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14452 POST THIS CARD NEAR FRONT OF BUILDING ` y PERMIT NUMBER CITY•.OF CUPERTINO 14452 INSPECTION DIVISION. JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS (J�U� UNIT# LOT# A PERMIT EXPIRES IF WORK OWNER 9qL /yn/ CONTRACTOR IS NOT STARTED WITHIN ;: '- ,INSPE ION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - NOTE: ANCE OR 180'DAYS FROM - ; UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE 1 TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING - , ELECTRICAL ISSUANCE DATE MECHANICAL. BLDG ELECT I PLO. MECR _ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOORPAW VALUATION INFORMATION $LFT. PLUMBING � - •� MECHANICAL- 18 • ELECTRICAL . I•e"MIT ro l�Y FRAMING ' INSULATIONSTORIES TYPE CnNsnt. • - OCC GROUP HES UNITS IPLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 1 I ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa rr rLooR ARCA TOTAL ncRFncc DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RE IND COON PB olO . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL No ROUGH SAN.a PLUMBING ELECT,ENERGY - - TRACT NO PARCEL NO, TUBS&SHOW ER PAN PLUMBING ENERGY- ' MECHANICAL MECH,ENERGY ELECTRICAL BUILDING ENERGY- - ACC,DATE ACC,FILE NO FRAMING ELECT,FINAL TEST INSULATION PLUMBING ZONING,. ENG,SITE NO. GAS TEST GAS o- MECHANICAL FIRE SPRINK ! ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y ❑ 'N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE AL U C, INTERIOR SHEAR - FIRE DEPT, `'❑ N❑ Y ❑ IN[D SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING ' INTERIOR LATH TEMPORARY FIPPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY - SEISMIC FEE + OCCUPANCVOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED By BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, _ ELECTRIC FI . ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING o PLEASE GIVE JOB ADDRESS WHEN PHONING. r � — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST..rnx PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION, OFFICE COPY 10624 R.and Lan P__ __—�-- --.•---. .— — . cot No. --- NO. CITY OF CUPERTINO APPLICATION FOR BUILDING PERMIT 100. � - :]GI:•a Ulla Ul•. PS F,;+r„ '.y'iT.i;::r. io r „ .)—.'.H ( 1.56 scj CL' _ ?ddl,) .. ....... ......_.._....__. •� . iy;.•e 1._CC_il _I_L L' r ' "f:Btj r-,nw :IS in c;cr,t:rtic:'•::z �:nlh pini pnn, :,�rin; and iq.oi':o . f�b.{'trl�S�yNC)4i)a ry%`r ,Sy,#,t' n 'Fir et , , t ✓dSk y��,�R�jr r -., , ) 'ti.,, ti) i d�jl eit��r tDx�yp��"C�r�I� �f�wi n�;9t pr rw) ��':�'`�¢j1� .:ELECTRICAL INSPECTION RECORD .,REStDENf1AL71 "PATE ' • INSFECTOR � :`,: ".; CO ERC Ai4.' ' ''` TATE' :',1N57CCTOR r UNDERGROUND ROUGH UNDERGROUND ROUGH ROUGH WIRING ;� r ROUGH WIRING FINISH WIRING FINISH WIRING _ 5� £, ',.FIXTURES -- —_ INTERIOR FIXTURES ^^ t MOTORS _�— -- EXTERIOR FIXTURES FINAL MOTORS — --- FINAL MISCELLANEOUS INSPECTIONS x, -- — — 7 —77777, w 6 ^ t. 1 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMITNUMBER- HUILnINGADDRW APPLICATION& PERMIT ^ �Q COO RA,,J LR.,j� BUILDING - ELECTRICAL-PLUMBING-MECHANICAL V NAME S PLAN CHECK VALIDATION n�19R ' �� eL�s �SZ-y0 Y. ELECTRIC PERMIT FEE ✓ PHGNE CONTRACTO NAME UTLETS-SWITCHES-RECEP 10,00/1.004r - .. , '• LIC.NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTORS - APPLIANCES-RESIDENTIAL 4.00 ADDREas PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECTPANELS (OVER 200 AMP)' 20.00 PLAN CHECK FEE P.C:NO. OR ENGINEER LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION SS ZIP EMP.METER OR POLE INS.