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15318 POST THIS CARD NEAR FRONT OF-BUILDING? PERMIT NUMBER. CITY, OF CUPERTINO 1531 " INSPECTION DIVISION JOB INSP TI N R CORD PERMIT EXPIRATION j JOB ADDRESS UNIT# _LOT# PERMIT'EXPIRES IF WORK ,I CANE A- - - CONTRACTOR IS,`NOT STARTED'WITHIN I INSPECTION DATE INSPECTOR ,INSPECTION RECORD 180.DAYS OF PERMIT ISSU, 1 .. FOUNDATION ` ANCE OR 180 DAYS FROM NOTE: ?+ LASTCALLED INSPECTI ON: � - UFER ALL GRADING AND DRAINAGE SHALL BE WSTALLED 1 PREGUNITE' - TO COMPLY WITH THE APPROVED PLANS AND CITY OF <`PERMIT VALIDATION 1, „CUPERTINO'STANDARDS. GARAGE SLABS - - , POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING - ELECTRICAL - - •` - _ ISSUANCE DALE MECHANICAL y,' _ a-�- ELEcr PLG. MECR-� DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDBUILDING PERMIT - - " I�, ,INFORMATION PLUMBING PLUMBING WOOD FLOOR - - VA UATJDN $SFT." MECHANICAL, ° PER TO ELECTRICAL N - " FRAMING INSULATION. - - sroRlEs $ •y1vFE comsTra. + -- OCC.GROUP 7 , + 'RES UNITS > PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - + SO. . •:TOT ' ROOF � "NOTE:NO FINAL INSP.SHALL BE MADE BEFORE FTFLOOR AREA ALACREAGEI DIAPHRAGM - THE CONSTRUCTION TAXIS PAID -BUILDING USE ROOF SHEATHING - „ , RES IND CON• PB APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS' DATE . 'INSP.' ' ❑ ❑ .❑' ❑ ROUGH SAN.N ASSESSORS PARCEL NO. 'PLUMBING:•.. , . ,•I, . ELECT.ENERGY TUBS 8SHOWER PAN " - � PLUMBING ENERGY., TRACT NO, PARCEL NO, '•'.� MECHANICAL - MECH.ENERGY' ACC.DATE "ACC.FILE NO ELECTRICAL - BUILDING.ENERGY FRAMING., ;; ' " ELECT.FINAL TEST - - INSULATION ' PLUMBING ; - zow NG ENG.SITE NO. GAS TEST - GAS - �' MECHANICAL: - a_ g• FIRE SPRINK ENERGY r"sa, COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING " "v ❑- "❑ ° ❑', "❑ EXTERIOR SHEAR . ELECTRICAL RELEASE' .'FLOOD ZONE A.L C. -i INTERIOR.SHEAR - FIRE DEPT. v ❑ N❑ v L7 . N❑: SHEETROCK: - GRADE . - FEE SUMMARY - ' EXTERIOR LATH - BUILDING' - ' BUILDING INTERIOR LATH TEMPORARY APPROVALS 7 "" SCRATCH COAT - ELECTRIC,, . - PLAN CHECK . GAS' "FEE Yi NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL,BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM + ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LU 0� ' 'ONE WORKING DAY BEFORE REQUIRED'INSPECTION PLUMBING ' PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - - SEE PERMIT FOR EXPIRATION PATE.-"' - MECHANICAL I'MPOR'TANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE ° f' CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPtl APPLICANT TO FILLrIN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION - .PERMIT NUMBER 9UIL ING APPLICATION & PERMIT - A ADDRESS r ' y BUILDING :-ELECTRICAL-PLUMBING-MECHANICAL I•5 q 102, ^F OWNER'S - GTVELECTRIC PERMIT FEE PLAN CHECK VA LIGATION . � � PHONE CONTRACTOR'S E OUTLETS'-SWITCHES-RECEP 10.00/1.00 - \`I r-�(x-r uc.rvG. LIGHTING FIXTUR ES 10.00/1.00 CONTRACTOR'S /-'3Q • , I^� ADDRESS 1� 1f�) y,(- APPLIANCES-RESIDENTIAL - 4.00 I'=Horve' _!,(j PANELS^ 10.00 DATE OF APPLICATION t ' OR PLAN CHECK FEE P.C.N0. OR - PANELS (OVER 200 AMP) 20.00 ENGINEER UC.NO. SIGNS TRANS- ' 3.00 - ARCH.OR ENG. - -PERMIT VALIDATION aoDREss SPECIAL CIRCUIT - 5.00 , ` `ZIP EMP.METER OR POLE INS. 20.00 APPLICANT'S - ADDRESS, , SCH. - J..AM OLrC' - SERVICE CHANGE o o LICENSED CONTRACTORS DECLARATION u v 1 hereby affirm that 1'am licensed under provisions of Chapter 9 - ' N <% (commencing with Section 7000)of Divislon,3 of the Business and ISSUANCE DATE -. H y i Professions Code Id n se is in full f BLDG. ELECT. PLG. MECH. iw o License' s Lie.Number u H w Date- - Contmclor - M a w a OWNER-BUILDER DECLA a .� BUILDING PERMIT o A ° -- INFORMATION cense MISC. w.; v_.N I hereby affirm that I am exempt from tie Contractor's Li - y REFER TO.ORD u0 ¢" Law for the following reason.