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18248 POST THIS CARD NEAR FRONT OF BUILDING I'I'HNtIT NI"'flEll CITY OF CUPERTINO 18248 INSPECTION DIVISION JOB INSPECTION RECORD �`" / PERMIT E�XPIRATIO JOB ADDRESS_(6 , V Jam- � yLB-•y UNIT tk— OT PERMF(f EXPIRtS IF O K OWNER ( 1/L CONTRACTOR w-VII, S E IS NOT STARTED WITHIN . 'INSP TONz'.V,`yi,"' i.W ATE INSPECTOR "ri'OWINSPECTION,RECORD" 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM FOUNDATION NOTE: LASTCALLED INSPECTION. UFER AL ING AND DRAIN LL BE INSTALLED T OMPL�WI E APPROVE ANS AND CITY OF Prn Nln VAI.IOAnuN PREGUNITE U RTI STAN R GARAGE SLABS i V � POUR NO CONCRETE UNCI ABOVE HAS BEEN SIGNED!; ( `�q UNDERGROUND /SLAB PLUMBING ' 71 ZY ELECTRICAL ISSUANCE DATE MECHANICAL DBi� In.uc EEl ❑ El LECT PLD, mel, 00 NOT POUR FLOOR UNTILABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING /1l ArT-kqI MECHANICAL (f✓� V vl m TO ELECTRICAL FRAMING INSULATION OCC (iHUUl RES UNITS PLACE NO SUBFLOOR UNTI ABOVE HAS BEEN SIGNED 51) 1 1 tl(Illlr ANfe It)InL n1:N(At:f ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING las IND FON PIT D,m. El 0 0 El Cl APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS -DATE INSP. A$$ESSIINS 1'PRCEL NO ROUGH SANA PLUMBING ELECT.ENERGY IHAf.I NO 1'ANCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST 77,Nr, ENG. SITE NO INSULATION PLUMBING GAS TEST GAS FINE SPf11NK ENERGY T 74 MECHANICAL 1 N ❑ NO COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Ik111l lUNI ALUC EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. `"[j N� ❑ No SHEETROCK GRADE FEE SUMMARY j" EXTERIOR LATH BUILDING BUILDING 1 INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRICPLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONI=252-45005JELECTRIC irl w ONE WORKING DAY BEFORE REQUIRPLUMBING PLEASE GIVE JOB ADDRESS WHEN PHZ MECHANICAL - SEE PERMIT FOR EXPIRATIOCONST.TAX IMPORTANT! 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 BUI LD1 NG PROJECT I DENTI FICATION PERMIT NUWBER mn DING APPLICATION & PERMIT q r� A p ADDRESS Q�vV1 � � / I 2 4 0 11�� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 1 'ROH• OWNERS 1/I TA PLAN CHECK VALIDATION �.Fy //! s+'[✓I1- G/ i1�1 OTY. ELECTRIC PERMIT FEE PRDNIJO`f / CGrRAcroRs NA" UTLETS-SWITCHES-RECEP 10.00/1.00 ME OWb+ 5IACerJ^eTA1LrC.No. LIGHTING FIXTURES 10.00/1.00 �� v i CONTRACTOR oRs PPLIANCES-RESIDENTIAL 4.00 CONTRAS PHONE PANELS 10.06 DATE OF APPLICATION ARCHITECT ��L/ `� G` PANELS (OVER 200 AMPI 20,06 PLAN CHECK FEE P.C.NO. • ENGINEER on uc,No. ISIGNS TRANS. 3.00 ARDR.oR ErvG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ADD Ess, L-[L xIP EMP. METER OR POLE INS. 20.00 APPLILANrS MOTORS SEE FEE SCH. l L( AD RE55r1� I/�[ _ DJ Vv �IIp , SERVICE CHANGE 20.00 1 rl �-T )A , , oo LICENSED CONTRACT ORS DECLA RATION J- TI TI I Ls-1 F l ¢ u U 1 hereby aflinn that Sec 1 am licensed under provisions of CneS,. ') J ISSUANCE DATE waw (commencing with Section]000)of Division 3 of the Business anJ ELECT. PLG. MECH. F m z Professions Coda and my license is in full❑are and effect. ❑ O ❑ z o u, License Class Lie.Number n.`, of^u__yno 0 0 H w Lice Contru Number. W{y. V NCIp Q y E J ¢ a a OWNER-BUILDEk DECLARATION BUILDING PERMIT ¢ w INFORMATION oAD MISC.- REFER TO ORD wq LL I hereby collo tlnt I Inn exempt from the Contracnr..License VALUATION S/FT. H .. 04 I-uw fur the following reason.