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11808 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PERM IT MBER 1 INSPECTION DIVISION ' 11808 • JOB INSPECTION RECORD. PERMIT EXPIRATION JOB ADDRESS 1102 HUNTERSTON PLACE UNIT# LOT# PERMIT EXPIRES IF WORK OWNER RICHARD COTTER CONTRACTOR VALLEY HEATING IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM UFER LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION, POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB 1� �,• ! ,t �, PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ELECT. PLG. MECH. ❑ El Qi DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION $/FT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO FRAMING - / r INSULATION STORIES TYPE CONSTR. OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF SO FT,FLOOR AREA TOTALACREAGE DIAPHRAGM BUILDING USE RES IND ccN' PB 0"'" APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - El El1:1 ❑ ROUGH ASSESSORS PARCEL NO. PLUMBING `- GAS TEST TRACT NO, PARCEL NO. MECHANICAL ELECTRICALFINALS DATE INSP. ACC.DATE ACC.FILE NO. FRAMING ISAN # INSULATION IPLUMBING ZONING - ENG.SITENO. GAS MECHANICAL FIRE SPRINK ENERGv r.2a COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 2 Y ❑ N Y ❑ N❑ LATH—INTERIOR ITLECTRICAL FLOOD ZONE A.LUL. ATH—EXTERIOR FIRE DEPT. Y❑ N❑ - ' Y ❑ N❑ HEETROCK GRADE HEAR INTERIORFEE SUMMARY BUILDING HEAR EXTERIOR TEMPORARY APPROVALS BUILDING REWALLS ELECTRIC PLAN CHECK GASFEE 1 TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED UCCUPANCv SEISMIC FEE UPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANTI CONST.TAX APLEISE READ REVERSE SIDE BEFORE { CALLING FOR FINAL INSPECTION. TOTAL r OFFICE COPY �� .. .. - �, �� 1 3 r F � � - � " 1 � Li I M .• �1� � /-'_ 1 . ,APPL(CANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY •BUI LDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT AOOREss I J0Q N 118 0 8 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S _ ^ PLAN CHECK VALIDATION " / OTY. ELECTRIC PERMIT FEE PHON tg^a �/n^. CONERACTOR5 UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 rorviRAcioR s/� C+ APPLIANCES-RESIDENTIAL 4.00 ADDR ss 1 1 J PHONE PANELS 10,00 DATE OF APPLICATION ARCHITECT "„q 1 PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P,C.NO. OR ENGINEER LIC.No. - SIGNS TRANS. 3.00 ADDRESS ervc. SPECIAL CIRCUIT 5,00 PERMIT VALIDATIO/ry / ZIP EMP. METER OR POLE INS. 20.00 /� /G /�7 AvaucANrs MOTORS SEE FEE SCH. n `�r ADDRESS '(/J` SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION G u I hereby W7irm that I am licensed mmc,provisions of Chapter 9 ISSUANCE DATE N i (commencing with Section 7000)of Division 3 of the Business and ¢ BLDG. ELECT. PLG. MECH H y i V Professions Cad d ,�tfrroat.L nse is in full for - Cr i m W License ass n Lia Number Date Contractor a x s BUILDING PERMIT ¢ ¢o IS < OWNER-BUILDER DECLARATION INFORMATION w g y I hereby affirm that I am exempt from the Contractor's LL License MISC.- REFER TO ORD u O a Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT. - � � Code:Any city or county which reyuiresa permit to construct,alter,re B, PERMIT ISSUANCE 10.00 ELEC.CONTE. LIC.NO. a o improve,demolish.or repair any structure,prior to its issuance,also ELEC. o¢ requires the applicant for such permit to file a signed statement that TOTAL E m w he is licensed pursuant to the provisions of the Contractor's License PERMIT TO HiQ Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe i D Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE ¢ H m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. III 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)J: ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP REB.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 does not apply to an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 so.Pi.FLooR AREA TOTALACREAGE himself or through his own employees,provided that such improve- orimprovemennlended or within offeredfor year o IL howeveq the thebuilding GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or improvement is sold within one year of completion, the owner builder will have the burden of proving that he did not build or im- GAS,EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose of sale.). RES IND CON PB Other ❑ d as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30,00 ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.O. 6.00 ASSESSORS PARCEL NO. and Professions Code:The who builds o License Law docs not apply to tr owner of property s with builds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractoE s)licensed pursuant to SEWER-SAN ITARV-STORM EA200ft/10.00 the Contractor's License Law. . TRACT NO. PARCEL N0. reason❑ I am exempt under Sec.-,BAP,C.for this WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC FILE No. WORKF-RS'COMPF-N'SATION DECLARATION WATER TREATING EQUIP, 5.00 1 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 the Policy IN ❑ rt10ed COPY is hereby(Drnished. FIRE SPR I NK ENERGY T Z Z Certifi�d��p�yt�filed t t nspeetion division. s4 F O Applicant 1!"11ii"1 �1�T ' MISC.- REFER TO ORD: Y ❑ N❑ Y ❑ No LO CERTIFICATEOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG. D' O (This section need not be completed if the permit is for one TOTgL Y❑. N❑ Y ❑ N❑ Z) Z hundred dollars(SI00)or less U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. a Dme Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >_ W NOTICE TO APPLICANT: If,after making this Certificate of Ex- FZ 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 GJ such provisions or this permit shall be deemed revoked, AIR HANDLING UNIT(TO 10/]OOC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE 1 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. MICROFILM 3007,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC I certify that 1 have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply withall city and county PLUMBING ordinances and stale laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby emhoriae representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. above-mentioned property for inspection purposes. MECHANICAL f o (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 any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 gra I ofthis permit MECH.CONT. LIC.NO. MECH. ' PP / U TDTAL �oo TOTAL gotl G fore DIA licant Contractor D OFFICE COPY