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18425 POST THIS CARD NEAR FRONT OF BUILDING ER MIT NUMRER CITY. OF• CUPERTINO 18425 INSPECTION DIVISION JOB INSPECTION RECORD' f 7 ' 01� ERMIT EXPIRATION JOB ADDRESS / •VuJ (,J KSY UNIT# _LOT# IT PEXPIRES IF WORK OWNER � r_/ �/ , CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED, PREGUNITE TO COMPLY WITH THE APPROVED PNO CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED AUG 1 ' PLUMBING UNDERGROUND /SLAB ' IIF <<W� ELECTRICAL 'at Issun"c ATE MECHANICAL RLDG. ELEC PLG. MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED -7:060 ottzpW BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBINGIct MECHANICAL ELECTRICAL ERMI FRAMING INSULATION STORIES TYPE CONSTR OCC GROUP RES UNITS PLACE.NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • SO FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM -ROOF THE CONOSTRUCTION TAX SFINAL INSP. LPAID ID ADE BEFORE� - ROOFSHEATHINGRES - INDUI LvCOcN USE P9 . om.f APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.4 - ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY ' TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO MECHANICAL - MECK ENERGY ' ELECTRICAL ,� BUILDING ENERGY Acc.DnrE acc.FILE NO FRAMING V ELECT.FINAL TEST F' INSULATION PLUMBING ZONING ENG SITE NO GAS TEST GAS ` MECHANICAL FIRE SPRINK ENERGY T24 COVER NO WORK UNTIL ABOVE HA BEEN SIGNED HEATING Y "❑ ❑ "❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE, AL U.c. INTERIORSHEAR FIRE DEPT. Y E) "❑ Y❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH ' BUILDING INTERIOR. LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED 'occuPANDY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o.� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z 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 BU LDING PROJECT I DENTI FICATI ON PERMIT NUMBER BOILINGAPPLICATION & PERMITReol 1' 18425 Aoo�itss BUILDING -ELECTRICAL-PLUMBING-MECHANICAL' © 3 /YraR/1 �irsro OwN[n'sR /r PLAN CHECK VALIDATION NAME,r T` �(�L "(•r� Y r/ ! CITY. ELECTRIC PERMIT FEE /1 �7'TR LGti0 A PHONE /J•J `/ Y / //1 �!/ CONTRACTORS NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 / LIC NO. LIGHTING FIXTURES - 10,00/1.00 ADDRESS - PPLIANCES-RESIDENTIAL 4.00 CONTO PHONE PANELS 10.00 DATE OF APPLICATION '- ARCHITECT - PLAN CHECK FEE P.C.DR px PANELS (OVER 200 AMP) 20.00 . ENIA &1.4.40 Mrr/^ 1'C NO.C/6('�/� SIGNS TRANS. 3.00 ADDRESS ENG. ' SPECIAL CIRCUIT 5.00 P PVALIDATION zIP EMP.METER OR POLE INS_. $,Qp9 Q,QQ ��� � Avvucarvrs 2/730 ALO/rkA/Z .4L srg MOTORS SEE FEE SCH. Ao0RE5s uPIA�i� - On' So/ SERVICE CHANGE 20.00 D o LICENSED CONTRACTORS DECLARATION a i w 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE TE a u (commencing with Section 7000)of Division 3 of the Business and 10 BLDG. ELECT. PLG- MECH. H w z Professions Code,and try license is in full force and effect. .1:1 ❑ ❑ o Z w Liccnsc Class Lie.Number ' City Of Cup"no F w H J Date-Contracim a uBUILDING PERMIT ¢ ¢ a OWNIiR-BUILDER DECLARATION o a ea - INFORMATION F ; H I hereby affirm (hut 1 am exempt from the Contractor's License MISC.- REFER TO ORD wa. O Law for the following reason.ISec.7031.5,Businessaur Professions PERMIT ISSUANCE / VALUATION SIFT. f or Code:Any cityor comity which requiresa permit construct,alter, ¢ ¢ a O improve,demolish,or repair any stnmt are,prior to its issuance,also ELEC.CONTR. L.C.NO. ELEC. �Tn /)-)� 0, requires the applicant for such permit to file a signed statement that TOTAL.Lf I rP` PERMIT A. tam he is licensed pursuant to,the provisions of the Contractor's License F z¢ Law(Chapter 9(commencing with Section 7000)of Division 3 oftbe 4 0 Evenness and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE ¢ I-$ the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TYPE CONSTR. e. by any aPplieant for a permit subjects the applicant to a civil penalty ALTER-DRAIN .5.00 of n�ot�san titan five hundred dollars(5500).): P as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 Occ.GROUP RES.UNITS their,sale compensation,will do the work,and the structure is not 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 BO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees.provided that such improve- ments are not intended aroffered for sale.If,however,the building GAS-EA.SYSTEM-I1NC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2,00 builder will have the burden of proving Ilan he did not build or int BUILDING USE prove for purpose or sale.). I RES IND CON PB Other ❑ 1,as owner of the properly,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 1:1 ❑ El ❑ 11 licensed contractors to construct the Project ISec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contmcls for such projects with a contractorls)licensed pursuant to SEWER-SAN EA.200ft/10.00 the Contractors License Law. TRACT NO, PARCEL NO. ❑ lam exempt under Sea ,B.&P.C.nim this WATER HEATER W/VENT 6.00 reason Owner - Date #/K* WATER SYSTEM - 5.00 ACC.OATE ACC.FILE NO. WORK ERS,COMPF-NS '1'10! DECLARATION WATER TREATING EQUIP. 5.00 1 herehy n(four that I have a certificate of consenl to set6lnsure, - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy Ihereol(Sec.3800, ab CJ. �.M�- /- -41 Policy No. mt ♦gy ' 0 ❑ CcRdie COP Is berchy furnished. . - FIRE SPRINK ENERGY T$4 Z 2 pferlified copy is filed with the city inspection division. I- p Applicant MISC.- REFER TO ORD. Y C] N[D I Y [:] NE] CC y PERMIT ISSUANCE 10.00 CERTIFICATE 017 EXEMPTION PROM WORKERS' , FLOOD ZONE A.L.U.C. W COhIPENSATION INSURANCE PLG.CONTR. ❑C.NO. PLG. CL 2 f Phis section need riot be completed it the permit is for one TOTAL Y N� Y C:] NEI hundred dollars(5100)or less.) _ U O 1 certify that in the Performance of the work for which this Per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shat[riot employ any person in any manner so as to U L, become subject to the Workers'Compensation Laws of California. Date Applicant BUILDING a ALTER OR ADD TO MECH. 5.00 } N NOTICE TO APPLICANT: Jr,after making this Certificate of Ex- Z So ption,you should become 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 permil.shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCT'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE 1 hereby affirm that Imre is a cmistruction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,CR.C.L - HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I ceftily that l have read ihistimlic:lion End state that the above VENTILATION FAN (SINGLE) 4.00 inlUrination is correct. I agree to comply with all city and county PLUMBING ordinances and Stam laws relating to building construction, and BOILER-COMP(3H.P.or100,000B.T.U.) 6.00 herehy authorize representatives of this city to enter almn the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in xny way accrue against said City in conscutua ee of the rantin o' 's Permit MECH.CONT. LIC.NO. MECH. TOTAL TOTAL �• 1 azure of Applican Contra am OFFICE COPY .