(Sec.7031.5.Itusinessand Professions PERMIT ISSUANCE 10.00 Y Code'.Any city or county which nspures a permit to construct,alter, ELEC.DONTR. LIC.N0. ¢ Q rt O improve,demolish,or repair any structure,prior to its issuance,also ELEC. - O u requies the applicant for such permit to file a signed statement that TOTAL PERMIT TO n w m he is licensed pursuant to the provisions of the Contractor's License Hiso Law(Chapter 9(contmencingwith Section 7000)ofDivision3oftbe + C ' M i a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ I-O the basis for the allege)exemption.Any violation of Sect ion]031.5 STORIES TYPE CONSTR. .w by any applicant I,or a permit subjects the applicant o a civil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(5500).): ❑ 1,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 OCC.GROUP RES.UNITS intended or oll'ercd for sole (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 does such work FIXTURES-PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACREAGE P himself or through his own employees,Provided that such improve- mentsara not intended or offered for sale.If,however.Fire building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 t✓ or ImprovernenI is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDwG USE builder will have the burden of proving Firm he did not build or int RES IND CON PB Omer ,✓ prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 i ❑ I,as owner of the Property,ant exclusively contracting with licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and I'rofeWor,Code:1'he Contractor's License Live Joel not apply to an owner of property who builds or improves there...and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contracrono licensed pursuant to the Contractor's License Law. SEWER-SAN ITAR V-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ 1 con exempt under Sce. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date IWATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, I'r WOk6ER5'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate TIC consent to sel4insure, 1 or a eertilicate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab C.). Policy No. Company - O O Certified 'opy is hcrebyfhcd FIRE SPRINK ENERGY R24 Z z �ferti ' r eco y lay y wit the Ci I 'pection division. MISC.- REFER TO ORD. Applicant at'. v N v N F' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U,C. Lu > Cli 'IPICATF:OFIC-MPTIO RAN WURKIiRS' Lu a COh11'IiN5AT1(yN INSUkANCI? PLG,CONTR. LIC.NO. PLG. Y N Y � N❑ fThis Section need not he completed if the Pcnmit is 1br He TOTAL 0 z Hundred dollars(5100)or less.) U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H not is issued,I shall not employ any person in any nanncr so as to O U become subject to the Workers'Compensation Laws of Calilorma. Date Applicant ALTER OR ADD TO MECH. 5.00 BU LDING } N NOTICE'f0 APPLICANT: If,after making this Certificate of 1>x- z emptim,you should bceonmsubject to the Workers Compcnsatiun APPLIANCE 5.0 PLAN CHECK provision., of the Labor Code, you most forthwith comply with FEE U sad,provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC-F.M.) 4.00 o- CONSTRUCIION LENDING AGENCY AIR HANDLING UNIT(OVER 1000C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH D ) k 5.00 the performance of the work for which this permit is ksued(Sec. HEATING UNIT(TO 100,0 ,) MICROFILM 3097,Civ.C.). Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address j.A I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 ordinances i, correct 1 agree to comely with all city and county BOILER-COMP(3 H.P.or 100.000 O.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP IOvar 100,000 BTU)SEE FEE SCH. MECHANICAL £-•�" above-mentioned property for inspect...(purposes. b (We) agree to save, indemnify unit keep limitless the City of MISC.- REFER TO ORD Coinertino against liabilities,judgments,costs and expenses which CONST.TAX Indis y it any way,accrue .I st said City in conseyuena of the PERMIT ISSUANCE 10.00 n n of Ibis P'mit. MECH.CONT. LIC.NO. MECH. �1 TOTAL TOTAL �� AU Sig Hue Applicantl moor U e / OFFICE COPY