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11591 J _ I q POST THIS CARD NEAR FRONT OF BUILDING I ��p I'l li M1lll NVAINEH CITY OF CUPERTINO 11591 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS -/4 2 C4 -on, i7 L�,< UNIT# _LOT# ,/ PERMIT EXPIRES IF WORK OWm+NER EiL LiCONTRACTOR /1 Tv IS NO! STARTED WITHIN INSPECTIOW DATE I INSPECTOR 'rl;'^ .P;:INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION _ ANCE OR 180 DAYS FROM UFER ' LASTCALLED INSPECTION. PREGUNITE Ft nKUF VALI UA MON POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING F .. ELECTRICAL ISSUANCE IPLG. MECHANICAL BLOC. EC1 PLG. NTcr,H, El 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ING PERMIT WOOD FLOOR PLUMBING tr;T y1LUAlIU 74ORMATION S/FT MECHANICAL ELEC RICAL Elf�` PERMIT TO FRAMING $l Ulll[S IYI'C CONSiIi. INSULATION OCL' GROUP ICS UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED fl00F 5O FI,FLOOHAIIA TOTALACIIIACI. DIAPHRAGM BUIwING USE IiLS INV 1,111 PIT unu., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ ROUGH ASSESSORS PAHCTL NO. PLUMBING GAS TEST I IIACI NO. PARCEL NO. MECHANICAL ACC.DATE ACC FILE NO. - ELECTRICAL 1D07/5;t 1 FINALS gi(, INSP. FRAMING Cr P pL SAN # Nt 10NING ENG.SITE NO, INSULATION PLUMBING GAS MECHANICAL ❑ N�COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATINGLATH—INTERIOR ELECTRICAL FLooO roar A.L.0 c. LATH—EXTERIOR _ � FIRE DEPT. r ❑ N❑ Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING O REWALLS ELECTRIC PLAN CHECK GAS FEE .NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE UCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC I- 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 ' ' TOTAL CALLING FOR FINAL INSPECTION. APPUCANTS POSTING COPY " POSTTHISCARD NEAR FRONTOF BUILDING PFRNIIT NUMBER CITY OF CUPERTINO 1591 INSPECTION DIVISION. JOB INSPECTION RECORD , J ) ' • %� I P � - /PERM-IT - EXPIRATION JOB ADDRESS �4 01011yUNITLOT# PERMIT EXPIRES IF•WORK OWNER I CONTRACTOR { IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LIFER - LASTCALLED INSPECTION. ' PREGUNITE _ PERMIT VALIDATION - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL - ISSUANCE DATE MECHANICAL BLDG. ELECT, 1. PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMI - INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING _ MECHANICAL ELECTRICAL PERMITTO , FRAMING � ,ill � INSULATION STORIES TYPE CONSTR. OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED- ROOF SO FT,FLOOR AREA TOTAL ACREAGE DIAPHRAGM. awl.Dmc USE .RES IND CON PB DIN,, APPLYAO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING GAS TEST ' TRACT NO. PARCEL NO. � - I MECHANICAL ACC.DATE ACC.FILE NO. ELECTRICAL - 0- -Y FINALS DATE INSP. FRAMING SAN * - ZONING ENG.SITE NO. INSULATION "' � � PLUMBING GAS MECHANICAL II /� FIRE SPRINK 'ENERGY T 2 V�fl V COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING I min Y ❑ NE] El N❑ .BLOOD zoNE A.L.0 c. LATH—INTERIOR ELECTRICAL l) v❑ N❑ v❑ N❑ LATH—EXTERIOR " b_' FIRE DEPT. SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIORTEMPORARY APPROVALS BUILDING FIREWALLS 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 IS SIGNED BY BUILDING INSPECTOR. MICROFILM n ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o�ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN,PHONING. Z .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 s BU I LDING PROJECT I DENTIFICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT fr[DRESS r. 11591 101il F raItBUILDING -ELECTRICAL-PLUMBING -MECHANICAL WN PLAN CHE VALIDATION NAME John Ra n Ne_V PHONE rjU pg OTV ELECTRIC PERMIT FEE �G�7 CONTRACTORS G NAME (uO ZC�r) � UTLETS-SWITCHES-RECEP 10.00/1.00 3L� C, LI LIGHTING FIXTURES 10.00/1.00 7/4 nooaEss'oR/s^ KLiG.( PPLIANCES-RESIDENTIAL 4.00 GV _PANELS 10.60 DATE OF APPLICATION onnCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.NO. SIGNS TRANS. 3.00 AARCH.OR DDRESS ENG. SPECIAL CIRCUIT 5,66 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANTS ADDRESS MOTORS SEE FEE SCH. ✓/( � SERVICE CHANGE 20.00 9 w 02 LICENSED CONTRACTORS DECLARATION r/^re� o a ng wSection )oon Business an ur w 1 hereby affum that I am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing Si7000f Division 3 of the Busid rR BL G. MECH. F N Pr[fLsions Code se is in full fofrPe and effect. L,/H ,�.,r z o ,_�or Llcen Cl ss'_{/-`'p Lia Numbere'L�I o a 1"y'!I 4 � w Date Cornractor �lJ DJry PIE rt w st OWNER-BUILDER DECI. RATIO / A NFUkNI TRMIT w N ION I hereby affem that I am exempt from the Contractor's License MISC.