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18375 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 16375 INSPECTION DIVISION JOB INSPECTION RECO D /// 1j �" " " �-� _ NI # - _LOT# .< PE�F3}MIT E%P RATION JOB ADDRESS PERMIT EXPIRES IF WORK OWNER - CONTRAdTOR _ _ IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD - 180 DAYS OF PERMIT ISSU. FOUNDATION' ANCE OR 180 DAYS FROM NOTE: . LAST CALLED INSPECTIOW'r UFER ALL GRADING AND.DRAINAGE SHALL BE INSTALLED P.REGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT v9UUATION ' GARAGE SLABS CUPERTINO STANDARDS. 1 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND' /SLAB �•2'�.�� /,,�,/-/]/fJ PLUMBING ELECTRICALI ISSUANCE DATE MECHANICAL - — BLDG LECT. -PLG. MEC. E ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION 5/FT. • MECHANICAL / �� ELECTRICAL ft PER60 ,TO FRAMING v'`�� e• ��L' INSULATION STORIES TYPE C NSTH. OCC GROUP RES.UNITS wPLACE NO UBFLOO UNTIL ABOVE HAS BEEN SIGNED ' SO,ii, OOR A.1 A TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE IAo' DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOFSHEATHING RES INeuILGLrvoN usEPB Do- -APPLY NO ROOFING UNTIL ABOVE HAS BEENSIGNED FINALS DATE INSP, .❑ El El. ASSE SSGRS PARCEL NO ROUGH SgN.N • PLUMBING ELECT.ENERGY _ ?RACY NO. PARCEL NO. TUBS&SHOWER PAN ' - PLUMBING ENERGY - , MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE ACC.PILE NO FRAMING ELECT.FINAL TEST ' ZONING ENG.SITE NO. INSULATION - PLUMBING • GAS TEST GAS 1 MECHANICALFIRE$PRINK ENERGY T.24 rvf ❑ ❑. : ❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING r N Y [:] N �' ' - - .-L---711111111E a.L u.c, EXTERIOR SHEAR ELECTRICAL RE" INTERIOR SHEAR FIRE DEPT. v[:] . "❑ v I] N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING' BUILDING �Cr � INTERIOR LATH �, TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE :5 OCCUPANCY OF BUILDING IS NOT PERMIT.TE D UNTI L BUI LDING F I NA L IS SIGN ED BY BUI LDING I NSPECTOR. MICROFILM ._� LU ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING /) O PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL SEE-PERMIT FOR EXPIRATION DATE IMPORTANT! CONST.TAX . ' PLEASE READ REVERSE SIDE.BEFORE CALLING FOR FINAL INSPECTION. . TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES ' USE BALL.POINT PEN ONLY ' BUILDING PROJECT 1 DENTI FICATION PERMITNUMBER BUILDING APPLICATION & PERMIT p' AOOR S2 sf . BUILDING-'ELECTRICAL-PLUMBING-MECHANICAL 't 18375 OWNER'S PLAN CHECK VALIDATION NAME TY. ELECTRIC PERMIT FEE /^1 ONE n /V CO T11110TAS NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.NCgnk* LIGHTING FIXTURES "10.00/1.00 rr co TR1.CT 'S aOOREEE PPLIANCES-RESIDENTIAL 4.00 Ha1YE� " - t�(/,��f�, PANELS 10.00 DATE OF APPLICATION ' ABIT`14GT , PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 , ENGINEER LIC.No. SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT V IDATION ADDRESS SPECIAL CIRCUIT 5.00 ZIP - EMP.METER OR POLE INS. 20.00 ADDRESS MOTORS E H. fV aOOREss / SERVICE CHANGE' 20.00. . 0 0 o LICENSED CONTRACTORS DECLARATION - , i ca U I hereby affirm Owl I am licensed Under provisions of Chapter 9 ISSUANCE DATE Hi<-N (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. H "z Professions Code,and my license is in full force and effect. ❑ ❑ ❑ _i o y 2 License Class Lic.Number - Z r to Date y _Contractor X ¢ OWNER-BUILDER DECLARATION BUILDING PERMIT o U INFORMATION w R;a- IH I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD ac o a, Law for the following reason.