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13849POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS � dcrC .i- UNIT# _LOT# OWNER L ; CONTRACTOR a Cs' INSPECTION DATE INSPECTOR /INSPECTION RECORD FOUNDATION UFER L ABOVE HAS B UND/SLAB ' ELECTRICAL MECHANICAL 00 NOT POU MECHANICAL ELECTRICAL FRAMING INSULATION rr Rn''r lvlln�elt 49 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. r- 0 1 0 I p l p SIGNED I v BUILDING PERMIT, . "P '.,INFORMATION VALUATION f� PERMIT TO PPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH PLUMBING GAS TEST MECHANICAL ELECTRICAL FINALS' DATE INSP. -� FRAMING SAN n INSULATION PLUMBING GAS MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH -INTERIOR ELECTRICAL LATH -EXTERIOR FIRE DEPT. SHEETROCK GRADE SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS 1. 1—— GAS FNOTAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LOING FINAL IS SIGNED BY BUILDING I LU ARRANGE FOR INSPECTION BY PHONING 252-450! a 0 ONE WORKING DAY BEFORE REQUIRED INSPECTI Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. ."PLICANTSPOSTING COPY RES IND CON PB ❑ ❑ ❑ C L =IRE SPRINK ENERGY T ]< ❑ N ❑ Y ❑ N ❑ 'LOOD ZONE A. L.U.C. Y N❑ Y❑ N❑ BUILDING PLANCHECK FEE SEISMIC FEE MICROFILM ELECTRIC PLUMBING MECHANICAL CONST. TAX TOTAL .. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENT[ FICATI ON APPLICATION &PERMIT UILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 13849 aV ILOING AD1:2,?V �osE ,A4,- /flur� Nl OWNER'S NAME Mlet4 e s►�' �S9 TY. 'ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION RAcroRs NAM �p G L2 tAiY19 Itz(I:Iyc-ANo. Soon % OUTLETS -SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 r CON;qEsspTORS [ ADD y/ �i ,c/e AtiPNONE //,2 APPLIANCES -RESIDENTIAL 4.00 PANELS 10.00 ARCHITECTPANELS OR ENGINEER uc. No. (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ADDRESS ENG' SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION rrEMP. METER OR POLE INS. 20.00 zip Aa AGOREGORESSs MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 VL(1/�" LICENSED CONTRACTORS DECLARATION T/�/ d¢7 I hereby affirm that I am licensed under provisions Df Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cone nil cynic nsc is in full fort appd effect. ry License Clnsd- Lic. Number �U O J ISSUANCE D(((ATE BLDG. ELECT. ❑ ❑ I PLG. MECH. ❑ D:IIe *�� Contractor OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the sndr Contractor's License Professions Code: Any city or county which requirese permit to consua c , aeq Code;Law rthe Arycityl owimgreasov.ch c. requires a permit to improve, demolish, or repair any structure, prior to its issuance, also permit to file a signed statement that the dp pursuant for He requires ilicensed en the provisions n the700 H ofDdcrors License he Is licensed 9(commencing Law (Chapter 9 fcommencingwith Section is exempt he e f 3 ofthe of t therefromand Business and Professions Code) or that he is exempt Tom and BUILDING PERMIT INFORMATION MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION $/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT O M�jC I DTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation ofSection 703t.5 ectio by any applicant fora permit dollars the applicant toacivil penalty malty .fit at more than five hundred dollars (5500).): ALTER -DRAIN -WATER IEA.) 5.00 O 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK F LOW PROTECT. DEV ICE 4.00 OCC. GROUP RES, UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who docs such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however, the building FIXTURES - PER TRAP 5.00 SD, FT. FLOOR AREA TOTAL ACREAGE GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion. the owner. builder will have tire burden of proving that he did nor build Or int -GAS - Prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with .. GAS - EASYSTEM -OVER 4 IEA) 200 BUILDING USE RES IND CON PB Omer ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Set. 7044, Business and Professions Code: The Contractor's License Law dues nor apply to an owner of property who builds or improves thereon, and who LAWN SPRINKLERS -I INC 5 V.B. 6.00 ASSESSORS PARCEL NO, ILAWN SPRINKLERS - OVER 5 IEA.) 1.00 contrails for Such projects wi0racontractorls)litensed pursuant to the Contractor's License Law, License SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. , B.51'.C. for this reason WATER HEATER W/VENT 6.00 Owner Dam WATER SYSTEM 5.00 ACC.OATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECLARATION 1 hereby alfirm that I have a certificate of Consent to self -insure, Ora centificme f Cokers' Compensation Insurance, or a certiFial ZONING ENG. SITE NO. copy thcreol�s L ; 00, I!of C.I Policy No. I Compony ❑ Cerlifieilc p,ls herehy furnished ❑ Certified copy is Filed with the city inspection division. Applicant FIRESPRINK v❑ IN ENERGY T 24 Y❑ IN MISC.- REFER TO ORD. CERTIFICATE OF EXEMPT [ON I,(OM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. PLG.CONTR. LIC. NO. PLG. TOTAL COMPENSATION IyE�U ANpE This section need not be completed If/('�blc permit is for one hundred dollars , a or less.) � I mrtity hal i the performance of the ork for hick this per- mit is issi d, I s at not em oy any p&x r In any u ncr sn us to Y ❑ N❑ Y ❑ No DTV. MECHANICAL PERMIT FEE - FEE SUMMARY BUILDING hecol y t o Workers p nsat n Lo o Cuff n' Dare / Applicant - NOTICE- T I' E CANT: IL afte making t r eHifi ale of caption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply withFEE such provisions or this permit shall be denned revoked, ALTER OR ADD TO 5.00 1S APPLIANCE 5.00 PLAN CHECK AIR HANDLING UNIT,(TO 10,000GF.M.) 4.00 AIR HANDLING UNIT (OVER 1p"gFM0 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency foY - EXHAUST HOOD IWl;,ii lSl'1CT Y 5.0 the performance of the work for which this permit is issued (Sec. 7097, Civ.C.). - MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state that Ore above VENTILATION FAN (SINGLE) 4.00 information Is correct. l agree to comply with all city and county and Grahame aril state laws relating to building construction,here PLUMBING BOILER-COMP(3 H.P. 01'100,000 B.T.U.I 6.00 y above- utiorlrc representatives of this cilLlu enter upon the aIIOVC- rentlOn[d plop II�.�-(-,-InSpCCtIOn purposes. (�) agree/to sav� In -nil nm(fy and keep harmless If City of C. rano against liabilities, jtidgmGnis, costs a expe es which mpy m any way accruehagainst slid City in C as eyu of the m tmg of [his permit! `I � BOILER -COMP IOiar 100,000 BTU) SEE FEE SCH. MECHANICAL ✓ MISC. - REFER TO ORD. CONST. TAX PERMIT ISSUANCE 10.00 0 MECH. CONT. LIC. NO. TOTAL i `/ TOTAL nature ofAl f OFFICE COPY