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18043 POST THIS CARD NEAR FRONT OF BUILDING FdmlT NUMBER CITY OF CUPERTINO 18043 ~ INSPECTION DIVISION JOB INSPECTION RECORD �q—� PERMIT EXPIRATION JOB ADDRESS_( (/V—Me\—h UNIT# `` ,1 LOT# PERMIT EXPIRES IF WORK I OWNER Ur%A- CONTRACTOR �``W ll`d:T— IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION "ANCE OR 180 DAYS FROM " NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PpLA�NS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. Pfv® GARAGE SLABS _ _ r POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED NOV 0 7 1983 UNDERGROUND /SLAB PLUMBING Cir, 1 ` A, �� I " N \ � C I < 'R"'It00! ELECTRICAL - ISSUANCE UPIE MECHANICAL BLDG I ELECT I PLG. me ❑ El ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT - INFORMATION WOOD FLOOR VALUATION $IFT. PLUMBING MECHANICAL ELECTRICAL PERMIT To FRAMING 1 STCRILS TYPE CONSTR INSULATION ,OCG GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED " ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sD.IT FLooR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING use ROOF SHEATHING I "s INE CON rB 0 II., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. SP ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL - MECR ENERGY ACC DATE ACC.FILE.No ELECTRICALBUILDING ENERGY FRAMING . ELECT,FINAL TEST ZONING. ENG.SITE NO. INSULATION PLUMBING GAS TEST GAS FIRE$PRINK ENERGY L]4 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ m❑ Y ❑ NL LOOT?()NE ALUC, EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. Y L NL ' L NO 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 I I SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. ' MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC � ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL .04 IMPORTANT! coNsr. TAX PLEASE REAL) REVERSE SIDE BEFORE TOTAL DD CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY // BUILDING PROJECT IDENTIFICATION PERMIT NUMBER � n`o9�gFss APPLICATION & PERMIT q �O A �43] Pg/ J� ( BUILDING - ELECTRICAL-PLUMBING-MECHANICAL I.1 I Owg�NER'S PLAN CHECK VALIDATION l•-,C(.!-•O/ y)�`h ��..��j,S�C TV. ELECTRIC PERMIT FEE (, CJ PHONE . CONT NAME crDRs UTLETS-SWITCHES-RECEP 10.00/1.00 NAME '/ [ �_ �� / / NO ��){/�_6 LI HTING FIXTURES 10.00/1.00 CONTRACTOR S PPL NCES-RESIDENTIAL 4.00 �`J,�(�O/�1H?.P�Lf.I.�-I`-6' •�u/-DJ�(o PANEL 16,00 DATE OF APPLICATION " ONE ARCHIrecTPANELS ( ER 200 AMIN 20,00 PLAN CHECK FEE P.C.NO. OR ENGINEER J sec.No. SIGNS TRAN . ' 3.00 S ARCH.OR ENS SPECIAL CIRCUIT, 5,00 PERMIT VALIDATION AODRE55 �( Zi P EMP.METER ORP E INS. 20.00 "L APPucANr$ MOTORS SEE FEE SCH. l avoREss (1� „SJ(.Ohl h"I,FiL ser SERVICE CHANGE 20.00 1 1,. woo LICENSED CONTRACTORS DECLARATION �f '� I O u o 1 hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE Is< oAi (commencing with Section 7000)of Division 3 of the Business and �1 BLDG. ELECT. PLG. MECH. r N z Professions Co m license is in full force f / b U J ❑ ❑ ❑ z 0 w - Lic E Class Lie.Number V q z E w Date---��Contrucmr- OCR a x E ( �i Agr..E E - BUILDING PERMIT w OWNER-BUILDER DECLARATION INFORMATION IF ;LL I- I hereby affirm that 1 can exempt from the Contractor's License MISC.- REFER TO OR LLoj Law for the following reason(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. Code:Any city or county which requiresa peres I roconstrle Iuct,almq ce¢ o improve,demolish,or repair any sen ewre,prior to its issoance,also ELEC.CONTR. LIC.NO. ELEC. - O 0 re(lones the applicant for such permit to filen Signed statement that TOTAL PERMIT TO a cam" he is licensed pursuant to the provisions of the Contractor's License "•--�V` Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe a Business and Professions Code)or that he is exempt therefrom and )LAWN PLUMBING PERMIT FEE r o the basis lin the alleged exemption.Any violation of Section 7031.