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18727POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION .. JOB INSPECTION RECORD -/PERMIT JOB ADDRESS —(_/�..V--�— �✓-PrUNIT#-_LOT# OWNER iz CONTRACTOR RMIYNumRER 18727, EXPIRATION PERMIT EXPIRESIFWORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM ; LASTCALLED INSPECTION. - INSP CTION ATE INSPECTOR INSPECTION RECORD FOUNDATION , NOTE:, ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED.PL[�y AND CITY OF CUPERTINO STANDARDS. I"�1y1 UFER PREGUNITE PERNOT VAI.m ATION ISSUANCE DATE GARAGE SLABS ' E. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING r Ci:�-Gf CUperti o ELECTRICAL ., MECHANICAL - - sLDO 7 ❑ ELECT. PLO. •MEOR. ❑ ❑, DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED -, BUILDING PERMIT INFORMATION t WOOD FLOOR VALUAiioN PLUMBING - - - - - MECHANICAL"I ELECTRICAL FRAMING INSULATION - STORIES TYPECONSTR. • UCC. GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED •SO. ROOF I NOTE: NO FINAL INSP. SHALL 8E MADE BEFORE THE,CONSTRUCTION TAX IS PAID' Fi FLOOR AREA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING BUILDING USE RES IND CON Pe OMd, ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SANA ASSESSORS PARCEL NO PLUMBING ELECT. ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY -' TRACT N0 •... PARCEL NO. MECHANICAL 'MECH. ENERGY - ELECTRICAL _ - - BUILDING ENERGY ACC DATE ACC FILE NO, - 'FRAMING ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG. sire No. .GAS TEST GAS MECHANICAL FIRE SPRINK Y ❑ N❑ ENERGY T24 Y ❑ N❑' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - EXTERIORSHEAR ELECTRICAL RELEASE FLOOD ZONE YY ❑. N❑ AL.0 C. : ❑ NO INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE` FEE SUMMARY EXTERIOR LATH BUILDING BUILDING' , .INTERIOR LATHS TEMPORARY APPROVALS SCRATCH COAT ELECTRIC D^ 'PLAN CHECK FEE - - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED By BUILDING INSPECTOR. MICROFILM U.1 ARRANGE FOR INSPECTION BY PHONING 252-4505, o~�. ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING.. -.SEE PERMIT FOR EXPIRATION DATE - ELECTRIC. �p'Q PLUMBING MECHANICAL CONST, TAX IMPORTANT!' T PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY ' O Z z CC N . LU = Q_' CI Z) z' Uo LL U Ow A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENTI FICATION '- APPLICATION & PERMIT- _ BUILDING'- ELECTRICAL- PLUMBING - MECHANICAL PERMITNUMBER '� 87Z7 a• O 1 BDILDING aDDFE55 y� '" KA'N og - ,Ks 1� OWNER'S NAME p L FORT PITONP,J�� QTY. ELECTRIC PERMIT FEE - PLAN CHECK VALIDATION DATE OF APPLICATION NDNERAcrORs C"W � LIC. NO. 8� / UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOn'S aaD Ess. �/ - FOK'JOK 'If PHONE LG- PPLIANCES- RESIDENTIAL 4,00 PANELS 10.00 ogcHlrecT - M/ LIC. NO. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.c. Na. SIGNSTRANS. , 3.00 ADDRESS nNG' pp 'tS g- kAMbp ZROQ SPECIAL CIRCUIT 5.00 PERMIT VALIDATION 1 0 a 4-N�O \AJ I ISSUANCE DATE . BLDG. ELECT. PLG. ECH. ❑ ❑ ❑ EMP. METER OR POLE INS. 20,00 Uli APPLICANTS_ ADDRESS MOTORS. SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CON' I' RACfORS DECLARATION 1 hereby affirm that I am licensed Ruder provisions of Chapter 9 (commencing will, Section 7000) of Division 3 of he Busin�Iss and Prate a ch Code f my license is in full to - •�/y q License Class_ Q Lic. Number ISP I_ Date Contractor O ER -B DILDER DECLARATION -� 1 hereby affirm that I .r CXec.7 form the Contractor's s License Luw for the followigreason.lSec. 7031.5. OusinessunJ Proessions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also file applicant for such permit to,Iile a signed., utemcnt that is licensed pluxuant to (he provisions of the Contractofs License Law (Chapter!) (commencing with