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18427 POST THIS CARD NEAR FRONT OF BUILDING PF.RMITN 9ER CITY OF CUPERTINO, 18427 INSPECTION DIVISION JOB INSPECTION RECORD (� C(�� PERMIT EXPIRATION JOB ADDR ESS l_G/1/ C..� UNIT# _LOT# - /f��Go�l�� PERMIT EXPIRES IF WORK owmeR ' m comACTOR G• GTL IS NOT STARTED WITHIN INSPECTION DATE• INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERN111 VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED �C•""�(` UNDERGROUND /SLAB - - - PLUMBING T - ELECTRICAL ISSUANCE DATE MECHANICAL- - ,. B= ELECr I PLG, .cR. ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION VAl JATLL.)N $LFT, PLUMBING /� `I//'1.4�1 MECHANICAL /-�'� ELECTRICAL - - ot Goal" PERMI ro/ FRAMING �`"+"'"✓ INSULATION , STORIES TYPE CONSTR OCC GROUP RES UNITS k�J ! PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn,IT PLooe AIa!A roiAi.ncn EnGt DIAPHRAGM THE CONSTRUCTION TAX IS PAID '1T - DBUILDING ICON USE "�S•'_ _ROOF SHEATHING lO IND , ICON K Q Op", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 'FINALS DATE INSP. ASSES50RS PARCEL NO ROU H A SAN.k PLUMBING _ ELECT.ENERGY TRACT NO, PA RCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY qCC.DATE ACC.FILE NO ELECTRICAL' BUILDING ENERGY FRAMING ELECT.FINAL TEST - . INSULATION '_ PLUMBING ZONING ENGSITE NO GAS TEST GAS .. MECHANICAL FIRE SPRINK ENERGY T"24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ NEI ° ❑ . .N� ' EXTERIOR'SHEAR • ELECTRICAL RELEASE FLOOD ZONE A L U C. INTERIOR SHEAR - FIRE DEPT. Y ❑ NE] v ❑ No SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING • INTERIOR LATH" 'TEMPO RARYAPPROVALS BUILDING SCRATCH COAT - ° • ELECTRIC PLAN CHECK GAS , FEE - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE - ". OCCUPANCY OF BUILDI NG IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY P=24C5TO 252-450 ELECTRIC ELECTRIC . F- ONE WORKING DAY BEFORE REQPLUMBINGZ� PLEASE GIVE JOB ADDRESSWHESEE PERMIT FOR EXPIRAMECHANICAL IMPORTANT! , CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPi . -APPLICANT TO FILL IN INFORMATION.WITH IN RED LINES USE BALL POINT PEN ONLY " BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 18427 AODRE55 cEN-/ C C(( —ELECTRICAL—PLUMBING —MECO tHANICAL �.tO A ( _,,LJ OWNEGiPLAN CHECK VALIDATION NAME r OTV. ELECTRIC PERMIT FEE NAMERAcroFs UTLETS-SWITCHES-RECEP 10.00/1.00 GV fn LIC.NO.2,40"X-Ifa LIGHTING FIXTURES 10.00/1.00 corvTR scroea JPPLIANCES-RESIDENTIAL4.00 , - C PHONE;j '041 PANELS � 10,00 DATE OF APPLICATION ORRCNREr PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER uc.NO, ISIGNS TRANS. 3.00 ADDRESS ENGSPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 //��•{ q�� AMOTORS SEE FEE SCH. ADDRESS oREss�+e CO C SERVICE CHANGE 20:00 Dai r 02 LICENSED CON'T'RACTORS DECLARATION a U v I hereby affirm Ihm Lam licensed under provisions of Chapter 9 ISSUANCE DATE n 3 w (commencing with Section 7000)of Division 3 of tate Business and BLDG, ELECT. PLG. MECH. r m i Professions Code,and my license is in full force and effect. ❑ ❑ El ❑ z o m m — Licee Class Lie,Number - mF w Data Contraaur OWNBR-BUILDER DECLARATION O < Y 1989 .BUILDING PERMIT a 0 w u 'TION ' H wit LL H I hereby ritual that I am exempt from the Contractor's License MISC.