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16802 POST THIS CARD NEAR FRONT OF BUILDING eRMlrNumaeR '' CITY OF tUPERTINO, 16802 C "INSPECTION DIVISION JOB INSPECTION RECORD ' PERMIT EXPIRATION JOB ADDRJJE1�SS P���Lu •' �JNIT# •�" -LOT# • .p E"�MI? EXPIRES IF WORK OWNER .'j/ at 4_ CONTRACTOR VENJ N (C - cb cON. ;IS`NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD i80 DAYS OF PERMIT ISSU- , FOUNDATION 2_l2- - „ ,- ANCE OR 180 DAYS FROM E'�'t"\, NOTE: - LAST CALLED INSPECTION. UFER _ •AL'L GRADI NG1'AND DRAINAGE SHALL,BE',INSTALLED PREGUNITE 'TO COMPLY WITH THE APPROVED PLANS AND C TV.OF , PERM T VALIDATION, CUPERTINO STANDARDS. GARAGE SLABS - h. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED' UNDERGROUNDPSLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL' , Luc, ELECT. PLs;• NIECH,.; ' .. .� ❑ ❑ DO NOT POUR,FLOOR UNTIL ABOVE HAS BEEN SIGNED' - - BUILDING PERMIT WOOD FLOOR - INFORMATION - • VALUATION PLUMBING` : - - MECHANICAL' _ « .• .;r .Q' �j ELECTRICAL- , . - - PAID r•.._ '^w FRAMING - STORIES ,TYPE O S , INSULATION' - .`1988 . '. :• -" ,-.• "UCL.' OUP TIESUNITS - City.of Cupertino A1C 1 ,IR, i PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ) 0- _; It t I { SO.FT,FLOOR AREA TOTAL ACREAGE I ROOF i NOTE'NO FINAL INSP.SHALL BE MADE BEFORE' - .DIAPHRAGM THE CONSTRUCTION TAX IS PAID _T BUILDING USE ROOF SHEATHING. - RES IND CON. PB u ,., t APPLY NO ROOFING.UNTIL ABOVE HAS BEEN SIGNED FINALS DATE ' INSP. ASSESSORS PaHCEL NU, ROUGH SAN.q " , PLUMBING ELECT:ENERGY' TRAC1.NO, PAHcL NO . TUBS 8 SHOWER PAN- ,', .+ , PLUMBING ENERGY - MECHANICAL - MECH.ENERGY ' aE NO + ELECTRICAL .' � 'Z BUILDING ENERGY aCC.OATE ACC.F v FRAMING r 2- ELECT:FINALTEST1 r ' z - INSULATION PLUMBING - 7.0N1N6 o ENG ITe N GAS.TEST _ GAS _ • „ - MECHANICAL - 'FIRE SPRINK ENERGY T124 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1HEATING. Y:E 'oY ❑ -NE], .FLOOD ZUNI, l: A.L.L)C.: EXTERIOR,SHEAR�_'..; _ " . ELECTRICAL RELEASE INTERIOR SHEAR.: ' FIRE DEPT. - Y❑ N❑ Y h N❑- SHEETROCK ,,.4 - ,V GRADE - FEE SUMMARY EXTERIOR LATH4T BUILDING INTERIOR LATH' ! TEMPORARY APPROVALS ' BUILDiNc 2:07,(V- SCRATCHCOAT ELECTRIC - PLAN CHECK - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE. OCC UPAN CY OF BUILDING 15NOTPERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. .MICROFILM ARRANGE.FOR INSPECTION BY PHONING 252-4505, r ELECTRIC ONE WORKING DAY'BEFORE REQUIRED INSPECTION.- ,' PLUMBING1_ o PLEASE GIVEJOB•ADDRESS WHEN PHONING: '' ' f MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - ' IMPORTANT! CONST.TAx ;,„PLEASE.READ REVER§E SIDE BEFORE ", 'Z CALLING FOR FINAL INSPECTION. TOTAL' OFFICE COPY ' APPLICANT TO.FI,LL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY _ . IL BPERMIT NUMBEROILDING PROJECT IDENTIFICATION _ . ///�� . BUILDING APPLICATION & PERMIT • 1 .6 8 0 2- ADDREss .