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16540 1 POST THIS CARD NEAR .FRONT OF BUILDING 70 PFUMIT NUMBEF♦•'.' CITY OF CUPERTIN 16540 INSPECTION DIVISION JOB INSPECTION RECO PERMIT EXPIRATION J(IH F /p vr�_cTF :1 .- r2d nODHESS .. -_, .`_..__...... - _ ..__UN Il .--.— __L Ttt PERMIT EXPIRES IF WORK HD ,^CIOR IS NOT STARTED WITHIN _ _ INSPECTION DATE INSPECTORINSPECTION RECORD 180 DAYS OF PERMIT ISSU P OI1N__DMl0N ANCE OR 180 DAYS FROM NOTE: L•ASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR E(iUNI TE TO COMPLY WITH THE APPROVED PLANS AND CITY OF IYJO.RT NALIUAI ION CUPERTINO STANDARDS. GNIAGC St.nOti — - P_OU_RNO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 11RIAR B �- _ _ UNDERGROUND /SLAB PLUMBING •yZ•-l` CI' City ul cupotqq- F:LFCTR ICAL yL\ ISSUANCE DATE MEC14ANICAL ULUG ELECT PLG. MEUI i -- ❑ ❑ ❑ j DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED I/— ' � BUILDING ER / IINFORMA?IONfs,i WOOD FLOORLS PLUnn BING D�Y b nA,ION �SIFT. 0" � , w l•i I MECHANICAL �p F,LEC �.,�1• �f , �� Q� rEnnm. F-- — V I ) RAMING �,_-5�- ��FT �•R`VU INSULATION s, rots ry D ,.I A.,, Uf.L (:,IO TIES ES UNITS , Z� ,ti'i �n.tG t rl+.rya, '-h CIi 3 I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ✓�'/) �'r�''C )10 LIZ! r-),WTT-0enal" SO Ir ILOONANEA TOTAL ACREAGf • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE / DIAPHRAGM THE CONSTRUCTION TAX IS PAID O ROOF SHEATHING !/, r 9VILUI NG USE I, •p�. uEs IND ON PB Omr, APPLY NO ROOFING UNTIL ABOVE HAS BEEN tIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.11 ASSESSORS PAUCE I.NO PLUMIIING ELECF.ENERGY I UIl:KSI I0WHI VANIUM.I NO. PAI c L No PLUMBING ENERGY MECIIAPJ ICAL MECH.ENERGY ' ELECTRICAL ncc Onrt, ncc FILE No BUILDING ENERGY I FRnMIN(] ELECT.FINAL TEST INSULAOON PLUMBING ZONING ; ENG.SITE NO. GAS TIS IGAS I MECHANICAL FINE SPRINK ENERGY T24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ° El NO Y 0' NEIEXTERIOR SHEAR FLOOD ZONE A.L U.C. _ _ _ ELECTRICAL RELEASE INTERIOR SHE N1_ .......... 1.1__._,. FIRE DEPT. .E-`f �-1M Y❑ N❑ . ❑ :.. N❑ ^.HEC IHOCK GRADE eaF.�E-6UMMAIII''- �; ;r. EXTERIOR I.AT11 BUILDING IN n1.nIDR Ln FllTEMPORAR'T APPR ALS BUILDING S (r SGRAICH COAT ELECTRIC PLAN CHECK GAS FEE flf- NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNEDOCCUPANCY / SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC • o0 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 u CALLING FOR FINAL INSPECTION. APPLICANTS POSTING COPY POST THIS CARD NEAR-FRONT OF BUILID INGl A \ RMI NUMBER CITY OF CUPERTINO 4/6 . 16540 INSPECTION DIVISION c6D. I' JOB INSPECTION RECORD / L -7 , / •'-� �/ �J l `-J JOB ADDR ES �aCO�J PERMIT EXPIRATION UNITAc*oa PERMIT EXPIRES IF WO RK OWNER V4, CeLOT tferRD IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD - ... DAYS OF PERMIT ISSU FOUNDATION - ANCE OR,180 DAYS FROM NOTE: - LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. nM• GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDvpT;�f M�R UNDERGROUND /SLAB 5-1c),pO 5'ieL-All ,1u4, PLUMBING C* of CUpow '-• i I�� ,..ri% <,;.. ELECTRICAL VW 'ISSUANCE PATE MECHANICAL � �1O_I� /11o� � BLOC rLecT PLC, MECR. o 1V7 GK.\r K '\ ❑ I ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNE - Q���g l �.5 ��NL BUILDING PERMIT WOOD FLOORNM INFORMATION PLUMBING - �N VALUATION oN ST . 3 coG MECHANICAL G O✓ems /�?py� ` v,1i�y 1-,P% 11-17- ELECTRICAL - PERMRT To FRAMING I _ A J d 41 INSULATION - STORIES TYPE c NSTW. