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16211 POST THIS CARD NEAR FRONT OF BUILDING . PERMIT NUMBER - CITY OF CUPERTINO 16211 INSPECTION DIVISION ' JOB INSPECTION RECORD I �, /y7 ,.p�0 �� PERMIT EXPIRATION JOB ADDRESS�L1!/ " �V 0(_ � ,UNIT# _LOT# ,PERMIT-.EXPIRES IF.WORK OWNER CONTRACTOR IS'.,NOT "STARTED WITHIN INSPECTION - DATE INSPECTOR INSPECTION RECORD 180,DAYS OF PERMIT 1SSU- FOUNDATION - ANCE'OR 160`13AYS'FROM I NOTE: LAST CALLED INSPACTION..; UFER - •ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAUIDAnoN'L I GARAGE SLABS •CU• PERTINO STANDARDS. / ' �i t " "• 1` ''•" �" I POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I • r. UNDERGROUND /SLAB PLUMBING - •i ' ELECTRICAL ISSUANCE DATI MECHANICAL - BLCG. ELECT PLG. ME ❑ ElI ❑ 121 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATIbN. I" VALUATION $/FT. , PLUMBING. MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION - STORIES TlPe.CONsnr. UCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 1 ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sO FT.FLOOR AREA - TOTAL ACREAGE-. DIAPHRAGM THE CONSTRUCTION TAX IS PAID. , ROOF SHEATHING RES IND ILm ON usEPB Co'.' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 'FINALS - DATE INSP. , ," A,,ESSORS PARCEL NO • ROUGH SAN.N PLUMBING ELECT ENERGY. TRACT NO PARCEL NO TUBS 8 SHOWER PAN, PLUMBING ENERGY MECHANICAL- MECH.ENERGY ELECTRICAL - - ,BUILDING ENERGY ACC.DATE ACC.FILE No. FRAMING ELECT.FINAL TEST t INSULATION PLUMBING - ZONING ENV".TE No. ..,qr V. T GAS TEST GAS - MECHANICAL — FIRE SPRINK N'GNERGV-T.aa, COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v 7 IN I WIL, ""�`0'' N� I°u "E] FLOOD7NE A.L UG EXTERIOR SHEAR ELECTRICAL RELEASE ' - INTERIOR SHEAR FIRE DEPT. o N❑ ❑ N� SHEETROCK GRADE FEE SUMMARY•; EXTERIOR LATH BUILDING - INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC ' PLAN CHECK NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY UFBUILDIN G IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 0 -ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. z 'MECHANICAL • - 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 L f : BUILDING PROJECT I DENTIFICATION ;PERMIT NUMBER BUILDING APPLICATION & PERMIT ADD s kt I BUILDING -ELECTRICAL-PLUMBING -MECHANICAL . 1, OWrvER'S PLAN CHECK VALIDATION NAME ((�'� 1 1 CITY. ELECTRIC PERMIT FEE PROrvE'17�- y ,. CONTRACTOR OUTLETS-SWITCHES-RECEP 10.00/1.00 PQ OeRT LIGHTING FIXTURES 10.00/1.00 , DSS OR� , S+ PPLIANCES-RESIDENTIAL 4,00 ADDRESS ADDREDRESS PHO. 4- (^ b PANELS 10.00 DATE OF APPLICATION ARCHITECT DR PANELS (OVER 200 AMP) 20.00 PLAN CHECKFEE P. NO. ENGINEER LIC.No. ISIGNS TRANS. - 3.00 ' ADDRR'ESS ENc' SPECIAL CIRCUIT 6.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 V' ANTI'NLaCGI /Mw-1- APADORESSP I ANTS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 1 w woo LICENSED CONTRACTORS DF-CLARATION t, •�� <o u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE . z"' (commencing with Section ]0001 of Division 3 of the Business and 0 a,y ❑ ELECT. PL❑G. MEC r o Z (commend Co rot cense is in full 2 O=- Licen CI' Lia NumbSF O m R Date� is radar!! 1 _-v ¢ m - BUILDING PERMIT IS 0 n o OWNER-BUILDER DECLARATION '- INFORMATION wI hereby affirm llml I am exempt from the Contractor's license MISC.- REFER TO ORD u_O ¢ Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT. 4 PERMIT ISSUANCE 10.00 f �>E Code:Any city or county which mquiresa permit to construct,alter, ¢ ¢O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. n w m, requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO - he is licensed pursuant to the provisions of the Contractor's License F z a Law(Chapter 9(commencingwith Seclion 7000)of Division 3 ofthe A 4 D Easiness and professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE .