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8303 POST THIS CARD NEAR FRONT OF BUILDING PFRMIT NUMBER CITY OF CUPERTINO 8303 INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS PERMIT EXPIRATION i iC/?/1"/ /V/�{<J./fl'�UNIT LOT# PERMIT EXPIRES IF WORK OWNER O CONTRACTOR IS NOT STARTED WITHIN INSPECTIO •`.N=:e'.�,'''. ,7r DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION r";L - C--A-�F 4OR 180 DAYS FROM 4 ASTCALL DINSPECTION. UFER PERMI /L10 AT ION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED- UNDERGROUND /SLAB PLUMBING - ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ECT. PLC. mECN. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED' BUILDING PERMIT WOOD FLOOR . INFORMATION PLUMBING vALunrlaN S/Fr. MECHANICAL ELECTRICAL Rmlr FRAMING 7 INSULATION ORIES TYPE CONSTR.. OCC.GROUP RES.UNITS: PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED- ROOF SQ FT.FLOORAREA TOTALACREAGE DIAPHRAGM BUILDINGUSE RES IND CON PB Orner APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED. ❑ ❑ ❑ 1:1 ASSESSORS PARCEL NO, ROUGH PLUMBING GAS TEST GOAL a ,, _� TRACT No. PARCEL No MECHANICAL 7 - ELECTRICAL _ g6' 'L-FINALS' ,i - DATE.. INSP:,. Acc.DATE ACC.FILE No. ; FRAMING .'j'1 SAN * ZONING ENG.SITE NO. INSULATION PLUMBING _�� GAS FIRE SPRINN ENERGY T�Z< MECHANICAL - - f Y [3 N� Y ❑ No COVER NO,WORK.UNTILiABOVE HAS'BEEN SIGNED': HEATING LATH-INTERIOR ELECTRICAL FLOOD ZONE A.L.u.C. LATH-EXTERIOR FIRE DEPT. r NF] Yo N[3 SHEETROCK GRADE 'FEE SUMMARY SHEAR INTERIOR I BUILDING SHEAR EXTERIOR TEMPORARY TPPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL'ABOVE HAS;BEEN SIGNEDI OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z 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 "BUILDING PROJECT IDENTIFICATION A ERMIr NUMBER BIIILmNG APPLICATION & PERMIT j- ADOREss1ra�ZS � 5 � n t BUILDING-ELECTRICAL-wPLUMBING-MECHANICAL 3 0 3 Ow'ER'S t�"� 4 ��7 I`V" �{I,'.f �S " 1 {w^ pt�,�& 'E .i3 .spy- PLAN CHECK VALIDATION "vis /�(/ OTV ��+-"EL'ECTRIC VERMMMM t,•rt �P&E4//'$ CONTRACTORS UT LE -SWITCHES-RECEP 10.00/1.00 NAME S�7 LIC No. LIOHTI NG F IXTURES 10.00/1.00 CONTHACTOR a e1w, PPL ANCES-RESIDENTIAL 4.00 >Dly ay' , *^-� SS PHONF /QLI gO PANELS 10,00 DATE OF APPLICATION ORnON'ui^/TE[0-T Y'YFL/I PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE yC.NO. k ENGINEER •--tn � C� SIGNS TRANS. 3.00 IC.Na / ARCH.OR ENG, SPECIALCIRCUIT 5,00 PERMIT VALIDATION ADDRESS /{/,.�� }�� j C1 Q Il)1)1a+.0r.0 ZIP 14t EMP.METER OR POLE INS. 20.00 ^ / ASNrs MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 D o o LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 P W_u I hereby affimn that I am licensed under provisions of Chapter 9 IBS ANC N< a (commencing with Section 7000)of Division 3 of the Business and BL��.If L y ❑ MECH. Professions Code, my license is i,full f e fe L JI`N ❑ z o - License Cla Lic.Number ? z Date Contract 44 ' IT i s w a OWNER-BUILDER DEC" ATION -°-€;1xlA NPQRMATION3;t OAU MISC.- REFER TO ORD K ; w r I hereby collo that 1 am exempt from the Contractor's License VALUATION S/FT. LLOa Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 - - Code:Any city or county whichrequiresa permit to construct,alter, OQ.00D i a, < . improve,demolish.or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. / - O u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO ' w $ he is licensed pursuant to the provisions of the Contractor's License H Z t Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe r- builder y.) i. 7 irzTdfixs"Businea and Professions Code)or that he is exempt therefrom