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18679u " POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS.��a�4VI_�t't'v`UNIT4 LOT# OWNER (� CONTRACTOR �� Q PERMIT NUMBER 18679 Pj• E`MIT/EXPIRATION ! ~ PERMIT EXPIRES`IF WORK IS ;NO,T STARTED) WITHIN 160 BAYS OF P�AMIT ISSU OR 180 DAYS FROM LASTCALLED INSPECTION. IN CTION DATE INSPECTOR INSPECTION RECORD FOUNDATIONANCE NOTE: ALL'GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PREGUNITE- PERMIT VALIDATION /-7 J 'j�5""6%.E.tiC'(.••E.''".-iz�... / "DANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ . .�,-,1 UNDERGROUND /SLAB PLUMBING ,��I`I �! ....... _ ELECTRICAL 'BLOC ELECT. PLG. MECR MECHANICAL v._ ` ❑ ❑ ❑ I DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR A rloN O siFr. � s PLUMBING MECHANICAL ELECTRICAL L n O ��V ,` I vvu 1c) FRAMING � INSULATION iiEs L� -rvveoNsrR I I. C GRDUY V' 1� 1 RES UNITSPLACE NO SUBFLOOR UNTILABOVE HAS BEEN SIGNED _ ROOF NOTE: NO FINAL INSP, SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID SO. 1T ILOOR AREA (9 'DDD TOTAL ACREAGE DIAPHRAGM BUILDING USE BEs IND CON PB Om., ❑ ❑ ❑ ❑ ❑ ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN,# PLUMBING ELECT. ENERGY IRACi NO PARCEL NO TUBS & SHOWER PAN PLUMBING ENERGY _MECHANICAL MECH. ENERGY ACC DATE ACC FILE N0. ELECTRICAL BUILDING ENERGY FRAMING ELECT. FINAL TEST ZONING ENG. SITE NO. INSULATION - PLUMBING GAS TEST GAS FIRE SPRINK v ❑ N❑ ENERGY T.]4 v F) NE] MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD znNE v rv� ALuc v ❑ ry❑� EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING oZ INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION�,'Y PHONING 252-4505, IL ONE WORKING DAY BEFOR-EAEQUIRED INSPECTION. 00 PLEASE GIVE JOB ADDRESS V1NEN PHONING. Z • —SEE PERMIT'FOR EXPIRATION DATE — ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL V OFFICE COPY �Y APPLICANT TO FILL IN INFORMATION WITHIN RED LINES- USE BALL POINT PEN ONLY UI LDING PROJECT I DENTIFICATI ON APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL PERMIT NUMBER a 18679 BUILDING ADDRESS- z % J' ow 'S NAME Z _ QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE PJ/S�� C /f%_ =kTo0f, s TGCC >I -r4 OUTLETS - SWITCHES -RECEP 10.00/1.00 'n�A L LIC. No. LIGHTING FIXTURES 10.00/1.00 /�� t.7 C�1 _ / �j 1 \T� ATE OF APPLI ATION CONTRaCTOR'S aoo ss O PRONE % APPLIANCES - RESIDENTIAL 4.00 PANELS 10.06 ARCHITECT OR ENGINEER GO LIC. NO. PANELS (OVER 200 AMP) 20,00 - PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH. OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP APPLICANTS Aopacea (C/7iJ 0 MOTORS SEE FEE SCH. SERVICE CHANGEP-AID, 20.00 LICENSED CONTRACTORS DECLARATION ,.Ij �('1 1, J 1J7u I hereby affunl that I um licensed order Provisions of Chapter 9 (commencing with Selllon 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. ' License Class Lic. Number Date Contract.,-- SUANCE DATE LOG. y -r, A/I Y" ELECT. PLG. MECH. ❑ ❑ El , D V IID BUILDING PERMIT OWNER -BUILDER DECLARATION I hereby affirm that 1 um exempt from the Contractor's Licenor Law for the following reason. (Sec. 7031.5, Businessund Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, 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 LicenseT Law (Chapter 1) (commencing with Section 7000) of Division 3 of the Business' and Professions Code) or that he is exempt therefrom and INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE 10.00 �LUATION `1Q Lf(/ ELEC. CONTR. LIC. N0. ELEC. TOTAL PERMIT TO y- -Z /& r UK r0r QTY. PLUMBING PERMIT FEE STORIES �- TYPE ONSTR. r�� -j_N',+i CY the basis for the alleged