� ISR$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN (EA.) 5.00 of not more than five hundred dollars(5500)): ❑ I,as owner of the property,or my employees with wages as BACKFLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure iS not intended or offered for Sete (Sec. 7044, Business and ProfessionsDRAINS-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 wlm does such well FIXTURES-PER TRAP 5,00 SQ FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such inrprovc- GAS-EA.SVSTEM-1 6.00 cents are not RICTIded or offered for x1110.If,hnwevca the building or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM OVER 4 (EA.) 200 builder will have the burden of proving that he did not build or hit- - . . - BUILDING USE prove for purpose of sate.). RES IND CON PB OtherINDUSTR IAL WASTE INTER. 30.00 ❑ d :is owner of the property,he exclusively commuting with licensed contractorto The Contractor's priced,La ]044,Business LAWN SPRINKLERS-1 INC5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The who builds 's License Law does not apply to tr owner of property who builds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contmnar(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I mn exempt under Seo. ,N.&PC.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 - ACC.GATE ACC FILE NO. WORKFRS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to sell'-insure, or a Certificate of Workers'Compensation lmm, ee,or a certil ied ZONING ENG,SITE N0, copy it c 00,LAC.((�W - Policy' ' mpnty l'f3:.1E , O ❑ erlifiedcopy is hereby furnished. FIRESPRINK ENERGY T 24 Z Z 1�/Cerl'i c 1 Is fi t uI 'nspeclion division. O Applicant Ir�T - MISC.- REFER TO ORD. Y �' N❑ Y0 N[ ~ Lo �� C� PERMIT ISSUANCE 10.00 - � CIiRTIFICC0 OF EXEMPTION FROM WORKERS' FL000 ZONE A.L.U.C. W > COMPENSATION INSURANCIi PLG.CONTR. � uc.No. PLG, CL a (This seclion need not be completed if the permit is for one TOTAL Y[] N Y ❑ N . D Z hundred dollars 1S 100)or less.) U O 1 certify that in lire performance of the work Iiv which this per, DTV. MECHANICAL PERMIT FEE FEE SUMMARY W F mit is issued,1 shall not employ any person in any manner so as to Ow become subject to the Workers'Compensation Laws of California. y Date Applicant BUILDING } W NOTICE '10 APPLICANT: If,after making this Certificate of fix- ALTER OR ADD TO MECH. 5.00 F Z emption,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 10,000 C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 1000C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction tending agency for EXHAUST HOOD (WITH DUCT) 5.00 ate performance of lite work for which this permit is issued(Sec. MICROFILM - 3097,Cm,CI HEATING UNIT(TO 100,000 B.T.U.) :: , Lender's Name HEATING UNIT(OVER 100,000 B.T.U.1 Lender's Address ELECTRIC I Certify that I have read this application and scam Nat Ne above VENTILATION FAN ISINGLE) 4,00 information ¢ correct.I agree to comply with all city and county nd BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING information and stale tows relating m building construction, and hereby authorize representatives of this city to enter upon the (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. BOILER-COMP2 (We) agree to save, indemnify and keep, harmless the City of MISC.-' REFER TO ORD. uperhim against Ilubililies,judgments, costs and expenses which PERMIT ISSUANCE CONST.TAX may in any way accrue against said City in consequence of the ra O(lhia permit IyIE HQ CONT. LIC.NO. ,MECH. gV\f�V�t CIY TOTAL CC TOTAL g a re of Applicant/Contractor Da !-�' MnL-�- �0 �/ �I CID OFFICE COPY