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18410 POST,T:HISCARD NEAR'FRONT OF BUILDING PERMIT NUMBER :CITY OF CUPERTINO 18410 INSPECTION DIVISION JOB,INSPECTION RECORD „^� L✓1 �;6 PERMIT EXPIRATION JOB ADDRESS!Ul C I I UNIT# _LOT'# V ' PERMIT EXPIRES IF WORK. OWNER CONTRACTOR IS NOT STARTED WITHIN • INSPECTION DATE INSPECTOR INSP TION RECORD - 180 DAYS OF PERMIT ISSU. FOUNDATION - -NOTE: ANCE OR 180 DAYS FROM - ' LIFER � � - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT vn uunnoN • - CUPERTINO STANDARDS. ` GARAGE•SLABS AYVW-GN� POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED • FAID- UNDERGROUND /SLAB '(' ) PLUMBING 1 'b ELECTRICAL / ISSUANCE DATE MECHANICAL CiV q- 0 - BLDG I E CT. Lc MECR ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION PLUMBING VALUATION $/FT. - � ._ MECHANICAL , ELECTRICAL r PER M(}`�.i of j FRAMING INSULATION STgI TYPECONSTR - - OCC GHOUP HES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED Sp IT.FLOORAREA TOTALACFEAGE ROOF NOTE:NO FINAL INS .SHALL BE MADE BEFORE 00 DIAPHRAGM:, THEECONSTRUCTIO TAX IS PAID BUILDING USE ROOF SHEATHING NES , IND CON PB' om,., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ASSESSOR5PAHCEL NO ROUGH SAN.tt PLUMBING ELECT.ENERGY 1 iH ACT•NO. PARCELNO. TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECR ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE ACC FILE NO FRAMING ELECT.FINAL TEST - INSULATION PLUMBING ZONING ENG.SITE NO. ' GAS TEST GAS - MECHANICAL FIRE SPHINK ENERGY T,24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N Y N❑ ELECTRICAL RELEASE FLOOOZONE A.LUC. EXTERIOR SHEAR � _��� 'INTERIOR SHEAR Y NY ❑ FI . N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH IBUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT r - ELECTRIC PLANCHECK . GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL.BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC / S o Z � ONE WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING PLEASE GIVE.JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION'DATE = MECHANICAL . IMPORTANT! - coNST'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. BU I LDING PROJECT I DENTIFICATI ON PERMIT NUMBER q„LDING APPLICATION & PERMIT O ADDREss • ' !`��I•C D U -_ BUILDING—ELECTRICAL—PLUMBING —MECHANICAL OWNER 3 �J PLAN CH ECK VALIDATION NAME / /hamt DTY. ELECTRIC PERMIT FEE - A/G� UCIP_ MOND' �J . 40 CONTRACTORS f UTLETS-SWITCHES-RECEP10.00/1.00 /J uc.rvo. LIGHTING FIXTURES 10.00/1.00 CONTRACT Rs APPLIANCES-RESIDENTIAL - 4.00 ADDRESS^ ON� G PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT - PANELS (OVER 200 AMP)- 20,00 PLAN CHECK FEE P.C. O. ON 7 L1) LIC.NDT31ry_7( ISIGNSTRANS., 3.00 ARCH.OR ENG. - SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ADDRESS ZIP TEMP.METER OR POLE INS. 20.00 RoomAPPLICANTES 'S MOTORS SEE FEE SCH. ADDREW SERVICE CHANGE 20.00 o o LICENSED CONTRACTORS DECLARATION PAID a v w 1 hereby affirm that 1 um licensed under provisions of Chapter 9 ISSUANCE DATE wz (commencing with Section 7000)of Division 3 of the Rushes and ¢y Y1\/ BLDG. ELECT. PLG. MECH. I- D z Professions Code d myy license is in full foreaa�++GGl��yyff V 'I ❑ ❑ ❑ -❑ U6 1989 z o L- License Class � L Lic.Numher 3 - 8 z— • Dale Contractor a y f p` f IT, ' BUILDING PERMIT ¢ ¢o ex OWNER-BUILDER DECLARATION Clthr ^ INFORMATION , w ; LL m I hereby affirm that I:un exempt from the Contractor's License MISC.— REFER TO ORD LL o j Law 1'or the following reason.