� /1 2234-�8+ T2 EZF� /�P-� Iz (�. BUILDING - ELECTRICAL-PLUMBING-MECHANICAL OWNER'S - PLAN CHECK VALIDATION 1 .AVED , _�Szro47 OTV. ELECTRIC PERMIT FEE m:orvE CONTRACTORS NAME NAME a,. y�,� OUTLETS-SWITCHES--RECEP 10.00/100 CO PIC' 3r LIGHTING FIXTURES 10.00/1.00 s 7 ADDRESS Rs PPLIANCES-RESIDENTIAL 4.00 ADDRESS ) Sa - ©$ _ `11`1 l4 PHONE`17�T I r7 zr PANELS 10.00 PATE OF APPLICATION ARCHDECT r�� , PLAN CHECK FEE P.C1N0. - oR•. lj't•�y tJo-f, a Ccv�.c7 . PANELS (OVER 200 AMP) 20.00 - ,- - ENGINEER "r uc,No.0 2�(7 Fj SIGNS-TRANS.�,', ' . 3.00 ' ARCH,OR EN p'� - PERMIT VALIDATION ADDRESS r' 14�"-'-•,��'t]'�z , SPECIALCIRCUIT - 5.00 Su "7c "2_ fo 5At4 J!.3 C4 zA& 4o EMP.METER'OR POLE INS: 20.00 , (� APPLICANTS - MOTORS' - SEE FEESCH. ADDRESS SERVICE CHANGE 20.00 - - r 0 o LICENSED CONTRACTORS DECLARATION AN Q QL,v 'I hereby affirm thin I mo licensed under prv+viuons of CInPtcr 9 - - ° ISSUANCE DATE - H rt m (commencing will Section 7000)of Division 3 of hho-Businesfl and pG. ELECT. 'PLG. 'MECH.- r,w z Professions Code,� my license is in full fur'•' d eff���cL cl u ❑ ❑. 1988 i3O m- License Class _I_Iec.Number_,r 57lt 7 x II�VIi 0 1- w Date Coulturial JZ / /! H N a w a OWNI R-RUILDER EFCLARATION. BUILDING PERMIT X 3:LL a 1 hereby affirm that I am exempt from the Contractor's License MISC.- ORD INFORMATION ca FN0J Law forthe following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE -ih VALUATION $/FT. Code:Any chy,orcounty whichrequiresaperntittoconslnml,ulcer, 10.D0 12•(7 ff�� unprove,dem lisp reimir any structure,re pn r t it:I:Ranee,also ELEC,CONTR. _ LIC.NO.• [LEC. �(� 2(,f La EL O rc cquires the uppllc uu for sucll�permll to filo a slhncJ statement chub TOTAL'(/�l ]V xow he is licensed pursuant to the provisions out the Contractor's License PERMIT TO - ca� 0 Law(Chapter 9(commencing with Section 7000)of Divlflion 3ofiha �1VV -q 4 o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE M 1-$ the basis for the alleged exemption.Any viola l ion of Sect ion 703 L$ - i0 IES TYPE ONS u ; _ by any applicant foraindrSubject s theuppl{cum toacivil penally ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hnundreed dollars(5500).1: ❑ 1,as owner or the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 their sole compensation,Salo (S the work,and the structure is not •-O G U ( ES.UNITS intended or offered for sale (Sec. (toe Nosiness and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5,00 K-�,f Code:The Contractor's hicenseLaw dory not a+ply to an owner nl /1- ' property who builds or improves thereon,and who d-es Such work „ FIXTURES.-PER,TRAP 5.00 so.FT.FLOOR AREA TOTALACREAGE .� himself or through his own employees,provided that such improve. ments are not intended oroffered for 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- GAS EASYSTEM OVER 4 IEA) 2.00 builder will have the burden of proving that he did not build or I[". - . . . BUILDING USE RES IND CON PB Our., prove fors owner al the pr INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,he exclusively. 