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12746 / POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO. ?FRA,IT NUMBER• 12746 (� INSPECTION DIVISION , v JOB INSPECTION RECORD c,• - PERMIT EXPIRATION JOB ADDRESS�r7 / a'9 F41,<wo.0 b5 GT, UNIT# LOT# PERMIT EXPIRES IF WORK OWNER pL OC: CONTRACTOR Sof• IS NOT STARTED WITHIN INS ECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION 114es „30 M�� ANCE OR 180 DAYS FROM UFER 'r 106 LAST CAL LE D I NSPECTION. , PREGUNITE ` PERMIT VALIDATION t .1, Cke`eS 7—"7 1 PLAID POUR NO CONCRETE UNTIL ABOVE HAS BEE SIGNED UNDERGROUND/SLAB jl� N PLUMBING ,F,,,..F� ELECTRICAL Y Of CD 590E DATE MECHANICAL BLDG.- ELECT. PLG. MFLCR. ❑ . ❑ ' ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR ' INFORMATION VALUATION $/FT, PLUMBING MECHANICAL d _ /3-r7 A6 V' ELECTRICAL '_- 7 9 PERMIT TO FRAMING e :C I- ' INSULATION STORIES TYPE CONSTR. -f 3 ' ', t,14JP714e - r .. OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ ROOF SO.FT,FLOOR AREA TOTAL ACREAGE DIAPHRAGM -P qq ��11 �yq BUILDING USE L/ 1 -IVVCI ,RES IND CON PB Owa APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - ❑ ❑ ❑ ❑ ❑ ROUGH ASSESSORS PARCEL NO. PLUMBING .7_ /_ �ZS ' GAS TEST TRACT NO. PARCELND. - MECHANICAL ELECTRICAL FINALS DATE INSP. ACC.OATE ACC.FILE NO, FRAMING - SAN a ZONING ENG.,SITE NO. INSULATION ,ZQ, g PLUMBING GAS MECHANICAL FIRE SPRINK 'ENERGY T 24 , COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N Y ❑ N❑ LATH-INTERIOR ELECTRICALFLOO D ZONE A.L.U.C. LATH-EXTERIOR FIRE DEPT. I ` Y❑ No Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING ' SHEAR EXTERIOR -2 - TEMPORARY APPROVALS BUILDING A f o FIREWALLS. - ELECTRIC PLAN CHECK 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 Lu 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 — MECHANICALI IMPORTANT! coNST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL C- r CALLING FOR FINAL INSPECTION. • - OFFICECOPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATION _ PERMITNUMBER ° BUILDING APPLICATION & PERMIT ABs' F�� GTg P• BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 12746 • OWNEImS PLAN CHECK VALIDATION iI.E f /4 "d d) DTV. ELECTRIC PERMIT FEE f�/L(�/ W[I�VJ PRONE CONTRACTOR UTLETS-SWITCHES-RECEP 10.00/1.00 uc.No.4332Z LIGHTING FIXTURES 10.00/1.00 ADDRESST Rs PPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE C.NO, OR PANELS (OVER 200 AMP) 20.00 ENGINEER LIC.NO C�TSIGNS TRANS. 3.00 ARCH,ORENG.n c,,�,y PERMIT VALIDATION ADDREas 0/0Z SPECIAL CIRCUIT500 TEMP.METER OR POLE INS. 20.00 APPLI CANTS A.OR MOTORS SEE FEE SCH. �I _ D.ESS ESS SERVICE CHANGE 20.00 F 00 LICENSED CONTRACTORS DECLARATION , ; `, WU. ¢/p . - F U I hereby affirm that I am licensed Under provisions of Chapter 9 V Y ISSUANCE DATE va 4 w (commencing with Section 70001 of Division 3 of the Businessand BLDG. EL CT. PLG. MECH. o =_o Professions Co nd my licenu is N full for d ffB t ( � �^ ❑ ❑ z O w- License I Li' Number 1! F s La Detc Contractor , ce aw a O NUR-BUILDER DECLARATION BUILDING PERMIT I hereby affirm that I am exempt from the Contractor's Lice. MISC.- REFER TO ORD INFORMATION Law for the following reuson.(Sec.70315,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION S/FT. Code:Any city orcounty which requiresa per-mil toconstruct.alter, QFO improve,demolish,or repair any structure,prior to its issuance,also ELEC,DONTR, LIC.NO. ELEC. O u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO r $ a he is licensed pursuant to the provisions of the Contractor's License �� r Law(Chapter 9(commeneing with Section 71X)0)of Division 3 of the Business and Profussions CWe)or that he u exempt therefrom and OTV. PLUMBING PERMIT FEE ¢ =S the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. e , by any applicant fore permit dollars the applicant p<nehy ALTER-DRAIN -WATER (EA.) 5.00 ,)`� Sjv �jj of not more than rive 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 sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREACOND. 5.00 Code:The Contractor's License Law does not apply to an owner ofk -, -1, / A property who builds or improves themon,and who docs such work FIXTURES-PER TRAP 5.00 Bo.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments menare not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC. OUTLETS 6.00 or improvement Is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 200 builder will have the burden of proving that he did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other 11 1:1 0 11❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. 7144,Rostrum LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code.The Contractor's License Law docs 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 conlractons)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.2DOft/10.00 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. WORKERS'COMPHNSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of comm to wlGinsure. or a certificate of Workers'Com 'on Insurance,o certilicd - ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.0-). d Policy No. Company (] ❑ Certilie a pY is here u shed.\ FIRE SPRINK ENERGY T-24 Z Z 0 Ccrtifi d py 1 cd wit11 the YY inspection division. F0 APVhcant MISC.- REFER TO ORD. YO N� Yo NQ � m CGRT -CATE EF i MPTI ON FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. 11J 5 COMPF-N TION ON PLG.CONTH. LIC.NO. PLG. CL 0 (This section need not be completed if the permit is for one TOTAL Y V 0 N� :D Z h a n dred do 11 ars(S 100)or less) U O 1 certify that in the performance of he work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued,I that not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. LU 0 i BUILDING Date-Applicant ALTER OR ADD TO MECH. 5.00 7/d'�" 0 NOTICE TO APPLICANT: If,after making this Certificate of Ex- F" 2 emption,you should become subject to the'Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Lzbor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.N4) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 101000CFM-) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.), r - HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name H EATI NG UNIT(OVER 100,000 B.T.U.)9.50 Lender's Name ELECTRIC • I certify that 1 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 and state laws relating m building construction, and BOILER-CONP I3 H.P.Dr100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Oser 100,000 BTU)SEE FEE SCH. drove-mentioned property for inspection purposes MECHANICAL (We) nee to save, indemnify and keep hamlllss the City of MISC.- REFER TO ORD. p Cupertl o gainst liabilities judgments, costs and expenses which - CONST.TAX / O May i on way accrue 'nst said City in roes ire e f the PERMIT ISSUANCE 10.00 gmnli g of is pe tit. MECH.CONT. LIC.NO, MECH. j TOTAL TOTAL 1006 � Signal ApP1i nt/Con c or ate OFFICE COPY