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18173 •' POST THIS CARD NEAR FRONT OF'BUILDI'NG PERMIT NUMBER CITY OF 'CUPERTINO 18173 INSPECTION DIVISION JOB INSPECTIbN RECORD - �r JOB ADDRESS �)'"/ / I .�,'� RN—UNI` P�MITE XPIRATION '�" ' a # _LOT# - - Y. PERMIj EXPIRES'I��--••WORK OwNEH�"1,�' d-� \-- CONTRACTOR - Q CO (WC. IS RIOT START€D�VlpF N INSPECTION DATE INSPECTOR S ECTI ON RECORD 18o DAYs 6F'vX I.TzI S FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. ,. .UFER;, ALL GRADING AND DRAINAGE SHALL-BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVBD•RLANS AND CITY OF PLRNiIT VALIDATION CUPERTINO STANDARDS;IIl�"dd''9988NNJJ ' GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ IlV- IgGJ UNDERGROUND /SLAB pp PLUMBING .' . It '19rq Ill@ . -.-J f•�^4�T V'�'C. 0 I ELECTRICAL . - ISSUANCE DATE MECHANICAL B�L.D.IGG ELECT, PLG. MECH.. Y-� la qL ^'T 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOORVALUATION s/FT. PLUMBING MECHANICAL PERMIT Tp ELECTRICAL ' FRAMING. l V� - sroRlEs TYPE co"sTH. INSULATION OCC.GROUP RES.UNITS PLACE•NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED w ' ,• ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so ET ELooR AIreA TorAL ACBEACEI . DIAPHRAGM, THE CONSTRUCTION TAX IS PAID ' BUILDING USE ROOF SHEATHING RES .IND CON PB Um., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ El CD , ❑ ROUGH SAN.q ASSESSOR 5PAHCELNO • PLUMBING QV4�_ ELECT.ENERGY, TRAGI NO. PARCELNO - TUBS B SHOWER PAN PLUMBING ENERGY ' MECHANICAL MECH,ENERGY ELECTRICAL - L/ BUILDINGENERGY 7 ACC DATE ACC.FILE NO.. FRAMING ELECT.FINALTEST + INSULATION PLUMBING ZONING ENG.SITE NO', + .• � GAS.TEST GAS -. FIRE SPRINK ENERGY T.74 MECHANICAL HEATING Y ❑ N� Y 0 NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED FLOOD zo"e A.L OC EXTERIOR SHEAR ELECTRICAL RELEASE '• FIRE DEPT. YO <:1Y 01 "� INTERIOR SHEAR SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING i INTERIOR, LATH TEMPORARY APPROVALS - BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNEO OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC I- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 01J- O PLEASE GIVE JOB ADDRESS WHEN PHONING. . Z MECHANICAL - SEE-PERMIT FOR EXPIRATION DATE IMPORTANT!. CONST.TAi PLEASE READ REVERSE SIbE-BEFORE. TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY PERMIT NUMBER BU LDING PROJECT IDENTI FICATI ON APPLICATION & PERMIT Fft IR 18173 �� A�oREss BUILDING -ELECTRICAL-PLUMBING-MECHANICAL - -f o z LIUI* u�s- OWNER'S PLAN CHECK VALIDATION NAME rs}}��jpy �y E/��y'1 ^/ •^_ OTY. ELECTRIC PERMIT FEE 1. JAU n"SYrr LL PHONE LSV �O r E CONTR TORS I UTLETS-SWITCHES-RECEP 10.00/1.00 Q Ile NAM sec.No., a0 LIGHTING FIXTURES 10.00/1.00 Z Q.11Cl Co TRACTOR - r ,3 [APPLIANCES-RESIDENTIAL 4.00 .0t) 1 ADDRESS e N IIarvE SSR'-ObS $PANELS 10.00 DATE OF}.dPL16-kW O� ORRCHITECi -g- PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.D.NO. ENGINEER Ic.NO. $ SIGNS TRANS. 3.00 AARCH.OR DORESE ENG. .4; SPECIALCIRCUIT 5.00 PERMIT VALIDATION �� ZIP TEMP.METER OR POLE INS. 20.00' AAoo ICAMOTORS SEE FEE SCH. SERVICE CHANGE 20.00 I� h oo LICENSED CON TRACTORS DECLARATION a u w I hereby affirm that 1 am licensed under provisions of Chapter 9 1 ' ISS'U'ANCE DATE w a N (commencing with Section 7000)of Division 3 of the Business and r BLDG. ELECT. PLG. MECH. r o z Professions Cod and my license is in full far n •f {--a 20 o Lnum C xx Lic.Number d Date Contractor BUILDING PERMIT ex w OWNER-BUILDER DECLARATION INFORMATION o e I- 1 hereby affirm that I am exempt from the Contractors License MISC.- REFE O ORD X3, m Y' p VALUATION HLLo J Law for the following reason. 