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14875 POST THIS CARD NEAR' FRONT OF BUILDING PF'RMITNUMBER CITY- OF CUPER.. TINO 4$75 INSPECTION DIVISION •r JOB INSPECTION RECORD - r' ' p -P PE RMIT'E XPIRATION JOB ADDRESS '�o �u " E �� �'T UNIT# • LOT# ' PERMIT EXPIRES IF.WORK bWNER _ �/ p CONTRACTOR' !z-.�.G „�K�/�. IS NOT STARTED WITHIN INSPECTION DATE JINSPECTOR - INSPECTION RECORD 180 DAYS OF PERMIT ISSU: FOUNDATION ANCE OR 180 DAVS FROM NOTE: LAST CALLED INSPECTION. .. „. .: .. UFER + ALL GRADING,AND DRAINAGE SHALL BE,INSTALLED 'PREGUNITE ` R,. - .TO.COMPLY WITH THE APPROVED PLANS AND CITY OF PEHMIT VAI IDArION - CUPERTINO STANDARDS. GARAGE SLABS,, • POUR NO CONCRETE"UNTIL ABOVE HAS BEEN SIGNED 1 "" UNDERGROUND"/SLAB PLUMBING ELECTRICALS +ssuANce un�iE{ MECHANICAL ' - - BLDG, ELECT I PLG. MECH. a ❑. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT / �� � INFORMATION .WOOD FLOOR .N�-� VALUATION $/FT. PLUMBING;- - MECHANICAL F PERMIT TO ELECTRICAL + - •"9 _ %TC . '!/ FRAMING - C 4z INSULATION STORIES TYPE CONSER I UCC cNOUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED " ROOF - - -NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.Er.FLOOR AREA TOTAL ACREAGE DIAPHRAGM .`- - THE CONSTRUCTION TAX IS PAID - ROOF SHEATHING ' ' ,` _ + - NBUILDING USE ES IND 'ONING PB 0111n " APPLY NO ROOFING UNTIL ABOVEHAS BEEN SIGNED FINALS DATE INSP. ❑ Ell ❑ '❑ ❑ ROUGH, _ SAN,N ASSESSORS PARCEL NO. PLUMBING - ELECT.ENERGY - TUBS&SHOWER PAN PLUMBING ENERGY " - TRACT NO PARCEL No MECHANICAL + - MECH.ENERGY - { ELECTRICAL "+ ..+ BUILDING ENERGY. 'F., ACC DATE ACC,FILE No, FRAMING' , I' - ELECT.FINAL TEST INSULATION- - PLUMBING ZONING ENG.SITE NO GAS TEST - + GAS ' MECHANICAL - FIRE BPRINK ENE RGY r.24 COVER ND WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ ' ❑ N❑� EXTERIORS HEA R ELECTRICAL RELEASE ELooO zoNE A:L,u c. INTERIOR SHEAR FIRE DEPT: v❑ "� ° ❑ "❑ SFEETROCK GRADE _ FEE SUMMARY EXTERIOR LATH BUILDING - _ TEMPORARY APPfl OVALS BUILDING (�� ..._. INTERIOR LATH - ' SCRATCH COAT' - - ELECTRIC - PLAN CHECK, GAS FEE NO TAPE OR PLASTER UNTIL.-ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTEO UNTIL BUI LDING FINAL IS SIGNED BY BUILDING INSPECTOR. N1ICROF.JLN1 w T . - ARRANGE FOR�I'NSPECTIONIBY PHONING 252-4505,' ELECTRIC , LU .ONE'WORKING DAY BEFORE REQUI'RED,INSPECTION; PLUMeI'Nc 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. g TOTAL OFFICE COPY APPLICANT TO FILL IN' INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY ' BU LDING PROJECT I DENTI FICATI ON - PERMIT NUMBER ED LDIss ING - - 1'` v l rt - APPLICATION ADN USS AL LE� -�-.� Cr BUILDING''-ELECTIRICAL-PLUMBING-MECHANIC y+�( OWNER'S PLAN CHECK VA_LJQATION NA/M'IE��� /� QTY. ELECTRIC PERMIT FEE �. /�' x-/`�t��IY� •`�� PHONEgoe- 7 l� . CONTRACTOR 9 .� NAPE ee�� �j OUTLETS-SWITCHES-RECEP 10.00/1,00 .� ��� lTM1I I/Vf�fH Lic.NO//''��/2.7`���••11 1 LIGHTING FIXTURES _ 0.00400 rOrvTRArORs TIAL 00ADDRESS APPLIANCES-.RESI DEN bC ((L_ PHONE4/S-gpOJ7 b '. PANELS 10.00 DATE OF APPLICATION ARCHITECT -OR PANELS (OVER 200 AMP) 20.00 PLA_NCHECK FEE ENGINEER LIC.NO SIGNS TRANS. 3.00 ADDRESS LNG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION Z11 TEMP.METER OR POLE INS. 20.00 - - APPLICANT'S -�7^ ADDRESS MOTORS SEE FEE SCH. Q-&0 GHU2C.H(c__ SERVICE CHANGE 20.00 ' Foo. LICENSED CONTRACTORS DECLARATION_ ��,�/a , < it U I hereby alTirm that I am,licensed under provisions of Chapter 9 - `' ISSUANCE DATE (commencing with Section 70001 Of Division 3 of the Business and D e. BLDG. ELECT. PLG. MECH: 0 7 i Professions Code, d my license is in full force a/nd eUgey. ® ❑ ❑ 2 i Leena ass Co Number "1 Z7 4 I-"w atCContracwry rl IS4 I ' N a mi d BUILDING PERMIT II ' at a OWNER-BUILDER DECLARATION - - - o INFORMATION X ; a N I hereby affirm that I sam on,(See, 7 front31,5,Be Contractors License MISC.