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16370 POST THIS CARD NEAR'FRONT OF BUILDING PERMIT NUMBER ' CITY OF CUPERTINO " 16370 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS //p 6S •w7S '�Gs CT UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER PQBG-CQ CJ b CONTRACTOR _I IS NOT STARTED WITHIN INSPECTION DAIFE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT,ISSU- FOUNDATION ANCE OR 180 DAYS FROM • NOTE: LAST CALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED . UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE uATE MECHANICAL BLDr. ELECT PLG! MEC. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR nLunnDN - SIFT. PLUMBING ',,. 1 MECHANICAL ELECTRICALFERN' TD FRAMING (W" • d L� INSULATION STORIEZ IYPE CONSTR. OCC GROUP RFS UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.F! FLOOR ARCA TOTAL ACBFAr,e DIAPHRAGM I I THE CONSTRUCTION TAX IS PAID - BUILDING USE ROOFSHEATHING —sj , C r RES IND CON PB OR... APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ 0 ❑ ASSESSORS PARCEL NO, ROUGH SAN,9 PLUMBING ELECT.ENERGY TRACT NO, PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH,ENERGY ELECTRICAL IAW BUILDING ENERGY ACC.DATE ACC.FILE NO FRAMING - Q ELECT.FINAL TEST ZONING ENO.SITE NO. - INSULATION - PLUMBING GAS TEST II. !..23_81 zc IGAS FIRE SVRINK ENERcv T 2 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v "� ° NE] FLOOD]ONE ALUC. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. No SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH BUILDING - INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRICPLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPAN CY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED By BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505,' ELECTRIC w o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - rMECHANICAL IMPORTANT! T.TAx PLEASE READ REVERSE SIDE BEFORE TALI ' CALLING FOR FINAL INSPECTION. �1j OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ''; BUPlDI NG PROJECT I DENT[FICATION yp .PERMIT NUMBER aUILO1NG - oClr APPLICATION & PERMIT [� I]O ADDRESS lJ 1 / � �J BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S J PLAN CHECK VALIDATION NAME DTV. ELECTRIC PERMIT FEE _;7) CONTRACTORS NAM ERADTOR's.G AfV UTLETS-SWITCHES-RECEP 10.00/1.00 .. ..•k G� ec ,G uc.No. Q� LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'SI �y�,,," l/ APPLIANCES-RESIDENTIAL 4.00 POOR ESS // PHON!/E PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER _UC.NO. SIGNS TRANS. 3.00 - A OGRESS ervc. SPECIAL CIRCUIT S.00 PERMIT VALIDATION ZIP EMP. METER O OLE INS 20.00 APPLICANTS MOTORS SEE FEE SCH. AODRE$S / / SERVICE CHANGE 20.00 o o LICENSED CONTRACTORS I)ECLARATIO< - f t �•1�0 a - a u w I herehy affirm that 1 ant licensed under provisions of Chapter 9 SUANCE DATE w ¢w (commencing with Section 7000)of Division 3 of the Business and 0 ECT. PLG. MECH. r 0 z Professions Cod' n se is in full fore ad f c1. z 0'J,' - License u'• Lic.Nmnber -e--f/es� 2 m I-2 Date Cnntrucror J Q2'.'iG_ ¢ y id C'tyxualf"BUILDMI3 PERMIT ¢ ¢ a OWNER-BUILDER DECLARATIONINFORMATION a'xt N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD uo¢ Law for the following mason. 7031.5,Businesiand Professions PERMIT ISSUANCE 10.00VALUATION $/FT. � - J Code:Any city or county which requires a permit to construct,alter, QQ Q 0 Improve,demolish,or repair any Structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT T9,_,w $ he is licensed pursuant to the provisions of the Contractor's License y) z i Law(Chapter 9(commencing with Section 7000)of Division 3 of the �� • /-O LC g 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ H o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN -WATER (EA.) 5.00 .fn 0 1 more than five hundred dollars($500).):0 I,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 Sold Professions DRAINS-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 work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE ` 4y himself or through his own employees,provided that such improve- mmWwGAS-EA.SYSTEM-11NC.40UTLETS 6.00 y 1 es are not inlmed or offered for sale.If,hower,the building - r or improvement is sold within one year of completion,the owner GAS-EASYSTEM-OVER 4 IEA) 200 builder will have the burden of proving that he did not huild or im- . . . BUILDING USE prove for purpose nfsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Om., ❑ I,as owner of the property,am exclusively Contracting with ❑ El El licensed contractors to construct the project(Sec. 7044,Business - LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Corte:The Contractors License Law does not apply to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 contracts fursuch projects with acontractods)licensed pursuant to SEWER-SANITARY-STORM EA.200f[/10.00 the Contmclur's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec. - ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO, W'ORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 l hereby aff¢m that l hove uc'crtiFicate ofconsent to selfinsum, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy lhereof(Sec.3800,Lab.C.). Policy No, Company Q ❑ Certified copy is hereb �srl'shed. FIRE SPRINK ENERGY T-24 Z_ Z -Certific o) d y h et e n division. MISC.- REFER TO ORD. O pplica0t Y❑ N❑ Y ❑ . No ~ can LU CERTIFIATE OP I PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W COMPIiNSAAl1ION INS FROM WORKERS'. � ' URANCIi PLG.CONTR. LIC.NO. PLC. 13 11 lin, section need not be completed if the permit is for one TOTAL Y[DF]N Y [D N❑ hundred dollars($100)or Icss.) ) 0 ],certify that in the performance of the work for which this per QTY. MECHANICAL PERMIT FEE FEE SUMMARY W F mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of CulifWaia. y Dara Applicant ALTER OR ADD TO MECH500 mBUILDING >_ m NOTICE 1'0 APPLICANT': If,after making this Certificate of Ex- . . F ? eption,you slmuld become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions althe Labor Code, you most forthwith cmnply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 ' CONSfRUC'1'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency I'or EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT 170100,000 B.T.U.) 8.00 Lender's Name- H EATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC �+ \xv) I 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 801LER•COMP(3 H.P.or 100,000 B.T.U.1 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP lover 100.000 Biul SEE FEE scH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to Save, Indemnify and keep harmless the City of MISC'.- REFER TO ORD. uperI mo against ilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX ay in any w' accrue against mid C'y in consequence of[he ranlin O(1 n -'7/ MECH.CONT. LIC.NO. MECH. TOTAL TOTAL a� Si re ol'Applicanl/Cmttnc�tar. Date OFFICE COPY