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14605 ,POST THIS CARD,NEAR FRONT OF BUILDING PERMIT NUMBER CITY "OF CUPERTINO 14605 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB AD DR ESS �� S9�T� T��QC�`�' Q UNIT# _LOT# ">+•"` ' ` PERMIT EXPIRES IF WORK., OWNER 00 eLr - - CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180DAYSOF PERMIT ISSU- FOUNDATION'. - ' ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. LIFER ALLGRADINGAND DRAINAGE,SHALL BE INSTALLED. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED �` �',�;� :L..^'✓ UNDERGROUND /SLABy/ ' PLUMBING - �r ELECTRICAL ISSUANCE DATE MECHANICAL -aloe ELECT. PLG. MECH 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED • BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT?"sy PLUMBING , • - MECHANICAL ELECTRICAL- Ci /PERMIT To FRAMING J1RIEs TYPE CONST 8I INSULATION d1CUP RES UNITS CRVATCE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED' ' ` SO.FT 'LOOP AREA i0i4L ACPF AGE _ ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IN E CON PB Olmn' - + APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. E�0 ROUGH sAN.n ASSESSORS PARCEL" NO. '+ PLUMBING - ELECT.ENERGY L NO. TRACT NO. RCE TUBS&SHOWER PAN PLUMBING ENERGY ' MECHANICAL - MECH.ENERGY 'ELECTRICALBUILDING ENERGY AGC,DATE Aca.w LE No FRAMING - ELECT.FINAL TEST ' ZUNING ENG.SI TE NO. INSULATION - '� � � PLUMBING _ GAS TEST GAS MECHANICAL / FIRE SPRINK ENeary taa ��' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [] N Y E] N[] EXTERIOR SHEAR - ELECTRICAL RELEASE fLDODZONE A.L UC. - INTERIOR SHEAR FIRE DEPT. YQ, No10 N❑ SHEETROCK GRADE A FEESUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS- BUILDING SCRATCH COAT ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC P ONE WORKING.DAY BEFORE REQUIRED INSPECTION. PLUMBING o PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL — SEE PERMIT FOR EXPIRATION DATE = . .IMPORTANTc,CNST.TAX 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 r Pun-DING APPLICATION & PERMIT - n O Pu / BUILDING — ELECTRICAL—PLUMBING —MECHANICAL ,. Go—— PLAN CHECK VALIDATION NAM CITY. ELECTRIC PERMIT FEE OpQ�PXON NAMERAcroxs OUTLETS-SWITCHES-RECEP 10.00/1.00 LC.NO. LIGHTING FIXTURES - 10.00/1.00 CONT,RRAcrorrs ADRA PPLIANCES-RESIDENTIAL 4.00 - ' PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT -PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.N0. ENGINEER LIC.NO SIGNS TRANS.- - 3.00 ARCH. oo Ess ExG. SPECIAL'CIRCUIT 5.00 PERMIT VALIDATION AZIP - EMP.METER OR POLE INS. •20.00 ADDDRDREESSSS MOTORS SEE-FEE SCH. SERVICE CHANGE 20.00 - ^ /y Sid woo LICENSED CONTRACTORS DECLARATION 00 v u Q I herchy I firm that I ain Ilcmucd u nder provisions o f Cha For 9 `! w6 ISSUANCE DATE (contmencing wish Section 7000)of Dlvisiou 3 0l'the Business and BLDG. ELECT. PLG. MECH. H i Professions Code,and my license is in.full force and effect. 101 ❑ .❑ 1 o 0 H o License Class LIc.Number - - - m �_ Date Contractor ¢ Y s BUILDING PERMIT ¢ ¢w¢ OWNER-BUILDER DECLARATION ' " MISC.— REFER TO ORD INFORMATION w °g I herby affirm that I nm exempt from the Contractor's License Law for the following reason.[See.703L5,Buxincssand ProfessionsPERMIT ISSUANCE 1000 VALUATION $/FT: Code:Any city or county which rcquiresa permit to construct,alter. ' . 5 ¢ ° improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR; LIC.NO. IE LEC. n m¢ requires the applicant for such permit to file a signed statement that TOTAL w he is licensed pursuant no the provisions of the Contractor's LicenseLRM'iTO H z a LAW(Chapter 9(commencingwilh Section 7000)of DRidop3 ofthe 8G-' f 4 ° Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE IS r$ the basis for tine alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. 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).)', ❑ 1,as owner of tlne property,or my empluyecs with wagesas BACK FLOW PROTECT: DEVICE their sale compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-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 who does such work FIXTURES-PER TRAP SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are nut intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11 6.00 or improvement is sold'willim one year of completion, the owner- builder will hove the burden of proving that he did not build or in. GAS-EA.SYSTEM-OVER 4(EA.) BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 REs IND CDN PB Omer 'E❑ I,as owner of the property,am exclusively contracting with 1:1 1:10 licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS'-1 INC 5 00 ASSESSORS PARCEL NO. and Professions Code:The Contractors License Law does not apply V.B.. . to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contracmr's License Law. SEWER-SANITARY-STORMEA.200ft/10.00 TRACT NO. ~PARCEL NO. ❑ exemptund 'c. If&P.C.forthis � WATER HEATER W/VENT 6.00 (o• — ' reason Owner Il;ve"T9—ems' WATER SYSTEM 5.00 ACC.DATE ACG FILE NO. /WORKERS'COMPFNSAIION DECLARA I'ION WATER TREATING EQUIP. 5.00 ' I,hereby of firm that I have a certif icate of consort to self-Ivsare. oyy n��eeztificate of Workers'Compensation Insurance,or a certified ZONING ENG,SITE N0. _ cdpy thereof(Sec.3800,I-A.C.). `n Policy No. Company' 0 ' O ❑ Cetlil'ied copy is herCM1y furnished' RE SPRINK ENERGYTY4 Z Z ❑ Certified copy is fled wish the city inspection division. Y .N� vQ NE] Applicant MISC.- REFER TO ORD. N CERTIFICATF:OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.001/o. — FLOOD ZONE A.L.u.c. L COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. C' a (This section need not be completed if the punuil is for one TOTAL 0 V❑ N� V Q N� ::) Z hundred dollars 1$100)or V O I certify that in One performance of the work for which this per. OTV. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any partner so as to U become subject to the Workers'Compensation Laws of California. 0 y Date-Applicant ALTER OR ADD TO MECH. 5.00 BUILDING'' } N NOTICE l'O APPLICANT: If,after making this Certificate of Ex- 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 will] FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO,10=C.F.M.) 4.00 " CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=1C.EM.) 6,00 SEISMIC FEE I heleby affirm that there is a.construction;ending agency for EXHAUST HOOD(WITH DUCT) 5.00 - the Performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.L HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UN IT E R 100,000 B.T.U.)9.50 ' - Lender's Address ELECTRIC I certify that 1 have read this application and.state that tile above VENTILATION FAN (SINGLE) 4.00 information is correct 1 agree IN comply with at city and county BOILER H.P.Dr 100,000 B.T.U.) 6.00 . PLUMBING ordinances and state laws relating to building construction, and _ hereby authorize representatives of this city to enter upon the 801 LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We),agree to save; indemnify and keep harmless the City of MISC.- REFER TO ORD. upet[ino against liabilities,judgments, costs And expenses which PERMIT ISSUANCE ,.10.0.0 CONST.TAX may Ip any way accrue against said City in Carscyuence of the r ntldg Of lh uL� / MECH.CONT. LIC.NO. MECH.' CCC___�� TOTAL TOTAL Sngvalure of pp]wnt/ ]tractor to ' OFFICE COPY