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15235 POST THIS CARD NEAR FRONT OF BUILDING PERM I r NUMUER •CITY OF CUPERTINO. 15235:' INSPECTION DIVISION JOB INSPECTION'RECORD - / PERMIT EXPIRATION JOB ADDRESS/Q ^w �'`/ UNIT# - _LOT# - PERMIT EXPIRES IF WORK OWNER T/ET r=n/ CONTRACTOR y.0 L A .�c-��/ - IS NOT STARTED WITHIN NSPECTION DATE INSPECTOR INSPECTION RECORD 16o Dnvs OF PERMIT Issu- FOUNDATION - - - ANCE OR 180 DAYS FROM NOTE: - LASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMI T,VA um TION CUPERTINO STANDARDS. GARAGE SLABS - - �- -�--"" POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - UNDERGROUND/SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL - PLUG. ELECT I PLG. MECH, 0 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED qUILDING PERMIT ', WOOD'FLOOR }- INFORMATIOPAIE., PLUMBING AfMISAIION SIFT. MECHANICAL, ELECTRICAL FRAMING - INSULATION _ SIDHIES TYPE CONSTR. OCCGHOUR RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' . ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO.FT.FLOOH AHZA TOTAL ACRLAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING "Is IND CON PB Dm:, ' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.H ASSESSORS PARCEL NO. " PLUMBING - O- ELECT.ENERGY ' - TUBS 8 SHOWER PAN � PLUMBING ENERGY TO ACT NO. PARCEL NO MECHANICAL - MECH.ENERGY ELECTRICAL o 40-�' BUILDINGENERGY 7ACC DATE ACC PILE NO FRAMING ( ,0 ELECT.FINAL TEST ZONING ENO.517'E NO. INSULATION 0 tua PLUMBING GASTEST, - GAS MECHANICAL - PwtSPHINK, ENERGY T 2n COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING -.. Y ❑ "❑ `. ❑ N❑ EXTERIOR SHEAR - ELECTRICAL RELEASE /14T FLOOD ZONE AL.U.C. - INTERIOR SHEAR FIRE DEPT. ' SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING ^Z BUILDING O.G' INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK - GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY - SEISMIC FEE S OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FO.R INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O� PLEASE GIVE JOB ADDRESS WHEN PHONING. ' . ,/.' z•" MECHANICAL . �._l —*SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL. �� .S OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDINGPROJECT IDENTIFICATION PERMIT NUMBER " ;� BO,LDANG APPLICATION & PERMIT 15235 - AOORESS ' / q BUILDING-ELECTRICAL-PLUMBING-MECHANICAL �' OWNER'S b - PLAN CHECK VALIDATION " 1h OTY. ELECTRIC PERMIT FEE O V V� PHONE en TOR's OUTLETS-SWITCHES-RECEP 10.0011.00 a LIC.No. 4N7 LIGHTING FIXTURES 10.00/1.00 I CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 ' ADDR s Eu/eY. -"`,A'--EC17?-q7q9 PANELS 10.00 GATE OF APPLICATION . oAR nCHI ECT PANELS (OVER 200 AMP) 20.00 _ PLAN CHECK FEE P.C.NO. ENGINEER • ' LIC.No. SIGNS TRANS. 3.00 nooAEss ENO SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 Ar$ PPLICA MOTORS SEE FEE SCH. ADDREM SERVICE CHANGE 20.00 D/�� 0 0 LICENSED CONTRACTORS DECLARATION {(�{�] a ice u I hereby affirm that 1 am licensed under provisions of Chapter 9es. ICE DATE w (commencing with Section 7000)of Division 3 of the Business and MIL Of. PLG: MECN. H N z Professions Cotte, my license is in full for •: f SJ `, Z o w - License Cla s Lia Number o r Date Contractor a m 2 ILDING PERMIT IS¢ OWNER-BUILDER DECLARATION a 0 a D INFORMATION wg;U N I bemhy affirm that I em exempt frons the Contractor's License 'MISC.- REFER TO ORD VALUATION FUN¢ Law for the followingreason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE ' n $/FT. Code:Any city orcourry which requires a permit t.construct.alteq zl-.y�q ac ¢ o Improve,demolish,or repair any structure,prior to its issuance,cels, ELEC.CONTR. LIC.NO. ELEC. / V V � V 0,Ca requires the applicant for such permit to file a signed statement that - TOTAL -PERMITT Fp he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9(commencing with Section 7000)ofDi0sion 3.title f 4 o Business and Professions Code)or that he is exempt lherefrnn and OTY. PLUMBING PERMIT FEE /-`e•G' �R IS the basis for the alleged exemption.Any violation of Section 7031.5STORIES TYPE CONSTR. e- by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA7_011= of not more than live hundred dollars(8500).): ❑ 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 nor intended or offered for Sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CONO. 5.00 Code:'fire Contractor's License Law docs not apply to an owner of • properly who builds or improves thereon,and who doessuch work FIXTURES-PER TRAP -CT.BO SO.