7031.5,Business and Professions PERMIT ISSUANCE ,` 10.00 Code:Any city or county which requims a permit to consno et.slue, Q Q ¢Q Improve,demolish,or repair any structure,prior to Its issuance,also ELEC.CONTR. LIC.NO. ELEf:. O u requires the applicant for such permit to file a signed statement that TOTAL 3 PERMIT TO w2 w he is licensed pursuant to the provisions of the Contractor's License /1/ ,M O Hi> Law(Chapter 9(Commencingwlth Section 7000)of Division 3 ofthe Al'rk I 0 Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE M H o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR, a ;m by any applicant fore permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 ,IJP of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as 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 Contractor's License Law does not apply to an owner of ^ property who builds or improves thereon,and wlho docs such work Q FIXTURES-PER TRAP 5.00 p SG.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees.provided that such improve- GAS-EA.SVSTEM-1 6.00 meats are or intended or offered for sale.If,however,tho building or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im. RES IND CON PB Onion prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 1:1 El 11 ID C-1❑ I,as owner of the property,am exclusively contracting with licensed Contractors to construct the project ISec 7044,Business LAWN SPRINKLERS-I 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 SEWER-SANITARY-STORM EA.200ft/10.00 , TRACT NO. PARCEL No. the Contractor's License Law. / - ❑ I am exempt under Sec. ,B.&P.C.fur this WATER HEATER W/VENT 6:00 ' reason Owner Dale WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. ` WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of foment to self-insuru. ZONING ENG.SITE NO. or a Certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.). _ Policy No. Company - 0 ❑ Certified copy is hereby furnished. ,FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy,is Bled with the city inspection division. RD. O Applicant MISC.- REFER TO OY ❑ N❑ Y ❑ N❑ ~ vlPERMIT ISSUANCE 10.00 .1, FLOOD ZONE A.L.U.C. UJ CERTIFICATE MPENE ION ION FROM WORKERS' UJ _ COMPENSATION INSURANCE PLG.CONTR. u0.NO. /� ❑ ❑ Q. O (This uTOTALmidn need not be completed if the permit is her one (/. O Y ElE]N Y N Z hundred dollms($1001 or less.) V O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issue.),1 shall not omp�"icict per 'n m, manner so. to O W heco h�,y�p1 [ 'the Workerp m of Califh a. �. Datuf(�1�y tAppu ant ALTER OR ADD TO MECH. 5.00 BUILDING } y NOTICE IAz APPLICANT: 1r ma hg Ihis Cenifmale o rix- H ? emption,you should become to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE l.J such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MCF.M.) 4.00 �- CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IO,ODOCF.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for I EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued fSec. MICROFILM 3097.Cie.C.l. HEATING UNIT ITO 100,000 B.T.U.) . 8.00 Lender's Name HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address D • 1Certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 AA information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING A QU ordinances and stale laws relating Io building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP Over 100,000 BTU)SEE PEE SCH. MECHANICAL above-mentioned property for inspection purposes. ON ) agr a to sa e, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino ai s[ ililics,judgments, costs and expenses which CONST.TAX ay in a agai st said City in nuyuence afthe PERMIT ISSUANCE 10.00 mnllmg asp il. MECH.CONT. LIC.NO. MECH. - TOTAL' TOTAL Isio re of Apliyfltiicontractor Date .OFFICE COPY