$ TORIES TYPE CONSTR. a, 12 by any applicant for a permit subjects the applicant to a civil penaltyER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars 155001.1: ❑ 1,as owner of the property,or my employees with wages asK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the siructme is not _ intended Or offered for sale (Sec. 7044, Business and Professions S-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of Properly wllO builds or Improves lheMOn,and who does Such workU S-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE • himschar et intends or offered for provided the improve- -EA. STEM-11NC.4 OUTLETS 6.00 meets are net ugh f cd or emplo for sale.11,however-the building or improvement is sold within one year of completion, the owner- -EA.SV TEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of moving that he did not build Or im- prove for purpose of sale.). USTRIAL STE INTER. 30.00 E IND CON Pe Omar ❑ 1,as owner of the property,ran exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec 7044,Business SPRINKLE - 1 INC 5 V,B. 6.00 ASSESSORS PARCEL NO. and Professions Code The Contractor's License Law does not applyto un owner of property who builds or improves thereon,and whoN SPRINKLERS- VER 5'(EA.) 1.00 contracts for such projects with a ectuoictor(sl licensed pursuant m the Contractor's License Law. SEWER-SANITARY-STD EA.200ft/10.00 TRACT NO, PARCEL NO. ❑ 1an,exempt under Sc,.-,It&PC.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK FRS'COMPENSAII ION DECI.ARA'I'ION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofconsenl to self-insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance.orest if'd copy tharayy//��yy��8�.1 pant'Lah.C.).Q Policy No'KIUJ r'(�ompony yllyT Q ❑ Certified copy is hereby forms ed. FIRE SPRINK ENERGY TI4 Z Z Certified co,(+y�Is�filed will the 'y,inspection division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ Al+p cent_'/'}./{-/'I'll Y N V N KN CERT'IFICAIEOFFFXEM PTIONPROM ORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.O. W > CObIPEN5AT10N INSURANCE PLG.CONTR. LIC.NO. PLG. CL CI section need not be completed if the permit is for one TOTAL V F] N❑ Y E] N❑ Z) Z hundred dollars IS 100)Or less.) U 0 1 certify that in the performance to the work for which this Per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY IL F mit is issued, 1 shall not enl Ploy ally person in any rl mane,eo as to O W beconse subject to the Workers'Ccan,...all..Laws of Cvlifornlo. Date Applicant BUILDING d ALTER OR ADD TO MECH. 5.00 } rn NOTICE TO APPLICANT': IL after making this r,'Coa fir of Iix- H ? Provision you should heretic Co subsea In the W rth.it commensal ion APPLIANCE 5.00 PLAN CHECK Provisions of the labor Code. you ..it forthwith comply with FEE U such provisions or this permit shall be deemed revokeJ. AIR HANDLING UNIT(TO 10p00 C.F.M.) 4.00 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10MOC.F.M.) 6.00 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(Sec. 7-1 HEATING UNIT(TO 100,000 B.T.U.) h�CO -[7D MICROFILM 3097,Civ.C.l. Lender's Name HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that l 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-COMP(3 H.P.Dr 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and Z� hereby authorise representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL �.C/✓ above nwntioned property for inspection purpose.. (We) agree ,, save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and exp nus which CONST.TAX may in an wary accrue against said City in elmseq ace if the PERMIT ISSUANCE 1'9vCO Z•OO grin o I Tnlil. ID (1JQ MECH.CONT. `/-,,�. LIC.NO. MECH. Sig re (Applicant/Contractor baro C3 �RS F G�Gt r! 57� TOTAL TOTAL OFFICE COPY