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14335 POST THIS CARD NEAR FRONT OF BUILDING PE RMIT NUMBER CITY OF CUPERTINO 14335 . •INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 20587 RODRIGUES _ UNIT#, -LOT# ' PERMIT EXPIRES IF WORK OWNER CONTRACTOR - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION 1 - ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERN+IT VALrDATION GARAGE SLABS CUPERTINO STANDARDS. - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED !2f UNDERGROUND /SLAB PLUMBING ! MS ELECTRICALrt155 • TU ANCE GATE MECHANICAL SLOG ELECT.I PLG- MEC. P IE67 ❑ ED Lo 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR � O INFORMATION PLUMBING - VALUATION SIFT. MECHANICAL - City Of Cupertino - ELECTRICAL PERMIT TO FRAMING INSULATION SIO.NIEs TYPE CONSTR. OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED . ' ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SOLT PLOORAREA TOTALACREAGE :(• DIAPHRAGM THE CONSTRUCTION TAX IS PAID \ ROOF SHEATHING - - RES IND aDCOG usEEa Om., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El ❑ El E-1 ASSESSORS PARCEL NO ROUGH SAN.W PLUMBING - -ELECT.ENERGY TRACT NO PARCEL NO " TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL (. ACC.DATE ACC FILE NO, BUILDING ENERGY - - FRAMING - ELECT.FINAL TEST ' INSULATION PLUMBING - zoNlNc ENc_srtENo. GAS TEST - ' GAS MECHANICAL FIRE SPRINK ENERGY T,24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y ❑ N❑ ° ❑ N❑ F L00 ZO NE A.L.UG, EXTERIOR SHEAR ELECTRICAL RELEASE . INTERIOR SHEAR FIRE DEPT: Y❑ N❑ Y ❑ N❑ SHEETROCK 2-%42- GRADE - FEE SUMMARY EXTERIOR LATH BUILDING - INTERIOR LATH TEMPORARY APPROVALS BUILDING , SCRATCH COAT - ELECTRIC - PLAN CHECK GAS - FEE ., NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - - SEISMIC FEE., OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC O~� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING - . Z PLEASE GIVE JOB,ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL CONST,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 lAI NG PROJECT 1 DENT(FICATION PERMIT NUMBER &IL�D�,NsG APPLICATION & PERMIT 14335 'A^7` isg L, BUILDING-'ELECTRICAL-PLUMBING-MECHANICAL , O-EER'S v -` PLAN CHECK VALIDATION ,.+ NAMEYA yx AdXA a QTY. ELECTRIC PERMIT FEE , corvrRAcroRs 2OUTLETS-SWITCHES-RECEP 10.00/1.00 NAME "LIC.NO. LIGHTING FIXTURES 10.00/1.00 goNTFACTOFa APPLIANCES-RESIDENTIAL 4.00 ADO FEas PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECTon PLAN(OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER - I:Ic.NO. ISIGNS TRANS. 3.00 ARCH.OR LNG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION SS ZIP TEMP.METER OR POLE INS. 20.00 AMOTORS SEE FEE SCH. DRESS Ess ADOF SERVICE CHANGE 20.00 O 00 0UfTNSED CONTRACTORS DECLARATION I L/C� D7 a u u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUA CE GATE yaw (commencing with Section 7000)of Division 3 of the Business and , BLDG. ELECT.' PLG. MECH. � Professions Code,and pry license is in full force and effect - ❑ ❑ ❑ a, '",i o License Class f ic.Number Date- - Contractor Y _ - a a OWNER-BUILDER UECLARA'1'ION BUILDING PERMIT w a o au INFORMATION X 1 hm ereby affirm that 1 am exempt fro I N the Contractor's License MISC.- REFER TO ORD Fw0J Law for the following reason. 7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. f0 Code:Any city or county which requireso permit to construct alter, w Ix Ie¢ O improve,demolish,or repair any structure•prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. ea D rt requires lire applicant for such permit to Elle a signed sta letarm that TOTAL A w.9 e- he is licensed pursuant to the provisions of the Contractors License PERMIT TO HZ > Law(Chapter 9(commencing with Section 7000)ofDwision3ofthe L 8 U,_ S__Wd0 a Business and Professions Code)or that he is exempt therefrom and QTY, PLUMBING PERMIT FEE r D the basis for the alleged exemption,An m g p ire applicant Of Section malty STORIES T LDNSTR; u ; � by any applicant fora permit subjects $500).licuntroacivil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than live hundred dollars($500).): ❑ I,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 DEC.GROUP RES.UNITS 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 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that sort,improve nears ore not imended or offered for sale.It however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 1 or improvement is sold within one year ofm copletion, the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the burden of proving that he did not build orim- BUILDING USE prove for Purpose efsal4.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB aeon ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ 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 property who builds or improves thereon,and who LAWN SPRINKLERS-O .) 1.00 contracts lot such projects with a cantmcloos)licensed pursuant to (be contractor's License Law. SEWER-SAN ITARV-STORM EA.200ft/10.00 'd TRACT NO. PARCEL NO. ❑ 1 a exempt and• ec. ,BAP.C.for this WATER HEATER W/ (,, 'I 6.00 reason01 Pill Owner�� Data WATER SYSTEM ` 5.00 ACC.DATE ACC.FILE NO, WORKERS'COMPF.NSATION DIiC LARATI ON � WATER TREATING Eft ape .06 I hereby affirm that I have a certificate of-constat sal f-in ZONING nr a certificate of Workers'Compensation Insurance,o or a certified ENG.SITE N0. copy thereof(Sec 3800,C.......by ), Policy Na Company V 0 ❑ Certified Copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is fled with the city inspection division. MISC.- REFER TO ORD. O Applicant - Y ❑ N❑ Y ❑ N❑ ~ CC CERTIFICATE OF EXEMPTION FROM WORKERS'i4 PERMIT.ISSUANCE 10.00 leeaj FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR. LIG.NO. PLG. 'I_, r2 0 (This section need not be completed if lire permit is for one TOTAL Or-C-r V[:] N❑ V ❑ N❑ Z hundred dollars(5100)or less.) U O I certify that in the performance Of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mil Is issued,I shall not employ any person In any manner so as to 0 W become subject to the Workers'Compensation Laws of California. Dare Applicant BUILDING C. ALTER OR ADD TO MECH. 5.00 .} h NOTICE '10 APPLICANT It after ranking this Certil'icure of lix- F ? anption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10SMC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE I hereby affirn, that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 , lire perhorman e of the work for which this permit is issued(Sec. MICROFILM. 3097,CN.C.). r,• HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name H EATING UNIT 100,000 B.T.U.)9.50 Lemler's Address - ELECTRIC I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 W information is correct,1 agree to comply with all city and county PLUMBINGto ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.Of 100,000 B.T.U.) 6.00 hereby authorize 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. upertino against liabilities,judgments, costs and expenses which CONST.TAX ay in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 ranting Of this permit. - MECH.CONT. LIC.NO. MECH. . TOTAL TOTAL YlSignature of Applicant/Con[mctor - Data OFFICE COPY