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14863 POST THIS CARD NEAR FRONT OF BUILDING ERMIr NunTREa CITY OF CUPERTINO 14863 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESSjd� 2_0 "57 � ��J UNIT# _LOT# ,fn PERMIT.EXPIRES IF WORK OWNER �.GU �•-i,ej. CONTRACTOR O , -,L LCJ,C .IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION, LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED' PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VALIDATION .•y. CUPERTINO STANDARDS, GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED tv* -wt &l2e7 UNDERGROUND /SLAB =X �yR �L?rl If-.,4 PLUMBING GdNy/ OQ V& ?S 1. 1:.,E; , e' ELECTRICAL >� /^Z _h'L �l✓ is'sunNCE unrE ' MECHANICAL �j,C� A,(rLA, -ELECT Plc. I ME:c�. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED -i. ILDING PERMIT WOOD FLOOR �� 1k9F ,�'�-�/-4s� �ry '� INFORMATION PLUMBING / - ^ VALUATION SIFT. MECHANICAL pro ve'z .4 I"2/j - ELECTRICAL 0_//_ Gp/ QL@Gr icy PeanlT ro FRAMING - - T INSULATION O 5/OB OCA STORIES TYPE CONST13. — /_x;_ _G/ e%+/ ` OCC.GROUP RES.UNITS /- -- PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE _ SO i T.PLODR ARBA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID \ ROOF SHEATHING - RES IND CON 9 CON use . ' PB Omni APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DAT .1 SID. , ❑ ❑ ❑ ❑ - ❑ ROUGH - ASSESSORS PARCEL NO SAN.q PLUMBING �/-/9-sgl ELECT.ENERGY - TUBS BSHOWER,PAN 01PLUMBING ENER rR CT No. PARCELNG MECHANICAL MECH,ENERGY ELECTRICAL $�' BUILDING ENER Y AC DATE ACC,FILE NO FRAMING ELECT.FINALT ST INSULATION PLUMBING - NING ENG.SITE NO, GAS TEST GAS MECHANICAL FERE SPRENK ENERGY T 2. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEAS FLODD ZONE A U.C. INTERIOR SHEAR FIRE DEPT. Y❑ N❑ v ❑ N SHEETROCK GRADE EXTERIOR LATH FEE SUMMARY BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED. occuPANcv sElsMlc FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. ' � MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC Lu ��. LuONE 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 IDENTI FICATION APPLICATION & PERMIT PERMIT NUMBER ADESG 14863 FOORF55 // O(p�O BUILDING-ELECTRICAL-PLUMBING-MECHANICAL e.,,. OWNER'S PLAN CHECK VALIDATION NPME �/JJ OT ELECTRIC PERMIT FEE �� v�GHONE ONTR C R S NA ..S r�"b OOUTLETS-SWITCHES-RECEP 10.00/1.00 . Z LIC.No. LIGHTING FIXTURES 10.00/1.00 rorvTRAcroR's L/ b PPLIANCES-RESIDENTIAL 4.00 OO E55 �a S?�S PANELS 10.00 DATE OF APPLICATION AORRGINEER CRITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. EN �L �� LIE.No. SIGNS TRANS. 3.00 ARC Ess ENG' SPECIAL CIRCUIT 5.00 (f PERMIT VALIDATION ADDR201 EMP. METER OR POLE INS. 20.00 ADDRESS ADDRESS MOTORS SE - E SCH. `J SERVICE CHANGE .20.00 w¢ zy F o o LICENSED CON TRACTORS DECLARATION IN 1,0101, <v v 1 hereby at Run that I am licensed under provisions of Chapter 9 BSUANCE DATE � (commencing wish Section 7000)of Division 3 of the Business and w BLDG. ELECT. PLG. MECH. H H i Professio�n�s��C�oda_ gy,licensc is in fUllNumber r e 0 z.n da License./! a lO I.ic.Nnmber - ❑ ❑ ❑ 9 w✓w' Date Contractor N _ 4 x BUILDING PERMIT ¢ ¢ re 4 OWNER-BUILDER DECLARATION w ;.I- I hereby allinn Otm I um exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION FLL0a. 4 Law for the following re a son.