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C 8360 POST THIS CARD NEAR FRONT OF BUILDING CIT+ OF CUPERTINO • RA„TNUb,BER �J836 INSPECTION DIVISION � JOB INSPECTION CORD O• / PERMIT EXPIRATION JOB ADDRESS /Or ' UNIT# ' LOT PERMIT.EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPE 10 DATE INSPECTOR NSPE ION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LIFER LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION POUR CNAIEAE UNTIL AB VE HAS BE EN SIGNED , UNDERGROUND /SLAB PLUMBING ELECTRICAL - ISSU NCE DATE MECHANICAL BL ELECT, PLG. MECH. ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED . . BUILDING PERMIT WOOD FLOOR - INFORMATION VALUATION PLUMBING. S/FT. MECHANICAL , ELECTRICAL PERM TO FRAMING 'C• II INSULATION. STORIES ,T P CONST-. - - OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' ROOF ' SO.FT,FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE IND CON PB O'n.' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑• ❑ ❑ PLUMBING ROUGH ASSESSOR S PARCEL NO. GAS TEST TRACT NO. PARCEL NO. MECHANICAL ELECTRICAL FINALS DATE INSP. ACC.DATE ACC.FILE NO. FRAMING SAN # ' INSULATION PLUMBING ” ZONING ENG.SITE NO. GAS MECHANICAL FIRE SPRINK ENERGY T 24. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y ❑ "❑ Y ❑ NE�:'].' r LATH-INTERIORELECTRICAL FLOOD ZONE A.L.U.0i LATH-EXTERIORFIRE DEPT. Y❑ "❑ Y ❑ NF] SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING FIREWALLSELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOICCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM I ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC a� 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. .. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY PE ITNUMBER BUILDING PROJECT IDENTI FI ON APPLICATION & IT ^ r/�M BUILDING / l / O ADDBEss BUILDING-ELECTRICAL-PLUMBING-MECHANICAL V Of20 00 - o. E own ERs I I PLAN CHECK VALIDATION NAME ` OTY. ELECTRIC PERMIT FEE ® ©f S PHONE - CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 �/.., 5 LIc.NO C) LIGHTING FIXTURES 10.00/1.00 / CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 NE5p1-3/ PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE .C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER LIC.NO SIGNS TRANS. 3.00 ADDRESS ENG' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 i APPLICANT'S ADOREsa MOTORS SEE FEE SCH. SERVICE CHANGE 20,00 w a o LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 aar Z I hereby affirm that I am licensed under provisions of Chapter 9 Q m ISSUANCE DATE I commencing with Section 7000)of Division 3 of the Business and ECT. PLG. MECH. H 0 z Professions Cod rid psy license is in full farce and ffe _ ❑ ❑ ❑ Z 0,�,- icer.Class^/ Lic.Number' 9750 0 w F j Date Contactor a Y J ¢ ¢ w a OWNER-BUILDER DECLARATION U BU G PERMIT O INFORMATION R 5 a w 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u O j I:Iw for the following rcason.lSec.7031.5,Business and Pr0fetions W.LUA ION S/FT. L - PERMIT ISSUANCE 10.00 I �} y��p�r Code:Any city or county which structure permit loco issuanc alter p✓-ykx`(BO ¢ < improve,demolish,or repair any structure,prior to i6 issuance,also ELEC.CONTR. LIC.NO. ELECis . T TO G n esquires the applicant for such permit to file a signed statement that TOTA L -S K $ he u licensed pursuant to the provisions of the Contractor's License PERMIny./ F z¢ Law(Chapter 9(commenting with Section 70003 of Division 3 ofthe ANT i,t V Z i D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢�0 the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. d3 � by myapui the fora permit subjects S500d.he licam toecivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more Oen five hundred donors(55001.): ❑ I,as owner of the properly,or my employees with wages as BACK F LOW PROTECT.DEV ICE 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,AR EA,CON D. 5.00 Code:The Contractors License taw does not apply to an owner of properly who builds or improves thereon,and who doa such work 'd FIXTURES-PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own einployces,provided that such improve- meets are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INCA OUTLETS 6.00 or improvement is Sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER30.00 RES IND CON PB Other . O 1,as owner of the properly,am exclusively contracting with 1:1 El El ❑ 1:1 LAWN contractors to construct the project(Sec. ] 4,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 Ass ESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves Ihercon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 contracts for such projects with a contractorls)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACTNO. PARCELNO. ❑ lam exempt under Sec.-,BAP.C.for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACO.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 11 hereby affirm that I have a certificate of cotuent to self-insure. or a certificate of Workers'Compensation Insurance,or a cert ifin] ZONING ENG.SITE NO. copy thereof ISec.3800,Lab.0.1r- Policy No. Company y-.y.4T MA -TNCa ❑ rtified copy is here furmsl N. Z c _ py B 6 iy ht c y inspection division. FIRE SPRINK ENERGY T 24 ~Al` Applinnt ,3,� MISC.- REFER TO ORD. Y NE] Y ❑ NE] rn PERMIT ISSUANCE 10.00 cc - CERTIFICATE OF EXEMPTION 17ROM WORKERS' FLOOD ZONE A.L.u.C. LU - COMPENSATION INSURANCE PLG.CONTR. LIC.NO. d0 PLG.. Y❑ N❑ Y❑ N❑ L0 hundred saltire need not he completed if the lwnnit is for one TOTAL - hundred dollen IS 1001 m less.] U O 1 certify that in the perforrnan<of the work for which this pef- DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner 50as 1. U become subject to the Workers'Compensation Laws of California. a Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } 0NOTICE TO APPLICANT: If,after making this Certificate of E.- -301 ♦- ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with U such provisions or this permit shall be deemed revoker]. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE ,S0 I hereby ufrnn that there is a construction lending agency I'or 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 Lenders Address HEATI NG UNIT(OVER i DO,000 B.T.U.)9.50 ELECTRIC 1 certify that I have read this application and slate that the shove VENTILATION FAN (SINGLE) 4.00 Information is correct. I agree to comply with all city and rountyP.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction -CO , and BOILERW(3 H. hereby authorize representatives tativa of the city to cells upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL ahovc-mentioned property for inspection pia ser. Uo save, Indemnify d lett harmless the Ciry of MIS .- REFER TO ORD.st liabilities,j nif nus, c is and expenes which PERMIT ISSUANCE ORD. CONST.TAX y acc 'n id Cit in consequence of the10.00per MECH.CONT. LIC.NO. - MECH.TOTALTOTALre (Applicant/Contralto Date OFFICE COPY _