Section 7000) ofDivision 3 ofth,, ilusiness and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by an,applicanttha fora permit subjects file applicant macivil penalty five hundred dollars filly a 1: of not mora owner ❑ 1; as owner of the property, a my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who dues such work himself or through his own employees, provided that such improve- mentSare notintended 0rofteredfor sale. If, however, the. building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or am. prove for purpose ofsale.). Cl the1. as owner of e property, am exclusively c0ntraCfing with licensed contractors to construct the Project,(Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon. and who contracts Cor such projects wills a contractors) licensed purmant to theContractor'sLicenseLaw. ❑ lam exempt under See. -', B.&P.C. I'or this tease - - _ City of Cupef ino BUILDING PERMIT INFORMATION MISC.- REFER TOALt7� pERMIT ISSUANCE ELEC. CONTR. LIC. NO. ELEC.�^^��requires TOTAL lar Olie PERMITTO \N� i V OTY. PLUMBING PERMIT FEE STORIES I TYPE CONSTR. ALTER-DRAIN-WATER(EA.)''5.00 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 ''- FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 SO. FT. FLOOR AREA - TOTAL ACREAGE, GAS - EA. SYSTEM -OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PB Doer 11, INDUSTRIAL WASTE INTER. 30.00 . LAWN SPRINKLERS- 1 INC 5 V.B, 1. 6,00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 (EA.) 1.00 I - SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. - WATER HEATER W/VENT 6.00 owner ,nue WORK ERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab.C.). Policy No. Conspm, WATER SYSTEM - 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 - ZONING ENG. SITE NO. - - ❑'Certified copy is hereby furnished. x'Cetl�ifie�l /o,�l�y is fled w1q, the 'ty inspection division., Applicant s FIRE $PRINK' Y [D N 'ENERGY R24 Y ❑ NQ ' MISC. - REFER TO ORD. CER1'IFIC'ATE 017 ,'EAIPTION PROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars IS 100) or less.) I certify did to the performance of the work for which this per- mil is issued, I shall not employ any person in any manner so as to become subject to the Workeri Compensation Laws o"California. Date Applicant PERMIT ISSUANCE 10.00 FLOOD ZONE Y ❑ N[ A. L. u.C. Y [:] IN PLG. CONTR. LIC. NO. PLG. TOTAL QTY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING ALTER OR ADD TO MECH. 5.001 NOTICE TO APPLICANT: If, after making this Certificate of Ex. entplimi You should become sud,ct m the Worker' Campenemion provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. . CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency or the performance of the work for which this Permit it issued (Sec. 3097. Civ.C.). Name APPLIANCE 5.00 - PLAN CHECK FEE AIR HANDLING UNIT (TO 10=11F.M.) 4.00 AIR HANDLING UNIT(OVER10=C. EM.) 6.00 - SEISMIC FEE EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Lender's Address � Icertify that l have read this application and state that the above information is correct I'agree to comply with all city and county. ordinances and state laws relating to building construction, and herebyautioncd property forinsp ofth i purposes. above- authorise representatives of this city es cues upon the (We) agree to save, indemnify and keep harmless the City of lities, judgments, costs and expenses which aye against mid City in consequcn of the VA&0' n roc or )ate ut; HEATI NG UNIT 100,000 B.T.U.) 9.50 ELECTRIC J.O VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILEfl-COMP(3 H.P. Of 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEESCH. MECHANICAL MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT, LIC. NO. MECH. DTALTOTAL OFFICE COPY