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14067 POST THIS CARD NEAR FRONT OF BUILDING PFRMIT NUMBER CITY OF CUPERTINO 14067 INSPECTION DIVISION JOB INSPECTION RECORD 'PERMIT EXPIRATION JOB ADDRESS 20387 STEVENS CREEK UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER MRS. B 'S BASKETS co TRAcroR ACTIVE. SIGN IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION c ANCE OR 180 DAYS FROM LIFER LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED, r UNDERGROUND /SLAB ta" PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL - BLDG. ELE',tI PLG. MECR, DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $IFT. PLUMBING _ i MECHANICAL " ELECTRICAL - PERMIT TO FRAMING INSULATION , STORIES TYPE CONSTR. OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO FT.FLOOR AREA TOTAL.ACREAGE DIAPHRAGM ewwluse RES IND CON PR Other APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El ❑ ❑ ❑ Cl ROUGH ASSESSORS PARCEL NO. PLUMBING - TRgCT NO. PARCEL NO. GAS TEST MECHANICAL ELECTRICAL. ` FINALS . DATE INSP. gCC.DATE ACC.F _ ILE NO. ' FRAMING SAN # ' ZONING ENG.SITE NO. INSULATION � PLUMBING GAS FIRE SPRINK ENERGY LZC MECHANICAL Y ❑ No Y ❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING . LATH—INTERIOR ELECTRICAL FLOOD ZONE AL1Y.�l LATH—EXTERIOR FIRE DEPT. v❑ NEI I Y ❑ N❑ SHEETROCK - GRADE FEE SUMMARY SHEAR INTERIOR BUILDING jc 2.p SHEAR EXTERIOR TE PORARY APPROVA 'BUILDING FIREWALLS ELECTRIC PLAN CHECK , GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC -- Iw—� ONE WORKINGDAYBEFORE REQUIRED INSPECTION. PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z .MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — - IMPORTANT! coNST.TAz PLEASE READ REVERSE SIDE BEFORE TOTAL t7 CALLING FOR FINAL INSPECTION. OFFICE COPY - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER oDILDING APPLICATION & PERMIT A OGRESS 03 .5 STS✓e S UILDING-ELECTRICAL-PLUMBING-MECHANICAL 14067 OWNER'S PLAN CHECK VALIDATION NAME (� '�•t QTY. ELECTRIC PERMIT FEE J ftlrS. S 4-- PHONE CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1,00 Nq E - t,1 P 0, LIC.S t" ; LIGHTING FIXTURES 10.00/1.00 CONTRACTOR S APPLIANCES-RESIDENTIAL 4.00 ADDRESS S 9; ]- ` PRONE.`.lJ-L, PANELS IO.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.N0. OR , ENGINEER LIC.No. SIGNS TRANS. 3.00 ADDRESS ENc. SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 f` N=�OIw APPLICANTS MOTORS SEE FEE SCH. apoREss SERVICE CHANGE 20.00 Woo LICENSED CONTRACTORS DECLARATION ¢ is u 1 hereby affirm that 1 am licensed under provisions of Chapter 9 s..ISSUARCE DATE ¢ a a (commencing with Section 7000)of Division 3 of the Business and - •BLDG. ` `ELECT. G. MECH. HOZ Professions C s my license is in full f e id 1 u`` aO License Cla�s ,r Liatr'"nr z� I ❑ ❑ O 0 r w Dale Contractor ¢ y s BUILDING PERMIT ¢ ¢ ¢ OWNER-BUILDER DECLARATION ¢ w O INFORMATION wr.LL H I hereby affirm that I con exempt from the Contractor'sMISC.-Contractor's License REFER TO ORD VALUATION $/FT. H LL O J Low for the following reason.(Sec.7031.5,Business and Professions pERM1T ISSUANCE 10.00 0 - Nw Code:Any city orcounty whichrequiresapermitloconstnml,alter, �-Q ¢ ¢ ¢ 2 improve,demolish,Or repair any structure,prior to its issuance.also ELEC.CONTR. LIC.No. ELEC. �/] ¢ wD¢ requires the applicant for such permit to file a signed statement that TOTAL J PERMIT TO m¢ he is licensed pursuant to the provisions of the Contractor's License f ERMI to Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe ¢ Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE Q r o the basis for the alleged exemption.Any violation of Section 7031.5 1 STORIES TYPE CONSTR. i ;m by any applicant for v permit subjects the applicant toa civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.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- ments are not intended or offered for sale.If,however,the budding GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or insproventent Is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 (EA) 200 builder will have the burden of proving that he did not build or int - . . . - BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER30.00 RES IND CON PB GO.,. ❑ 1,as owner of the property;am exclusively contracting with ❑ ❑ ❑ ❑ ❑ 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 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 with a contmetorfs)licensed pursuant to SEWER-SANITARY-STORM EA.2001t/10.00 the Contractors License Law. TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 malrut OwnerDore WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSAT ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconwrit roself-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. ,copy thereof(Sec.3800,Lab.C.). - I'Olicy No. Company O ❑ Certified copy isherebyfurnished. FIRESPRINK ENERGY T 24 Z z // Certif d copy is 010 with the city Spection division. OF' pplicant CT'P. v c n l� Q IMISC.- REFER TO ORD. Y❑ IN Y ❑ N❑ CC LU vt PERMIT ISSUANCE 10.00 CERTIFICATE EXEMPTION FROMWORKERS' FLOOD ZONE a.L.U.C. W 2: COMI'ENIiNSATIATION INSURANCE PLG.CONTE. LIC.NO. PLG. 0- C)( This section need not he completed if the permit is for one TOTAL Y❑ [:] N E]N❑ Y hundred dollars IS 100)or less.) U O 1 certify that in the performeury of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL f- mit is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. BUILDING CL Date Applicant ALTER OR ADD TO MECH. 5.00 /74fD } W NOTICE TO APPLICANT: If,after making this Certificate of Ex- ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions Of rhe Labor Code, you must forthwilh comply with FEE // 3 U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the 3097 erC'v .C.) . e of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's aNcm e HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC �v Lender'sanAddress 1 certify that I have read this application and stare that the above VENTILATION FAN (SINGLE) 4.00 information is correct. 1 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 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree t0 save, indemnify and keep harmless the City of MISC.• REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses Muelt PERMIT ISSUANCE 10.00 CONST.TAX may i any way accrue against aid City in consequence of the glen I his permit. MECH.CONT. LIC.NO. MECH. TOTAL TOTAL 3 7 ignalure ol'Applicant/Contractor Date �^ OFFICE COPY