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11445 POST THIS CARD NEAR FRONT OF. BUILDING PERMIT NUMBER s CITY OF CUPERTINO 11445 INSPECTION DIVISION JOB INSPECTION RECORD n}� (� yJ� /K" - PERMIT EXPIRATION JOB ADDRESS d�7 I SIEVe' `✓ Creek UNIT# - LOT# ,T1 PERMIT EXPIRES IF WORK .-NERAemeo , - CONTRACTOR IS NOT STARTED WITHIN _ INSPECTION DATE I INSPECTOR SPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION •-6- kv e- ?, Arw-T'Co 1. D-1 ANCE OR 180 DAYS FROM kIZPfr B� V +�(1.te .Z.1" eTT Lt E 1 '- LASTCALLED INSPECTION. PREGUNITE 2, PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED t ' UNDERGROUND /SLAB - PLUMBING ELECTRICAL - ' - ISSUANCE DATE MECHANICAL Loa ELECT, PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT ` - INFORMATION WOOD FLOOR PLUMBING VALUATION... $/FT. - - � ' ., MECHANICAL ' ELECTRICAL FRAMING INSULATION STORIES TYPE CONSTR. Y OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF 50.FT,FLOOR RHEA TOTAL ACRLAGE DIAPHRAGM -'BUILDINGE - CON H[$ IND CON PB OJ,e, ' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ t ROUGH ASSESSORS PARCEL NO. PLUMBING - GAS TEST _ TRACT NO. PAN CEL N0. MECHANICAL ACC,DATE ACC.FILE NO. ELECTRICAL FIN DATE INSP. FRAMING SAN ,/ ZONING ENG.SITE NO. INSULATION PLUMBI G GAS - . MECHA ICAL FIRE SPRINK ENERGY-T24' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATIN - Y "� ° "� LATH-INTERIOR - ELECTRI FLOOD ZONE A.L.U.C. LATH-EXTERIOR FIRE DEPT. Y❑ NO Y❑ NEI SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING BUILDING SHEAR / •:r; � '' SHEAR ExrERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK w GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING koZ 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. OFFICECOPY. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILOING APPLICATION & PERMIT ADDRESS 11445 /)0-745 � S'B weE cfEF-k. -zwo BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OwNER'S PLAN CHECK VALIDATION NAM [ TY FjJ)JGLj ppj/�OTY. ELECTRIC PERMIT FEE U G PHOry L'2180 CONTRACTORS NAMOUTLETS-SWITCHES-RECEP 10.00/1.00 E /• p / ( sU'C uc.NO.D - j LIGHTING FIXTURES 10.00/1,00 EDACTORS APPLIANCES-RESIDENTIAL 4.00 Aarss 350 �y � et PHONE Y201 / PANELS '10.00 DATE OF APPLICATION ARCHITECT Nor"/f• lc PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEERW NL ��Cs•�ry��L•/ II�� LC.NO. SIGNS TRANS. 3.00 AARCH,OR ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION OOREss 2229 SMf�1N 5T HPI-AURRv W4i EMP.METER OR POLE INS. 20.00 APPLICDDREANr's MOTORS SEE FEE SCH. ADDRESS SERVICECHANGE 20.00 0 0 LICENSED CONTRACTORS DECLARATION n: - I hereby affirm that I am licensed under provisions of Chapter 9 U M 0S NCE DATE H i (crour encing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. Fw Professions Code,un my license is in full force'hit -Jk^`A� s_r 0 fx IrrTn ❑ zo - iciest Class se c.Nmnbcr_ `f _C fs N1}Jy L 0 y Date r Corlmetar.. V I u s rG"'w r" BUILDING PERMIT rc ¢ OWNER-BUILDER D17CLARATION E a a" MISC.- REFER TO ORD INFORMATION E ; y I hereby affirm that I am exempt from the Contractor's License H LL 0 a Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 q VALUATION $/FT. Code:Any City or county which requires a permit to construct,alter, Q u,¢0 Improve,demolish,or repair any structure,prier to its issuance,also ELEC.CONTR. LIC.NO. ELEC. (/✓/ , ca LL requires the applicant for such permit to file a Signed statement that TOTAL PERMIT O E $ he is licensed pursuant to the provisions of the Contractor's License Hii Law(Chapter 9(commencingwith Section 7000)ol-Division3 ofthe a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES Y CONS R. e- by any applicant for a permit suhjems theapplieam toacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 DCC.GROUP RES.UNITS their sole compensation,will do the work,and tie structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does nor apply to an owner of . property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 S2 FT,FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- reents are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6,00 or improvement is sold within one year of completion, tire owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or Im- prove for purpose ofsale.). INDUSTRIALWASTE INTER. 30.00 es IND CON PB Other Cl 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contracrons)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lemexemplunder .Sec. .13AP.Cforthis WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.GATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent Rt self-insure, or a certificate of Workers'Compensation Insurance,or a ceriif d ZONING ENG.SITE N0. copy thereof(Sec.3800,Lab.C.). /1 c(1� A Policy No. .Company blLl-/lltla•.$ !� Q ❑ Certified Copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z 2 ❑ Certified opy Ol ith the city insl tion division. MISC.- REFER TO OR D. APPIicuN Y❑ N❑ Y❑ N❑ = N CER -ICATE OF EXEMPTION FROM W RKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > CONIPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL 0 (Phis section need not be completed if the permit is for one TOTAL Y❑ N❑ Y.❑ N❑ LD 2 InuadmEldoRers(5IO0)or less.) ) 0 I certify[but in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- 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. 0 LU Datc Applicant ALTER OR ADD TO MECH. 5.00 BUILDING /7Q } t0 NOTICE 1'0 APPLICANT: If,alter making this Certificate of Ex- eruption,you should become subject to Om Workers'Compensation APPLIANCE 5,00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE 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 10,000C.EM.) 6.00 SEISMICFEE 7S 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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ.C.). Lender's Name Lender's Address H EATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify That I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 1. information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3H.P.0,100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU) FEE SCH. MECHANICAL above-mentioned property for inspection purppus. (We) agree to save, indemnify and keep Imnmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, casts and expenses which PERMIT ISSUANCE 10.001CONST.TAX may In any way accrue.against said City consequmhce of the grand[ of tlh' permit. /J MECH.CONT. LIC.NO. MECH. TOTAL TOTAL Sig are of ApplecamOCcannactor Dat J OFFICE COPY