(Sec.7031.5,BinTmessmW Professions PERMIT ISSUANCE VALUATION S/FT. , Hw Code:Any city or county which requiresa permit to construct,alter, 2 ¢ a p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. C ¢ requires the applicant for such permit to file a signet)statement that TOTAL PE A w m he is licensed pursuant to the provisions of the Contractor's License RM1710 d!(T H z i Law(Chapter 9(Commencing with Section 7000)of Division 3 of The a Business and Professions Code)or that he is exempt therefrom:ted QTY. PLUMBING PERMIT FEE ¢ =$ the basis for thenlleged exemption.Any violation of Section 7031.5 sfcp IES T PE CONSTR. by by applicant for a permit subjects the applicant toacivilpenatly ALTER-DRAIN -WATER (EA.) 5.00 of net.more than five hundred dollars(5500).): ❑ 1,as owner of the properly,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do The work,and the stlucture is not 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 5.00 50.FT.FLOOR AREA TOTAL ACREAGE ;�. himself re through his own eared lots,gravid ed That such imprma- menlsurenotimcndeJorTafferedl'of sale,ILhowevee the 1111no pg GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 IEA) 200 builder will have the burden of proving that h - . . . e did not build or am- BUILDING USE prove for purpose ofsale.). INDUSTRIAL WASTE INTER. - 30.00 RES IND CON PB Other, ❑ I,as owner of the property,am exclusively contracting with 0 ❑ 0 ❑ 0 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 Contractor's License Law does not apply to an owner of property who hadds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a cnntracouts)licensed pursuant To SEWER-SAN V-STORM EA.200ft/10,00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ lam exempt under Sec.—,B.&P.C.for this x WATER HEATER W/VENT reason Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WORKERS'CO.MPENSATION DECLARATION WATER TREATING EQUIP, 5.00 1 botchy allium that I have a certlicate of consent TO SPINI sro' 20NING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.). Policy No. Company_CA3 14 O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY 24 Z Z ❑ Certified copy is Ned with the city inspection division. CC O Applicant MISC.- REFER TO ORD. YE] N E v NEI CC w PERMIT ISSUANCE — CIi RTII%CA'fE OF EXF:M1IPTION FROM WORKERS' PERMIT ZONE A.L.U.C. LU COMPENSATION INSURANCE PLG.CONTE, LIC.NO: P CL Z( This section need not be completed if The permit is for one I.G.TOTA Y N� Y ❑ N� hundred dollars IS 100)or Lssf U O 1 certify that in The performance of the work for which this per- OTY. MECHANICAL PERMIT FEE -FEE SUMMARY LL F of is issued,I ha11 not employ any person in uny manner so as to U become subject to the Workers'Compensation Laws of California. O w Dare Applicant ALTER OR ADD TO MECH. 5.00 BUILDING ED NOl'IC17 TO APPLICANT: If,after making This Cmfihicalc of I?x- Z caption,you should become subject In the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10,000C.F.M.) 4,00 CONSTRUCI[ON LENDING AGENCY A]RHANDLINGUNIT(OVER 10=C.RM.) 6.00 SEISMICFEE 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 MICROFILM .�- 3097,Civ,C.f 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 C / I certify that 1 have read this application and state That the above VENTILATION FAN (SINGLE) 4.00 infornalion is correct.1 agree to comply with all any and countyPLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEESCH. MECHANICAL hereby property forinsp of inn purposes. (We) agr a to save, indemnify and k ep harmless the City of MISC.- REFER TO ORD. Cupertino most liabilities,judg n r, STs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may a way accrue aginsr s id in consequence of The •ran this permit. MECH.CONT. LIC.N0: MECH. ` TOTAL TOTAL V Signatu o Applic Contracto Date OFFICE COPY' .