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11805' �'• POSTTHIS CARD NEAR FRONT. OF BUILDING p,,• •• . CITY :OF_CUPERTINO - PERMIT NUMBER 1905 INSPECTION DIVISION �. JOB INSPECTION RECORD .. - PERMIT, EXPIRATION. 7852 LILY ,COURT JOB ADDRESS UNIT# • _ LOT# : MARK VIGEANT, OWNER - coNrRAcroR VALLEY- HEATING ,PERMIT EXPIRES IF WORK is NOT'STARTED WITHIN 180 DAYS OF PERMIT ISSU- INSPECTION DATE INSPECTOR INSP CTI N RECORD OW 180 DAYS FROM LASTCALLED INSPECTION. FOUNDATIONANCE U PERU ' 7REGUNTE - PERMIT VALIDATION �r ,.I t✓' . ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND / SLA$' •+ - PLUMBING - - ISSUANCE DATE ' ELECTRICAL MECHANICAL - BLDG a ELECT. El❑. PLG. MECH. ' a " - DO NOT POUR FLOOR UNTIL'ABOVE HAS BEEN SIGNED _ T. BUILDING PERMIT INFORMATION - 'WOOD FLOOR, ALUATION $IFL PLUMBING -77:= - MECHANICAL' i ELECTRICAL'„' '' - PERMIT ro • FRAMING , INSULATION 't,. - STORIES' TYPE CONSTR. OCC. GROUP ,R.ES. UNITS _ .. PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF'DIAPHRAGM a. FT PLODRAREA TGTALACBEACE . (Coi BUILDING USE RES+} IND CON PB 0”" El ❑ ❑' ' ❑ Q APPLY,NO ROOFING UNTIL ABOVE HAS BEEN SIGNED , ROUGH ASSESSORS PARCEL NO. PLUMBING GAS TEST ^ - TRACT No, PARCEL No. MECHANICAL ELECTRICAL- FINALS ''DATE INSP. �yACC. GATE - Acc,.FILENO. FRAMING SAN# ' + INSULATION 'PLUMBING ZONING •ENG. SITE No. ' ... GAS. • MECHANICAL FIRE SPRINK . �' "� ENERGY T 24 '""``'" N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED . HEATING _a - LATH—INTERIOR' ELECTRICAL - _ 'FLOOOZONE A.L,U C. - Y� N� YN❑ LATH—EXTERIOR - FIRE DEPT. SHEETROCK i'GRADE FEE SUMMARY SHEAR INTERIOR - - BUILDING- BUILDING - - SHEAR EXTERIOR TEMPORARY APPROVALS - FIREWALLSELECTRIC - PLAN CHECK ' FEE GAS.. - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE • OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.. MICROFILM _. ARRANGE FOR INSPECTION BY PHONING 252-4505, Z�. ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLEASE GIVE JOB ADDRESS,WHEN;PHONING. ' ELECTRIC' - PLUMBING M ' SEE.PERMIT FOR EXPIRATION DATE — •. MECHANICAL CONST. TAX - I—,._.-. ,,--. - IMPORTANT! TOTAL �yQ PLEASE READ REVERSE SIDE BEFORE' CALLING FOR FINAL INSPECTION. „ - ., OFFICE COPY - - -A'$PLTCANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER a �O� 1 BUILDING ADDRESS r,-ry �11 +• OWNER'S Ill,1 CITY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION MN..a PHON e& ' CONTRACTORS 04§ I ucN UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR' Yl ADORE I 1 pPL1ANCES-RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPLICATION ARCHITECTPANELS on ENGINEER uc.'rvo. (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH. OR ENG. ADDRESS SPECIAL CIRCUIT 5.00 PERMITVALIDATION TEMP. METER OR POLE INS. 20.00 •ZIP (V� APPLICANTS ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 _ LICENSED CONTRACTORS DECLARATION 1 hereby affirm that 1 am licensed under provisions of Chapter 9 'ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Professions Code nd nu is in full ! License � Jss Lie. Numb Date ll 7 Contractor BLDG. ❑ ELECT. ❑ PLG. MECH. ❑ fb/ L;J BUILDING PERMIT OWNER -BUILDER DECLARATION .I hereby affirm that I am exempt from the Contractor's License Law for the following mason. (Sec. 7031.5, Business and Professions Code: Any city Or county which requiresa permit o construct, alter, improve, demolish, or repair any structure, prior to its issuance, also, INFORMATION MISC. - REFER TO ORD VALUATION S/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO, ELEC. requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License TOTAL PERMIT TO I Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for. permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500)J: OTY. PLUMBING PERMIT FEE CONSTR. ALTER-DRAIN-WATER(EA.) 5.00 ❑ 1, as owner of the property, Or MY employees with wages as their sole compensation, will do the work, and the structure is notintended Or offered for sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 7STORE ES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00Code: The Contractor's License Law docs not apply to an owner ofproperty who builds or improves thereon, and who does such work FIXTURES - PER TRAP 5.00 AL ACREAGE Improve- himself or through his own employees, provided that such improve- ment, are not intended or offered for sale. If, however, the building GAS-EA.SVSTEM-11NC.40UTLETS 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- prove for purpose of sale.). ❑ [,as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Other ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 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 of property who builds or improves thereon, and who LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law, SEWEfl-SANITARY-STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 ❑ lam exempt under Sec. -.B &P.C. for this reason Owner Dale WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 _ I'hcmby affirm that I have a certificate ofconsenl to self -insure. " or a certificate of Workers' I/nssuraneeyo-re ar-c�e�Ri�fie1J ZONING ENG. SITE NO. copy theyC,ompensat^ion �,HXyJ Policy N �Y1r 1-. �Ca'^'1`^ ❑ IiBed copy is hereby fuarr{ant)i�shed. � Cetli i 'o Y III(_,fL'�1 L ) y pTsMhIhM division Applicant Adlw l�1llT FIRE SPRINK Y ❑ IN ENERGY T�Y4 Y ❑ N❑ _ _- _ �_ _ -MISC.^ REFER TO ORD. CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 ROOD ZONE A.L.u.C. PLD.CONTR. LIC. NO. PLG. TOTAL COMPENSATION'INSURANCE Section need not be completed if the permit is for one Y❑ NE] v❑ N[](This QTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or less.) • I certify that in the performance of the work for which this per- not is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant BUILDING ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT': If, after making this Certificate of Ex. emption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLIANCE 5.00 AIR HANDLING UNIT (TO 10OODCF.M.) 4.00 PLAN CHECK FEE AIR HANDLING UNIT (OVER 10=1CF.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM I hereby affirm that there is a construction lending agency for the performance of the work, for which this permit is issued (Sec. 3097, Civ.CJ. .. HEATING UNIT (TO 100,000 B.T.U.) 8.00 o HEATI NG UN IT (OV ER 100,000 B.T.U.) 9.50 VENTILATION FAN (SINGLE) 4.00 ELECTRIC Lender's Name Lender's Address I certify that I have read Misapplication and state that the above information is correct. I agree to comply with all city and county ordinances and stale laws relating to building construction, and hereby .authorize representatives of this city rD enter upon the above mentioned property for inspection purposes. (Wh) agree to save. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the PLUMBING BOILER-OOMP(3 H.P. Or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL MISC. - REFER TO ORD. CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. UA`I_ 1� l_ b� 54 TUOTAL �I�tll TOTAL V grantin this permit I II IT I o pplicanl/Contractor Date U, OFFICECOPY -