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1388811 • POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO3$88 INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS ��}�c" .,J,:;'�/� "`'� UNIT# _LOT# ��. OWNER 2 pA_ �; CONTRACTOR �� /) PFRMIT NUMBER PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. IN PECTION DATE INSPECTOR INSPECTION RECORD ;: FOUNDATION UFER PR EG UNITE PERMIT VAUDATION ISSUANCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL BLDG. EI cCS, PLG. MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ;I BUILDING PERMIT INFORMATION - WOOD FLOOR vALunnON $DFT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION STORIES TYPE CONSTR, OCC. GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SOFT. LOOK AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE RES IND CON PB 011", ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH ASSESSORS PARCEL NO, PLUMBING GAS TEST TRACT NO. ,PARCEL NO. MECHANICAL ELECTRICAL d^ FINALS - DATE INSP. ACC.DATE Acc, FILE No. FRAMING SAN # INSULATION PLUMBING ZONING ENG, SITE NO. GAS MECHANICAL FIRE SPRINK Y ❑ N� ENERGY T-74 v ❑ No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH—INTERIOR ELECTRICAL FLOOD ZONE v ❑ Ng A,L.U.C. v ❑ N❑ LATH—EXTERIOR FIRE DEPT. SHEETROCK GRADE 'FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, II--. ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANTI PLEASE READ,REVERSESIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL A67r^I.ICANTS rOSTI NG COPY ,.-APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY BU I LDING PROJECT I DENTIFICATI ON APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PEHMITNUMBER 13888 BUILDING ADonsss 3CteKILA t O NER'a _QV- NAME OT�jV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE CONTRACTOR S NAME I, I' I. No. V UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 Q -� CONT naCT ns ADDRESS APPLIANCES -RESIDENTIAL 4.00 PANELS 10.00 U PHONE I DATE OF APPLICATION ARCHITECTPANELS(OVER OR NGINEER ' uc. No. 200 AMP) - 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH. OR ENG. ADDRESS SPECIAL CIRCUIT 5,00 PERMIT VALIDATION EMP- METER OR POLE INS. 20.00 ZIP Gtly� ADDRESS MOTORS �I-'iSEE FEE SCH. SERVICE CHANGE LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing' with Section 7000) of Division 3 of the Business and•, Professions CodA, d my license is in full Ilirce and @! Ucens Class Lie. Number ISSUANCE DATE BLOC. ElEl❑ ELECT. PLG. MECH. Uale Contractor _ BUILDING PERMIT INFORMATION OWNER-BUILDFDECLARATION I hereby affirm that I am exenspt from the Contractor's License Law for the following reason. (Sec. 7031.5, Businessand Professions Code: Any city or county which requinsa permit to construct, alter, Improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement thatAN he is licensed Pursuant to the provisions of the Contr;mtor's License Law (Chapter 9(commencingwith Section 7000)(if Division 3 of the Business and Professions Code) or that he is exempt therefrom and MISC. - REFER TO ORD PERMIT ISSUANCE 10.00 -Q -� VALUATION $/FT. ELEC. G NTR. LIC. NO. ELEC, nQ _ , uttf So V I. O TOTAL 709 avy-1 PLUMBING PERMIT FEE PERMIT TO ` STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 1V by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 05000.): ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do tire work, and the structure is not BACK FLOW PROTECT. DEVICE 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 does such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however, the building SG. FT. FLOOR AREATGTgL ACREAGE FIXTURES -PER TRAP • S.00 GAS-EA.SYSTEM-l1NC.40UTLETS 6.00 Or improvemenl is sold within one year of completion, tine owner, builder will have the burden of proving that he did not build or an- prove for purpose of sale.). ❑ I, as owner of (he property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 OVER- . 1.. BUILDING USE RES IrvD eOry Pe Other ❑ ❑• ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves thereon, and who LAWN SPRINKLERS- 1 -INC 5 V:B. 6.00 LAWN SPRINKLERS, .OVER 5 IEA.) 1.00 ASSESSORSPARCEL NO. - contracis for such projects with a contmctor(s) licensed pursuant to the Cont actor's License Law. SEWER -SAN V-STORM E _y A:; 20QftlfO.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-, BAP.C. for this reason WATER HEATERW/VENT' 6.00 Owner Date WATER SYSTEM 5.00 ACC:OATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent m self -insure, or a certificate of Workers' Compensation Insurance, Or u cerlified ZONING ENG. SITE NO. - copy thereof •'I3 m pab.C.l.I 'olicy erF it. Company -11 FIRE SPR INK Y N ENERGY T 24 Y ❑ NE] ❑ Certified copy IhCre by fur0151h• ❑ Certified c 0ed .6city inspection division. Applicant- MISC. - REFER TO ORD. CERT1FIcnTE OE EXE V N FROM woRKElts. PERMIT ISSUANCE 10.00 O-� FLOOD ZONE A. L. U.C. COMPENSATION INSURANCE (This section need no be completed if the permit is for one PL TR. _ LIC. NO. C PLG. TOTAL Q Y ❑ N Y [D NE] hundred dollars IS 100) or les,.) I certify that in the performance of the work for which this per- mit is issued, 1 shall not employ any person in any manner So as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK emption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10,000C.F.M.) 4.00 FEE AIRHANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I 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. 3097, Civ.C,l. MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC --') /a Oa_ Lender's Address VENTILATION FAN (SINGLE) 4.00 I certify that I have read this application and slate that Bre above information is correct. I agree to comply with all city and county ordinances and state laws reining to building construction, and PLUMBING w 0 - BOILER- COMP (3 H.P. Or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. MISC. - REFER TO ORD. CONST. TAX (We) agree to save, indemnify and keep harmless the City Of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 granting of this permit Vera MECH. CONT. LIC. NO. MECH. TOTAL TOTAL igaatme of pplicanl/Co ctor Date W"lut: 6YPy