- REFER TO ORD VALUATION $/FT. H LL o J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE y Code:Any City or county which requires a permit to construct,alter, rtw¢20 improve,demolish,or repair,any structure,prior to its issuance,also ELEC,CONTR. I.C.NO. ELEC. (�U O LL requires the applicant for such permit to file a signed statement that - TOTAL /V �- PERMIT TO is$ he is licensed pursuant to the provisions of the Contractors License HiQ Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe E 4 o Business and Professions Code)or that he is exempt therefrom and QTY. _ PLUMBING PERMIT. , FEE r $ the basis lox the alleged ciemption.'Any violation 61Section-7031.5 STORIES TYPE CONSTR. is by any applicant for it pertmit subjects the applicant to a civil penalty - ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(8500).1: ❑ I,as owner of the property,or my employees with'wagesas BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale*(Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License'Law does not apply to an owner of ^hila property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that SUCH improve- mentsare notiromdedorofl'Bred For salc:.if,however,'the budding GAS-EA.SYSTEM'-1,1 NC.4 OUTLETS 6.00 - C 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 int. BUILDING USE d'V prove for purpose of Sale.). I RES IND CON PB Other ❑ 1,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ' licensed contractors to Construct the project lSec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner oI'property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1,00 contracts for such projects with a contractods)licensed pursuant to the Contractor's License Law. - SEWER-SANITARY-STORM EA.200ft/10.00 •TRACT NO. PARCEL No. ❑ lam exempt under Sec: - ,B.&P.C.fonhlr MATER HEATER W/VENT 6.00 reason Owner - ,Date ' WATER SYSTEM 5.00 / ACC.DATE ACC.FILE N0. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 hereby affirm that I have a certificate of consent to self-a sure, •' a v, or a certificate of Workers'Compensation Inniruse,or a certified -%j ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). - i' Poli No. Company - O Certified copy is herebyfurnished. FIRE SPRINK ENERGY T24 I Z Z ❑ CeRifieyL �cop 01qd yJt(I the t inspection division. p Applicxnl-I<EIJ_4-A' 911A - MISC.: REFER TO ORD. . Y N� - YQ 'N� ~ PERMIT ISSUANCE 10;00 CIiRTI PIC OMPFNEWION INS FROM WORKERS' - FLOOD ZONE A:L.u.C.• W COMPIiNSA'I'ION INSURANCE PLG.CONTH. I LIC.N0. .PLG: . -'Y ❑ Y , Q (This section need not be completed it the Permit is far one - _ TOTAL NN _ I 0 Z hundred dollars IS 100)or less.) - - U O. 1 certify that in the performance of the work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I Shall not employ any person in any manner so as in Q w become subject to the Workers'Compensation Laws of California. Date Applieml BUILDING. O S`O a ALTER OR ADD TO MECH. 5.00 } W NOTICE'1'O APPLICAsl If,after making this Certificate of Ex. ' FZ chip' imi,you should become'subject to tine Workers''Compensation . APPLIANCE '1' 5.00 PLAN CHECK ' provisions of the Labor Code, you must forthwith comply with .FEE such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCT'ION LENDING AGENCY AIR HANDLING UNIT(OVER MODOC.F.M.) 6.00 SEISMIC FEE -I hereby affirm.that there is a construction lending agency for EXHAUST HOOD(WITH DUCT). 5.00 of the performance of the work for which this permit is issued(Sec. - MICROFILM 3097,Civ.C.L i HEATING UNIT(TO 100,000 B.T.U.), 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.0.50 Lender's Address ELECTRIC rh'x s I certify that I have read this application andstate that the above VENTILATIOMFAN (SINGLE) 4.00 - Information Is Correct. I agree to comply with all city and county g01LER-COMP13 H.P.Dr 100,000 B.T.U.1 6.00 PLUMBING . •d ordinances and state laws relating to budding construction,and hereby antliorize,representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCIi. MECHANICAL above nuen Toned property for Inspection purposes. = (We) agree to save, indemnify and keep harmless /he City OI MISC.- "--' +;-REFER TO ORD. " upertino against liabilities,judgments, costs and expenses whichp PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue Ig,' t id City in consequence of the rantingof his per I. MECH.CONT. - LIC.NO. MECH. TOTAL TOTAL ignition,of Applican/C nlract r Uatc OFFICE COPY