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15412 POST THIS CARD NEAR FRONT OF BUILDING � PERMIT NUMBER CITY OF CUPERTINO 15412 INSPECTION DIVISION ,1 JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 20580 Homestead Avenue UNIT# _LOT# _ - PERMIT EXPIRES IF WORK OWNER Payless Druc Store CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 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 PEHNvI VALm AT'ON CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICALISSUANCE DATE' MECHANICAL BLDG. FELEG7T PLG MEC`i ❑ ❑ 4 ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION s/FT. MECHANICAL ELECTRICAL PERMIT To FRAMING nq 2 - INSULATION Siu�• sroRles TYPE corvsrR. . .1,111 VIiT UCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED •. ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SD.`T.`I.00B ARIA TOTAL ACREAGL DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING - BUILDING USE Hes IND CON PB 00— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.k , ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY. TUBS&SHOWER PAN PLUMBING ENERGY TRAC.NO. PARCEL NO MECHANICAL - - MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACC.FILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONING ENG,SITE NO. GAS TEST GAS c co 3 MECHANICAL FIRE svgmrc ENERGY nza COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v ❑ N'❑ r ❑ IN EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD/ONE A.Luc. INTERIOR SHEAR FIRE DEPT. 'Y N❑ Y ❑ N❑ SHEETROCK GRADE • EXTERIOR LATH .. FEE SUMMARY BUILDING INTERIOR LATH - TEMPORARY APPROVALS BUILDING ' SCRATCH COAT ELECTRIC PLAN CH ECK �, NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IUUUUFANCY 'SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTEDUNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� 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 CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY • _ „ BUILDING PROJECT I DENTIFICATION PERMIT NUMBER IL BUDING APPLICATION & PERMIT ADDRESS o��s0p� TI'/ KE ST 4/�L BUILDING-ELECTRICAL-PLUMBING -MECHANICAL 15412 7 DINER'5 PLAN CHECK VALIDATION NAME p • a(.�Ss 41 J�r4i, �RONEa7S.3 9��"0 QTY ELECTRIC PERMIT FEE NAMERAcroRs UTLETS-SWITCHES-RECEP 10.00/1.00 �I!/Ae/3/ uc No 3 �9 LIGHTING FIXTURES 10.00/1.00 CADDRESSoNfRACTOR'S ©r7r/. APPLIANCES-RESIDENTIAL 4.00 4*t71J1A&C1J vRONE(e30 XS2I0 PANELS 10.00 ' GATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C:NO. oR PANELS (OVER 200 AMP) 20.00 ENGINEER Llc.No, SIGNS TRANS. 3.00 ARCH ESS G. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ilv EMP.METER OR POLE INS. 20.00 ^ (zOf/"g"'--' ADDRESS L APPLICANTS Nr$ MOTORS SEE FEE SCH. l�//` SERVICE CHANGE 20.002/&31 ff ,00 LICENSED CONTRACTORS DECLARATIONd 1 V SE u u 1 hereby affirm that 1 am licensed under provisions of Chapter 9 y < y (commencing with Section 7000)of Division 3 of the Businesj and ISSUANCE DATE r D 2 Professions Code,end my license is in full for e- f b BLDG. ELECT. PLG. MECH. Z O m- License Class Lic.Number ❑ 4 Z t. o ' Date Contra lar BUILDING ERMIT ¢ ¢ w a OWNER-BUILDER Dli RA'PI o A D INFORMATION X ; 0 y I hereby ulllrm that I am exempt from the Coniructor's License MISC.-' REFER TO ORD .. o v, Law for the following•reason.(Sec 7031.5,BcvRcSsand Professions VALUATION - s PERMIT ISSUANCE 10.00 S/FT. Cade:Any city oh co;nty reputably icy structure p riot to is issuance,also ¢ ¢st O improve,Demolish,or repair:my 9ruclum,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEG. n w m¢ requires the applicant for such permit m file a signed statement that TOTAL he is licensed pursuant to the provisions of tiro Contractor PERMIT TO s Liccnsa F Z a Law(Chapter 9(commencingwith Section 7000)of Division 3 of the q o Rusiness and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE the basis for the alleged exemption.Any violation ofSeclion 703 LS STORIES TYPE CONSTR. d ; _ by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500).) ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECTDEVICE 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 docs not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP, 5.00 SOL FT.FLOOR AREA TOTAL ACR EAGE O himself or through his own employees,provided that such improve- - - meats are 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 IEA.) 2.00 builder will have the burden of proving that he did not build or in, BUILDING USE prove for purpose of sale.). RES IND CON PB Otbn ❑ I,as owner of the property,an,exclusively contracting with INDUSTRIAL WASTE INTER. . 30.00 licensed contractors to construct the project ISec. 7044,Blrslness0 El LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL and Professions Code:The Contractor's License Law docs not apply NO. 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 eontmctorOl licensed pursuant to the Contractors License Law. SEWER-SANITARY-STORM EA.200tt/10.00TRACTNO. PARCEL NO. ❑ lam exempt under Sec ,B.WBC.Ibr this reason WATER HEATER W/VENT. I,h'� 6.00 Owner Date WATER.SYSTEM 4 e` 5.00 ACC.DATE ACG FILE N0. WORK IiRS'COMPIiNSA'I'[ON DECLARATION WATER TREATING EQUIP., Ey O, "•� 5.00 I hereby affirm that I have a certificate ofeamsent to selflneu re. ) IX I. or a certificate of Workers'Com mention Insurance,or a certified `d ZONING ENG.SITE NO. copy thereof(Sec,3800,Lab.0 Policy No. Com Puny Ery C r1�0Qi ❑ Cenil'iedco ylsher• YfrgiisN if. G�ry.v z ❑ Cerlihic{��ry wed the ily in spcclion division. _ FIRE SPR INK ENERGY T-24 O Applicant ST/• ( i/`/7Af C� � MISC.- REFER TO ORD. v N v No w CIiR IPICATE OF EXE IP N FROM WORKERS' PERMIT ISSUANCE 10.00 d FLOOD ZONE A.L.u.c. W COMPENSATION INSURANCE PLc.COrvTR. LIC.No. ITOTAI / CL Q (This rection need not be completed if the permit is for one YE] NE] Y � NE] hundred dollars 1S1001 or less.)LL O 1 certify that h the t cHiplmmcc of the work llt which Wis per- QTY MECHANICAL PERMFEE SUMMARY LL U mit is issued, I shall not employ tory person in any manner r as toOED become subject to the N scant 'Comperomion Laws ofQdilomia. ¢, Uslc Applicant ALTER OR ADD TO MECH. BUILDING N NOTICE TO APPLICANT: If,cher making this Certificate of lis-emptioo,you should become subject to the Workers Compensation APPLIANCE PLAN CHECK provisions of the labor Code, you must forthwith comply with FEE such provisions or this permit sbAl he deemed revoked. AIR HANDLING UNIT(TO 10=CCONSTRUC'T'ION LENDING AGENCY AIRHANDLINGUNIT(OVERIOAOOSEISMIC FEE 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. 3097,Civ C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 . Monances n correct. 1 agree to comply with all oily and county PLUMBING 6 ordinances and stole lawsblsrelating to building construction, and BOILER-CCNNP I3 H.P.ar 100,000 B.T.U.) 6.00 hereby anti ice representatives of this city es enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in ny way a w ue against Said City in conserucnce of the PERMIT ISSUANCE 10.00 Y of l •r l MECH.CONT. LIC.NO. MECH. TOTAL TOTAL Vsuirplure of A Pplicadift/Lboractor Uu[c l` OFFICE COPY