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18536 POST THIS CARD NEAR FRONT OF BUILDING PFRnuT NUMBER CITY OF CUPERTINO 18636. INSPECTION DIVISION JOB INSPECTION RECO`RC 3 S_ SSS PERMIT EXPIRATION JOB ADDRESS_Q_-=+.1S `� V 4U !—UNIT#` _LOT# 'PERMIT EXPIfiE51F WORT( owrvER .CjJ ONTRACTOR G� IS NOT STARTED WITHIN INSPE TION DATE INSPECTOR - INSPECTION RECORD IOU DAYS OF PERMIT ISSU ANCE OR 18R DAYS FROM FOUNDATION NOTE: LAgj�ALLVOINSPECTION. UFER ALL GRADING AND DRAINAF VE INSTALLED a PR EGUNITE TO COMPLY WITH THE APPR S AND CITY OF PERMIT VALIUATION .CUPERTINO STANDARDS. GARAGE SLABS . ` . .yir7'. . .SEP Y 1989 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB Of PLUMBING - Jt' .. {' U.i V/ ELECTRICAL ISSUANCE DATE MECHANICAL AR, EL cT PLG. W.C. J� ❑ ❑ DO­NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING - A MECHANICAL ELECTRICAL ERMIT TO �r- FRAMING VIAL GiiOC STORIES TYPECONSTR. . INSULATION OCC IGHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE sa 11.aaml AIIPA coral.ACH[aCE DIAPHRAGM' THE CONSTRUCTION TAX IS PAID 6uaOI ON USE ROOF SHEATHING HLB IND CON Pp Owr, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.. ❑ ❑ .11 ❑ ❑ ASSESSORS PARCEI.NO ROUGH SAN.N PLUMBING - ELECT.ENERGY TRACT NO, PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY - - MECHANICAL, MECH,ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACC.TILE No. FRAMING ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING GAS TEST - GAS' . MECHANICAL f PRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING r ESN,O .L U EXTERIOR SHEAR - - ELECTRICAL RELEASE FLOOOZONE AC. INTERIOR SHEAR FIREDEPT. YO NYO N❑ SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH BUILDINGAl, . .BUILDING { O D INTERIOR LATH • TEMPORARY-ArrMUVALZI SCRATCH COAT - ELECTRIC PLAN CHECK GAS FEE . Zli NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING.IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM 1 ARRANGE FOR INSPECTION BY PHONING'252-4505, ELECTRIC J o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. Z I MECHANICAL —�^�-• - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX _..._- PLEASE READ REVERSE SIDE BEFORE TOTAL ', CALLING FOR FINAL INSPECTION. OFFICE COPY " APPLICANT TO FILL IN INFORMATION WITHIN REDLINES - USETBALL POINT PEN ONLY ' BUILDING PROJECT IDENTIFICATION . PERMIT NUMBER EU L ss °' _ y�Q - APPLICATION &;PERMITADI _ 1 O C e�C ST �- CQE35 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 18536 OWNER'S - PLAN CHECK VALIDATION NAME nn ONE Y DTV. ELECTRIC PERMIT FEE I ' U �12nNG1 Ca l.eM• /S"5707,yp - coNTRACTaRs 1. - OUTLETS 10.00/1.00 NAME , („ LIC.No.''37S-9ir 6 LIGHTINGFIXTURES - ' 10.00/1.00 CONTRACTOR'S . - PPLIANCES-RESIDENTIAL 4.00' ` ADDRESS �/� „ r,S 1.600 0411 IPUJ. 491 ONEEI/ '�J6 Q PANELS 10.00 ' DATE OF APPLICATION ITC • _ PLAN CHECK FEE P.C.NO. oft - PANELS (OVER 200 AMP) 20.00 y0 ENGINEER , - DID NO 7�3(e0 SIGNS TRANS. 3.00 ' .32 ADDRESS ARCH OR ENG,pp SPECIAL CIRCUIT 5.00 PERMIT VALIDATION SPL/OPr Ci [i nP940I EMP.METER OR POLE INS. 20.00 APPLICANT ADDRESS MOTORS' SEE FEE SCH. C �• y,� X00 C71-A-143 O Sn //IACD SERVICE CHANGE 2000. , r O O LICENSED CONTRACTORS DECLARATION ` a v w 1 hereby affirm.that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE W a Icommeneing with Section 7000)of Division 3 of the Business andSEP 7 1989 BLDG. EL'ECJ PLG. MECH. -H w-i Professions Code nd my license is in full Porc�ypru_ep e-t. - o 0"o License .lass Lia Number ]Yr 7 y J - - Da[e Contractor �' + MV W1.CUOMO .¢ ¢w a - OWNER-BUILDER DECLARATION BUILDING PERMIT 'w ;u I hereby affirm that 1 am exempt from the Contractor's License MISC.