7044, ins with I Q 'O 0 11 and Ped•csi6tis od to construct the project(Sec. 7044,Business LAW N'SPRINKLERS- 1 INC 5 V.B. 6:00 ASSESSOR S PARCEL NO. and n owner of property The Contractor's s Lroprov Law does not apply to tr owner of property who builds tr Improves Ihted Ib and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 the Cods for such projects with a anhlnmlartxl IicmiseA liursuwhLnh ` the Controctor'sl.iccnse L:iw. � I I ' SEWER-SANITARY-STORM EA.20011170.00 - - TRACT No. PARCEL No, -❑ lamexempf:mdur Sec. ,B.&P.C.1orlil, WATERHEATERW/VENT 6.00 ' ' reason ' , Owner, Dote WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have acertificate of consent to self-insure, - or a certificate of Workers'Cotupensatio I surunce,Or a certified _ ZONING ENG.SITE NO. - opy thereof(flet 3800.Lab i C) ee'A Policy'No. � Company Lrf �•" /7)'D'7y-ol "O .❑ Cerlifiul a+Py,is hareby fuanShetl L FIRESPRINK ENERGY T"24 Z Z ❑ 'cert IC' c+pyls tiled tucc t the Cllr insplidn•division: N� Y NEI T - `C'b O Applism- - 4 MISC.- ' REFER TO ORD. V CL y CERT'I FICA1'E 017 EXEMPTION 17RONI WORK HRS•• PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. LU COMPENSATION INSURANCE, PLG.CONTR. ❑C.NO. PLG. d O (This scetion need not be cmimlemd if the permit N.for one TOTAL Y❑ Np Y N❑ Zthundreddollars(SIO(Dorless.) U,O •L certify that in the performance of the work fur which this Dery CITY MECHANICAL PERMIT FEE _ 0 U mit is issued,I shall noL Workers' any Person;many manner w as to FEE SUMMARY U Lu become Subject l0 111 flicmtfl'Contpe uutw I L : f California. - .y Dote - Al plicunt BUILDING; ALTER OR ADD TO MECH. 5,00 _ !D AD _ } to NOTICE f0 Al l LIGAN"f: If;aper mak nq sus Certificate of fix- � � t •FZ ,• 11 emption,you should been..subject to lhe,Workc,s Campensuti;... APPLIANCE 5.00 PLANICHECK s - provisions.of the Labor Code, you musl forthwith comply with FEE U ' such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 " CONSTRUCIONLENDINGAGHNCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE /� O -1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 r the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.).:? 'l_ _ HEATING UNIT(TO100,000 B.T.U.) 8.00 '• - Lvndcr'sAd Ite Lender's Ad It,, HEATING UNIT 100,000 B.T.U.)9.50 d � - � ELECTRIC .SDs" I acrtifyIlial llmve read this applicatior,and elate that the above, 'VENTILATION FAN-(SINGLE) 4,00 information is:correcU I agree to comply with all city and county PLUMBING ordinances and slam laws relating to building construction, and BOILER-COMP(3 H.P.of 100,0008.T.U.) 6.00 hereby authorize represenmtives of this city to enter upon the BOILER-COMP (Over 100,000 BTUI$EE FEE SCH. MECHANICAL above mentioned property for inspection purposes. - (We) agree to suvc, indemnify and keep harmless the City of MISC.-: :.REFER TO ORD. Cupertino against,liahilities,judgments, costs and expenses which' - CONST.TAX• - TRY, in Jany waY 'nccruu again sald"City in colisearuence4+L the ' A PERMIT ISSUANCE ,- 10.00 ;ranting of this permit. ' MECH.'CONT. LIC.NO. MECH. _js TOTAL ' TOTAL l[ L=u,of of Apph%ILSdiedil Dale - OFFICE COPY '