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17145 POST THIS CARD.NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 17145 - INSPECTION DIVISION JOB INSPECTION RECORD ' T �C}'([�[ �^/ PERMIT EXPIR{A,TI N JOB ADDRESS-L_S_!-C7 '/tJ\ l UNIT# _LOT# , �Y) . 7 !F.. 6PERMI EXPIRES IF RK OWNER {yf a CONTRACTOR �� Y KNOT STARTED W THIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: ' LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. / TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PREGUNITE CUPERTINO STANDARDS' ' GARAGE SLABS - - PAIDa- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED " UNDERGROUND /SLAB APR 2000, 989 ��+�• V?t I/ ✓cc PLUMBING S--I.cj-Yj q,- �bry�L s.,( .gyp ,- ELECTRICAL CI y1 upel Yno ISSUANCE DATE MECHANICAL eLor. [CECT. PLG. MECH El 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED Gj_a�_ 9 c�\�q'B (�N0 SI�B BUILDING PERMIT INFORMATION WOOD FLOOR - VALUATION SIFT. _ PLUMBING - MECHANICAL © D ELECTRICAL RMIT TO iv,Vn.. i FRAMING �'E'1 INSULATION STORIES -YPECONSTR, OCC.GROUP RES UNITS 'P.L•AGE NO SU BFLOOR UNTIL ABOVE HAS BEEN SIGNED w A61- i � 50 FT.FLOOR AREA TOTAL ACOEAGf ,. ROOF NOTE:NO FINAL INSP. MADE BEFORE I . e DIAPHRAGM THE CONS7}3 TI N TAX _ _ ` BUILDING USE ' ✓'��PROOF SHEATHING � RES IND -coN PR QR,- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS 40RATE INSP. ❑ El ❑ 1:1 ❑ ASSESSORS PARCEL NO. ROUGH SAN.# I - PLUMBING ELECT.ENERGY t' TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO PAIIEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC OnrE ACC FILE No ._ . . ... FRAMING ELECT:FINAL TEST - - ZONING ENG.SITE NO, INSULATION PLUMBING GAS TEST GAS FIRE SPRINK ENERGY LZa MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ E ALuc. Yo❑ N� FLoaO zoN EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR. FIRE DEPT. r❑ N� v ❑ N❑ SHEETROCK - GRADE A FEESUMMARY EXTERIOR LATH BUILDING - INTERIOR LATH TEMPORARY APPROVALS BUILDING .sv SCRATCH COAT, ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE ,o OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. `' PLUMBING � �•,. °i' 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 h BU I LDING PROJECT IDENTIFICATION PERMIT NUMBER gO,Lplq� �k3 APPLICATION & PERMIT 17145 ACDRtSS BUILDING-ELECTRICAL-PLUMBING-MECHANICAL S OWNER'9 PLAN CHECK VALIDATION "a QTY. ELECTRIC PERMIT FEE ' � - �i �1HGNE3r36-z5 � .. CONTRACTOR"S NAME { OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No. LIGHTING FIXTURES 10.00/1.00 P 1J �D L ? /1 DDREScrORs AS - PPLIANCES-RESIDENTIAL 4.00 �L ADDRES PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PLA_CHECK FEE P.C.NO, OR PANELS (OVER 200 AMP) 20.00 ENGINEER uc.No. SIGNS TRANS. 3.00 ' An CH.OR ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 4( ADRESNrs MOTORS I SEE FEE SCH. r ADoADDRESS' SERVICE CHANG A 20.00 - I ac 14V�y Vw o o LICENSED CONTRACTORS DECLARATION V Uu I hereby affirm that I am licensed under provisions of Chapter APR ISSUANCE DATE Z a (commencing with Section 7000)of Division 3 of the Business and BLDG. I ELECT. I PLG: I MECH. D z Professions Code,and my license is in full force and effect. �...p Z 0=W License Class Lie.Number I at pup I VII ED ❑ ❑ L Date Contractor - Cupertino r-P'L _ I- OWNER-BUILDER DCCLARA' 10N BUILDING PERMIT o a v INFORMATION wg'c w I hereby affi m that 1 am exempt from the Contractor's License MISC,- REFER TO ORD H .. m J Law for Ile following reason.(See.7031.5,Basin Ess and Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. m Code:Any city or county which requiresa permit to construct,alter, /^ 10 90 to¢ p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. // y r LL requites the applicant for such permit to file a signed statement Ilial TOTAL PERMITTO w$m he is licensed pursuant to the provisions of the Contnuctor's License ' H10 Law(Chapter 9(commencing with Section 7000)of Div son3ofthe a Business and Professions Code)or(hut he isexempt therefrom and DTV. PLUMBING PERMIT FEE r the basis for the alleged exemption.Any violation of Section 7031.5 1 STORIES YPE CONSTR. byany applicant fora permit subjects the applicant too civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(5500)): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE - 4.00 their sole compensation,will do the work,and the structure is not DCC.GROUP RES.UNITS 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 prUPerty who builds or Improves therein,and who does suCll work FIXTURES-PER TRAP - 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE ~T:f himself or through his own employees,provided that such improve. _ 'f mcnts ure not intended oroffered forsule.If,however,the huilding GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he dirt'not build or int- BUILDING USE prove for purposeof Salo). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Ode, ❑ I,as,owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code: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 contactors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 ' thu Con r' t�ense Law. TRACT NO. PARCEL NO. ❑ o h (ond'fS�- ,B.&P.C.for is WATER HEATER W/VENT 6.00 reason __ L / _ Owner. Dme( WATER SYSTEM 5.00 ACC.GATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I haven eerlificute of consent to wilainsure, ZONING or a certificate of Workers Compensation Insurance,or a certified ENG.SITE NO. copy thereof(Sec.3800,Lab.CJ. Policy No. Company ❑ Certified copy is hereby furnished FIRE SPRINK ENERGY T-24 .z Z ❑ Cetified copy is fled with the city inspection divisio O Applicant rn. MISC.• REFER TO ORD. y N v N (n PERMIT ISSUANCE 10.00 ❑ ❑ ❑ ❑ Lu - CE RTI FICCOMPENEXEMPTIOINS PROMW'ORKIiRS' FLOOD ZONE A.L.U.C. W � COMI'IiNSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Z (This section need not be completed if Ilse permit is for one TOTAL Y[:] NE] Y E) ❑ N hundred dollars IS 100)or less.) U O 1 certify that in The perforoumco of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY {L H' mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. Q y Dale Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } to NOTICE TO APPLICANT: If,utter making this Certificate of fix. ` F Z cmptims,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must lor(hwith comply with FEE V -- such provisions or this permit shall be deemed revoked.. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVERlO=C.EM.) 6.00 SEISMIC FEE _O (� I hereby affirm that there is a construction Icnrling agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATINGUNIT(OVER100,000B.T.U.)9.50 ELECTRIC n 1� I certify that I have read this application and state thal the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING . .indinanceal5nd state laws relating to building construction, and BOILER-OOMP(3H.P.Or 100,000B.T.U.1 6.00 hcrcby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL' -6 y above-mentioned properly for inspection purposes. (We) agieo in save, indemnify and keep harmless the City of MISC.- REFER TO ORD. &'n against liabilities, ents, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX way ace ahrnt said Ci(y in consequence of the MECH.CONT. LIC.NO. MECH.TorALTOTAL pplium Contractor Date I OFFICE COPY