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15437 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO .15437 INSPECTION DIVISION JOB INSPECTION RECORD t / PERMIT EXPIRATION JOB ADDRESS//_�� -1 UNIT# -LOT# PERMIT EXPIRES IF WORK OWNER :C-s�TC9 c CON TR ISNOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATIONANCE OR ,180 DAYS FROM NOTE: - LAST CALLED INSPECTION. UFER. ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VALIDATION - CUPERTINO STANDARDS. GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED L UNDERGROUND /SLAB PLUMBING J ELECTRICAL - .. ISSUANCE DATE MECHANICAL - _ `lI,>,r� t+ SLOG ELECT I PLG. MECH 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED LL; " ' BUILDING PERMIT • .WOOD FLOOR - - ' - INFORMATION PLUMBING . VALUATION. : MECHANICAL - PERMIT TO ELECTRICAL - FRAMING INSULATION - - STORIES TYPE CONSTR. F , - OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED p - SD.FT,FLOOR AREA_ TOTAL ACREAGE ' ROOF .' NOTE:NO FINAL INSP,SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE - ROOF SHEATHING - - RES IND CON PR 00- . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ -. ASSE550R5 PARCEL NO ROUGH SAN,a PLUMBING ELECT:ENERGY TRACT NO. PARCEL NO - .. , • . TUBS 8 SHOWER PAN . - - PLUMBING ENERGY' - - - MECHANICAL MECH.ENERGY ELECTRICAL - - BUILDING ENERGY ACC DATE ACC,FILE NO. FRAMING - - - ELECT.FINAL TEST INSULATION. PLUMBING - ZONING ENG.SITE NO, GAS TEST GAS FIRE$PRINK ENERGY T 24 'I MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ MY ❑ IN[D EXTERIOR SHEAR ELECTRICAL RELEASEFLOOD ZONE A.L UC ' - INTERIOR SHEAR FIRE DEPT. Y❑ N❑ v❑ IN ' SHEETROCK - L " GRADE - - FEESUMMARY EXTERIOR LATH • BUILDING - INTERIOR LATH - - - TEMPORARY APPROVALS BUILDING SCRATCH COAT, ELECTRIC - _�- PLAN CHECK GAS FEE NOTA PE OR PLASTER UNTIL ABOVE,HAS BEEN SIGNED' OCCUPANCY L ISEISMIC FEE OCCUPANCY,OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM , ARRANGE FOR,INSPECTION BY PHONING 252-4505, ELECTRIC jw •'� \ ONE WORKING DAY BEFORE REQUIRED"INSPECTION. � PLUMBING LLI'p ,` PLEASE GIVE JOB ADDRESS WHEN PHONING: '--SEE PERMIT FOR EXPIRATION DATE - = MECHANICAL . IMPORTANT! . CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES = USE BALL POINT PEN ONLY r BUILDING PROJECT IDENTIFICATION PERMIT NUMBER.,- APPLICATION PERMIT 1547 BUILDINGS - - 11 ADDR/u�P"•� / • I {orlybfs�� sLO� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 4 OWNER'8 PLAN CHECK VALIDATION 40 ,s/ "AmE�C� l� J OTY. ELECTRIC PERMIT FEE 1 L1\ � PHONE CONTRACTOR'S ry E UTLETS'-SWITCHES-RECEP 10.00/1.00 Cl*nV ✓e� {c.rvD. < LIGHTING FIXTURES 10.00/1.00 - CONTRACTORS - PPLIANCES-RESIDENTIAL 4.00 � *MIA// �/ �j -PHONE 1 I�/�7� � PANELS 10.00 DATE OF APPLICATION ARCHITECTPLAN CHECK FEE PC.NO. OR - PANELS (OVER 200 AMP) '20.00 ENGINEERI LIC.No.' SIGNSTRANS. 3.00 - ARC"OR ENG, SPECIALCIRCUIT 5.00 PERMIT VALIDATION - xIP TEMP.METER OR POLE INS. 20.00,,76 - /1 •- ADDRESS MOTORS SEE FEE SC H. SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION +, a i w I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE - m ¢ u (commencing with Section 7000)of Division 3 of the Business and x „ BLDG. ELECT. PLG. MECH. H Z Professions Code, d my license is in Lull for •n d flet - h4AI %, z O= License Cl ss Lic.Number - -- v - ❑ O z I-w Date - - Contractor F N J < :t a ¢ OWNER-BUILDER DECLARATION IRIti f1 r'1rf ''I't BUILDING PERMIT g o a u - INFORMATION K R: H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD FuLaw far the following reason.