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13297 POST THIS CARD NEAR FRONT-OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 132.97 INSPECTION DIVISION " JOB. INSPECTION RECORD PERMIT EXPIRATION 'JOB ADDRESS' 21730 STEVENS' CREEK '" UNIT# DoT# ' �+Qm PERMIT.EXPIRES IF WORK y 'OWNER TRAVEL INCENTIVE R.E. WF41TACTOR ICOM MECH ' IS NOT STARTED-WITHIN INSPECTION •• DATE INSPECTOR- INSPECTION RECORD `leo DAYS OF PERMIT ISS6'' ,. FOUNDATION' ANCE OR 180 DAYS FROM LIFER � .. _. ,. �' . : '. - LASTCALLED INSPECTION. PREGUNITE - - ' PERMIT VAu OATI ON , POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -UNDERGROUND/SLAB' / f PLUMBING +/ AI((,�� ELECTRICAL - I suArrrkkkE DATE MECHANICAL' - - BLDG. ELECT- PLG. CR DO NOT POUR FLOOR.UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR " INFORMATION \ vAWATION $/FT. , PLUMBING - - - r . , MECHANICAL' ELECTRICAL - P��//RR�jM/l/r}ro f FRAMING � � ' '• " '_/ r` INSULATION I' •' r STORIES TYPE CONSTR, ' - 'OCC.GROUP RES:UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - - - » ROOF SO.PT�.FLOOP AREA TOTAL ACIIEAGE. y DIAPHRAGM'. RUamNG USE RES�' IND CON PB 00... APPLY,NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ' " ❑ El ❑ ' ❑ El ASSESSORS PARCEL NO, ROUGH . PLUMBING ' Yi,;.• ' " " ' ` GAS TEST. TRACT'NO. PARCEL NO. - - MECHANICAL • - r ACC.DATE ACC.FILE NO. ELECTRICAL FINALS •DATE INSP. - FRAMING SAN # • - .. ZONING' 'ENG.SITE NO. INSULATION PLUMBING - - GAS . . { MECHANICAL _ ' FIRES?RINK ENERGY TyA -- ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING- - El NEI Y ❑ NC_] . . , . LATH-INTERIOR • ELECTRICAL � FLOOD ZONE, ALUC , LATH—EXTERIOR , � - FIRE.DEPT:' Y❑ N❑ : ,Y,I] :4 11 SHEETROCK - - GRADE - - FE UMMARY 'SHEAR INTERIOR . - BUI LDING n - SHEAR EXTERIOR'. ' 4 :, ;• .,,"TEMPORARY APPROVALSBUILDING ' FIREWALLS' •�I, ELECTRIC r PL�NCREC�i00/ ',.e•1EE ,. GAS : NO TAPE OR PLASTER UNTIL ABOVE HAS-BEEN SIGNED OCCUPANCY sBl�jv i 'v@@BCI 0 OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINACISSIGNED By BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, I''., ELECTRIC . �� •' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING. .y O PLEASE GIVE JOB ADDRESS WHEMPHONI'NG. Z r " t J� .:v - 'MECHANICAL ay ' — SEE PERMIT FOR EXPIRATION•DATE — 'CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE «* ;IT '" C' J TOTAL CALLINGFOR FINAL INSPECTION. OFFICECOPY. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY •- • p BUILDINGPROJECT IDENTIFICATION " PERMIT NUMBER 1' manyouND ' APPLICATION & PERMIT ADDRESS �N *-" BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 1 329 OwrvER'SPLAN CHECK VALIDATION NA7!1!VMV.* 1064W ELECTRIC PERMIT 'FEE ,• I P o NTRA�rCTo7R's (e�W�/� (' OUTLETS-SWITCHES-RECEP 10.00/1.00 Nay�A I-'�'�/�' •ua No. $/�' LIGHTING FIXTURES 10.00/1.00 CONTRACTORS ao An �kle PPLIANCES-RESIDENTIAL 4.00 ?� PHONEZ041 PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP[ 20.00 PLAN CHECK FEE P.C.NO. DR ENGINEER ' 'uc.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS t. + ZIP EMP.METER OR POLE INS. 20.00 AE - MOTORS . SEE FEE SCH. ADDDDRESSSS SERVICE CHANGE 20.00 00 LICENSED CONTRACTORS DECLARATION 7 (XJ(y�0 < I hereby affirm that I an licensed under provisions Of Chapter 9 .I�OANCE DATE •r $a (commencing with Section 7000)Of Division 3 f the Business and - BLDG. ELECT. PLG. MECH. " '^ Professions Code,Irl cense is in full fore• /�¢I�yro z o w License Class '6,lIU Lic.Number DGQQ ❑ ❑ ❑ G m f w Uale �-�-�)-Contractors/ ¢ y •I A �• BUILDING PERMIT ¢ 2 w u OWNER-BUILDER DECLARATION '- w3: H, 1 hereby affirm lhat'I am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION u'00¢ Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE -10.00 VALUATION S/FT. Code:Any city or