- - __ REFER TO ORD INFORMATION LL o A Law for the following reason,(Sec.7031.5,Business and Professions D VALUATION $/FT. H - PERMIT ISSUANCE 10.00 Code:Any city or cor rep which requirese permit to construct,,also a improve,demolish,Or repair any shucture,prior to its issuance,also ELEC.CONTR. LIG.NO. ELEC. d DLL requires the applicant for such permit to filet signed statement that TOTAL2 b,�0 PER MIT TO w m he is licensed pursuant to the provisions of the Contractor's License HiQLaw'(Chapter 9(commencing with Section 7000)of Division 3 of the s 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE Ito"C49II /CL Mthe the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. is. „- by any applicant for a permit subjects the applicant to a civil penalty IEA.) 5.00 of not more titan ALTER-DRAIN&VENT-WATER an five hundred dollars($5001): Y ❑ 1,as owner of the property,or my employees with wages as BACKFLOW PROTECT. DEVICE 4.00 Oce.GROUP RES.UNITS their sole compensation,will do the work,and the structure 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 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- - - '� ' menu are not intended or offered for site.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion Al e owner- GAS-EA.SYSTEM-OVER 4(EA.) _ 2.00 builder will have the burden of proving that he did not build or ITT BUILDING USE p rove for purpose of sale). RES IND CON PB Orher ❑ 1,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 D 0 0- 0 0 - licensed contractors to construct the project(See..,7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractors License Law docs 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 with a contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT No. PARCEL NO. ❑ l am exempt under Sec. ,BAP.C.tin this WATER HEATER W/VENT 6.00 reason Owner Date _ WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERSICOMPENSATION DECLARATION WATERTREATING-EQUIP. 5,00 1 hereby affirm that I have a certificate of consent to Sell mane, - nr a certificate of Workers'Compensation Insurance,or certified ZONING ENG.SITE NO. copy thereof(Sec.3900,Lab.C.I Z���� Policy NoY1YY7/_NJMnpany &Iiize t6we 11 wet [a - O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-29 -Z Z ❑ Certified opy D dad with the .1Y mspu I division. •V N Applicant a '�q'ru [ ire. MISC.- '.REFER TO ORD: ~ OPERMIT ISSUANCE 10.00 ' N CRRTIPICATEOF EXEMPTION FROM WORKERS' FLOOD ZONE A.L.U.C. "LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO, PLG. 'd O (Phis section need not be completed if the permit is for one TOTAL V Ej N[ Y NO, D Z hundred dollar,IS 100)or less.) U O 1 certify that in the performance of the work for which this per- OTY MECHANICAL PERMIT FEE - FEE SUMMARY U_ F- mil is Issued,I shall not employ any person in any manner so as to Q W become subject to the Workers'Compensation Laws of California. - -Z- emptier, - )) D t Date' Applicant ALTER OR ADD TO MECH. 5.00 - 'BUILDING NOTICE TO APPLICANT: If,after making this Certificate of F.x- Z em tion,you should become subject to the Workers Com ramation �-- - P. . v j p APPLIANCE_ - 5.00 PLAN CHECK pr visions io the Labor Code, you must forthwith comply with FEE such provisions or this permit shall he deemed revoked. _ AIR HANDLING UNIT(TO 10,000OF.M.). 4,00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 -SEISMIC FEE 7 T J hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 1 the performance of the•work for which this permit is issued(See MICROFILM . 3097,Cry CA HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T',U.)9.50 26 Lender's Address � - - ELECTRIC .L I certify that l have read this application and state that the above VENTILATION FAN (SINGLE) - 4.00 . information n correct. cos rel ti comply with all city and county BOILER- H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, andmy - hereby authorize reperty.fatives'of this city es'toter upon the .BOILER-COMP love,100,000 RTU)SEE FEE SCH. .MECHANICAL above-mentioned pDe Pcsentatins*oftnparposes. - (We) agree to save, indemnify and keep liarnless the City of MISC.- REFER TO ORD. _ mpertino against liabilities,judgments, costs and expenses which - PERMIT ISSUANCE " - 10.00 CONST.TAX 9;9�tractor gainst said City in consequence of the ' MECH.CONT. LIC.NO. MECHCy419y_/ TOTAL TOTALactor Date - ( `-^ OFFICE COPY .