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED . - . SO FT FLOOR AREA TOT AIACREAGE T ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID !7 ROOF SHEATHING _ R[s IND LoCON USE 0'1'• APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ -❑ ROUGH SAN.k I�� I ASSESSORSPAHCELNO - y, //�� /1 57 PLUMBING ELECT.ENERGY TTG(P - I�- 0 TUBS&SHOWER PAN PLUMBING ENERGY TRACT No PARCEL No MECHANICAL MECH.ENERGY ELECTRICAL ' BUILDING ENERGY ACC DATE AGC.PILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING - ZONING ENG.Si TE NO, GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZUNL ALUC INTERIOR SHEAR FIRE DEPT. N❑ Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - ILDING -ZZ- INTERIOR LATH MPORAR BUILDING - SCRATCHCOAT - ELECTRIC PLAN CHECK 5 e4p_' -"'i NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY LSEISMIC FEEF - OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. • MICROFILM ' ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING y� z PLEASE GIVE JOB ADDRESS WHEN PHONING. �TJ - SEE PERMIT FOR EXPIRATION DATE'- MECHANICAL• IMPORTANT! CONST.TAX y PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. ' � • u OFFICE COPY :i APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY rB BUI CCY NG PROJECT IDENTIFICATION PERnII16540 N6 5 4 0- I;VILDING APPLICATION & PERMIT ADDRESS Gw BUILDING - ELECTRICAL-PLUMBING-MECHANICAL H OWNEn'$ N%* �L 6•r -Wd)�APLAN CHECK VALIDATION NAME W TV. ELECTRIC PERMIT FEE PHON � � NoTORe'� - UTLETS-SWITCHES-RECEP 10.00/1.00 Fz'r-- L LIGHTING FIXTURES 10.00/1.00 CONTRACTOR S APPLIANCES-RESIDENTIAL 4.00 - S PANELS 1000 PHOry . DATE OF APPLICATION AR°wTe PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P,C:NO. ENGINEER��� �LIC,^.O.. /• Q SIGNS TRANS. 3.00 ADDRESS ENGtT/� �• SPECIAL CIRCUIT 5.00 PERMIT VALIDATION Z,p APPLIC EMP.METER OR POLE INS. 20.00 ADDRESS MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE .20.00 2 F 0 0oo LICENSED CON"TRACT'ORS DECLARATION ' a U U I hereby affirm that I am licensed under provisions of Chapter 9 2 w r'� Z (commencing with Section 7000)of Division 3 of the Business andMAR ;ISSUANCE DATE .,V.r - LOG. ELECT. PLG. MECH. D i Professions Co J my license is in full fop} •yy .. z o m- Lice ]a,, Lic.N'umh 'j ClZ ICf � E O of H Dale -3 •'� Gonlmctorr'Z"^1IA,xi City of Cupertino IL`l SE y f J ¢ ¢ wa OWNER-BOLDER DECLARATION BUILDING PERMIT a: 0a " MISC.- REFER TO ORD INFORMATION w a- 1 hereby affirm that I mn exempt from the mv,,Contractor's LLoj Law forthefollowingreuon.ch reuiresa.ermit tocnd Professions VALUATION $/FT. r - PERMIT ISSUANCE 10.00 Cprovo,demolish, Countywhiny structurep riot t oconsuance,lter,also - p� n^ ¢ ¢¢ improve,dttno ish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. 1,10 WO ¢ requires the applicant for such permit to file a signed statement that ea m m he is licensed ulsuanl to the - TOTAL PERMIT TO p provisions of the CDnlmctor's License HZQLaw(Chapter 9(commencing with Section 7000)of Division 3o fth, ^I ` � i o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE r` ¢ ,-m the basis for the allege)exemption.Any violation of Section 7031.5 STORIES TYPE CO TR. dam _ by any applicant for a permit subjects Ute applicant to a civil penalty gLTER-DRAIN -WATER of not more than live hundred dollars(5500).1'. (EA.) 5.00 ❑ Las owner the property,of my employees with wages as their sols;compensation,will do Ute work,and ye structure is not BACK FLOW PROTECT.DEVICE 4.00 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 dos not apply to an