county which requires a permit to construct,alter, an Q Q 0 Improve,demolish,Or repair any structure,prior to Its Issuance,also ELEC.CONTE. LIC.NO. ELEC. La 0 requires the applicant for such permit to file a signed statement that ' TOTAL .PERMIT TO X m he is licensed pursuant to the provisions of the Contractor's License Hii I.aw(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe ¢ Business and Professions Code)or that Ile is exempt therefrom and r.GAS PLUMBING PERMIT FEE sin ¢ H [he basis for the alleged exemption.Any violation of Section 703 L5 STORIES TYPE CONSTR. a $$ by any applicant for a permit subjects the applicant toy civil penalty of IEA.) 5.00 of not more than five hundred dollars($500).)', ❑ I,as owner of the property,or my employees with wages asBACK FLOW PROTECT.DEVICE 4.00 .00C.GROUP 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,AR EA,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 workFIXTURES-PER TRAP 5.00 SG.FT.FLOOR AREA TOTALACREAGE himself'or through his own employees,provided that.such improve- ments are not intendedoroffered for sale.ll',however,the huilding -EA.SYSTEM-11 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 'builder will have the burden of proving that he did not build or ins BUILDING USE prove for purpose of,ale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB omen - ❑ 1,as owner of the properly,am exclusively contracting with ❑ ❑ Cl ❑ ❑ licmd 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 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 contractorfs)licensed pursuant to SEWER-SANITAR V-STORM EA.200ft/10.00 the Contractor's Liomse Law. TRACT NO. PARCEL NO. ❑ 1 an 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. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. nr a certificate of Workers Compensation a tfcd On B.C.). jly _ac Poll d Q elic p�Y eor y I FIRE SPRINK" ENERGY T-24 A� Ce D,fi• copy is d with the city inspection division. I LL1,11 /�f _ MISC.- _ REFER TO ORD. Y ❑' N❑ Y ❑ N❑ ~ m .,A.•-- PERMIT ISSUANCE - 10.00 � Cli IFICAI'I:OF li% IP1'ION PROM WORKERS' FLOODZONE A.L.u.D. LU 1 COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. - d 0 (Phis section need not be completed if the permit is for me TOTAL Y,❑ N❑ Y❑ N❑ Z) 2 hundred Aollars[$100)Or less.) U O I certify that in the performance of the work for which this per. OT MECHANICAL PERMIT FEE FEE SUMMARY LL l- mit is issued,I shall not employ mry person is any Inanner xo zs m U become:subject to the Workers'Compensation Laws of California. - i Date Applicant ALTER OR ADD TO MECH. 5.00 Q BUILDING - } ED NOTICE TO APPLICANT'. If,after making this Certificate of 1°x- Z emption,you should become subject to the Workers'Compensation APPLIANCE ' .00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10=1J.F.M.) 4.00 -t CONSTRUCTION[.ENDING AGENCY AIR HANDLING UNIT(OVER 10 C.F.K)-61A0 '' SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT)` 5.00 _ the performance'of the work toy which this permit is issued(Sec. HEATING UNIT(TO 100,000T.U, 8' MICROFILM 3097,Civ.C.). C+ Lender's Name HEATING UNIT(OVER 100,0 .T.U.)9.50 ELECTRIC Lender's Address _ 10 1 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 1 . hereby.authorise representatives of this city to enter upon the BOILER-COMP (Over 100,000BTUISEE FLESCH. MECHANICAL- a' above-mentioned property for inspection purposes. `•� (We) agree to save, indemnify and keep harmless the City of MISC.'- s REFER TO O Cupertino against liabilities,judgments, cost's and expenses which CONST.TAX may in any way accrue against aid City is consequence of the PERMIT ISSUANCE 10.00 RD. g of Bus Permit. MECH.CONT. LIC.NO. MECH. TOTAL A TOTAL Si iaturcof Ap licm /Contractor UDate OFFICE COPY t t k