(Sec.7031.5,Businessand Professions VALUATION $/FT. _ PERMIT ISSUANCE 10.00 sw0 < Code:Any city or aunty which mquiresn Permit toeoretReLaller, 3 0(� Ii Q O 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 a signed statement that TOTAL PERMI TO A. w m he Is licensed pursuant to the provisions of the Conlnmtor's License „ter H z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe a Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE I i o ¢ H $. the hu5)5 for the alleged exemption.Any violnlion of Section 7071.5 STORIES YPEC NSTR. n. 3 by any applicant fora permit subjects S500).licum taacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500).1: ❑ Las owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole r offered ion,will(S the work,and Ow etmclufe is nos - Code ed or offered for sale (Sec. 7044, Business and n owner ns DRAINS-FLOOR,ROOF,AREA,COND. 5.00 + property Contractor's or License Law don not apply to an owner al' himself who builds or improves employees, In and who does 91Ch Work FIXTURES-PER TRAP - 5.00 s FT. OR AREA TDTALACREAGE himself re through his own employees.provided[hal such improve. mems are not intended or offered for sale.If,however,the building GAS-EA:SVSTEM-11NC.40UTLET$ 6.00 � or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the burden of proving that he did not build or int- BUILDING USE prove for purpose of sale.). RES IND CON PB OIL., ❑ I,as owner of the property,am exclusively contmcsing with INDUSTRIAL WASTE INTER. 30.00 11 11 0 licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 SSESSORSPARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 ,. contracts for such projects with a contfactods)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 r"son Owner Date WATER SYSTEM 5.00 ACC.OATE ACC,FILE NO. WORKERS'CONIPBNSA'I'ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby att'irm that I have a certificate or consent to sdPinsure, or a certificate of Workers'Compensation Insurance,or a certified ZONING_ ENG.SITE NO. copy thereof(Sec.3800,Lab.C.L - Polico. Company _ O FYCertiU co ishereb f Z Z ❑ Corti • c py t city ins cction division. FIRESPRINK ENERGY T 24 HO A ` MISC.- REFER TO ORD. YE] N YNF] CERTIFICATE EXP IPl'ION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. COM iNSA'I ION INSURANCE PLG.CONTR. LIC.NO. ' PLG. Cl (This section need not be completed if the permit is for one TOTAL Y E] N Y❑ N hundred dollars IS 100)or less.) U O I certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY 1L.F- mit is issued,I shall not employ any person in any manner so as to Q w become subject to the Workers'Compensation Laws of California. a Datc Applicant BUILDING /1 >_ N NOTICE TO APPLICANT. It,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5,00 / /(J F ? emption,YOU should become subject to the Workers'Compensation APPLIANCE _ 5.00 PLAN CHECK provisions of the Lobo. Code, you most fotlhwith comply with FEE U such provisions or this permit shall he deemed revoker. AIR HANDLING'UNIT(TO 10/100C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.EM.) 6.00 SEISMIC FEE 50 -' 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.CJ. HEATING UNIT(TO 100,000 B.T.U.). 8.00 Lender's Name ( Lenderi Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC• I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is cancer. I agree to comply with all city and county PLUMBING- r ordinances and state laws relating to building construction, and BOILER=COW(3 H.P.Of 100,000 B.T.U.) 6.00 hereby authorize representatives Inspection city es enter Upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property tar vesp ofth i purposes. gree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. ertin againsg!libi'iej ots, costs and expenses which PERMIT ISSUANCE 10.00CONST.TAXn y way a tai it ml expense of thean 'ng If this pMECH.CONT.' ,LIC.NO, 'MICH. ore ofA ah C ctor 0C TOTAL TOTAL OFFICE COPY '