owner of property win.build,Or Improve,thelenn,and who does such work FIXTURES-PER TRAP 5.00 $Q FT.FLOOR AREA TOTAL ACREAGE himself or through his own employes,provided that such improve- ,y ments 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 o builder will have the burden of proving that h -e did not build or im- BUILDING USE prove for as owner of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ L u owner of the property,he exclusively contracting with ❑ ❑ O 0 0 licensed contractors tore C.mtutthe project(Sec.7044,Business LAWN SPR IN KLERS-1 INC5 V.B. 6.00 ASSESSORS PARCELNO. and Profession' Cole The Contract Ors License Law does not apply to an owns of property s who ha contr improve,ensed p,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 'Z 269 - 1 •T_/15 contracts for such cense is with a conlmctor(s)licensed pursuant to :J eV/ V L.J the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 ❑ TRACT NO. PARCEL NO. Pum tnempt under sec. ,B.&P.C.for uus reason WATER HEATER W/VENT 6.00 Owner Date - WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. woRKERs'compENsn'floN DHCLnftniiON WATER TREATING EQUIP. 5.00 1 hereby affirm for I have a certificate of consent to self-insure, - or u certificate of Workers'Compensation InsuranCce,or a certified ZONING ENG.SITE NO. copy thereof tree.3800.Lab.C.l. LV� Policy er Company 0 L] Certified copy is hereby furnished. FIRE SPRINK ENERGY T"24 z Z Py(IS" Cerlift carry is filed w h th- �y , . tion "on. F,p A pheanr F;y� tgYy�_e�"� MISC.- REFER TO ORD. y N� v LTC.a CERTIFICATE OF li%IiMPTION FROM WORKERS' PERMIT ISSUANCE - 10.00 FLOOD ZONE A.LC. LU > COMPENSATION INSURANCIi PLG.CONTR. LIC.NO. pLG CL O (This section need not be Completed if the permit is for one TOTAL v� N� Y� N� Z hundred dollar,(S 100)or less.) U O 1 testily that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY - LL U mit is issued, I shall not empluy any person in any nmmnsr so as to become subject to the Workers'Compensation Laws of California. � y Dam Applicant ALTER OR ADD TO MECH. 500 BUILDING } to emption,TO APPLIshould become If,alter making this Certificate u Ex-se.ion r F Z emvision you the Labor Code, totheWorkers'Compensation APPLIANCE 5.00 PLAN CHECK Provisions io the Labor Code, you must forthwith comply with U such provisions or this permit shall be deemed revoke). AIR HANDLING UNIT(TO 10pODQF.M.) 4.00 FEE CONS'I'RUCfION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE. Gf SD I hereby aRlrra that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) ,5.00 1 the performance of the k for which this permit is issued(SP" PLUMBING MICROFILM 3097,Civ.C.). ING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Namc Lender's Address I NG UN IT E R 100,000 B.T.U.)9.50 ELECTRIC I certify that I habe read this application and state that the aboILATION FAN (SINGLE) 4.00 ordiinfonances n tourer. I agree to compty with all city and counR-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinanc- and rr tc Taws relatinx to building construction.hereby authorse representative, of this city to enter upon tabovo-mentioned property for inspection purposes. ER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save indemnify and keep harmless the City .- REFER TO ORD.apeina against liabilities,judgments', twin and expenses whiCONST.TAXmay in any way accrue against said City in consequence of tIT ISSUANCE 10.00LIC.NO. MECH L7TOTAL TOTAL 983 0 urea Applicant/Cont,eros Dao -- - OFFICE COPY