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17882 ' POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 17882 INSPECTION DIVISION JOB INSPECTION RECORD / - PERMIT EXPIRATION JOB ADDRESS_7� � � I( CT UNIT# _LOT# PERMIT,EXPIRES IF WORK OWNER TIL e./ CONTRACTOR ��rl.I' - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECT—YO—NJ—RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION '- T ANCE OR 180 DAYS FROM NOTE: I LAST CALLED INSPECTION. UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF y PERMIT VALIDATION GARAGESLABS CUPERTINO STANDARDS. PAEDT��/ � �y POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ H " UNDERGROUND /SLAB AY i_:,,.III / PLUMBING ELECTRICAL - City Of CDperhRO ISSUANCE DATE MECHANICAL - BL G ELECT. PLG MEC. ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED _ BUILDING PERMIT • INFORMATION WOOD FLOOR - VALUATION SIFT. PLUMBING _ 0 ' MECHANICAL ELECTRICAL �J{UvE.&II TO FRAMING - I CIA wr INSULATION STOR11 IES -.mPE CONSTR. . ODD GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF ` NOTE'NO FINAL INSP..SHALL BE MADE BEFORE SO.n.1Lo09 mu.A TIITAE ACRLACE AD DIAPHRAGM THE CONSTRUCTION TAX IS PAID - BUILUING USE ROOF SHEATHING RES IND. LON PB 01111, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS' DATE INSP. Cl ❑ • ❑ ❑ ❑ . ASSESSO.S VA.CEL NO ROUGH SAN.N PLUMBING ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO MECHANICAL MECH.ENERGY hA I ' ELECTRICAL BUILDING ENERGY ' 4CC.DATE ACC.FILE NO FRAMING ELECT.FINAL TEST, - INSULATION - PLUMBING .TONING ENG.SITE NO. GAS TEST GAS FIRE SPRINF. ENE0RGY T2 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING N� y FLOOD ZONE A.LUC EXTERIOR SHEAR ELECTRICAL RE EASE INTERIOR SHEAR FIRE DEPT. ' Y❑ No v ❑ N� SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING' . . INTERIOR LATH 12/L jef TEMPORARY APPROVALS BUILDING ^�a SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED loccuPANCY SEISMIC FEE .�. OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LDING FINAL IS SIGNED BY BUI LDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 0� 'ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z -PLEASE GIVE JOB ADDRESS WHEN PHONING. "' MECHANICAL— SEE PERMIT FOR EXPIRATION DATE — . ' 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 IDENTIFICATION PERMIT NUMBER APPLICATION & PERMIT BUILDING 17882 ADDRESS - ' 7930-s�� CT• BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OyINER'S ��0 riilnliE/ PLAN CHECK VALIDATION NAME iH0 Q��/C c. OTY. ELECTRIC PERMIT, FEE Cons .,., Pf9--e770 N^MERncroas UTLETS-SWITCHES-RECEP 10.00/1.00 �A2/2 �L SC uc.NO. LIGHTING FIXTURES 10.00/1.00 AS APPLIANCES 4.00 OOREss oTgtl_/a'E' 95i1� - 4S$ T PRONE $ PANELS 10.00 DATE OF APPLICATION ARRCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO, ENGINEER LIC,NO. SIGNS TRANS. '3.00 ARCH.OR ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ` zu, EMP. METER OR POLE S. 20.00 S--( --'�/ APPLICANTS - INZ ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 o o LICENSED COMRACI'ORS DECLARATION a W I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE a (commencing with Section 7000)of Division 3 of the Business and OLDy. ELECT. PLG. MECH. r m i Professions Code,and my license is in full force and effect. - I�`V-T{Is El I] Lo Z D o - License Class Lie.Number - O w H Unto Contractor ^'ysr ��ss,,,� .a, m ¢ a OM'N Ii R-B UILUIiR DECLARATION City If WpeftO BUILDING PERMIT re o INFORMATION w3 A m I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u O j Law for the following reason.(Sec.7031.5,Bmmess and Professions VALUATION S/FT. r _ PERMIT ISSUANCE 10.00 D Code:Any City or County which requires a permit to construct,alter, �fy D Ec Q 0 improve,dereolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO, ELEC. !/ o e, requires the applicant for such permit to file a signed stalemetl that TOTAL PERMIT TO a w m he is licensed pursuant to the provisions of the Contractors License -/y Hai Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe RJ /Ir li z o Business and Professions Code)or that he i esempt therefrom and OTY. PLUMBING PERMIT FEE (cF the basis for the alleged sto,ruption.Any viola t inn of Sect ion 7031.5 STORIES T PE CONSTR. u3 by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN (EA.)o - f not more than five hundred dollum(55001.1: - ❑ 1,as owner of the properly,or my employees with wages as BACK F LOW 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(Sec 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 ' Code:The Contractor's License Law does not apply to An owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE ® himself or through his own ,Hployces.prrvided the rich improve- - . mems are nut intended or offend for sale If,however,lire building GAS-EA.SYSTEM-1 INC-4 OUTLETS 6.00 r improvement 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 ire- BUILDING USE prove for purpose nfsale.). INDUSTRIAL WASTE INTER. 30,00 RES IND CON . PB Omer ❑ 1,as owner of the property,am exClusivcly contracting with •❑ ❑ El 1:1 El contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V'.B. 6.00 - ASSESSOR SPARCEL No. and Professions Code:The Contractor's Licenx'Law does nrl apply to un owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C.fur Ibis WATER HEATER W/VENT 6.00 rcuam Owner -Dam WATER SYSTEM 5.00 ACC.GATE ACC FILE NO, WORKERS'CON1PENSA'MON DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate of Consent to sel4insure. - or a certificate of Workers'Compensation Insurance,or a ce,litied ZONING ENG.SITE NO. copy thereof(Sec 3800,Lah.CJ. Policy No. Company - O ❑ Certified copy is hereby furnished I FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy 6•filed with the city inpcction Division. MISC.- REFER TO ORD. O Applicant Y❑ N❑ Y F] N❑ ~ wPERMIT ISSUANCE 10.00 - CERTIFICATE OF li%Ii MI'1'ION IBOM WORKERS' FLODDZOrvE AC,UA, LCL U > COMPI.NSATION INSURANCE PLG.CONTE.' ❑C.NO. PLG. ❑ ❑ Y ❑ NE] V N f Phis •section need not be completed if the permit is rix one TOTAL Z hundred dollars IS 1001 or Ico.) U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued.1 shall not employ any person in any manner so as to '- U Ixcome�sp�h�ey'�t to the Workers Comp su Non Lawy,of California - > CL D:nc.S/!Z/..TC�Applicam- - ALTER OR ADD TO MECH.' 5.00 BUILDING 00 - Eb NO'I'IC�r'fO AI'I'LICANT: If,after makin this Cert ifnam of fix" - F ? emptier,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M) ,4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.EtvU 6.00 SEISMIC FEE j 4`-0 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.0 y HEATING UNIT(TO 100,000 B.T.U.) 8.00 lander i Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I ceHil, that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is currcct. I agree to comply with all city and county PLUMBING urdiwnces enJ state laws relating to building construction, and BOILER-ODMI`(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 10,000 BTU)SEE FEE SCM. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify add keep harmless'the City of MISC.- REFER TO ORD.X4.4. ' upertino e liabilities,judgments, costs and expenses which CONST.TAX may in an accrue a said Cil in corse PERMIT ISSUANCE 10.00 Y 8 y yuence of the .l granting permit.' MECH.CONT. LIC.NO. MECH. TOTAL res/a9 TOTAL Signalurc of Ap Cit/Contractor Date OFFICE COPY