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16451 POST THIS CARD NEAR FRONT OF BUILDING EHMIT NUMBER 4 CITY OF CUPERTINO 16451 INSPECTION DIVISION JOB INSPECTION RECORD' •y , 02�0 f ��` �e� 'PERMIT EXPIRATION JOB ADDR ESS �1 UN174LOT# PERMIT EXPIRES IF WORK OWNER L C. CONTRACTOR IS NOT STARTED WITHIN I PECTION DATE INSPECTOR INSPECTION RECORD 188 DAYS OF PERMIT ISSU FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF .PLHNII I VALIOATION CUPERTINO STANDARDS. GARAGE SLABS ,�-- POUR NO CONCRETE.UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING. ELECTRICAL ISSUANCE DALE MECHANICAL a 'FLOG ECT. .. PLG. MEW ❑ DO NOT POUR FLOOR UNTIL ABGVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUAIION SIFT. MECHANICAL ELECTRICAL ELECTRICAL ; - PEHMIT To FRAMING - IlWe;l Jc,A, /yDA._ INSULATION STOHIES - TYPFCONSTH. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED C 0 t&14A CV&- fi00FNOTE:NO FINAL INSP.SHALL BE MADE BEFORE $11-11,110.11aneA rornL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID I ROOF SHEATHING BVICDING USE HES •INO CON PB - " APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0-L L L L ROUGH SAN.P 4n SSESSUHS PARCEL NO. ' PLUMBING ELECT.ENERGY' TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO ' MECHANICAL14 MECH.-ENERGY ELECTRICAL- BUILDING ENERGY ACC.DATE ncc FILE No FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONING ENG.SITE NO. GAS TEST AS M HANICAL FIRE SPRINK ENERGY'TQa COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEA ING V L "L v "� PLOOU LONE AL U.C. EXTERIOR SHEAR ELEC ICALRELEASE INTERIOR SHEAR FIRE DE N❑ "❑ N L "❑ ' SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH. BUILDING —T= INTERIOR LATH - TEMPORARY APPROVALS" BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE (I OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED13Y BUILDING INSPECTOR. MICROFILM ELI ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING `- o� PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR.EXPIRATION•DATE - MECHANICAL IY 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 9UI LD1 NG PROJECT I DENTI FICATION PERMIT NUMBER " Ds APPLICATION & PERMIT ADDRESS. , BUILDING. -ME CHANICAL21 (94-r FrL , 4, 16451 APLAN CHECK VALIDAT N � AMEMe/ - OTY. ELECTRIC PERMIT FEE 1 u ! PHONE ZSS-3s(Y yo E CT°Rs UTLETS-SWITCHES-RECEP 10.00/1.00 ca SZ- / 7 LIC.Na, LIGHT(N 3 FIXTURES 10.00/1.00 t ADDRESS oRa PPLIANCES-RESIDENTIAL 4.00 PHONE - PANELS 10.00 - DATE OF APPLICATION •... ARCHITECT - - PLAN CHECK FEE P.C.�NO. OR .A �l"AI� �-fc�( PANELS (OVER 200 AMP) 211.00 ENGINEER /"I ' LIC.NO. / 970¢ SIGNS TRANS. 3.00 ARCH OR ON SGC I.1.a1 d(L� ✓C PERMIT VALIDATION ADDRESS t-/ [) y `� SPECIAL CIRCUIT 5.00 G bet( Q EMP.METER OR POLE INS. 20.00 /I �- APPuc4Nrs 1 ADDRESS MOTORS SEE FEES n SERVICE C 1.HANGE 20.00 D Foo LICENSED CONTRACTORS DECLARATION 4 F z W I hereby affirm that I am Focused under provisions of Chapter 9 �� ISSUANCE DATE n (commencing with Section 7000)of Division 3 of the Business and RL ELECT. PLG. MECH. F N z Professions Code,and hay license is in full force and effect ❑ ❑ z o sat - License Clas Lie Number y- Date mra Cocr H � m _ '¢ w a OWNER-BUILDFR DECLARATION /yy I G PERMIT E u m 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD of NFORMATION .. o Law for the followingrcason(Sec.7031.5.Business and Professions . VAw $/FT. - m g Code.Any city or count PERMIT ISSUANCE y which strict a a permit to construct,alcor, - p improve,demolish,or repair any structure,prior m its issuance,also ELEC.CONTE. - LIC.NO. ELEC. 3 ra o_LL rquim5 the applicant for such permit to rile a signed statement that TOTAL/ PERMIT T _ w 9 he is licemed pursuant t0 the provisions of the Contractors License i Law(Chapter 0(commencing with Section 7000)of Divisiun 3 of the f i o Business