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18667 POST THIS CARD NEAR FRONT OF BUILDING .. PERMIT NUMBER' CITY OF CUPERTINO 18667 INSPECTION-DIVISION JOB INSPECTION RECORD Ira JOB ADDRESS �-yilJlM �GI,C� ^^ff - / _ ERM47EXP,JBA ION UNIT O`��/_LOT# 'G — 1' . �� PERMIT19XPIRES If! WORK OWNER - CONTRACTOR � � IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD .180 DAYS OF PEtfWtT ISSU- FOUNDATION - +jNCE OR 180(DAYS/FROM NOTE: ASTCA��DINSPI<CTION. LIFER ALL GRADING AND,DRAINAGE SHALL,BE.INSTALLED `�.� — PREGUNITE TO COMPLY WITH THE'APPROVED PLANS AND CITY OF PERMIT VAuaATIq� CUPERTINO STANDARDS. Ems(, • GARAGE SLABS. _ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ -• 1 {�.EI�7�/nc�'Y UNDERGROUND /SLAB PLUMBING -PAID - ELECTRICAL e +' - '• - IS A CC DATE MECHANICAL - l". I+ „ .- RL.DG. - ELECT I PLG. ,MECH, /A1 IT DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ..colty ot uUpeTnu__ BUILDING PERMIT WOOD FLOOR - INFORMATION _ PLUMBING � VALUATION SIFT.-� �' - (� / y� /�/� MECHANICAL I O v'�wo ELECTRICAL PERJIT To FRAMING • INSULATION'S - STORIES ,TYPE CONSTR. OCC GROUP RES.UNITS y PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ ROOF SO FT.FLOOR AIIEA TOTAL ACREAGE ' NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING - - INo coN BUILOING USE ve oOOP"e APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ - ROUGH SAN.H ASSESSORS PARCEL NO. PLUMBING ELECT.EN ERGY ` TUBS 8 SHOWER PAN TRACT NO. PARCEL N0: ,. ' PLUMBING ENERGY• MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY Acc,DALE -Acc.FILE NO FRAMING ELECT.FINAL TEST INSULATION' PLUMBING ZONING ENG.SITENO, GAS TEST I 1 GAS ,• / MECHANICAL FIRE SPRINK ENERGY T2 COVER NO WORK UNTIL ABOVE HAS BEEN S GNED HEATING - Y ❑ "❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLooO zarvE A.L a c. 1. INTERIOR SHEAR ,FIRE DEPT. Y❑ "❑ ° ❑ "❑ SHEETROCK - GRADE - FEE SUMMARY EXTERIOR LATH BUILDING UD _ .INTERIOR LATH_• - TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK _ - GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY 7 'SEISMIC FEE ' -T OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ua AR,RANGE FOR INSPECTION BY PHONING 252-4505,. . ELECTRIC ' F–� ONE WORKING DAY BEFORE REQUIRED INSPECTION., _rPLUMBING - 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. - DOTAL L/-/ 'OFFICE COPY L,ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LOI NG PROJECT I DENT[FICATION -PERMIT NUMBER SUILDIN" APPLICATION & PERMIT 167 ADDR@sw Ca4 / ® �T�� /JJ R, BUILDING-ELECTRICAL-PLUMBING-MECHANICAL �;a', 8+0677 OWNER'a �,.,py� - PLAN CHECK VALIDATION' OTY. - ELECTRIC PERMIT FEE cI�` PHONE 'mow• /',/OO ,. ��� ' wT� `.. CONTRACTOR'S r+ Aii(P ��� OUTLETS-SWITCHES-RECEP 10.00/1.00 -r /OB'��a LIC.No. LIGHTING FIXTURES 10.00/1.00 e7/ i6- ICS_-�2''LV-{Q roNTRAc*ons PPLIANCES-RESIDENTIAL 4.00 / ys(,(/{ PHONE PANELS 10.00 - OATEOFAP [CAT N ARCHITECT PLAN CHECK FE P.C.NO. on - PANELS (OVER 200 AMP) 20.00 85a Q N ENGINEER LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. • 5,00yRMI�VAlID`T ADDRESS SPECIAL CIRCUIT Zlv EMP.METER OR POLE INS. 20.00 ADDREss ADREN rs MOTORS SEE FEE SCH. .. SERVICE CHANGE 20.00 0.O o LICENSED CONTRACTORS DECLARATION - - a v W I hereby affirm that 1 am licensed under provisions of Chapter 9 15 E DATE n < w (commencing with Section 7000)of Division 3o the Business' d L BLD EL CT• - PLG. MECH. H m z Professions Co an n license is in full for^ �''� ❑ ❑ z o w- License Cla s_ Lic.Nw - 2 w r w Uale Contra ¢ y E - BUILDING PERMIT M ¢ OWNER-BUILDER DECLARATION ¢ o a " MISC.- 'REFER TO ORD INFORMATION X LL, 1 hereby affirm that I am exempt from the Contractor's License la 04 Law for the following reason.