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17626 POST THIS CARD NEAR FRONT OF BUILID ING PERMIT NUMBER CITY OF CUPERTI,NO 17626' INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESSUNIT# _LOT#t I owrvER Q Q( coNrRAcYoR e Co PERMIT,EXPIRES IF WORK SC•h a IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSP C ION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR '180 DAYS FROM NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY.WITH THE APPROVED PLANS AND CITY OF PERNRT VALIDATION CUPERTINO STANDARDS. 9 GARAGE SLABS �' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED .,• j UNDERGROUND/SLAB " b'a PLUMBING APR 141 F to v<c i ELECTRICAL ISSUANCE DATE MECHANICAL BLDG ELPCT 1 PLG. I MEER - It ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION SIFT. MECHANICAL ELECTRICAL veRMIT FRAMING INSULATION cp - STORIES TYPE CONSTR ., UCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED If SO FT :LOOH AREA TOTAL ACREAGE .ROOF NOTE:NO FINAL'INSP.SHALL BE MADE BEFORE , DIAPHRAGM' THE CONSTRUCTION,TAX IS PAID _ ROOF SHEATHING - - HES IND LDCON USE D: APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED " " FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.q ASSESSORS PARCEL NO " - PLUMBING - ELECT.ENERGY ' TRACT NO. PARCEI.NO TUBS 8 SHOWER PAN PLUMBING ENERGY - MECHANICAL MECH.ENERGY ELECTRICAL �/ - BUILDING ENERGY ACC DATE ACC,PILE NO. FRAMING JL- ci ELECT.FINAL TEST zoNlNc ENG SITE NO, INSULATION a PLUMBING GAS TEST GAS FIRE SPRINK F.NfiHGV T 2 + ' MECHANICAL ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED, HEATING ` ❑ " "❑ ` ❑ "❑ FLooD zoNE n.L.Uyc. EXTERIOR SHEAR ELECTRICAL RELEASE _ INTERIOR SHEAR '•� FIRE DEPT. °❑ "❑ '�`❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING 8'�;, o Q SCRATCH COAT ELECTRIC' PLAN CHECK GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE t , OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDINGFINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252=4505, ELECTRIC -� Iw-� ONE WORKING'DAY BEFORE REQUIRED INSPECTION. PLUMBING' O PLEASE GIVE JOB ADDRESS WHEN PHONING. . Z MECHANICAL ' — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! CONSTTAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. IT OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT,PEN ONLY PERMIT NUMBER BUILOINc, FV' BUILDING PROJECT IDENTI FICATION ' APPLICATION & PERMIT �/� ^^ RDORE55 / �� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL G FV' OWNER'S - PLAN CHECK VALIDATION "AM - QTY: ELECTRIC PERMIT FEE (/V rye PRONE J CONTRACTORS NAME /I P• OUTLETS-SWITCHES-RECEP -10.00/1.00 C 71iJ¢Y C.No. LIGHTING FIXTURES 10.00/1.00 A�•/,•{j[ACTOR , s . T_ -RESIDENTIAL .4.00ADDRESS1A CAPPLIANCES frrofzwt rv~a / p PANELS 10.00 DATE OF APPLICATION ! agcRlTEcr - _ PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER ' LIE.NO, ISIGNS TRANS. 3.00 0o ESS E "G SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. - 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE - 20.00 oo LICENSED CONTRACTORS DECLARATION vo� 4; u�� a u 1 hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE wan (commencing with Section 7000)of Division 3 of the Business an BLOC. ELECT. PLG. MECH. Pot fessions Co .md m license join full for r o i=W Li reuse Class r y Lic.Numbed • TX p L I_ J DRe- Contractor �pn a Y 2 � city.Of cupr 00 BUILDING PERMIT ¢ ¢o n u OWNER-BUILDER DECLARATION INFORMATION wg _ 1 hereby affirm that 1 am exempt from the Contractors License MISC.- REFER TO ORD u O a In Law for the following reason.(Sec.7031.5,Businessand ProfessionsVALUATION $/FT. PERMIT ISSUANCE .10.00 (;k,017 �q Code:Any city or county whichre(juiresu permit to construct,alter, ¢0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. J d iL m¢ requires the applicant for Such permit ID file a signed statement that ' TOTAL PER ITT �� I t he is licensed pursuant to the provisions of the Contractors License �( i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe -� OW io Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE rST 1 00 lir ¢ f p the basis for the alleged exemption.Any violation of Section7031.5 STORIES TYPE CONSTR. dam by any applicant for a permitsubjects theapplicant fair civil penalty . ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(5500).):' Cl 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.urvlTs their sole compensation,will do the work,and the structure is not intended or offened for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 v Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintended or offered for sale.It however,the building GAS-EA.SYSTEM-11NC.40UTLETS 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 plfor purpose of sale. 0 p RES IND CON PB Other .,.30.00 ❑- ❑ ❑ ❑ ❑ I,as owner of the property,em exclusively contracting with INDUSTRIAL WASTE INTER. licensed contractors (o construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Cade:The Contractor's License Law does not apply to am owner of property who builds or imprrveS Meteor,and who LAWN SPRINKLERS-OVER 5(EA.) . 1.00 ' contracts for such projects with a contmefor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contactors License Law. TRACT NO. PARCEL NO. ❑ lam cxemptuwcr Sec ,B.&P.C.fur r.la WATER HEATER W/VENT •6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSA ZION DECLARATION WATER TREATING EQUIP. 5.00 ' 1 hereby affirm that 1 have a certificate ofeanisent to sel&insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Ser.3800,Lab.C.k Policy No. Company O ❑ Cert' d copy is here by fuHtisllegl. FIRE SPRINK ENERGY T-24 Z Z GYCe IT- try is led v' I l e city spectian division. 0 Applicant_ Misc.- REFER TO ORD. v ❑ rv❑ v ❑ N[]Lr N Cl OP - EMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W >_ COMPENSATION INSURANCE PLGCONTR. LIC.NO. PLG., EL 0 (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ :) Z- hundred dollars(S 100)ar Ices) U O 1 certify that in the Ecrforman e,of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL h mit is issued,I shall not employ any person in any manner so as to O w become subject to the Workers'Compensation Laws of California. IL Dutc Applicant BUILDING >_ N NOTICE '10 APPLICANT: If,after making this Cerfl'eme of Ex- ALTER OR ADD TO'MECH. 5.00 /A /) H 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 3p. U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO W=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MO C.EM.) 6.00 SEISMIC FEE I hereby affirm that there is a constnmtion lending agency for EXHAUST HOOD (WITH DUCT) Lq A5.00 the performance of the work for which this permit is issued(Sc,. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B,T. .1 -S.Ocr Lender's Name H EATI N G UNIT(OVER 100,000 B.T.U.)9.50 Z��U Leaders Address ELECTRIC - I-certify that l have teed this application and state that the above VENTILATION FAN (SINGLE) 4.00 informmion•Is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, anti BOILER-COMP H.P.OF 100,000 B.T.U.) 8.00 hereby aothorice representatives of this city to enter upon the (` above-mentioned property for inspection purposes. BOILER-COMP (OYBr 100,000 BTU)SEE FEE SCH. MECHANICAL J (We) agree to save, indemnify and keep harmless the City of Misc.- REFER TO ORD. IJ Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX m any way accrue against mid City in cons"Lence of the anti of this Penal. MECH.CONT. LIC.NO. MECH. TOTAL ' TOTAL (3`0 Signature of ippe4hit/Contractcor Late - OFFICE COPY