(Sec.7031,5,Businessand Professions PERMIT ISSUANCE - -10.00 �- VALUATION S/FT. � Code:Any city or county'which requires a permit to construct,after, � ELEC.CONTR. LIC.NO. ¢ 2¢ Fo improve,demolish,or repair any structure,prior to its issuance,also ELEC. D O (/'6 i ¢ requires the applicant for such permit to file a signed statement that TOTAL ✓ w m he is licensed pursuant to the provisions of the Contractor's License ^� PERMIT TO Fz > Law(Chapter 9(commencing with Section 7000)ofDinision3otitle 1&-0-y14. {�dLas 4 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE to H $ the basis for[he alleged exemption.Any violation of Section 7031.5 - STORIES TYPE CONSTR.' by any applicant for a permit subjects the applicant loo civil penalty of not more than five hundred dollars(5500).1: ALTER-DRAIN&VENT-WATER (EA.) 5.00 - ❑ I,as owner,of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 400 their sole compensation,will do the work,and the structure is not . . OCC.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 does 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 TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedoroffered 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-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have file burden of proving that he did not build or Im- BUILDING USE p rove for ur pose e.)' INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other ❑ 1,ass owner ofthof h .e property,am exclusively contracting with - - licensed contractors to construct the project(Sec.-7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 11 ❑ ❑ 11 ❑ and Professions Code:The Contractor's License Law does not apply ASSESSORS PARCEL NO. to an owner of property who builds or improves thereon,and who LAWNSPRINKLERS-OVER 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&P.C.for this WATER HEATERW/VENT 6.00 Mason- Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure. or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(See,3800,Lub.C.). - • - Polwy,No, i Company U Cl Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Certified y}py floitlyth�-city inspection division. - pp ant- �[/`�� MISC.- REFER TO ORD. E] IN[J YC) N[] ~ w PERMIT ISSUANCE 10.00 - CIi R'fI FICATE EP. AEMPTINS FROM WORKERS' FLOOD ZONE A.L.U.C. W � �. f -COMPISNSATION INSURANCE PLG.CONTR. - LIC.NO. PLG. 1 Q' (This section need,net be completed if file permit is for one TOTAL Y❑ N� Y ❑ IN Z hundred dollars IS 100)or less.) - -U O I certify that in the,performance ofihe work fur which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued.1 shall not employ any person in any manner so as to O W become subject collie Workers'Compensalion Laws of California. BUILDING y Date Applicant ALTER OR ADD TO MECH. 5.00 >_ m NOTICE-f0 APPLICANT: If,after making this Certificate of IEx- s F. Z emption,you should became subject to 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 bedeemedrevoked. AIR HANDLING UNIT(TO 10OODC.F.M.) 4.00 CONSTRUCTION L17NDING AGENCY AIR HANDLING UNIT(OVER 10MIC.EM.) 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. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.503� Lender's Address ELECTRIC 1 certify.that I have read this application and state Ilmt the abuve VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county BOILER•OJMP13 H.P.Dt 100,000 B.T.U.1 6.00 -PLUMBING nc ordinaes and state laws relating to building Consltuction, and - hereby aulhorivc representatives of this city to enter Upon file BOILER-COMP (Over 100,000BTUISEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless file City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may tri any way ecme against of Cily in consequence of the PERMIT ISSUANCE 10.00 coming of Rl is it/ �/� MECH,CONT, LIC.NE- MECH. Signa fm ol/ 6actor�/ - TOTAL TOTAL . SlgnalBre of AppldanQCop(racfor Ir Uate OFFICE COPY