(See.7031.5,BusinessanJ Professions PERMIT ISSUANCE S EVApLUMATION- $/FT. ¢ ¢ o Code mpro:Any city or County which requires a permit to construct.alter,emo ,or repair any structure,prSLED.CONTR. LIC.NO �vWlo� ¢ improve,dlishior l0 its issuance,also ELEO. i w m¢ requires the applicant for such permit to file a signed statement that .. TOTAL PER IT TO he is licensed pursuant to the provisions of the Contractor's License Fzi Law(Chapter 9(commencing with Section 7000)of Division 3 of the ¢ Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ F c the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. A. by any applicant for a permit subjects the applicant IDS civil penally ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(S500).): ❑ I,as owner of file property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCG GROUP RES.UNITS +' intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law docs 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 TOTALACREAGE himself or through his own employees,provided that such improve- f- ments are 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- GAS EASYSTEM OVER 4 IEA) 200 builder will have the burden of proving that he did not-build - . - . . build or un- BUILDING USE pmvcforpurpoxo'sale.). INDUSTRIAL WASTE INTER. 30.00 E IND CON PS Dlhe. U 1,as owner of the property,am exclusively contracting with _ ❑ .❑ ❑ ❑ licensed.contractors to construct the project ISce. 7044,Bueincss LAWN SPRINKLERS-.1 INC 5 V.B. 6,00SSESSORS PARCEL NO. and Professions Code:'Ihe Contractor's License Law dues not apply to an owner of properly who builds or improves thereon,and who LAWN SPO INKLERS-OV ER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to ' the Contractor's License Law. SEWER-SANITARY-STORM EA.'200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.SP.C.for this WATER HEATER W/VENT 6.00 reason • Owner - - Date WATER SYSTEM '5.00 ACC:OATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION 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 ycer�n ficd copy thereof)Sec.38 Co Lab.0 `l Policy No. Company 0 ❑ Certified Is hereby furnished Z 2 FIRE SPRINK ENERGY T-24 O UIIcCe'ti i e h U ty ms tion division. MISC.- REFER TO ORD. y N v N = N CERTIFIICCAAT E OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C, LL > COMPENSATION INSURANCE. PLG.CONTR. LIC.NO. PLG,- - 0- 0 • IThis section need not be completed if the permit is for one TOTAL Y[I No Y❑ N hundred dollars IS 100)or less.) U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued, 1 shall not employ any person in any manner so as to O Go, become subject to the Workers'Compensation Laws of California. y Date-Applicant - ALTER OR ADD,TO MECH 5.00 BUILDING } W NOTICE TO APPLICANT. If,after making this Certificate of fix- ' ? emption,you should become subject W the Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked, AIR HANDLING UNIT(TO 10,000C,F.M,) 4.00t III CONSTRUCTION LENDING AGENCY AIRHANDLING UNITIOVER 10=C.F.M.) 6.00 SEISMIC FEE ' 2G 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(Sec MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 ,1. Lender's Name HEATI NG UN IT E R 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 uev information is correct'I agree to comply with all city amJ county PLUMBING ordinances and state laws refuting m building construction, and BOILEfl-COMP(3 H.P.Or 100,0008.T.U.) .6.00 r hereby authorize representatives of this city toenter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL T above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. *aym gainst liabilities,judgments, Los's and expenses which PERMIT ISSUANCE 10.00 CONST.TAX way accrue gains) said City in conxyuehce thethis 1 MECH.CONT. LIC.NO. MECH.TDTALTOTALOq Applicant/Comm Dat OFFICE COPY .