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16690 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO5690 INSPECTION DIVISION JOB INSPECTION RECORD . QPERMIT EXPIRATION JOB ADDRESS_ �O :3 UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER v CONTRACTOR Q IS NOT STARTED WITHIN INSPECTIO DATE INSPECTOR INSPECTION RECORD I813 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: ' LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF (PERMIT VAI.iDATIGN CUPERTINO STANDARDS, GARAGE SLABS a POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND IISLAB PLUMBING ELECTRICAL - - ISSUANCE DATE MECHANICAL -'BLDG ELECT PLG. MECR 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING, MECHANICAL ELECTRICAL pmb PERMIT To FRAMING- STORIES smRlEs rvpE cnNsrrv. '. IVRY Of ID DCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so Er.FLOOR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING . RES IND CON PB om., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.N ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY nvnr,T No. PArvcEL No MECHANICAL MECH.ENERGY ACC DATE ACC.FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST INSULATION IPLUMBING ZONING ENG SITE NO. GAS TEST GAS ' MECHANICAL 7 EIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD?ONE A L U C INTERIOR SHEAR FIRE DEPT. - Y❑ NO 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 OCCUPANCY SEISMIC FEE OCCUPANCYOF 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 ,p0' IMPORTANT! CONST.TAX PLEASE'READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. CDU OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT 1 DENTI FICATION PERMIT NUMBER, BUILDING APPLICATION & PERMIT ADDRESS 21836 Monte Ct, BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME• Evelyn Jones OTY. ELECTRIC PERMIT FEE PHONE CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00 Dial One Beffal0$r.NO. 233558 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS ADDRESS APPLIANCES-RESIDENTIAL 4.00 ,A ADDRESS yt1245 Space Park Nh E Mt. View PANELS 10.00 GATE OF APPLICATION ORRCHITECT PANELS (OVER 200 AMPI 20.0Q PLAN CHECK FEE .0,NO. ENGINEER None ua No. ISIGNS TRANS. 3.00 An H.OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT 5.00 w� zip TEMP.METER OR POLE INS. 20.00 `U APPLICANT'S MOTORS SEE FEE SCH. ADDRESS SERVICECHANGE iAI020.00 D O o LICENSED CONTRACTORS DECLARATION < i w 1 hereby affirm that I am licensed under provisions of Chapter 9 0 V ISSUANCE DATE N (commencing with Section 7000)of Division 3 of the pB�u[siness and 4A 3J5B LOG. ELECT. PLG. MECH. r i Professions Code,and�myy license is in full force 0 2: 0 License ClaEs'�`�.3.6. __Lia Number I Y e upertino ❑ Ir.-rA'll r w F j Date- 0-09 Contractor 4 x 2 , BUILDING PERMIT a o a OWNER-BUILDER DECLARATION INFORMATION X N I hereby affirm that I am exempt from the C.vractoi s ease MISC.- REFER TO ORD FLLN J Law for the following reason. 7031.5,Businessand Professions PERMIT ISSUANCE - 10.00 VALUATION $/FT. wy Code:Any city or county which requires a permit to construct,alter, a is ¢p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTH. LIC.N0. ELEC. u u¢ requires the applicant for such permit to file a signed statement that TOTAL w w he is licensed pursuant to the provisions of the Contractor's License PERMIT TO HZ� Law(Chapter 9(rommencing with Section 7000hrf Division3 of the f 4 o Business and Professions Code)or that Ire is exempt therefrom and OTV. PLUMBING PERMIT FEE ¢ r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. e- by any applicant for a permit subjects the applicant toacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500)): O 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will Jo the work,and the structure is not intended or offered for sale(See. 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 huilJs 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- ments are not intended or offered for sale.If,however,the building GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS EASYSTEM OVER 4(EA) 2.00 builder will have the burden of proving that h - . - e did not build or im- BUILDING USE prove for purpose of sale.). RES IND CON PBC Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ❑ O ❑ 0 0 licensed contractors to Co struct the project(Sec.7044,.Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Pro fesswns Cotte:The Contractor's License Law does not apply to an owner of property who builds or improves thereon•and who LAWN SPRINKLERS-OVER 5(EA.) ' 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO. PARCEL NO. Cl I am exempt under Sec..,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.GATE ACG.FILE NO. WORKIIRS'COM PF.NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, ZONING or a certificate of Worker'Compeneition Insurance,or a certified ENG.SITE NO. copy thRs]BtTSo-'L�3 ab.0-L pacific Comp Policy T. n v r O ❑ Certified copy' Crchy fay :IteA. FIRE SPRINK ENERGY T-24 Z z QL Certified o Is I• tl Ihe ' peW Ion Division. MISC.- REFER TO ORD. Q Applicant r,�,`�-,- Y � N� y [3 NC] w r PERMIT ISSUANCE 10.00 � - CfiRTI PICCOMPE IAA I PTION FROM RK F.RS' FLOOD ZONE A.L.U.C. W � COMPENSATION INSURANC: PLO, LIC.No. PLG. CL a (This section need not be completed if the permit is for one TOTAL Y❑ N� Y C] NE] dollars(S 100)or less.) L 1 O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY W F mit is issued,I shall not employ any person in any manner so as t0 O W become subject to the Workers Compens'mion Laws of California. y Dale Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } U) NOTICE:TO APPLICANT; If,after making this Certificate of lix- F Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith Comply with FEE V such provisions or Ibis permit shall be deemed revoked. AIR HANDLING UNIT(TO 10JXDC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1 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(SeaMICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Ira_0 Lender's Name H EATI NG UNIT(OVER 100,000 B.T.U.)9.50 Lendei s Address ELECTRIC I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with allcity and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3H.P.or100,000B.T.U.) 6.00 Hereby authorize representatives forms inspection this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL Hereby .Doone,property forinsp ofth i purposes. (We) agree to save, mileamify and keep harmless the City of MISC.- REFER TO ORD. Caper tino agai liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 D 1 CONST.TAX Day in any accrue against said City in consequence of the .Dung permit MECH.CONT. LIC.NO. MECH. JS TOTAL Z It Ob TOTAL Sig a icaml/CoTt Date OFFICE COPY