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16666 POST THIS CARD NEAR FRONT OF BUILDING PERM1,IT NUt,� CITY OF CUPERTINO 6 INSPECTION DIVISION I 1A JOB INSPECTION RECORD " x PERMIT EXPIRATION JOB ADDRESS ssyE>\ Do UNIT# LOT# - - ,PERMIT EXPIRES IF WORK �l OWNER 61A_gsb-e CONTRACTOR �.Z �L ,G IS NOT STARTED WITHIN + INSPECTION D E INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION . NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAI.G]ATTON CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE GATE MECHANICAL HLIx ELECT PLO. MECR. [:] El ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION . WOOD FLOOR T EtVALUAnoN SBFT. PLUMBING MECHANICAL 0 V ELECTRICALuul W /�- 8O 1 FRAMING c' P't ST TYPE CONSTH. INSULATION _ I IZ UCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED b $O.ft FLOOH AREA TRIAL ACRE.GE ROOF NOTE:N SP.S E ADE BEFORE _ THE CONSTR TAXIS DIAPHRAGM ROOF SHEATHING MD � - RES INOUILO`ON USE Pe CI APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El ❑ 11 El 11_ .. - SS ESSUHSHAH CE l , ROUGH SAN.# - PLUMBING ELECT.ENERGY _ TRACT NO: PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL - IFIRSPRINK ACC FILE NO, BUILDING ENERGY FRAMING ELECT.-FINAL TEST ' ENG.SITE NO. INSULATION � � - PLUMBING GAS TEST GAS ENERGY L1<MECHANICALCOVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ r ❑ . NO A LuC. EXTERIOR SHEAR ELECTRICAL•RELEASE -INTERIOR SHEAR FIRE DEPT. ❑ ❑ NO SHEETROCK - GRADE FEE SUMMARY 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 NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC Qv: o� ONE WORKING DAY.BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - 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 • BUILDING P ROJECT I DENTI FICATI -PERMITNUMBER 4 BUIL ING «q� / APPLICATION & PERMIT 6666 YEN BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION A NAME �� OTY. ELECTRIC PERMIT FEE CONTRACTOR'S 1 NAME UTLETS-SWITCHES-RECEP 10.00/1.00 %Z�PG LIC.NO DSPs- .� LIGHTWG FIXTURES loaeMeo CONTRACTOR PPLIANCES-RESIDENTIAL 4.00 PRONEDATE OF APPL1' ICATION' PANELS IO.00 ARCHITECT PLAN CHECK FEE OR PANELS (OVER 200 AMP) 20.00 ENGINEER uc.NO. SIGNS TRANS. 3.00 EOR ENG' SPECIAL CIRCUIT 5.08 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. AOOREu SERVICE CHANGE 20.00 o Ic i Foo LICENSED CONTRACTORS DECLARATION a u w 1 hereby affirm that 1 am licensed under provisions of Chapter')ti with S i z ( ISSUANCE GATE vHi (commencing wecon 7000)of Division 3 of the Business and Q ^M ELECT. PLG. MECH. H x Professions Cale nIl license is in full fore d z o su2- iEense CI ss Lia Numher o res Date //jS Coolrctor a x s Q V6 0 ( 1s0`ss UILDING PERMIT a ¢ w a OWNER-BUILDER DECLARATION U INFORMATION w >;d I hereby affirm that I am exempt Gum the Contractors License MISC.- REFER TO ORD A u 0 Law for Any cithc y or io ny w which cc.703saliensin in orutrict III r "VALUATION $/FT. 0. Code Codc:Any city or county which raluiresapennit toconswci,oiler, PERMIT ISSUANCE 41 �. , ¢ BE a improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. ❑C.NO, ELEC. O / O PERMIT' TO DLL requires the applicant for such permit to dile a signed statement that TOTAL wm he is licensed pursuant to the provisions of the Contractor's Licenx - Ezr Law(Chapter 9(commencing with Section 7000)ofDivision 3 cfthe � - I ¢o Business and Professions Cale)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. u ; - by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(5500).1'. ❑ 1,as owner of the property,or by cm pluytts with wages as BACK F LOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the sinIctun,is not OCC.GROUP PES.UNITS- intended or offered for sale (Sec. 7044, Business and ProfessionsDRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law don 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 n through his own employees,provided that such improve- ments arrHimuintended oroffered oyces. moved that r.such building GAS-EA.SVSTEM-111NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) -2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove for puTow ofsoleJ. INDUSTRIAL WASTE INTER. 