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14818 I POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF •CUPERTINO 14816 INSPECTION DIVISION JOB INSPECTION RECORD - ^^]] ,/ PERMIT EXPIRATION JOB ADDRESS /�5'�7 7"Rl/nlL�',C/ybt` �`'1✓c UNIT# � LOT# / JJ �/,may PERMIT EXPIRES IF WORK OWNER Z&7" Q �`�' CONTRACTOR ".Q.,Q2Q./.( L;�,ca a7ie �c.� IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: LEER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF . PEHMi1 VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED !/=30- W C . *� X, UNDERGROUND /SLAB QLAItT • . PLUMBING y• �l CN (/.ri `^'"//`^'"//,7w,79'- ELECTRICALU•�'j-8'� �j..- i(L•4 tT yLOG ISSUANCE DATELECT E MECH MECHANICAL �6 , �7��gyL I �,Lv_ �c��r• pR ❑ O ❑' ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED j X1.8$ R YCT Cu BUILDING PERMIT .}��. �, INFORMATION WOOD FLOOR /fy 4. Nf� �5�: /h: VALUATION $/FT. PLUMBING MECHANICAL /N ELECTRICAL PERMIT TO FRAMING w INSULATION - STORIES TYPE CONSTR UCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO,FT aooR AHeA TOTAL AcncnDE DIAPHRAGM THE CONSTRUCTION TAX IS PAID +. BUILDING USE ROOF SHEATHING I I IRES IND CON Pe om.' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.q ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY TRACT NO PARCEL NO TUBS BSHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICALBUILDING ENERGY ACC DATE ACC FILE NO FRAMING ELECT.FINAL TEST _ INSULATION., PLUMBING ZONING ENOSITE NO. GAS TEST GAS MECHANICAL FIRE$PRINK ENERGY T-24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y ❑ N❑ ` ❑ N❑ ELOOD ZONE A.L UC. EXTERIOR SHEAR ELECTRICAL RELEASE ,J - ❑ No YL7 AlfINTERIOR SHEAR FIRE DEPT. 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 JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUI LDI NG IS NOT PER MITTED UNTIL BUILDING FINAL 15 SIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ~o�. ONE WORKING DAY BEFORE REQUIRED INSPECTION. - PLUMBING 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 •' " ' ` BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 14818 ADDRESS BUILDING - ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME I¢, OTy, ELECTRIC PERMIT FEE ONE CONTRAL OH'B NamE C,it) UTLETS-SWITCHES RECEP 10.00/1.00 - LIC.NO. LIGHTING FIXTURES 10.00/1.00 ADDRESS TOR's - PPLIANCES-RESIDENTIAL 4.00 I2 t' AA, PHONE _0'?W PANELS 10.00 DATE OF APPLICATION ogcmrecT PANELS (OVER 200 AMP) 20.00 - PLAN CHECK FEE P.C.NO, ENGINEER LIC.NO: SIGNS TRANS. 3.00 ADDRESS ENG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP. METER OR POLE INS. 20.00 • ADDRESS MOTORS EE FEE SCH. a00RE55 SERVICE CHANGE 20.00 '1 .- Oo LICENSED CONTRACTORS DECLARATION a E,w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000)of Division 3 orthe Business and �n ¢ INK a BLDG. ELECT. PLG. MECH. r N i Professions Cole,and m license is in full force�a�µµ{{L cj rQ0 ❑ ❑ ❑ ZO i m o License Class 1.le.Number�j., f/ , F m r J Datc__ 1Contraclor fL 1 C �, BUILDING PERMIT ¢ ¢ w a OWNER-BUILDER DECLARATION - INFORMATION MISC.- - REFER TO ORD w ;e N wforthereby collo that I ant exempt from the Contractor's License VALUATION $/FT. u o¢ Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 - ' Se improve, e,dem y demolish, conn pair any structure permit riot n is issuance, also 2 at a O improve,demolish,or repair any structure,prior 10 its issuance,also ELEC.CONTR. LIC.NO. ELEC. u 0 , requires the applicant for such permit t0 file i1 signed statelncut that TOTAL PERMIT TO K m he is licensed Pursuant to the provisions of the Contractor's License r Z a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe - f 4 o Business and Prolkssiuns Code)or that he is exempt therefrom and (ITY. PLUMBING PERMIT FEE ¢ I- m the basis for the alleged exemption.Any violation of Secl ion 7031:5 STORIES TYPE CONSTR. u3 - by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(5500).): ❑ I,as owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do(he 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 - S0.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. mems are not intended or offered for sale.if,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner. builder will have the burden of moving that he did not build or im- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. .3000 RES IND CON PB Omn . ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to.emstmet the project(Sec, 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,unit who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contractons)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. " PARCEL NO. 01 I O um exempt under Sec. ,B.&P.C.for thisreason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM ' 5.00 ACC.DATE ACC FILE N0. WORKIi RS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that I have a certificate of commint(o self-insure. or a.certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(See.3800,Lab.0.). Policy No. Company ❑ Certified copy ishereby furnished. FIRE SPRINK ENERGY TZ4 z Z O Certified copyyy filed ith 11 city inspection division. Fp Applicant- __ _� MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑ N �- CIiRTIFICAT(/fi�OF IiXEAt N FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L;U,C. - LL �. COMPF:NSATIO IN PLG.CONTR. LIC.NO, PLG. CL Zr (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ O hundred dollars($100)or[us,.) s I certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to Ow become subject to the Workers Competuation Laws ol-California. a Date Applicant BUILDINGALTER OR ADD TO MECH. 5.00 >_ W NO]]CE TO APPLICANT: If,after making this Ce«ificate of EK- Z_ em tion,you should become subject to the Workers'Compensation I.- provisionof the Labor Code,you must forthwith comply with APPLIANCE 5.00 PLAN CHECK E5 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000CF.M.) 4.00 FEE CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10A000.F.M.) 6.00 SEISMIC FEE ' I hereby affirm (hat there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is ismed(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.UJ8.50 Lender's Address ELECTRIC I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information n correct I agree to comply with all city unit county BOILER PLUMBING ordinances and state laws relating to building construction, and (3 H.P,Of 100,000 B.T.U.) 6.00 hereby authorize representatives of this city es enter upon the BOILER-COMP IOVBr 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property forinsp ofth i purposes. (we) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue agaipst said City in consequence or the granting of(I crmil' MECH.CONT. - LIC.NO. MECH. �✓ q-12MECH. TOTAL TOTAL Signature of Applicant/Contra o Date OFFICE COPY