(Sec,7031.5,Business ad Professions VALUATION Fw0 . Code:Any city or county which onlinusu permit to construct,alter, PERMIT ISSUANCE - 10.00 y, K at 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. - ec iL m u requires the applicant for such permit to file a signed statement that ELEC TOTAL pEflMIT TO,'. w he is licensed pursuant to the provisions ofthe Contractor's License -rzQ Law(Chapter 9(commencing with Section 7000)of Division 3 oflhe • ' i 0 Business and Professions Code)or that he is exempt therefrom and GTV. PLUMBING PERMIT FEE 1-m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a 3 � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN - .(not one than five hundred dollars($500B.) (EA.) 5.00 ,r . DEVICE '4:00 OCC.GROUP RES.UNITSI,as owner of the property,or my employees with wages as BACK FLOW PROTECT . their sole compensation,will do the work,and the structure is not ` intended or offered for.sale (See. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 5.00 Code:The Contractors License Law does not apply to an owner of _ property who builds or improves thereon,and who does such work FIXTURES-PER TRAP - 5.00 60.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- - mentsare not intended or offered for sale.If,however,the building GAS-EA,SYSTEM-1INC.4 OUTLETS 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.). ' PARCEL NO.WASTE INTER. 30.00 RES IND CON PB . Omer ❑ I,as owner of the properly,am exclusively contracting with ElEl 1:1 contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS and Professions Code:The Contractors 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 oommctons)licensed pursuant toI the Contractor's License Law. - SEWER-SANITARY-STORM EA,200ft/10.00 TRACT NO. PARDEL No. - ❑ lam exempt under Sec..,B.&P.C.for this WATER HEATER W/VENT 6.00 ' reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affum that I have a certificate of consent to'self-i acne, - or a certificate of Workers'Cam nsation Insurance, a certified ZONING ENG.SITE NO. copy the 33$$0�QQ,Lab.C.I Policy NLCf1rllpanyQ 19 IC O ❑ ertifed copy is here yFmisseJ T- fIHE SPRINK ENERGV,T R4 Z Z �e ifi d9�yye1; Is Ir N e I Y inspection division. F O Applicant til y U en MISC.- REFER TO ORD. Y Q NE] Y.C3 N� UJ to CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.' W COMPENSATION INSURANCE PLG.CONTR. - LIC.NO. PLG. CL O (This section need not be completed if the permit is for one - TOTALa Y E] N[] V ❑ No � Z hundre'd dollars($100)or less.) U O I certify that in the performance'of the work for which,this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY W'I- mil is issued,I shall not employ any person in any mannerso as to ' Cf W become subject to the Workers'Compensation Laws of California. BUILDING W Date Applicant ALTER OR ADD TO MECH. • 5.00 F- NOTICE TO APPLICANT: If,after making this Certificate sa Ex- h Z e 0 i n,you should become subject to the Workers'Compensation APPLIANCE 5.00 :PLAN CHECK provisions"provisions the Labor Code, you must forthwith comply with FEE V such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10{100 C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 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 3097,Civ.C.). , HEATING UNIT(TO 100,000 B.T.U:) Lender's Name HEATING-UNIT UUNIT(OVER 100,000 B.T.U. � Lender's Address ELECTRIC ' I certify that 1 have read this application and state that the above VENTILATION FAN'(SINGLE) 4.00 information is correct. I agree to Comply with all city and county BOILER-CUMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and stale laws relating to building construction, and hereby authorize representatives ec This city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property forinspofpurposes. 23-- (We)-agree to save, indemnify and keep harmless the City of MISC.- REFER TOORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCES /- CONST.TAX may it any way accrue against said City in consequence of the ' r nti his penniL C NT. LIC.NO. . (� IIJ MECHTOTAL V�� TOTAL 7 Si at r o QO pplicant/Contractor .Daft / IV •�• 2n, OFFICE COPY