- 'REFER TO ORD .. o a Law for the following reason.(Sec.7031'.5,Businessand Professions PERMIT ISSUANCE 10.00 VAI lUATl N(s S/FT. Code:Any city or county which requiresa Permit to construct,alter, 3 ylhy_-Hyilru Der ino 2 2¢ 0 improve,demolish,or repair any stricture,poor to its issuance,also ELEC.CONTR. LIC.NO. ELEC /!/f/ O ce requires the applicant for such permit to File a signed statement that TOTAL PERMIT TO z he is licensed pursuant en the provisions of the Contractor's License i Law(ChapterProcssion, ode) r Section is 010)exempt therefrom Pl" - a the bass and he alleged Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE the basis for the alleged exemption.Any applicant of Section 7031.5 nulty STORIES TYPE CONSTR. A , by any applicant lora permit dojcds S500R.liant macivil ptnulty ALTER-DRAIN -WATER (EA.) 5.00 of not mom than Five hundred Dollars(5500).): ❑ I,as owner of the property,or my employees with waVsm BACK FLOW PROTECT. DEVICE 4.00 their sole eampensalion,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sok (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 t- property who builds or improves thereon,and who docs such work F IXTUR ES-PER TRAP 5.00 SQ.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- meats are not intendal or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 1 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving thut be did not build of im- Prove for propose ofsale.). INDUSTRIAL WASTE INTER. 3066 RES IND CON Pe Our., 0 I,as owner of the property,am exclusively contracting with , ❑ 0 ❑ 0 ❑ licensed contractors to construct the ponied(Sec. 7044,Businw LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does 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 contsactot(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL No. ❑ I um exempt under Sea ,N.&P.C.for this WATER HEATER W/VENT 6.00 awn Owner Date WATER SYSTEM 5.00 ACGDATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby infirm that 1 have a certificate of consent t0 self-insure, ZONING ENG.SITE NO. or a certificate of Worked Compensation Insurance,or a certified copy thereof(Sec.3800,tab.C.)./.4-. � �2 Policy No. Company � /QJ '-'&A_ O ❑ Ccrtif dcopy is her yfr mshcd. FIRE SPRINK ENERGY T$4 Z_ Z 0 Certif- any is rl (with 41 -city spe,fmr division. MISC.- REFER TO ORD. O Applicant V N Y N ~ rn PERMIT ISSUANCE 10.00 � - Cl>RTI ICATF OF EXEMPTION PROM WORKERS' FLOOD ZONE A.L.U.C. I W > COMPENSATION INSURANCE PLG,CONTR. LIC.NO. PLG. CL 0 (This section need not be, completed if the permit is for one TOTAL v N v N hundred dollars IS 100)or Tess.) - U O 1 certify that in the pe,Vurm me of the work for which this Per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL H Ioil is issued,I shall net employ any person in any manner so as to U become subject to the Worked Compensation laws of California. 0. Date Applianl - OJ BUILDING >- w NOTICE'10 APPLICANT: If,after making this Certificate of rix- ALTER OR ADD TO MECH. 5.00 - F Z em pt ion,you should men me subject to the Workers'Core Nom ion APPLIANCE 5.00 PLAN CHECK gc,isions of the Labor Code, you most fnrthwith Comply with FEE U ssS h provisions or this peranit shall be deemed revoked. AIR HANDLING UNIT(TO 10 4,00 1 C.FM. a CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER . 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITHDUCT) v 5.00 1he performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100, WB.T.U-) 6 Lender's Name HEATING UN IT 100,000 B 1' .50 Lender's Address ELECTRIC I certify that 1 have mad this application and stale that the above VENTILATION FAN (SINGLQ% 4.00 information is Correct. I agree to comply with all city end county PLUMBING ordinances and state laws relating to building construction, and BOILER-COWI1 ,H.P.or 100,000B.T.U.) 6.00 V • hereby authorize representatives of this city to enter upon the BOILER-COMP (Osco 100,000 BTU)SEE FEE SCH. MECHANICAL / ahove-mentioned property for inspection purposs. //�✓ (We) agree.to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. u vino aganst li bililies,judgments, costs and expcnus which PERMIT ISSUANCE 10,06 CONST.TAX may any way a rue,agahgt acid City in consequence of the grant gel is Pe t. MECH.CONT. LIC.NO. MECH. - TOTAL /S+'U TOTAL / SitninteoT Applica t/ on.actor Dae l' OFFICE COPY