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11129 „ . 'P.OST.THIS.CARD NEAR FRONT OF BUILDING , I'Ii RMIT NUMBER 'CITY OF CUPERTINO 1.1129 INSPECTION DIVISION' -JOB INSPECTION RECORD ����Q/ ' PERMIT EXPIRATION • - JOB ADDRESS '- 'ONIT# LOT# 1 EXPI RES IF WORK OWNER CONTRACTOR - IS. T. STARTED WITHIN INSPECTI N ATE INSPECTOR _ INSP C ION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION. - - _ •ANCE OR 180 DAVS.FROM . - - '�- LAST CALLED INSPECTION. LIFER . PREGUNITE - PERMIT VALIDATION POUR NO CONCRETE UNTILABOVEHAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING - u ELECTRICALr - - ISSUANCE IiA IE _ MECHANICAL' _ - • et;pa ELEcr. PLc. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ; '- BUILDING PERMIT r � .WOOD FLOOR - - - INFORMATION' VALUATION, PLUMBING - - - MECHANICAL I ELECTRICAL - PER ITTo FRAMING • ' ' -STORIES TYPE CONSTR. INSULATION. /' .yy� I. 60 - OCC.GROUP RES.UNITS - PLACE NOS UBFLOO RUNTIL ABOVE HAS BEEN SIGNED +- I SO.FI,FLOOH AREA , TOTAL ACREAGE ROOF .. . '�..,. DIAPHRAGM .•'1 1 BUILDING USE RES IND CON PB Ober -APPLYING ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PA13CEL NO. ROUGH PLUMBING ' - - ' •3y - - TRACT NO. 'PARCEL NO. GAS TEST• MECHANICAL •: - ELECTRICAL - FINALS - DATE' INSP. ACC DATE ACC,FILE NO' FRAMING. , .' SAN # zONING ENG.sITENO. - 'INSULATION PLUMBING' - GAS - FIRESPRINK ENERGY T 24 • - MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - v ❑ , NE] Y ❑ ,N❑ FLOOD ZONE A.L.11.C. LATH—INTERIOR - ELECTRICAL LATH-EXTERIOR - FIR&DEPT. Y❑ NE] .y ❑ N❑ SHEETROCK GRADE - FEE SUMMARY SHEAR INTERIOR ' 'BUILDING - SHEAR EXTERIOR - TEMPORARY APPROVALS BUILDING FIREWALLS.” -I ELECTRIC - - PLAN CHECKr 1 '1 GAS ' FEE. +^' NO TAPE OR,PLASTER UNTIL ABOVE HAS,BEEN SIGNED OCCUPANCY SEISMIC FEE '- TOCCUPANCY,OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDINGINSPECTORt MICROFILM ; ARRANGE FOR INSPECTION'BY PHONING"252-4505;' M ELECTRIC � FONE WORKING DAY BEFORE REQUIRED INSPECTION PLUMBING _. . . Z PLEASE GIVE"JOB.'ADD,RESS;WHEN PHONING. — SEE'PERMIT'FOR EXPIRATION DATE — MECHANICAL c X" IMPORTANT! coNsr.rnx 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 IDENTI FICATION -, - PERMIT NUMBER BUILDING APPLICATION & PERMIT- A q n -� arDREss r BUILDING- ELECTRICAL-PLUMBING-MECHANICAL I I G O NER'S PLAN CHECK VALIDATION NAME •' OTY. ELECTRIC PERMIT FEE PHONE rvrmacrDRsPrfi NAME UTLETS-SWITCHES-RECEP10.00/1.00 LIC.No, LIGHTING FIXTURES 10.00/1 00 nooeesS' APPLIANCES-RESIDENTIAL 4.00 .� PHONE PANELS 10.00 DATE OF APPLICATION ARceOecr - PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P.C.NO. DR ENGINEER ' - Sec.NO, SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT - .. 6.00 PERMIT VALIDATION ADDRESS , iIP -EMP.METER OR POLE INS. 20.000 APPLICANTSDURESSMOTORS SEE FEE SCH. ` •tt/"�-n� SERVICE CHANGE 20.00 o O o LICENSED CON'I'RACfORS DECLARATION rlI/1' Gf' ¢u w I hereby affirm that I am licensed under provisions of Chimmi-9 I�yAH'Oa(ZIA720 H < m lu>mmmtgng with Section 70007 of Division 3 of the Business and y _ BLDG. 'ELECT. PLG. MECH. H w z Professions Code,and my license is in full force and effect. J / n 1 ❑ .❑ ❑ ❑ 2 o m- License Class Lie.Number 9 y Date Contractor • ' ¢ ¢¢ OWNER-BUILDER DECLARATION .. '1` Clf Of CuDer.InO BUILDING PER ¢ w - INFORMATION Aoao - MISC.- REFER TO ORD X 3 I hereby affirm Thal 1 am exempt from the Contmetdr's License VALUATION '$/FT. H ¢ 0< Law for the following reason.(See.7031.5,Business and Professions PERMIT ISSUANCE 10.00 6� w Code:Any city orcounty which requires a permit to construct,alter, Q ¢ ¢ 0 improve,demolish,or repair any Structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. a O ¢ requires the applicant for such permit to file a signed Statement that TOTAL t PE MIT i0 K m¢ Ile is licensed pursuant to the provisions of the Coatrnctor'I:License _ T r'ii Law(Chapter 9(commencing with Section 7000)of Division 3 of the (N `L' /u d4F a Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT - FEE I i o ¢ I- o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONS R. a �-- byanyapPlieant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($5000.): ❑ 1,as owner of the property,or my employees with.wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,GOND. 5.00 Code:The Contractor's License Law does not apply to an owner at �! property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5,00 z FLOOR AREA Torat ACREAGE himself or through his own employees,provided that Such improve- ' ments are not intended or offered for