and c L PLUMBING PERMIT1r, -€�yLP'E@ic the basis for the alleged exemption.Any violation of$ection 7031 $ s 3-a,�s ' .i:Ci�r,wSTORIES TYPE CONSTR. e. by any applicant for a permit subjects the applicant toa civil penaltyALTER-DRAIN&VENT-WATER (EA.) 5.00 ofnot more than five hundred dollars(55001.): ❑ I,as owner of the property,or my employees with wages asBACK FLOW PROTECT. DEVICE 4.00 OCCGROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and ProfessionsDRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The h obuilds i License Law does not who to an owner of property who builds or improves thereon,and who does such workFIXTURES-PER TRAP 5.00 ga Fr.RLODR AREA TOTAL ACREAGE himself or through his own employees,provided that such improveGAS-EA.SYSTEM•1 INCAOUTLETS 8.00 mems are not intended or offered for sale.If,however,the buildingor improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.1 2.00 BUILDING USE will have the burden of proving that he did not build or im- RES IND CON PB Otnar prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 AWESSORS PARCEL NO. and Professions Code:The 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 I forsuchprojectswithacontractortsl licensed pursuant to I he he ContSEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. Contractors License Law. ❑ I am exempt under Sea ,BAP.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 certificate of conunl to self-insum. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified ropy thereof(Sce.3800,Lab.C.)./A/j T,t (,• Policy No. Company Q Certified copy is hereby furnished.C,7711 P ,¢� FIRE SPRINK ENERGY T-24 Z ZO Certi Is c y is filed 'h the city mSQee[ian division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ itant V N V N ~ rnPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU CliR IFICE EXEMPTION FROM WORKERS' CL COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y❑ N❑ Y C3 N❑ CL O (This section need not be completed if the permit is for one TOTAL 7 2 hundred dollars IS 100)or lea.) I ?:W.P+*y ir°'+ IJ y rglkP. iA,rz rN',g1[,C:st' �' y, U O I certify that in the performance of the work for which this per >< v .% shMECNANICAI PERI�'IIT� �qi,. ",P@� �' - � ARLL f mit is issued,I shall not employ any person in any manner so n toY.r`L- ,. y ,..t¢t v s ,5x become subject to[he Workers'Compensation Laws of California. 's"^ '`-� n '"U iDate Applicant ALTER OR ADD TO MECH. 5.00BUILDINGNOTICE TO APPLICANT: If,after making this Certificate of Ex- emption,you should become subject to the WorkeriCompenationAPPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply witn FEEuh provisions or this permit shall be deemed revoked. AIR HANDLING UNIT ITO 10,00DC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=0C.F.M.) 6.00 % SEISMIC FEE1 hereby affirm that there is a construction lending agency forEXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 309],Civ.C.). Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)8.50 ELECTRIC Lender's Address I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is estate[. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER•17pPop I3 H.P.or 100,000 B.T.U.) 8.00 hereby authorize representatives of this city to enter upon the BOILER-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. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may I any way accrue against mid City in onsequence of the PERMIT ISSUANCE 10.00 grtnt�go hi permit. j MECH.CONT. LIC.NO. TOTAL }' PwlaY tG+a.'4i 77��.+�[1 S/�� pt�T,OTAI� 00 S'i�lsturc of Applicant/Contractor Date OFFICE COPY