— REFER TO ORD INFORMATION t- LL w< Law fur the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 00 VALUATION $/FT. mLA Code:Any city or county which requires a permit to construct,alter, BE ar ¢ improve,demolish,m repair:my structrne,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. eq, " r/ 0, requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO e w m LL he is(Chapter pursuant ID the provisions of the Contractor's License FzR Laww(Chand (commencing Section is 00)exempt theon3ofthe L/—Lvh BE i o Business and Professionsxemption that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ F $ the basis for tate alleged exemption.Any violation of Section malty STORIES TYPE CONSTR. a3 � by any applicant fora permit subjects 0m applicant toacivil penally ALTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than five hundred dollars(my em): ❑' Las owner at the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCD"GROUP RES.UNITS their sole compensation,will(S the work,and the structure is not intended Tor offered fns ice (Sec. 7044, Business Ito n of owner DRAINS-FLOOR,ROOF,AREA,COND. 5.00 " \ Code:The Contractor's License law dues not apply to an owner of s property who buildsorimproves thereon,vid who does such work. FIXTURES-PER TRAP 5.00 so.PT FLOOR AREA TOTAL ACREAGE imams are not hrough ownemred for sale. If,howeed ver,(lie improve- GAS-EA.SYSTEM-I 6.00 - menls are not intended or offered for salt.If,however,the building or improvement is sold within one year of completion,the owner. GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 I / builder will have the burden of proving that he did not build or int- BUILDING USE prove fors owner of Ilial' INDUSTRIAL WASTE INTER. 30.00 RES IND .CON PB Orbar ❑ d as owner of Ilia property,he exclusively contracting with ❑ '❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO, toProfessions Code:The Contractors Cicero Law Joos nal apply to tr owner of property who builds t r improves rased n,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts Cor ontractor's License with acontracmgs]licensed pursuantm SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law.' TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.forthis WATER HEATER W/VENT 6.00 - reason Owner - Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPFNSATION D17CLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a eertifleale of consent In s,H-insarv. ZONING or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO. copy Ihercol'(Set.3800,Lab.CJ. ' 1'oliey No. Company Q Cc,ldied copy is hereby furnished. FIRES PRINK - ENERGY T-24 Z 2 /Ty.CenifieJ ry�y��'Ih the Y,4-4 •` ,division. - O An Want E7---==�C-.[X( . _�,r, MISC.- REFER TO ORD. Y ❑ N❑ V❑ N❑ F-' �+ ' � PERMIT ISSUANCE LUCERTIPICCOI!01°EXEMPTION TINS FROM WORRIiRB' '� FLOOD—ZONE A.L.U.C. W � COMPENSATION INSURANCE PLG.CONTR. LIF N0.EL PLO. " EL 0 (This sermon need not be completed if the permit is'for one TOTAL YE] N Y❑ N❑ hundred dollars($100)or lass.) U O 1 Certify that in the part imnanot,of lire work for which this per. OTV MECHANICAL PERMIT FEE - FEE SUMMARY W F trait is issued,I shall not employ any person in any manner so as In W - becomesuhjectlotate Workers'Compensalinn Lawsof Cal ifornia. C. Date ApplicantBUILDING >_ 0 NOTICE 'f0 APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of lire Labor Code, you must forthwith comply with FEE U such provisions or this'pennit shall be dented revoked. AIR HANDLING UNIT(TO 10=1 F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 •� - lire performance of Tho work for which this pcnnit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 LenJur s Address -ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 ordinances is state.I agree to comply with all city and county BOILER;COMP 13 H.P.or 100,000 B.T.U.) 6.00 PLUMBING hereby as and state laws-relating to building construction, anti hereby authorize representatives of This city to enter'upon the - BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned preperty for inspection Purposes. v. . (WC) agree to save, indemnify and keep.hnnnless the City of misc.- - REFER TO ORD. upertino agaimt liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in consequence of the _ raining of this Pailful. ECH.CONT. LIQ NO. MECH. /fIe�� TorAL TOTAL L, Signature of Applicant/Contractor Da`ta OFFICE COPY