(Sec.7031.5.Business and Professions PERMIT ISSUANCE. VALUATION $/FT. � y Code:Any city or county which re(Laresa permit to construct,alter, 10,00 ce ¢ ¢O improve,demolish,or repair any structure,prior rn its issuance,also ELEC.CONTR. LIC.NO. ELEC. iL m LL requires the applicant for such permit to file a signed statement that TOTAL Q L n w he is licensed pursuant to the provisions of the Contractor's License PERMIT TO H z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe 4 oo Business and Professions Code)or that he is exempt therefrom and ¢ H the basis for the alleged exemption.Any violation of Section 703 1.5 OTV. PLUMBING PERMIT FEE .5 STORIES TYPE CONSTR. A3 2 by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(S500).): ❑ I,as owner of the property,or only cmpm,sx,with wages as ggCK FLOW PROTECTDEVICE 400 their sole compensation,will do tile . . e 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,COND. 5.00 Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who docs such well F IXTUR ES-PER TRAP 5.00 s0.FT.FLOOR AREA TOTAL ACREAGE himself re Through his own employees,provided that such improve= or nts improvemenetnt tended or within year o If,however,completion the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 or improvement is sob within one year u completion,the owner GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving lhm he did not build or int, BUILDING USE prove for purpose of saleJ' INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other ❑ I,as owner of the property,a111 cxclusivCIY contracting with - licensed contractors to construct the project(See.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. � 6.00 and Professions Code:The Contractor's License Law docs not apply ASSESSORS PARCEL NO. to an owner of property who builds or improves mereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contusions)licensed pursuant to He Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00'. TRACT NO, PARCEL NO,I am exempt under Sec. ,B.&1'.C.for this 6.00 reason WATER HEATER W/VENT Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKI'RS'COh1PIiNSn1'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure. or a certificate of Workers'Compensation insurance,or a certified ZONING ENG-SITE N0. copy Cher- f(Sc 00-Lab.CQ.7 5� � Pulicy No �( ,IriJ� U ❑ Certiliedcopyishurebylunnshed. 4�//f�- z z ❑ CeOiUcA copy is filed with dm city inspec'lion division. FIR E'SPR INK ENERGY T"24 F p1" Applicant MISC- REFER TO ORD. Nv ❑ NE] ir y CBRTIFICA'1'E OP EX1 MPT1ON PROM WORKERS- PERMIT ISSUANCE 10.00 W FLOOD ZONE A.L.U,C.� COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. 1 0 (This section need not be completed if the permit is for one TOTAL Y❑ N� Y❑ N� Z hundred dollars(5 100)or lex.l U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY 0 0 mit is issued,e I shall not employ any person in any manner so is to Q w bcmnle subject to the Workers'Compensation Laws of California. y NOT Dale-Applicant ALTER OR ADD TO MECH. 5.00 . BUILDING } N NOTICE TO APPLICANT: II',after making Dlis Certificate of ex- H ? emption,you should become subjectto the Workers'Compensation APPLIANCE 500 PLAN CHECK . Provisions of the Labor Code, you must forthwm ith coply with - U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000CF.M1 4.00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1 hereby afforn (hilt ihcre is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATWNO. MECH. TO 100,000 B.T.U.) 8.00 Lender's Name Lenders Address - HEATUNIT 100,000 B.T.U.)9.50 ELECTRIC CA 00 I certify that I have read this application and state that the above VENTAN (SINGLE) 4.00 information n correct I agree to comply with all city and countyPLUMBING ordinances and state lues ativesng to building construction. and BOILER .P.or 100,0006.7.U.) 6.00 hereby authorize representatives monies inspection this city to enter-upon the above-mentioned property for inspection purposes. BOILEver 100,000 BTU)SEE FEE$CH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC. REFER TO ORD. Capetian ainst liabilities,judgments, costs and expenses whichCONST..TAX may any ay accrue against - City in consequence of the PERMIE 10.00 r ting oft d perndf ECH.CONT. LIC.N0. MECH.TOTAL TOTAL i and/Contractor Uatc \ OFFICE COPY