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17402 POST THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER rOP. CITY OF CUPERTINO 17402 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS � 0� 3SIGt'VPUNIT4 _LOT# PERM I EXPIRES IF+WORK OWNER 1 - �b( CONTRACTOR -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 F PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VA[.Ioa nuN CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB MAR 2 4 15L'a u PLUMBING ELECTRICAL city ISSUANCE DATE •- MECHANICAL BLDG. ELECT I PLG: MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING, vawanoN SIFT. MECHANICAL ELECTRICAL A4-(To TOO/ 1� FRAMING NEW1 '"o Ems" ` ` Si ORIF:S .TYPE CONSTH. INSULATION - .. DCC GROUP RES UNITS, PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO IT FLOOR rnA TOTAL ACREnrr DIAPHRAGM THE CONSTRUCTION TAX IS PAID j'T•� BUILDING USE `I ROOF SHEATHING REs INDCON Pa• mow APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ID ❑ 1:1ASSESSORPARCEL NO . . ROUGH SAN.# PLUMBING - ELECT..ENERGY TNACT NO PARCEL NO. TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECR ENERGY ACC•DniE ACC FILE•NO • ELECTRICAL BUILDING ENERGY - FRAMING ELECT.FINAL TEST 2CNING ENG.SITE NO. •• INSULATION PLUMBING GAS TEST GAS • MECHANICAL FIRE SPR INK ENERGY T 2 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y C] "❑ ` ❑ "❑ PLDoo mNE, ALu.c EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. Y❑ "❑ Y ❑ "❑ SHEETROCK GRADE p - 'FEE SUMMARY EXTERIOR,LATH BUILDING INTERIOR LATH . 'TEMPORARYAPPRO BUILDING• 00. SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE �.'w`"""" NO TAPE OR PLASTER UNTIL ABOVE-HAS SIGNED OCCUPANCY SEISMIC FEE' IT J OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM. ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ��. ' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING ' PLEASE GIVE JOB ADDRESS WHEN PHONING: I Z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL #'oago CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY Eta]LD1 NO PROJECT 1 DENTI FICATION .PERMIT NUMBER BUILDING APPLICATION & PERMIT 17 O ADDRESS j BUILDING—ELECTRICAL—PLUMBING—,MECHANICAL ., OWNER'S PLAN CHECK VALIDATION ""ME /fJ 13,�,/�� QTY. ELECTRIC PERMIT FEE a PRDN C=10, NTE ORS NA � UTLETS-SWITCHES-RECEP 10.00/1.00 I 0 /�//7/A-O {f//r! uc.ND. LIGHTING FIXTURES 10.00/1.00 a F% V r-orvroRs, / pPLIANCES-RESIDENTIAL 4.00 ADD ss PHON �' PANELS 10.00 DATE OF APPLICATION RCRITECT - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. O OR ENGINEER ' LIC.NO. ISIGNS TRANS. 3.00 ADD Ess E "G' SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20:00 A �— �1L�9 ADDRESS MOTORS SEE FEE SCH. r PPLICAr$ SERVICE CHANGE 20.00 J e�-V� tD to V6;J IF o LICENSI'.0 CONTRACTORS DECLARATION ¢U U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE ya i (commencing with Section 7000)of Division 3 of lire Business and BLDG. ELECT. PLG. MECH, Professions Code. _m license is in full force f ct/z� MAR ❑ ❑ z 0 w — License CI Lic.Number Y o w r w 0atcCnntraclar !� ' City Of CB BUILDING PERMIT ¢ ¢ ¢ ¢ OWNER.BUILDER DECLARATION ' MISC.— REFER TO ORD INFORMATION E: 0 A y . 1 hereby affirm that I am exempt from the Contractor's License r .. o¢ Law for the following reason.(See.7031.5,Businessand Professions PERMIT ISSUANCE - 10.00 e V /VALUATION S/FT. Cade:Anycityarcounty which requires a permit to construct,alter, D /—OOH, p0 ¢a-2 improve,demolish,or repair any stnm¢oc,Prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. /YO ae m LL equirCa the Applicant for Such permit to file a signed statement tlsul TOTAL C�O/S PERMITTO n w he is licensed pursuant to the provisions of the Contractor's License �I�/`� va z rt Law(Chapter 9(commencing with Section 7000)of Division 3 of the PATID I VO E 4 D Business and Professions Code)or bat he is exempt therefrom uW QTY. PLUMBING PERMIT FEE ¢ H S the basis for rhe alleged exemption.Any violation ol'Section 7031.5 STORIES TYPE CONSTR. A. by tiny applicant for a permit subjects the applicant lou civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dolls rs(SSOOM: ❑ I,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 do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractors License Law does not apply to an owner of property who beilds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT,FLOOR A EA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenetintendcdorofferedfinsale,if,however,the building GAS-EA.SYSTEM-l1NC.40UTLETS: 6.00 9� or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4 (EA.) 200 �I BUILDING USE builder will have the burden of proving that he did not build or im- . - . . RES IND CON PB Other for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed commotion to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Cotte:The Contractors 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 contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200(1/10.00 the Contractor's License Law. TRACT N0, PARCEL NO. ❑ Iamexemplutder Sec. ,B.&PC.for this WATER HEATER W/VENT 6.00 reason Owner .Dote WATER SYSTEM - 5.00 ACC.DATE ACC.FILE NO, WOEKERS'COMPFNSA'I'ION DECLARATION WATER TREATING EQUIP. 5,00 I hereby affirm that I have a certificate ofennsent to sell'-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a ce IOed copy there L' Lab.C.l. [I CPO �gf ora Pany ❑ fl led LLLo Is herch y l urnislmd. FIRE SPRINK ENERGY T24 Z Z Certified is ft Wyy 4IT city p n division. O Applicant ji1 OYz' ;f p MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑ ~ va PERMIT ISSUANCE 10.00 - � C[iRTIFICA'fli Of li%IihIPTION FROM WORKERS' FLOOD ZONE A.Lu.c. W > COMPENSATION INSURANCE PLO.CONTE. -LIC.NO, PLG. CLZ' ('['his section need not be completed if lire permit is far one TOTAL Y❑ N❑ Y ❑ N❑ U O hundred dollars(8100)or less.) bcertify that in the performance of the work for which this pe" QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,1 Shull not employ any person in any manner so as to U become subject to the Workers Compensation Laws of California. IL Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >_ W NOTICE TO APPLICANT': If,after making this Certificate of Ex F ? Al lop 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 U such provisions or this Permit shall be deemed revoked. AIR HANDLING UNIT ITO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNITIOVER 10,(300C.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 fur which this Permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name t HEATI IN UN IT(OV ER 100,000 B.T.U.)9.50 D Lender's Address ELECTRIC I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 . information is correct. I agree to comply with all city and county PLUMBING ordinances anti slate laws relating tn-building construction, and BOILER-COMP 13 H.P.or 100,000 B.T.U.) 6.00 herch- auhorizc representatives ec this city es enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL tereby nlmarit property forinspofth i purposes. L ree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX y y accrue ag. st said City in 'onseque a of lire tMECH.CONT. LIC.NO. MECH.�� WOTAL TOTAL pelican/Contra!oS r Dale OFFICE COPY