and Professions Code)or that he is exempt therefrom and CITY. - PLUMBING PERMIT FEE �N X H $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. d � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 ofn t more than frac hundred dPlats(S500r): I,as owner of the pmperty.or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS then sole compensation,will do the work,and the structure is not intended or offend for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law dos not apply to an owner of ' property who builds Or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.IT.FLOOR AREA TOTAL ACREAGE himself or through his own employees.provided that such improve- GAS-EA.SVSTEM-11NC.40UTLETS 6.00 �( maims are not intended or offer sal for sale.If,however,the budding or improvement is sob within one your ofcompletion, the owner. budder will have the burden of proving thatt he he did did nott build or ireGAS-EA.SYSTEM-OVER 4 (EA.) 2.00- BUILDING USE prove for purpose of sale). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ 1,as owner of Cie property,am exclusively contracting with ❑ ❑ ❑ ❑. ❑ licensed contractors to construct the pm)cet(Sec 7044,Badness LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Profemuns Cale:The Contractor's Liana 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 contracmP,)licensd pun cant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. 0 lamexcmpt undo, car.. B.&P.C.for this WATER HEATER W/VENT 6.00 reason '' Owner n. .tom WATER SYSTEM 5.00 ACC.DATE ACG FILE NO. WORKF-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby air,. that 1 have u cenifcute of consent to nlFinuve' ZONING ENG.SITE NO. or v certificme of Worked Compensation Insurance,or a certifed copy thereof(Sec.3800,Iab.CJ- - r Policy No. Company 0 ❑ Cc,titicdcoPy'isbereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is fled with the Limy inspection division. MISC.- REFER TO ORD. O Applicant V C] IN E] V ❑ NE] y CERTIFICA'T;OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG. Y❑ 'N❑ CL Y ❑ N❑ 0 (This section need not be completed if the Permit is for one TOTAL Z) Z hundred dollars 1$11X7)or Iess.l U O 1 certify that in mire perrormance of the work for which this Icor- CITY MECHANICAL PERMIT FEE FEE SUMMARY LL H- mit is issued,1 shall not employ any person in any manner so as to U , become subject m mon the Workers'Copensatilaws TCalifornia. O BUILDING W Dam Applicant ALTER OR ADD TO MECH. 5.00L� } W NOTICIi'IU API'LICAN I': If,alter making dlis Cert it it,M Fs- -Z emptioo,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provision of the Labor Code, you must forthwith comply with - FEE CJ such provisions or this permit shall Ix deemed Hooked. AIR HANDLING UNIT(TO 10SWC.F.NL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNrr(OVER IQOOOC.EM.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5,00 the Perfommnce of Cha work for which this pernit is iuucd(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's AddHEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC � '� ress I certify that)have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 m inforation is correct. 1 agree to comply with all city and county PLUMBING ordirmnces and state laws relating m building construction, and BOILER-COIvP 13 H.P.or 100,000 B.T.U.) 6.00 hereby authorize represen Wtives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL sac-mentioned property for inspection on POWs. �. (we) agree no save, indemnify and keep harm)-ss the City of MISC.- REFER TO ORD. operon. against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 1000 CONST.TAX may in any way aceto against said City in consctluence of the ranting fda permit. MECH.CONT. LIG NO. ECH. TDTAML TOTAL ,7.. Signature of Applicant/Contractor Data 111 OFFICE COPY