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18004 S, POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 18Q04 INSPECTION DIVISION JOB INSPECTION RECORD Le �t JOB ADDRESS '20 L' �• ' O� pMl(f EX�fLAT UNIT,# _LOT# •� j PERMIT EXPIRES IF WORK ' OWNER comrRncroR IS NOT STARTED WITHIN . _ INSPECTION DATE I INSPf.GTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION t, R C —yam ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF. - ERN1I YVAUn DAoN CUPERTINO STANDARDS. r{p//}��,,J/ GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED q—IOL— pyT �. UNDERGROUND /SLAB 1'_ ' PLUMBING - ELECTRICAL —sAl ISSUANCE DATE ` MECHANICAL - aLDc ,ELECT PLG- MECR24 5 . 89 . ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILO INFORRMM PERMITATION ' WOOD FLOOR VALUATION SIFT. PLUMBING , - MECHANICAL �� ' ELECTRICAL - PERMIT{, TO ' FRAMING - ! _'•• . INSULATION ` STORIES TYPE CONSTR. - - OCC.GROUP RES.UNITS I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 FT FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM. THE CONSTRUCTION TAX IS PAID ROOF IVES IND USE SHEATHING CON PB ''O'nrr APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - FINALS DATE INSP. . 0 ❑ ❑ ❑ El ROUGH ASSESSORS PARCEL NO, . � SAN.k -- - PLUMBING . ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL No, MECHANICAL MECH.ENERGY ELECTRICAL BUILDING'ENERGY ACC DATE .ACC.FILE NO FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION - PLUMBING GAS TEST GAS MECHANICAL FIRE'SPRINK- ENERGY T;la COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ° "F] ' - EXTERIOR SHEAR ELECTRICAL-RELEASE FLOOD ZONE A.L.0 C, INTERIOR SHEAR FIRE DEPT. v❑ N❑ v ❑ NEI SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATHBUILDING INTERIOR LATH - TEMPORARY APPROVALS BUILDINGS J SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE ,O o. OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED By BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC. FW- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING- z F .PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! coNsr.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. • 'OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY PERMIT NUMBER BU I LDING PROJECT I DENTIFICATI ON - APPLICATION & PERMIT FU ILWNG ' i8004, POOR ' BUILDING =ELECTRICAL-PLUMBING-MECHANIC , / Q 0 O 4EOI 06,JiO OWNERS PLAN CHECK VALIOATI O NAME �&Ye OTY. ELECTRIC PERMIT FEE L) • ARe// ee-oNE axr-40601J 30/ CONTRACTOR'S UTLETS-SWITCHES-RECEP 10,00/1'.00 l y NAME woe K y 6S-96 f- Sac.No. (� LIGHTING FIXTURES 10.00/1.00 ' CONTRACTORS APPLIANCES-RESIDENTIAL 4.00 ADDRESS PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE OR ENGINEER LIC,NO. SIGNS TRANS. 3.00 ARC H.OR ENG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS , ZIP EMP.METER OR POLE INS. 20.00 / APPLICANTS MOTORS ' SEE FEE SCH. ADDRESS - Q - SERVICE CHANGE 20.00 oO o LICENSED CONTRACTORS DECLARATION a v u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE I- w (conmtencmg with Section 7000)of Division 3 of the Business and EWE - BLDG. ELECT. PLG. MECH To w i Professions Code,and my license is in full force and effect ❑ z out - License Class Lie.Number - //-,� qq 0 ❑^' o H ea Date Contractor R7 U U' Al 51989 �"- � -- BUILDING PERMIT rt w 'OWNER-BUILDER DECLARATION INFORMATION E: ;n y 1 hereby affirm that I am exempt from the Contractor's License MISC.- F VALUATION .S/FT, .. o¢ Law.forthe fallowing reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE - Code:Any city or county which requires a permit to construct,alter lo .+ Q Q Improve,demolish,or repair any structure,prior to Its Issuance,also ELEC.CONTR. LIC.NO. ELEC. - O LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO n w m he is licensed pursuant to the provisions of the Contractor's License /' - r z i Law(Chapter 9(commencing with Section 7000)of Division 3 of the 'V ¢ Business and Prol'cmions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ Imo- o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. i ;^' by any applicant for a permit subjects the applicant tea civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(5500).): VV1,as owner of the property,or my employees With wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS th tr sole compensation,will do the work,and the structure is not intended or offered for sale(Scc..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 does such work FIXTURES-PER TRAP 5.00 SO,FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedoroffered for Sale.IL however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4 (EA.) - 2.00 BUILDING USE builder will have the burden of proving that he did not build or inn. RES IND CON PB OR., prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 . ❑ Las owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.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 of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 - contracts 1'or such projects with a conlructor(a)licensed pursuant to the Contractor's License Law. - SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. .PARCEL NO, ❑ [a exemptunder Sec. ,"'.C'u"this WATER HEATER WIVE NT 6.00 reason Owner Dam' WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DIiCLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that•I have a certificate of consent to self-insure, ZONING ENG.SITE N0, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(See.3800,Lab.CJ. Policy No.-Company - Q ❑ Certified copy is hereby furnished. FIRESPRINK ENERGY T-24 Z Z O Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. - y ❑ N❑ y C] N❑ O Applicant ~ m PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. cc - CERTIFICATE OP EXEMPTION FROM WORKERS' - LL > COMPENSATION INSURANCE PLG.CONTR. - LIC.NO. PLG. 6. 0 TOTAL V❑ N❑ V ❑ N❑ (This section need not hu completed if the permit is for ani =) Z hundred dollars S100)or less.) U O 1 certify that in the performance of the work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY U H mit is issued,I shall nal emplo nY person in any manner so as to O w become syje/ykA Workers' npensati BUILDING , QQ Datemc,YaD/d a Worker ALTER OR ADD TO MECH. 5.00 } y NOTIC' AITLICAN'1': If,after making this Certificate of Fx- F 2 emption,you should become subject to the Workers'Compensation 'APPLIANCE - 5.00 PLAN CHECK Provisions of the Labor Code, you must forthwith comply with AIR HANDLING UNIT(TO 10 C.F.M.) 4.00 FEE V such provisions or this permit shall be deemed revoked. .� CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.001 SEISMIC FEE I 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(SecMICROFILM 3097,Civ.C•). - HEATING UNIT(TO 100,000 B.T.U.) 8.001 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 .ELECTRIC Lender's Address I'certify that)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-CCNu1P(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING - ordinances and state laws relating to.building construction, and - hereby authorise representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. CONST.TAX Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 ma 'n any way accrue against said'City in consequence of the r 11 Of 11113 pe tt' MECH.CONT. LIC.NO. MECH. c �FP9 TOTAL TOTAL j 77 . Signature of ADPlicanp ontractor. D tc T � E OFFICE COPY