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- mentsarenetintendedOroffercdf.,sale.If,however,lire building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of proving that he did not build or int- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND . CON PR Omer ❑ I,as owner of the property,am exclusively eontructing with El E] El 11 ❑ 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 properly who huilds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts fUrsUch projectswilh a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200tt/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I and exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner - Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO. WORKERS'COMPL'NSATION DECLARATION WATER TREATING EQUIP. 5.00 - - I hereby affirm that 1 have a certificate ofconsent to SONG'ure' ZONING ENG.SITE NO. or a certificate of W.rkeri Compensation Insuruac,or a certified ropy thereof(See.3800,Lab C.). Policy No. Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T]4 Z ZO)" ❑ Certified copy is fled with tiro airy inspection division. MISC- REFER TO ORD. Applicant Y ❑ IN][] Y [3 No ~ rn .tA9p CC - CERTIFICATE OF EXIiMPTION FROM WORKERS' PERMIT ISSUANCE � FLOOD 20NE A.L.U.C. L COMPI:NSATION INSURANCE PLG.CONTR, LIC.N0. PLG' Z (This section need not be completed if IIIc permit is for one NO.= TOTAL OL oC V E] N❑ Y C] N❑ hundred dollars IS 100)nr less,) - U O 1 certify that in the perform:m 'tkle"Mrate r d this per- OTV. MECHANICAL PERMIP- FEE FEE SUMMARY LL {- mit is is uad,1 shall not carp!. any n annc s.as to U w breo b' the Workers'C, boi 'California. o } y [)atcS/�Applicant ALTER OR ADD TO MECN. 5.00BUILDINGtq( NOTICCCCE 'I PPLICANI It,a r maof lie- ` F Z\ emRAion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, YOU must foullwith-comply with FEE U such provisions or this permit shm all be deemed revoked. AIR HANDLING UNIT(TO 10PWC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.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 dm 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 HEATI NG UN IT E R 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I 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 t. building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city W enter upon the BOILER-COMP (Ow,100,000 BTU)SEE FEE SCH. MECHANICAL / above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harMess the City of MISC.- REFER TO ORD. upertino against bahilitic :dgments, costs and expenses Winer CONST.TAX n y way accru agadns said City in consequence of the PERMIT ISSUANCE - 10.00 phu'Ungot his ern MECH.CONT. LIC.NO. MECN. °TPL TOTAL Sign lu o Apple Contractor OFFICE COPY ADDITIONAL PERMIT FEES WNAME VALUATION ECT IDENTIFICATIONFEE SUMMARY /9- vnOne �` BUILDING uc.NO.Q PLAN CHECK con TRACTORS FEE DDREss vnOrvE SEISMIC FEE CITY. ELECTRIC PERMIT F�E O UTLETS-SWITCHES-RECEP 4 ELECTRIC LIGHTING FIXTURES S-0 LUMBING PPLIANCES-RESIDENTIAL MEC ICAL PANELS SIGNS TOT L SIGNS TRANS. SPECIAL CIRCUIT EHMIT VALIDATION EMP.METER OR POLE INS. 0 MOTORS SEE FEE SCH. O SERVICE CHANGE / y / 0 Z o T TA F y SSUANCE DATE LEI ) CITY, PLUMBING PERMIT FEE aLDc. ELECT. vLc. MECN, CI_ O ❑ ❑ ❑ ❑ Z ALTER-DRAIN&VENT-WATER IEA.1 V O BACK FLOW PROTECT,DEVICE Ow DRAINS-FLOOR,ROOF,AREA,COND. N FIXTURES-PER TRAP FZ GAS-EA.SYSTEM-i INC.4 OUTLETS V GAS-EA.SYSTEM-OVER 4(EA.) INDUSTRIAL WASTE INTER. LAWN SPRINKLERS 1 INC 5 V.B. LAWN SPRINKLERS OVER 5(EA.) SEWER-SANITARY-STORM EA.200f1/ WATER HEATER WIVENT WATER SYSTEM WATER TREATING EOUIP. TOIAL CITY. MECHANICAL PERMIT FEE ALTER OR ADD TO MECH. APPLIANCE AIR HANDLING UNIT(To 10,0000F.M.) AIR HANDLING UNIT(OVER 10p00GF.M.) EXHAUST HOOD(WITH DUCT) HEATING UNIT ITO 100,000 B.T.U.) HEATING UNIT(OVER 100,000 B.T.U.1 VENTILATION FAN(SINGLE) BOILER-COMP 13 H.P.cN 100,000 B.T.U.) BOILER-COMP MP,10D.BB0 BTU)SEE FEE SCH, TOTAL