- 20.00 APPLICANT S ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE S(/20.00 i /`�j ^FT v fC - ( r o O LICENSED CONTRACTORS DECLARATION ' a W.u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE E z w (commencing with Section 7000)of Division 3 of the Business and H - < H Professions Co ,and my license is in full force and effect BLDG. ELECT. PLG. MECH. - dcnhF]o i w m License Class Lic.Number El El- ,A Dote Contractor - - J ac x < BUILDING PERMIT ac a ¢ OWNER-BUILDER DECLARATION o a O _ INFORMATION w ;0 I hereby al'1'inn that I um exempt from the Conlractnr's License MISC.- REFER TO ORD FLLNj Law forthe lollowingmason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 vawaTlON Code:Any city or county which requires a permiuo construct,alter, 2 a,Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO, ELEC. LL' requires the applicant for Such permit to file d signed statement that TOTAL PERMIT TO E Cr - he is licensed pursuant to the provisions of the Contractor's License - H z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe f 4 o Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE Qc the basis forthealleged exemption.Any violation of Smtion703L$ STORIES TYPE CONSTR. a ; - by any applicant(or a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP Res,UNITStheir sole compensation,will do the work,and the structure is dol �'. 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 docs such work FIXTURES-PER TRAP 5.00 _ $O.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- mcntsare not intended orofferedfor sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose of sale.). IRES IND CON PB Other D I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 56.00 ASSESSORS PARCEL NO. and Professions Cade:The Contmetrrr's License Law docs not apply - to an owner of property who builds or improves themon..anti who LAWN SPRINKLERS-OV EWWW.T1.0 contracts for such projects with a commeb ts)licensed pursuant to SEWER-SANITARY-STORM EA.200f the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I an,exempt under See.-,BAPA7.for this WATER HEATER W/VE 6.00 reason Owner Date WATER SYSTEM ACC.DATE ACC.FILE NO. WORKS RS'COMPENSATION DECLARATION WATER TREATING EQUIPUN 5.00 I hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab C.). Policy No. I Company O ❑ Certified copy ishereby furnished. FIRE SPRINK ENERGY T-ZO Z 2 O Certified copy is Iifid with the city inspection division. )--' O Applicant MISC.- REFER TO ORD. Y ❑ NF] Y ❑ - N[] rn C Ii R'1'II'ICAT'E OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE' 10.00 ,0 FLOOD ZONE A.L.U.L. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.No, PLG. CL O (This section need nofa t he completed if the permit is r one TOTAL V❑ NEJ Y N❑ 2 hundred dollars IS 100)or less.) U O I certify that in the performance of the work for which this per. OTV MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I staff riot employ any person in any manner so asto O W bccdme subject to the Workers'Compensation Laws of California. CL Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >_ Go NOTICE 1'0 APPLICANT: IL after making this Certificate of Ex- 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 this permit Shall be deemed revoked. AIR HANDLING UNIT(TO 10MCF.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(Sec. MICROFILM 3097,Civ.CA HEATING UNIT(TO 100,000.B.T,U.) 8.00 nder's • N Leante LeHEATING UNIT(OVER 100,000 B.T.U.)9,50 nder's ani. s' ELECTRIC 1 certify that I'have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county - PLUMBING ordinances and state laws relating to building construction, anJ BOILER-CCNv1P(3 H.P.or 100,000B.T.U.) 6.00 'fes I hereby authuriee representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for Inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperlirm against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX ay any way accrue a ainsl said City in consequence of the IT ay of this lief�y� MECH.CONT. LIC.NO. MECH. A�/GLvccPXi TOTAL TOTAL ignatureof Applic Contractor Dam OFFICE COPY