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18006 " 'POST THIS CARD NEAR FRONT OF BUILDING PERMITNUMBER CITY OF CUPERTINO 18006 INSPECTION DIVISION JOB INSPECTION RECORD �T ESS ol'y4 • ' `ST— PERMIT,EXPIRATION JOB ADDR UNIT# _LOT# S• pi�lS r,n PERMIT EXPIRES IF WORK OWNER • CONTRACTOR •IS NOT STARTED WITHIN .INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE CIA 180 DAYS FROM NOTE: LAST CALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED fzcmoF2- J706T,Lj�UpObbl UNDERGROUND /SLAB 0WORM -w' cYLA'«ZC0!( N"�- PLUMBING O - ' ELECTRICAL � �1 �9' ISSUANCE DATE '+ MECHANICAL BLOC E,LFCCTT. PLG. MECH. - x �I L29. JCi DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED9 198 BUINFORMATION PERMIT JUN - WOOD FLOOR VALUATION s/FT. PLUMBING Oty Of,c'pQ tv"o MECHANICAL - ` PERMIT TO ELECTRICAL FRAMING - F INSULATION STORIES TYPE CONSTR. OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 1 _ $O.Fi.FLOOR AREA TOTAL ACREAGE -ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID J BUILDING USE . .t y ROOF SHEATHING ' RESIND N APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DID El 1:1 ❑ EDATE INSP. ASSESSOR PARCELNO ROUGH SANA PLUMBING1 • (- 9 ELECT,ENERGY LjLb TRACT NO. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE ACC.FILE No FRAMING `�� j' ELECT.FINAL TEST ZONING - ENG•SITE NOr INSULATION' PLUMBING GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING " ` "[- PL000 zorvE A L u.c. EXTERIOR SHEAR - ELECTRICAL RELEASE ' - INTERIOR SHEAR FIRE DEPT. - SHEETROCK' GRADE FEESUMMARY EXTERIOR LATH" BUILDING INTERIOR LATH u TEMPORARY APPROVALS BUILDING SCRATCH COAT - - - ELECTRIC PLAN CHECK t{g /OQ GASFEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR' MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, EL`CTRicful I-ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING aa. 00 PLEASE GIVE JOB'ADDRESS WHEN PHONING. Z bo SEE PERMIT FOR EXPIRATION DATE — MECHANICAL "7 p IMPORTANT! CONST.TAx -PLEASE READ REVERSE SIDE BEFORE TOTAL �/9,• - CALLING FOR FINAL INSPECTION. OFFICE COPY „r„APPLICANT TO'FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY ` •low BU I LDINGPROJECT IDENTIFICATION , PERMITNUMBER BUILDING APPLICATION & PERMIT., ADORE � RUILDING-ELECTRICAL-PLUMBINGb 'MECHANICAL 06 OWNER'S a PLAN CHECK VALIDATION ./ 0 PHONc 7J�'7,/, �t QTY. ELECTRIC PERMIT FEE N CONTRACTORS NAMEOUTLETS-SWITCHES-RECEP. 10.00/1:00 . 49.049.0' - ' LIC.NO. LIGHTING FIXTURES '` 10.00/1.00 - • S CONTRACTOR'SADD HESS I PPLIANCES-RESIDENTIAL 4.00 - PHONE PANELS :10.00 GATE OF APPLICATION ARCHITECT r PLAN CHECK FEE- P.Cr NO. OR . PANELS (OVER 200 AMP) 20.00 ENGINEER No: SIGNS TRANS., 3.00 ' ARCH.OR ENG. - PERMIT.VALIDATION ADDRESS SPECIALCIRCUIT 5.00 - ZIP TEMP.METER OR.POLE INS. 20.00 [i APPLICANT'S a 6 ADDRESS MOTORS SEE FEE SCH. 9 . I o0 /ne- SERVICE CHANGE 20.00= J_w ,�w .� � ,02 LICENSED CONTRACTORS DECLARATION , W u w' I hereby affirm that I am licensed under provisions of Chapter 9 ` ISSUANCE DATE y a (commencing with Section 7000)of Division 3 of the Business and - `BLDG. ELECT. PLG. MECH. r o i Professions Code,and my license is in full force and effect � � - Z, z m o License Class Lic.Number H w H J 10 Date Contractor < x _ BUILDING PERMIT ¢ a: ¢ OWNER-BUILDER DECLARATION o d U Q1y .INFORMATION X ; LL F- I hereby affirm that 1 am,exempt from the Contractor's License MISC.-,. Ilm ORD Fuoa Law for the following reason.(Sec:7031.5,Business and Professions - PERMIT'ISSUANCE 10.00 VALUATION OO $/FT. Code Any city or county which requires a permit to N constrmalter, 2 w ¢ 0 improve,demolish,or repair any structure,prior rn its issuance,also ELEC,CONTR. LIC,NO, ELEC. 6 ` wO LL requires be applicant for such permit 10 file a signed statement that - I TOTAL �� , PERMIT TO m he is licensed pursuant to the provisions of the Contractor's License - FZQ Law(Chapter 9(commencing with Section 7000)of Division 3 of the x'a.