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16738 T POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 16738 INSPECTION DIVISION JOB INSPECTION RECORD •ie '' C - PERMIT EXPIRATION JOB ADDRESS- S s L _ UNIT LOT 4t ^ ' PERMIT EXPIRES IF WORK OWNER CONTRACTOR Cri LA, IS NOT STARTED WITHIN-1 INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- . .FOUNDATIONANCE OR 180 DAYS FROM _ NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED + PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERNUT VALIDATION CUPERTINQ STANDARDS. _ GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED r UNDERGROUND /SLAB 1 91988 PLUMBING _ "•� T , ELECTRICAL Qity Ot Cupertino ISSUANCr LATE MECHANICAL 77 VLOG ELECT I PLG MIIICCIH ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION S/FT. - ' MECHANICAL - ELECTRICAL. - PERMIT TO FRAMING J "'1. PC-• V� - r INSULATION SrURIES TYPE CONSTH. - - ,OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED Sll,li GIOOR ALL .TOTAL ACRr.AGE ROOF- NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION fAX IS PAID BUILDING USE ROOF SHEATHING IKS IND COrv': PB- OIL- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS'. DATE INSP:� ❑ ❑ - .O' ❑ ❑ • - ASSE560H5 PARCEL NO. ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO. - PARCEL NO • TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.-ENERGY ELECTRICALBUILDING ENERGY ACC DATE ACC FILE NO FRAMING ELECT.FINAL TEST INSULATIONPLUMBING - _ zoNlNc Ewc.SITE NO. GAS TEST GAS FIRE SPRINK ENERGY T 2 MECHANICAL . COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y E3 NE] - EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE A.L C. INTERIOR SHEAR. FIRE DEPT. - Y❑ No Y ❑ N❑ SHEETROCK GRADE FEESUMMARY EXTERIOR LATH BUILDING . .INTERIOR LATH � - TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHEC.K 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 w ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC o~� ONE WORKING DAY BEFORE REQUIRED INSPECTION. d PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING: - SEE PERMIT FOR EXPIRATION DATE- - MECHANICAL - _ DO ' IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL 01 17, CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES --USE BALL POINT PEN ONLY ,. BUILDING PROJECT IDENTIFICATION -PERMIT NUMBER aUILD—IN G APPLICATION & PERMIT O ADDRE s,/' o BUILDING—ELECTRICAL—PLUMBING —MECHANICAL OWNER 9 PLAN CHECK VALIDATION NOME' - ISZ3 OTY. ELECTRIC PERMIT FEE - I IaAmTRq TOR's• PHONE OUTLETS-SWITCHES-RECEP 10.00/1.00 uc.No. ?..• LIGHTING FIXTURES 10.00/1.00 ADDRESS 1CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 REss SHONE ' • PANELS 10.00 DATE OF APPLICATION. ORRCH ECT ! PANELS (OVER 200 AMP) 20.00 - PLAN CHEC K7F7 P.C,INO. ENGINEER LIC.NO. ISIGNS TRANS. . . 3.00 ADDRESS ENG, SPECIAL CIRCUIT 5,01) PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 I (` APPLICANTS - ADDRESS MOTORS SEE FEE SCH. [[ SERVICE CHANGE 20.00 o¢ i Foo LICENSED CONTRACTORS DECLARATION L,w I hereby affirm that am licensed under provisions of Chppmr9 )r <T (commencing with Section 7000)of Division 3 of Ilse Business anti ISSUANCE DATE r H H a Professions Cn �Q my license is in full for, ��d//gflfjf 2 r-ti ss DG. ELECT. PLG. MECH. po m — Licensc C, S. '_((J_Lic.Numhey�7T rt.— El El H w Dale -7 COntraclur Cif-- . Q Y tc Ic w OWNER-BUILDER DECLARATION _ BUILDING PERMIT wo d MISC.— -REFER TO ORD INFORMATION g w I hereby of firm that I am exempt from the Croon lot' Licensc or u.o J Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE VALOATION $/FT. m � Improve, e,Bern y or county which[eyuiresa permit prioto t,isxuu,t.e,al r, Code; 10.00 ar R Q 0 improve,deem ish,o[mpuir any Shuclum,prior lu IIs issuanec,also ELEC.CONTR.' LIC.NO. ELEG. LL requires the applicant for such permit to file a signed statement that TOTAL e w m he is licensed pursuant to the provisions of the Contractor's License PERMIT TO z Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe Hi a o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE X I- m the basis for the alleged exemption,Any violation of Section 7031.5 tTORIES TYPE CONSTR. e. 3 — by any applicant fora permit subjects the applicant toe civil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($5011 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4,00 their sale compensation,will do the work,and the structure is not OCC.GROUP RES,UNITS intended or offered for sole (Sec. 7044, Business and,Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5,00 Code:The Contractor's Licensc Law docs not apply to an owner of - property who builds or Improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that Such improve- mentsarenetintendedoroffered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or int- GAS-EA.SYSTEM-OVER 4 (EA.) _ 2.00 BUILDING USE Prove for purpose of Seale.(. INDUSTRIAL WASTE INTER3000 • RES IND CON PB Omer '❑ 1,as owner of the property,am exclusively contracting with . . 1:1 El E] ❑ 13licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:1'he Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects will,o contractor(,)Iieensud pursuant to - _ the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date - - WATER SYSTEM 5,00 - ACC.DATE ACC.FILE NO, WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. '5.00 . I hereby affirm that I have a certifo:atc ofconsem In self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. Copy thereof(Sec.3800,Leb.C.). Policy No. Company O ❑ Cerlifiudcopyishcrehyfurnishcd. FIRESPRINK ENERGY T-24 Z 2 w➢1 Sxr[i five , filed W�Wy�im��I,,�nn��t��I,,�,,,. Ily inspection division. F O pp,cant_-- tl(�. misc.- REFER TO ORD. Y ❑ N❑ I Y ❑ N❑ CC T CERT IPICATE 01'EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10,00 FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR, LIC.NO. PLG. CL O This sc ctim, need rat be completed if the permit is for ane TOTAL Y❑ N❑ Y ❑ N❑ D 2 hundred dollars(S100)or less) U O 1 certify that in the performance of the work for which this per. CITY MECHANICALPERMIT FEE FEE SUMMARY LL I— mit is issued,I shall not employ any person in any umnnerso as to O W become subject to the Workers'Compensation-Laws of California. rl DmcApplicant ALTER OR ADD TO MECH. 500 BUILDING. } 0 NOTICE TO APPLICAN'1": If,alter making this Cerlificale ul'His- . . ^1 ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 FEE CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6,00 SEISMIC FEE ' 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. Q MICROFILM 3097,Civ.C.). HEATING UNIT(TO 10 Learn S N.m 0,000 g.T.U.) 8.0 Lender's Address HEATING UNIT(OVER 100,000B.T.UA50 ELECTRIC I certify that I have read this application and state that 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 construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 herebyabove- enthoritc ropertyntir insves ec on city to enter upon Ih° BOILER-COMP.(Over 100,000 BTU)SEE FEE SCH. MECHANICAL P above-mentioned property forinsp at this purposes. (We) agree to save, int ,m fy and keep harmless the City of misc.- REFER TO ORD. upertino cin Iia At uegn,enls, costs and expenses which PERMIT ISSUANCE 10.00 <) CONST.TAX may I w a rue g inst said City in consequence of the •r:u,[in ,ir MECH.CONT. LIC.NO. MECH. ILS TOTAL ' D O f 1 D Signato pf Applicant/Contraclor Uate ' TOTAL t OFFICE COPY