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18415 POST THIS CARD NEAR FRONT OF BUILDING ,.. PERMIT NDmy , G CITY OF CUPERTINO 18415 INSPECTION DIVISION JOB, INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS'_/V � �V�-�O�UNIT# _LOT# PERMIT EXPIRES IF WORK 0ER J CONTRACTOR .� IS NOT STARTED.WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTI ON. .UFER - ALL GRADING AND DRAINAGE SHALL'BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALMAOON CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB, PLUMBING . 41. I VI t�C.'-• ELECTRICAL . ISSUANCE DATE~ .. MECHANICAL =G, eEEcr PLP. nnECR DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUAnoN SIFT, PLUMBING MECHANICAL `• ELECTRICAL _ ,ERNI LTD FRAMING - . '_e kV .eOAde . INSULATION - STOia ES TvrE CONSTR. DCC.GROUP RES UNITS EPWr9CE[N.D]SU,BFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE "' Er w.00R AI+EA TOTALAca eneE NqA _ `DIAPHRAGM ' - THE CONSTRUCTION TAX IS PAID • ROOF•SHEATHING RES IND LD`OON use F9• Om", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE - INSP. 0 ❑ 1:1 0 ❑ ASSESSORS PARCEL NO ROUGH - - SAN.N " PLUMBING - ELECT.ENERGY .TRACT NOf PARCEL NO ! TUBS 8'SHOWER PAN PLUMBING ENERGY - 1 MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACC.PILE NO FRAMING ELECT.FINAL TEST ZONING ENG SITE NO. ( INSULATION � � � GJ PLUMBING GAS TEST - - GAS MECHANICAL EIRE SPRINK ENERGY r.Za ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v NE] ° [j "E] EXTERIOR SHEAR ELECTRICAL RELEASE - 7 FLOOD ZONE A.E u.G. INTERIOR'SHEAR FIRE DEPT. - - Y N� ° L N❑ _ SHEETROCK ,� - GRADE FEE SUMMARY EXTERIOR LATH BUILDING �� V D INTERIOR LATH - TEMPORARY A PROVA S BUILDING SCRATCH'COAT ELECTRIC PLAN CHECK X{ N GAS FEE J1�C. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR:. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 1��sP Iw-�; ONE.WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING, -pD j` PLEASE GIVE JOB ADDRESS WHEN PHONING. " - SEE PERMIT FOR EXPIRATION DATE'- MECHANICAL IMPORTANT! CONST.TAX ----- I'"' 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 BUILDING PROJECT IDENTIFICATION PERMIT NUMBER a ILOING APPLICATION & PERMIT I O AODREss // J X63 �to-, {-X(A Cl Q BUILDING-ELECTRICAL-PLUMBING-MECHANICAL o OWNER'S o PLAN CHECK VALIDATION NAM OTY. ELECTRIC PERMIT FEE CONTERACTORS UTLETS-SWITCHES-RECEP. 10.00/1.00 ,60 - . NAMLIC.NO. LIGHTING FIXTURES 10.00/1.00 E coNTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 ADDRESS PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.No. ISIGNS TRANS. 3.00 AAT Do Ess ENO' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. '20.00 �- �7 APPLICANTS MOTORS SEE FEE SCH. a l--�I/ ADORESs(� /- s SERVICE CHANGE 20.00 T f. •` a 0 LICENSED CONTRACTORS DECLARATION A_ ` 0 Viii a u I hereby affirm that 1 an licensed under provisions of Chapter 9 ISSUANCE DATE. h rt N (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. PLG. MECH. H z HIA Professions Code,and dry license is in full force and effect . U 11ED( z0 w - License Class Lia Number - .UC mw Date Contractor a >< s cm cuplum BUILDING PERMIT ce ¢ ¢ OWNER.RUILDER DECLARATION o a,u INFORMATION wg ,� r 1 hereby affirm that I Sin exempt from the Contractor's License MISC.- REFER TO ORD u D a Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT. _ PERMIT ISSUANCE 10.00 ,Z, D D DO ,ACode:Any city or county which requiresa permit(.construct,after.re i a 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. (�� O u requires the applicant for such permit to file a signed statement that TOTAL 'g, � V PERMIT TO A. w m he Is licensed pursuant to the provisions of the Contractor's License - H z a I-aw(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe 4 st Business and Professions Code)or(hut he is exempt therefrom and DTV. PLUMBING PERMIT FEE .WC ¢ I-m the basis for the alleged exemption.Any violation of Section 703 LS TYPE CONSTR. S OHIES by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5,00 of not more than five hundred dollars(5500).) , d ❑ I,as owner of tire property,or my employees'with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS (heir sole compensation,will do the work,and the structure is not intended Or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License Law does not apply to an owner of property who builds or improves R,,Pon,and who does such work FIXTURES-PER TRAP 5,00 _o o SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such idrprove- ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the ownIT- builder USE will have the burden of proving that h .e did not build or im- RES IND CON PB Omer ing prove for purpose of Sale.). INDUSTRIAL WASTE INTER. 30,00 C3 1:1 ❑ C3 1:1.. fn,as owner of the property,um exclusively conlructwith 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 Contractors License Law does not apply to an owner of property who builds or improves thereon.and who ILAWN SPRINKLERS-OVER 5 (EA-) 1.00 - contractslirsuehprojectswithucont t Fit licensed punusnt to ' SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors Liaenec Law. TRACT NO. - PARCEL NO. ❑ lre mpt undcrS ,B.&BC. br this WATER HEATER'W/VENT 6.00 reason • Owner Date WATER-SYSTEM 5.00 ,Q V ACC.DATE ACC,FILE NO. ORKF.RS'COMPENSA'I'ION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that I have a certificate ofconsenl to selGinsure, ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.CJ. Policy No. Company O ❑ Certified copy is hereby fumiahed. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is fled with the city inspection division. REFER TO ORD. 'Q Applicant MISC.- RY ❑ N❑ Y ❑ N❑ w CERTIFICATE OI'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 / I OD FLOOD ZONE A.L.U.C. LUQ COM1IPFNSATION INSURANCE PLG.CONTR, - LIC.NO. PLG. , l Y❑ NY ❑ NE] Z 1'1'his section need not be completed if the permit is for one TOTAL ,/�� hundred dollars(S100)or less.) U O I certify that in the performance of the work for which this per. DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued,I shall not employ any person in any drainer so as to beconm subject to the Workers'Compensation Laws of Caloornia. O y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >_ m NOTICE TO APPLICANT: If,after making this Certificate of fix- F2 emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PEEN CHECK ^l provisions of the Labor Cade, you must forthwith comply with U such provisions or this permit shell be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 N CONSTRUCTION LENDING AGENCY a AIR HANDLING UNIT(OVER 10MOC.FM.) 6.00 SEISMIC FEE 7a 1 hereby affirm that Imre is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 `- the performance of tiro work for which this permit is issued(See. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 . Lender's Address ELECTRIC I C I certify that I have read this application and ,are Thal the above VENTILATION FAN (SINGLE) _ 4.00 information is correct. I agree,to comply with all city and county PLUMBING (/ ordinances and state laws relating to building construclion, and BOILER-COMP(3 H.P.or 100,0008.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over IOO,000BTU)SEE FEESCH. MECHANICAL -1-Dabove-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 PERMIT ISSUANCE 10.00 CONST.TAX ora IIn any way ac ue mgai t said City in consequence of the Q� apt g pe I. MECH.CONT. LIC.NO. MECH. / �� TorAL/� TOTAL 273 Slg era of Applicant Contractor Dale OFFICE COPY