•� D 4 c Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ITfs' Be H $ the basis for the alleged exemption.Any violation of Section 7031.5 - STORIES TYPE CONSTR. ag _ by any applicant for a permit subjects the applicant too civil penaltyALTER-DRAIN& VENT-WATE (EA.) '5.0 ' of not more than five hundred dollars($500R.) + ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DF flCE 4.000 OCC.GROUP RES.UNITStheir sole compensation,will do the work;and the structure is not intendedoroffered 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 does such work FIXTURES-PER TRAP 5.00 L•0 Ll 50.FT.FLOUR AREA .TOTAL ACREAGE . himself or through his own employees,provided that such improve- ' f mentsare not intended or offered for sale.If,however,the building GAS=EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE 1 builder will have the burden of proving that he did not build or in _ RES IND CON PB Other p Prov for purpose of sale INDUSTRIAL WASTE INTER.- 30.00 1:1 El El E] 1:1I,as owner of the property',um exclusively.contracting with lixd contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractors License Law does not apply s to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 + contracts for such p ojects with a contruclor(O licensed pursuant t< SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's enac Law. TRACT NO. PARCEL NO. - ❑ Iamexe made ,B.&P.C.for this WATER HEATER W/VENT 6.00 R - reaso Ownc e, WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. ' WORKERS'COMPENSANON DECLARATION„ WATER TREATING EQUIP. 5.00 - hereby affirm that I have a certificate of consent to self-insure, - or a certificate of Workers'Compensation Insurance,or a certified ZONING' ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). -- - Policy No. Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is filed with the city inspection division. - O Applicant - MISC.- REFER TO ORD, Y NQ Y ❑. IN y� PERMIT ISSUANCE 10.00 "�. FLOOD ZONE AL.U.C.CERTIFICATE OF EXEMPTION FROM �A W �_ COMPENSATION INSURANCE PLG.CONTR. _ - - LIC.No.- PLO. �� Ob Y E] NE] Y E) NE] CL Q (This section need not be completed if the pinnot`i, for one TOTAL ::)`Z' hundred dollars($100)or less.) - - - U O . 1 certify that in the performance of the work for which this per `FEE SUMMARY U. 1- mit is issued,I shall not employ any person in any manner so as to QTV. MECHANICAL PERMIT FEE O W become subject to the Workers'Compensation Laws of California. y Date Applicant - ALTER OR ADD TO MECH. 5.00 .OD BUILDING /O 00 '} N NOTICE TO APPLICANT: If,after making this Certificate of Ex- - I- Z emption,you should become subject to the Workers'Compensation APPLIANCE " 5,00 -PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE ' ",6D. V such provisions or this permit shall be deemed revoked. I AIR HANDLING UNIT(TO'10=C.F,M.), 4.00 . / CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10PWC.F.M.) 6.00 SEISMIC FEE" • 6-3 l,hereby affirm that there is a construction`lending agency for EXHAUST HOOD(WITH DUCT) 5.00 SO the performance of the.wark for which(his,permit is issued(Sec. • MICROF,ILM-, 3097,Civ.C.). I HEATING UNIT(TO 100,000 B.T.U.) 8.00 - Lender'sHEATING UNIT(OVER B.T.U39.50 ELECTRICS It Addr Lender's Address - - Tcertify that I have read this application unitstate that the above VENTILATION FAN (SINGLE) 4,00 information is correct. I agree to comply with all city and county PLUMBING' O.1- ordinances and state laws relating to building'construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 ' hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH, MECHANICAL, !Z 7. s-D above-mentioned properly for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. gatureofA nst liabiliti ,judgments, costs and expenses which •CONST.,TAX-. , , Trya a ai City in consequence of the PERMIT ISSUANCE _ 10.00 �. s per MECH.CONT. LIC.NO. , MECH: '• TOTALrO TOTAL 29 ppImmt/Contr clor OFFICE COPY