSHEATHING A�� •� BUILDINGCON HE$ IND (;pN PB Oprvr APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS D ❑, ❑ ❑ ❑ ❑ ROUGHSAN.H ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRnr,T No PARCEL No MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE AGC.PILE NO FRAMING ELECT.FINAL TEST ' 'INSULATION PLUMBING - ZONING ENG,SITE NO. GAS TEST GAS MECHANICAL FIRE SPRINK ENERG'ET7n COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING `' ❑ No V ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASEFLOOD ZONE n.LUC. INTERIOR SHEAR FIRE DEPT. `'❑ N❑ ❑ rv❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR 'LATH BUILDING INTERIOR LATHTEMPORARY APPROVALS - BUILDIrvG SCRATCH COAT ELECTRIC - PLAN CHECK GAS FEE NO 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 o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! covsT.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY $UILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 1 `+r)� O �"' ADDRESS r x I U 2 1.4 f}7 $y BUILDING—ELECTRICAL—PLUMBING—MECHANICAL ... OWNEa' `f • NAME COO S/jcTI( ELECTRIC PERMIT FEE ZA 9$ OTY. PLAN CHECK VALIDATION HONE NAMEagcrDRs UTLETS-SWITCHES-RECEP 10.00/1.00 uC.NO. LIGHTING FIXTURES 10.00/1.00 CONTRACADD HESS TORS APPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION ORRcwTECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. NGINEER LIC.Na. SIGNS TRANS. 3.00 ADDRESS ENa. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zIP TEMP.METER OR POLE INS. 20.00 APPLICANTS ADDRESS MOTORS SEE FEE SCH. (�•�`"-� SERVICE CHANGE 20.00 / FOO LICENSED CONTRACTORS DECLARATION ¢ v 1 hereby affirm that 1 an licensed under provisions of Chapter 9 Z w ISSUANCE DATE vHi a w Prssios(commencing with Section 700e i of Division 3 of the Business and BLDG. ELECT. PLG. MECH. H w Z Professions Code,and my license is in full fore and effect. pZ m W License Class Lic.Number m F Date Contractor a m ¢ ¢ a OWNER-B UILDFiR DECLARATION BUILDING PERMIT X ;LL IF. I hereby affirm that 1 am exempt from the Contractors License MISC.— REFER TO ORD INFORMATION u O j Law fertile following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. — Code:Anycitymol or coo ntywhich requires ep prior Inconstructal4r ¢ ¢ Q unprove,demolish,or repair any structure,prior to its issuance,also ELEC.nDNTR, LIC.NQ ELEC. FE W w IC requires the applicant for such permit to file a signed statement that TOTAL he is licensed pursuant to the provisions of the Contractors PER MIT TO License / H z i Law(Chapter 9(commencingwith Section 7000)ofDi EDd3ofthe 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE Y] ¢ r o the basis fill the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. aim by any applicant for a permit subjects the applicant to a civil penaly ALTER-DRAIN& VENT-WATER (EA.) 5,00 of not more than five hundred dollars($500).): ❑ 1,as owner 01 the property,or Illy employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole cmnpensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law dues not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE hinescif or through his own Employees,provided that such impowe- •- ments are no[intended or offered for sale If.however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 m or imprement 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 int- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB ,ental ❑ 1,as owner of the property,am exclusively contracting With licensed cup,actors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply V.B. to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.1 1.00 contracts for such rf projects with a controctos)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under See. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owncr - — WATER SYSTEM 5.00 ACC.DATE ACG FILE NO, WORKIiRS'COMI'ENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconscut so sel Ginsure. or a certificate of Workers'Compensation Insuronce..or a certified ZONING ENG.SITE NO. copy Ihercof(So,.3800,Lah.CJ. Policy No. Company 0 ❑ Certified copy is hereby furnished. - Z Z ❑ Certified copy is filed with the city inspection division. FIRE SPRINK ENERGY T 24 Applicant MISC.- RE O ORD. Y ❑ No Y ❑ No ~ O PERMIT ISSUANCE IL — CERTIFICATE EXEMPTION riOtOQ FLOOD ZONE A.L.U.C. CLO COMI'IiNSAT10N INSURANCE PLG.CONim LIC.NO. �9G ' - (This section eed not he completed if the permit i for encTOTAL . Yo N❑ Y E] N[D Z) 2 handled dollars lS 100)Ur less.) pQU O 1 certify that in me perfunnancc of the work I'or which[Ili,'o,r- GTYANICAL ERMIT�CI�` FEE FEE SUMMARY LL F mit is issued,I shall not employ arty person in any mannerso as to0 wbecome subject to the Workers'Conlpemation Laws ofCalifornia. °' DaoICANT:nt AD TO MECH. 5.00 BUILDING } rA Datc i TO APPLICANT: IL after making this Certificate of lix- eruption,you should hccomesubject m the Workers'CompEnsation A5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply withFEE such provisionsor thispermit shall be dcenned revoked. ANIT(TO 10,000C.F.M.) 4.00CONSTRUCTION LIiNDING AGENCY ANITIOVER IOAODC.EM.16.00 MELECTRIC I hereby affirm Oat (here is a construction lending agency lot EOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(See. 3097,Civ,C.). HEATING UNIT(TO 100,000 B.T.U.) Q-fl Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 I ...Illy that 1 haveread thisapplication and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all city and countordinances and state laws relating to building constructionand BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00hereby authorize representatives of this city to enter upon theabove-mentioned property for inspection purposes. BOE LER-COMP(Over 100,000 BTU)SEE FEE SCH. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which - CONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE /a ting of this permit. 11 p MECH.CONT. LIC.NO. MECH. /V, 6 TOTAL W TOTAL Signatureo ntrac pplicant/Cotor Date OFFICE COPY