3000 RES IND CON PB Dun.,❑ 1,a owner of . the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licennN connamors to construct the Project(Sec. 7044, Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Cuse:'I'he Contfuctur's License Law does not apply to an owner of property who builds or iCHEN,cs force,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contmetan o licensed pursuant to the Contractors License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sic.-,B.&P.C.for this WATER HEATER WIVENT 6.00 ' reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC FILE NO. WORK ERS'COM PI-NSA'DoN DECLARATION WATER TREATING EQUIP. 5.00 I hereby allirnl thin l have a cenificale ofconsent to slf-insure, ZONING ENG.SITE NO. or a certifcute of Workers'Contpcawtion Insurance,or a certified copy thereof(Sec.3800,Lab.C.l Policy'N'o. Come yWJ,p�l/� K7 , Z 2 ❑ Certified ish DY fµrnlshcd�g /� Celaif• Ilh the l ecuon divisiomdivision. FIRE SPANK ENERGY T]9 O Applicant i MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ ~ In PERMIT ISSUANCE - 10.00 LU CISRTI ICCOM OP COMPENSATION ION PROM WORKERS' FLOOD ZONE A.Lsu C. W � COAIPEM1'SATION'INSURANCIi PLG.CONTE. LIC.NO. PLG. ' 0- 0 ('This section need not he cumplemA it the permit is for o TOTAL Y❑ N❑ Y ❑ N❑ hundred dollars(S I OU)m Icss.) one U O 1 ecmiry that in the performance of the work for whmh this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any furwn in any manner so as to O w become subject to the Workers Compensation Laws of California. a Datc Applicant BUILDING } to NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 F ? emption,you should become subject to the workers'Compcnntian APPLIANCE 5.00 PLAN CHECK ori sions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10,000 C.F.M) 4.00 CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1 hereby afford 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.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 a/ O Lender's Address ELECTRIC 3 I certify that l have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information n correct. 1 agree to comply with all city and county and PLUMBING f indurates and Stam laws relating m comply with construct inn, and BOILFA-CCM�P(3 H.P.or 100,0006.T.U.) 6.00 hereby au0torlrc representatives of this City to enter upon the BOILER-COMP Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purpn.vs. f+' (We) agree to save, 'ndemnify and keep harmless the City of MISC.- REFER TO ORD. I/ Cupertino against Ii' (ties,judgments, casts and expenses which PERMIT ISSUANCE - 10.00 CONST.TAX may N any way Emc as. said City in consequence of the ranting f If itis 9 MECH.CONT. LIC.NO. MECH. TOTAL TOTAL I a a of Applicant/Cmati-Ticticur ate air - OFFICE COPY eke r'1 m =E PALK - a i 1�Yp r w.� r.[ •• �M _� UPUNO U, WAY l rARK a a i r µIll maw+c 1u • r �. _ .a� .: $ gun � '-� � � • '- , t r ) I [ �� wiq, evp k wort ln. .• < in .. < ti t;i.: f J ° ..a.e"mwrrt C 9 4.T �• !. ! ! � G { � 1LA,syr .\ 10 14 AV CP loo �•�\ �� 1 � is ` ! °. E. li .° .Iia __ ,. � ,.• ate,, � .. �{ l/�'� tr, ,` X• II q .. n� 4: ffa 8 ° E Aiv.�e. 9 . : . .r .S alt. ^'= y < �.� _ice F f < f • �� L-Z- Plv�ye.Z .. r I O ! ! ! • ! ! ! ! 1 .\ e x F ` �fPN Ply Y g . 3lE�MG 3 dieDan Allarl I FSprgrgs •- .,stshore Office Park• 220 Twin Dolphin d,�,Su e C' Redwood City, California 94065 • (415)5952100 s I r ,