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18020O POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO . INSPECTION DIVISION JOB INSPECTION RECORD �7 `�6 i4Ni - JOB ADDRESS UNNIIT4t - _LOT# OWNER ij CONTRACTOR I `-LC PERMIT NUMBER 18020 ,I v�I T�E P1a oN PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD' FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. LIFER - PREGUNITE PERMIT VALIDATION / --/J D l r /n{ "� J, A - A JlLL4vcG( ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING - - ELECTRICAL MECHANICAL ,- BLDG I ELECT I ❑ PLG. MECH ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED Pitu ftf__ BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $TFT. PLUMBING � ---' MECHANICAL ELECTRICAL [HMR TO ff I I t' Y" n19,/, FRAMING INSULATION ' Si ORILS TYPE CONSTR ' OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: 11 ALINSP.SHALL THE C NSTRUCTION TAX IS PLD lV`Jl 177 SO FT FLOOR ARLA TOTAL neeeaee DIAPHRAGM - ROOF SHEATHING BUILDING use HES IND CON PB 011— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE IV INSP. ROUGH SAN.# ASSESSORS PARCEL NO PLUMBING ELECT. ENERGY TUBS & SHOWER PAN PLUMBING ENERGY THACTNO ' PARCEL NO MECHANICAL MECH. ENERGY - ELECTRICALBUILDING ENERGY ACC DATE ACC FILE NO FRAMING ELECT. FINAL TEST' INSULATION PLUMBING zoNlrvr. ENG. SITE No. GAS TEST GAS MECHANICAL' FIRE SPRINK v NO ENERGY T.7a . N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE PLooD zo"c Y ❑ NED ALuc . - Y ❑ " INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH IBUILDING BUILDING �, DOINTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY* SEISMIC FEE 1 �' OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDMG FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505,' � ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL a CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY F1 I Z z F O LU - > CL 0 0 Z Uo LL U O ler H Z 'a APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I DENT[ FICATI ON APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 18020 BUILDING AD14hEss ZOSZ � I Q OWNER'S NAME AI n OTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION n� 'L PHONE (/ %J CONTRAcrORs NAME UTLETS-SWITCHES -RECEP 10.00/1.00 (,^i LIC. NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S ADD ss APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 O �jq �1 gV`PHONE (Ei7� V DATE OF APPLICATION " ORCHITEC OR ENGINEER LIC. NO. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH, OR ENG'SPECIAL ADDRESS CIRCUIT 5.00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP (7 J APPLICANT'S ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 1 . 14 VCC' J ' LICENSED CONTRACTORS DIiCLA RATION - I hereby uIfirm (h In 1 :nn licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Professions Co • and my license is in full fwl' tgIle License Class- LD. Number (� rt BLDG. ELECT. ❑ PLG. MECH. ❑ ❑ v e Date-Cnnlroctor U� _ BUILDING PERMIT 0-WINJI.11BUILDER DECLARATION I hereby affirmIlial I am exl'mpt fromthe COntraClOrs License Law for the following reason. (Sec. 7031.5. Businessand Professions Code. Any city t r c arty which requires I permit locunstrucl,ahey, improve, demolish, or repair any Slnmlure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License INFORMATION MISC. - VALUATION / D r0 i1 $/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO OTY. PLUMBING PERMIT FEE Law (Chapter 9 (commencing with Section 7000) Df Division 3 of life Business and Professions Code) or (hat he is exempt therefrom nail the basis for the alleged exemption. Any violation of Section 7031.5 STORIES TYPE CONSI . by any applicant for a permit subjects the applicant too civil penalty of not more than five hundred dollars (S500).1: ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sell, compensation, will do the work. and the structure is not intended or offered for sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 Doc. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code: The Contractor's License Law does not apply to an owner of ,,.perry who builds or inHimses(he,cnn, and who docs such work FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTALACREAGE himself or through his own employees, provided that such improve- mens are not intended or offered for sale. If, however, the building GAS-EA.SVSTEM-11NC.40UTLET$ 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.). ❑ 1, as owner of the properly, am exclusively conlnmting with licensed contractors to construct the project (Sec. 7044, Broiness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds .r improves thereon, and who GAS - EA. SYSTEM -OVER 4 (EA.1 2.00 BUILDING USE RES IND CON PB Diner ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200tt/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&I'.C. fur this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORK ERS'COMPHNSA'r1ON DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I [lave a ccrtifcate ofconsent to self-insme. or a eeHifico(e of Wo s' Com pensolion Insurance, or a certified ZONING ENG. SITE NO. copy thercof(Sec. 38 0 Lab.C.l. Policy No. )Puny a ❑ Plot 'd hpYl IercbY lumixhcJ. ert ifieJ co, f •d with a ty insPeclion division. Applicant - FIRE SPRINK Y ❑ N ❑ ENERGY T-79 V ❑ No MISD. - REFER TO ORD. PERMIT ISSUANCE 10.00 FLOOD ZONE A.LU.C. CER'I'IFICATIi017EXEMPFION FROM WORKERS' PLG. CONTR. LIC. NO. PLG. TOTAL COhIPIiNSATION INSURANCE it is R)r ne (This section need not be completed if the permo Y ❑ N ❑ V C]N ❑ DTV. MECHANICAL PERMIT FEE FEE SUMMARV hundred dollars (S 100) or less.) 1 certify that in the performance of the work for which this per, mit is issued, I shall not employ any person in :cry manner ser as OR become subject to the WorkeDi Compemulion Laws of California. Date Applicant NOTICE 1'O APPLICANT', If, after puking this Ccrlileme of E.- emp(ion, you should become subject to (he Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. BUILDING ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10D00C.F.M.) 4.00 AIR HANCLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE r CONSTRUCf10N LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30J7, Civ,C.). HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Nat Lender's Ad ress VENTILATION FAN (SINGLE) 4.00 PLUMBING Icerlily hat l if read application and slate that the above informatio is car ect. I agree to comply witll all city and county ordinance and s( le laws relating to building construction, and BOILER-COMPI3 H. P. or 100,0008.T.U.) 6.00 BOILER -COMP IooCr 100,000 BTU) SEE FEE SCH. MECHANICAL hereby a ho rice epresentativcs .f this city to enter upon the above -me Toned operly for insPectlon purpos MISC. - REFER TO ORD. CONST. TAX (We) a ce to ave, indemnify and kec tarn ess Lou City of Cupertino gulost liabilities, judgments, costs an expenses wt -ch May t an way accrue against said City in nsequcnce the PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO, KI MECH. TOTAL TOTAL 7Z. n 'ng of his p rhniL Signa re of A ,locant/Contractor f tet v OFFICE COPY