exemption. Any violation of5ection 7031.5 by any applicant for a permit subjects the applicant W a civil penalty of not more than five hundred dollars ($500f): ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the Property, or my employees will, wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions ggCK FLOW PROTECT. DEV ICE 4.00 OCC. elaouP 13- RES. urvrts DRAINS -FLOOR, ROOF, AREA, COND. 5.00 CodeThe Contractor's License Law does not apply to un owner of prop, r ly Mr. builds or orpNVCs IIICreon, and who does such work. FIXTURES - PER TRAP 5,00 SO. FT. FLOOR AREA TOTALACREAGE himself or through his own employees. Provided that such improvC- men« are not Intended or offered for sale. IL however, the building GAS - EA. SYSTEM -1INC. 4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- It. will have the burden of proving that he did not build or iIm prove for purpose of sale.(. ❑ I, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 - -BUILDING USE RES IND CON PB Omer ❑ ❑ ❑ ❑ ❑ INDUSTR IAL WASTE INTER. 30.00 LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to in owner of property who builds or improves thereon, and who LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts for melt projects with a contracter(s) licensed pursuant 10 the Contractor's License law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ tum exempt under Sea ,B.ffiP.C. lin this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE N0. WORK ERS'COMPLNSA'I' ION DECLARATIONWATER TREATING EQUIP. 5.00 I hereby affirm that 1 Imve a certificate of consort In oll-in,ur or a certificate of Workers' Compensation Insurance, or a cert" ZONING ENG. SITE NO. copy thercof(Bcc. b.C. I. Policy No COlnpany FIRESPRINK Y ❑ N ❑ ENERGYT"24 V ❑ N❑ 11 ❑. Ccrtif d copyishereby furni' ••d A, -u1 Cerci I .0 'is filed w' C city ccU n. A{+plicio t MISC. - REFER TO ORD. CER1'119CA1' E OF Ii XEM I NPROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. PLG. CONTR. LIC. NO. PLG. TOTAL COM ENSAI'M N SURANCI4 ('[his section need not be c tpleted it ' the permit is for one Y ❑ N ❑ Y ❑ N ❑ OTY. MECHANICAL PERMIT FEE . FEE SUMMARY hundred dollars (S I oon or less.) I certify that in the perfornnunce of the work for which this per- mit is issued, I shall not employ .Ing person in any Insurer so as to BUILDING become subject Io the Workers' Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NONCE 10 APPLICANT: 11, alter making this CeHoicat, nl' 1:x- emptirn, you should become subject to the Workers'Compensation provisions of the Labor Code, you mus( forthwith comply with such provisions or this permit shall be deemed revoked. APPLIANCE 5.00 PLAN CHECK FEE .r AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM -- I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097. Civ.C.). HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OV ER 100,000 B-T.U.)9.50 ELECTRIC Lender's Name Lender's Address I certify that l have read this application and state that the above intimnwthm is uncut. I agree to comply will, all city and <onm , ordinances and state laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER- COMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL hereby au motives of this city to enter upon the above ition d property for inspe - n purposes. MISQ - REFER TO ORD. CONST. TAX ( c) agree tr save, indent y nd kce+ annlcs ha City of Cup mina against liabilities d encs, c sand penses which may y�way accrue ai I said C' in quence of the PERMIT ISSUANCE 10.00 MECH. CONT. LIG NO. MECH. TOTAL TOTAL 7 ra g rHo, permit 'Sli!J gna ore of Applicant/SO tractor atC OFFICE COPY