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17966POST THIS CARD NEAR FRONT OF BUILDING " CITY OF CUPERTINO INSPECTION DIVISION, JOB INSPECTION RECORD •t JOB ADDRESS /O;2&J M/%✓0,4e 1 -?L .UNIT# _LOT - OWNER CONTRACTOR, eapur NUMBER 17966 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PE RMIT ISSU ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION" - NOTE:, ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CUPERTINO STANDARDS. �iT LIFER - PREGUNITE PE' VALIDATION ` 1t11 S[ i Ii. r GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UEP ZY n ISSUANCE DATE - UNDERGROUND (SLAB PLUMBING ELECTRICAL MECHANICAL - BLDG ELECT I El ElD El PLO. ❑ - OO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED �% I,11 QN5� '. BUINFORM PERMIT INFORMATION WOOD FLOOR unnoN SIFT. PLUMBING / /,�- �)� /�%� ��"TL�i /✓�/ MECHANICAL ELECTRICAL PERMn ro, FRAMING INSULATION STORIES TYPE Co STR. - OCC, GROUP '�; RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NOMINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID • ' sD. Fr aoDR AREA raTAL ACREAGE DIAPHRAGM - ROOF SHEATHING .BUILDING USE RES IND CON PB 00", ❑ ❑ ❑ 0, ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE. INSP. ROUGH SANA ASSESSOHSPAHCEL NO PLUMBING - ELECT. ENERGY TUBS TUBS B SHOWER PAN PLUMBINGENERGY No. PARCEL No ' MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC nnre ACC FILE No ' FRAMING ELECT. FINAL TEST' INSULATION PLUMBING lb 2bL ZONING ENG. SITE NO. GAS TESTGAS MECHANICAL , FIRE SPRINK Y ❑ No ENERGY TZG V ❑ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE v 0 NE] A,LU C. rl] N❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEESUMMARY EXTERIOR LATH - BUILDING BUILDING INTERIOR LATH TEMPORARY` APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE . GAS . _ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDINGFINAL ISSIGNED BY BUILDING INSPECTOR. I ', MICROFILM , ARRANGE FOR INSPECTION BY PHONING 252-4505, �' ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z� , PLEASE GIVE JOB ADDRESS WHEN PHONING., . -SEE PERMIT FOR EXPIRATION DATE ELECTRIC PLIUMBINIG. MECHANICAL CONST. TAX IMPORTANT! PLEASE 'READ REVERSE SIDE BEFORE,TOTAL CALLING FOR FINAL INSPECTION. l OFFICE COPY 'APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY • BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING —ELECTRICAL— PLUMBING —MECHANICAL ,PERMIT NUMBER 17966 BUILDING ` AODREs /° WL 6,3 Owry 'a.PLAN NAME OTY. ELECTRICPERMIT FEE CHECK VALIDATION HONE CO ACTORS NAME UTLETS- SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 C.N 1 l DATE OF APPLICATION l CONTR5A rORS POOR S NE 4061 APPLIANCES -RESIDENTIAL - 4.00 PANELS 10,00 OR HITECT ENGINEER LIC ri0. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ADDRRESS ENa SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP OR POLE INS. ' 20.00 EMP. METER APID I 1 • � !J H IU^i - ' ADDRESS PLICANTS MOTORS SEE FEE 5 SERVICE CHANGE- LICENSEDCONTRACTORSDECLARATION - lu - r 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lie. Number ISSUANCE DATE ,r „ .. 1 'BLDG, ELECT: 1:1 El❑ PLG. - MECH. Date Contractor - - OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Busuessand 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 filen signed statement Thal he is licensed pursuant to the provisions of the Contractor's. License BUILDING PERMITINFORMATION IMISC. — . REFER TO ORD 'PERMIT ISSUANCE 1000 . - VALUATION /FT. - ELEC. COINER. LIC. NO. - t ELEC. TOTAL •PERMIT TO QTY. PLUMBING PERMIT FEE Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and C� 1 1 STORIES - TYPE CO TR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permil subjects the applicant toa civil penalty of not more than five hundred dollars (3500).) ALTER -DRAIN (EA.) 5.00 ❑ '•I; as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not - BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES, UNITS DRAINS -FLOOR, ROOF, AR EA, COND. 5,00 - intended or offered for sale (Sec, 7044, Business and Professions Code: The Comma tor'a License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- meets are not intended or offered for sure. If, however, the building FIXTURES - PER TRAP 5.00 - GAS - EA. SYSTEM -1INC. 4'OUTLETS 6,00 S0. FT. FLOOR AREA TOTALACREAGE I or improvement is sold within'onryear of completion, the owner- builder will have the burden of proving that he did not build or int- prove -for purpose of sale.). t ❑ 1, as owner of the properly, am exclusively contracting with . .. GAS - EASYSTEM -OVER 4 (EA) 200 BUILDING USE RES IND CON re' -Other ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER.30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner ofproperty who boards or, improves thereon, and who 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 conlrusons) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200h/10.00 TRACT NO, PARCEL NO. ❑ tum exempt dnder,Sec. ,B.&P.C. to this reason WATER HEATER W/VENT fi00 VO Owner Dam . WATER SYSTEM 5.00 ACC.OATE ACC. FILE NO. WATER TREATING EQUIP, 5.00 WORKERS'COMPENSATION DECLARATION - I hereby a(for. that I ave a certificate 01 -consent to self-inxuc, or u certificate of Worker' Campnnwtiggqn Insuronee; pj u eertifled coyyyy [��er�y• OO,L .y , ZONING .ENO. SITE NO, I'yi� Comps y UL1n�J- J7— l❑ cul copy is he Ble fwith the y�• an1tif copy is fle with the city, inspection division: A1Rmc FIRE $PRINK' v N ❑ '❑ ENERGY T-24 v N ❑. ❑ MISC. - REFER TO ORD. PERMIT ISSUANCE A.— CERT(I ATE OIr EXEMPTION FROM WORK ERS' - FLOOD ZONE A.LU.C. COMPENSATION INSURANCE .(This section need not be completed_ if the permit is ror'one PLG. CONTR. LIC. NO, PLG. A^ TOTAL .uN Y ❑ 'N❑ Y ❑-. IN hundred dollars IS 100) or less I .I certify that in the performance of the work for which this per- mit is issued, I shall not employ. any person in any manner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensation Laws of California. Date ApplicantALTER OR ADD TO MECH. 5:00 NOTICE TO APPLICANT: If, after making this Certificate of nix- _ eruption, you should became suhject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked, APPLIANCE 5.00 AIR HANDLING UNIT (TO 10,000CF.M.) 4.00 PLAN CHECK FEE ' AIR HANDLING UNIT (OVER 10=C.FM.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm thill there is u construction lending agency for the performance or the work for which this permit is issued (Sec. 3097, Civ.CJ. - EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 ' MICROFILM' Lender's INS. Lenders AAddrdress HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC'. I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. VENTILATION FAN (SINGLE) 4.00 PLUMBING e . BOILER -COUP13H.P. or 100,000B.T.U.1',6.00 g01 LER-COMP (OVBr 100,000 BTU( SEE FEE SCH. MECHANICAL ' (We) agree u save, indemnify and keep harmless the City of ertino again t liabilities, judgments, costs and expenses which a in any wa accrue against said Cfly in consequence of the rant g o this p miL , MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX - MECH. CONT.' LIC. N0. NOTAL TOTAL / go ureof Applicant/Contractor - Date - OFFICE COPY