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15271 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15271 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS /0391.q A��' UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER Ksw"�o, CONTRACTOR CC L/,�(�-. IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION NOTE: ANCE OR 180 DAYS FROM - � UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERNIFI VALIDATION CUPERTINO STANDARDS. ' GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB . PLUMBING ELECTRICAL ISSUANCE OAIE MECHANICAL BLDG ELECrPLG. NIECE+ 1:3 11 © ❑ , DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WINFORMATION WOOD FLOOR - VALUATION SIFT, PLUMBING MECHANICAL ELECTRICAL w - PERMIT TO FRAMING - PAD STORIES TYPE CONSTIi INSULATION 1980 JUN2 OCC GROUPOCC RES UNITS PLACE NO SU BFLOOR UNTIL ABOVE HAS BEEN SIGNED CItY Of Up80 • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn Fr FLOORAREA TOTAL ACR eAeL DIAPHRAGM THE CONSTRUCTION TAX IS PAID IiLULU Gus[ ROOF SHEATHING LESiNo colt` ve on..., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ El ASSESSORSPARCEL NO• ROUGH SAN.# �4 PLUMBING . . ELECT.ENERGY E TRACT o, PARCEL No TUBS B SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE: Acr,.FILE NG., ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING GAS TEST GAS ,6 ) FINE SPRINK ENERGY T-}4 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v N❑I EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE AI.UC. INTERIOR SHEAR - FIRE DEPT. v F] N� Y ❑ N� SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED 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 . FF-- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING �! ;.J 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z ' - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! co NST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .BU I LDING PROJECT IDENTIFICATION PERMIT NUMBER 0rVI0 APPLICATION & PERMIT q �'71 nooness�^ BUILDING-ELECTRICAL-PLUMBING-MECHANICAL c,. 15 GRINER'S PLAN CHECK VALIDATION "A&6 DTV. ELECTRIC PERMIT FEE f/ / PMONE CONTRACTORS gyp) UTLETS-SWITCHES-RECEP 10.00/1.00 1�-- r LIaN g _ LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S PPLIANCES-RESIDENTIAL 4.00 ADDRESS 11175 5Z1ONE /�$ V PANELS O.00 DATE OF APPLICATION R rtELT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE- PC."NO. OR ENGINEER _LIC.No. SIGNS TRANS. 3.00 AARCHOR DDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 ^ �� APPucnrvrs ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION G U e~i 1 hereby affitn that 1 run li,ro,ed under provisinns of Chapter 9 ISSUANCE DATE (commencing with Section 7000)of Division 3 nl'the Business and BLDG. ELECT. PLG. MEGH. iProfessions COJJyy��a�irryy..y�licenseisinfullfo '�1�U�l PJ�'(�� z o w - Liccnsc Classes Lic.Numbc,';(�L r!.' ❑ ❑ ❑ Q m w Date�!�_�!�Q_Comnclor_ BUILDING PERMIT w OWNER-BUILDER DECLARATION o aMISC.- REFER TO ORD INFORMATION wLL I- I h,reby:Affirm Thal I am exempt from the Con Tractor's License uoa Law l'or me followingrcuson.ISee.7031.5.Businessund Professions PERMIT ISSUANCE 10.00 VALUATION SIFT. r - Code:Any city or county which requiresa permit to construct,alter, S ¢¢ 40 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. ca O ac requires the applicant lot Such permit to file a signed statement that TOTAL PERMIT TO A w m he is licensed pursuant to the provisions ol'the Contractor's License F z a Law(Chapter 9(c...n mending with Section 70000.1'Division 3 atilt, X$6 , i o Business and Professions Code)or thus he is exempt Therefrom and GTV. PLUMBING PERMIT FEE Ix I- o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. i ;m by any applicant for a'permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more Than five hundred dollars(55000: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE4.0 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not I,- intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON.. 5,0 Code:'the Contractor's License Law does nut apply to un owner ofall property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5. T FLOOR TOTAL ACREAGE • himself or through hisown ennployces,provided that such improve. .40UTLETS m . erits are not intended or offered for sale.If,however,the budding GAS-EA.SYSTEM-1 INC 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 im- proveforpurposeofsale.). INDUSTRIAL WASTE INTER. 30. RES wo CON PB .mer ❑ I,as owner of the properly,um exclusively contracting with ❑ ❑ ❑ ❑ ❑ lic,ns,d contractors m construct the pinject(Sec. 7044.Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Costs:'I lie Contractor's License Law does not apply to an owner of property who builds or improves thereon.and who ILAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contraclons)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200tt/10.00 TRACT NO. PARCEL NO. ❑ 1 in exempt Ruder Sec.-.If&P,C.for this WATER HEATER W/VENT .690 i mason owner Date' WATER SYSTEM 5.00 A.CC.OATE ACC.FILE NO. WORK FiRS'COSIPIiNSAI'ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of-consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers*L CC 1 cation Insuranc l copy 3 0,Lab.0). Policy ' any hereby O ❑ (,Qtl ted oPY is lyre by fool Heli. / FIRE SPRINK ENERGY T 24 Z Z Ife op, 's lied u he c v" division. MISC.- REFER TO ORD. O pplicanl Y ❑ IN Y ❑ N❑ Fy PERMIT ISSUANCE 4490 .OL FLOOD ZONE A.L.U.C. - C17RTI ,ATH OI'EXEMPTION 17ROM WORKERS' UJ COMI'IiNSAI'ION INSU RANCIi PLG.CONTR. LIC.NO, PLG. JL%vD Y❑ N❑ Y CL C] N❑ O ('Phis section need not he completed it the permit is for one TOTAL Z) Z hundred fullars(SIOO)or less.) U O 1 certify that in the performance of the work for which this per- GTV. MECHANICAL PERMIT FEE FEE SUMMARY U_ U ..hit is issued.I shall not employ any person in any manner so as to , become subject To the Workers'Compe cation Laws of California. O ED Oatc Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } W NOT'ICE *TO APPLICANT'. If,after nnaking this C,rtiliente of I!x- F Z clnption,you should become subject To the Workers'Connpensatiun APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be demncd revoked. AIR HANDLING UNIT(TO 10)"CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 109ODCEM.) 6.00 SEISMIC FEE I hereby affout That there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of The work for which this permit in issued(Sec. MICROFILM 3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's AddrName ss NHEATING UNIT(OVER 100,000B.T.U.)9.50 ELECTRIC I certify that l have read this applical ion and state that th'above VENTILATION FAN (SINGLE) 4.00 / y inibrniation is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating h, building construction, and BOILER-COV H.P.o-100,000B.T.U.) 6.00 hereby author;,, representatives of This city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above.mmrtioned properly for inspection purposes. (We) agree to save indemnify and keep harmless the City of MISC.- REFER TO ORD. areriino gm In Ilab ;tics,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in anp way uec m against Said City in consequence of the mnti o[ihisP mit MECH.CONT, LIC,NO. MEGH. TOTAL TOTAL Sig ' of Applicanl/C.Rlactor Dale OFFICE COPY