sale.If,however,the building AS-EA.SYSTEM-1'INC.40UTLETS 6.00 - or improvemmutis sold within one year of completion,the owner- GAS-EASYSTEM OVER 4 (EA) 200 builder will have the burden of proving that h . - . . e did not build or im. BUILDING USE Prove for purpose of sale.). INDUSTRIAL WASTE I NTER. 30.00 RES IND CON PB Omer ❑ 1,as owner of the property,am exclusively contracting with 1:11:10 1:1 • ❑ licensed contractors to consro" the proiect(Sec.7044,Business LAWN SPRINKLERS-1 INC 6 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 A, � .00 ^ contracts for such projects with a contraclops)licensed pursuant to the Contractor's License law. SEWER-SANITARY-STORM EA.2001t/10.00 TRACT,NO. PARCEL NO. ❑' lam exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT I `� 6.0 - reason - Owner (y ry' JgjIL'i(_ tiuc WATER SYSTEM ACC.DATE ACC.FILE NO. WORK Ii RS'COMPENSATION TTI::CLARATItWATER TREATING EQUIP, I y .00' t I hereby affirm that I have a certificate of consentdR self-insure, s or a certificate of Workers'Compensation haumnce,or it certified. - ZONING ENG.SITE NO. - cnpy thereof(Sec.3800,Lab.C.). , Policy No. Company O Cl Certified copy ishereby furnished! FIRESPRMK ENERGY T-24 Z Z ❑ Certified copy is filed with the city inspection division. - O Applicant MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ .N❑ ~ wPERMIT ISSUANCE 10,00 v FLOOD ZONE L.U.C.A. CC •CERTI FICATE Op EXEMPTION 17 ROM WORK Ii RSI lL �_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. d O (This Section need not be completed if Ore permit is for one TOTAL - Y❑ N❑ Y ❑ N❑ Z hundred dollars($100)or less.) U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL,F' m mil is issued,I shall not employ any person in any manner so as In - U- become subject to the Workers'Com ensalion laws of-California. O w ) pBUILDING 4-V M Date-Applicant - ALTER OR ADD TO MECH. 5.00 O - } m NOTICE TO APPLICANT: If,after making this Certificate of Ex- f" Z emPtion,you should become subject to the Workets'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=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a constructio olending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). 'HEATING UNIT(TO 100,000 B.T.U.)' 8.00 + Lender's Name - Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC30 V I certify that I have read this to applicat 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 m building construction, unci BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 V hereby authorize representatives'of this city to crier upon the BOILER-COMP (Over 100,000 BTU)SEE-FEESCH, 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 in any way accrue against said City in.consequence of the PERMIT ISSUANCE 10.00 grunting f this permit MECH.CONT.. LIC.NO. MECH. TOTAL' 'Sig tumof ADPH atContrxcmr TOTAL W 7� OFFICECOPY - J POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO Pfl�%%Ir NUMBER INSPECTION DIVISION 11129 JOB INSPECTION RECORD ��'J• PERMIT EXPIRATION JOB ADDRESS ///aJ�����"�-�'�✓�S �� UNIT# LOT# PERMIT EXPIRES IF WORK OWNER �//� u. ('-N £" CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PREGUNITE PERMIT VALIDATION I)l L POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND / ' I7 // ' •/ PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ELECT. PLG, MEEK 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $/FT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL FRAMING INSULATION STORIES TYPE CONSTR. OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 0 FT FLOUR AREA TOTALACREAGE ROOF , . DIAPHRAGM BUILDING USE RES IND CON PB Olu.� APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ El ASSESSORS PARCEL NO. ROUGH PLUMBING GAS TEST L TRACT No. PARCEL No. me MECHANICAL .P kec. ACC.DATE ACC.FILE No. ELECTRICAL � �.-� FINALS DA E INSP. FRAMING / SAN # ZONING ENG SITE NO. INSULATION PLUMBING GAS FIRE SPRINK ENERGY T34 MECHANICAL v ❑ N[:] r ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A.LU.L. LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEPT. Y NY ❑ N❑ SHEETROCK GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY I ISEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC f 11 LU PLUMBING � ONE WORKING DAY BEFORE REQUIRED INSPECTION. - 1 PLEASE GIVE JOB ADDRESS WHEN PHONING. �r Z — SEE PERMIT FOR EXPIRATION DATE — MECHANUgA. _Bi CaP.arur:0 IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. :APPLICANTS POSTING COPY .w N Cp m m m m a _ter, 1 � I I t - ! --'r X�zz i E � < LA m IT T C1.1-I off: m :) -�( W , m_ CD C ft ri rb - ,- -