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18189 POST THIS CARD NEAR FRONT OF BUILDING PERMiTNUMRER CITY OF .CUPERTINO. 1 8189 INSPECTION DIVISION JOB INSPECTION RECORD /yam J PERMIT EXPIRATION JOB ADDRESS YY 4,eC. �r_�C[_U N IT# _LOT# ' PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN I SPECTION DATE INSPECTOR INSPECTION CORD 180 DAYS OF PERMIT ISSU FOUNDATION ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER -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 Fax : UNDERGROUND /SLAB PLUMBING �VIV 11 IJV4I ELECTRICAL IJV ISSUANCE DATE MECHANICAL R G,•_ u eLOc ELECT PLc. m Jr11Q1(y0➢ ECH ❑ ❑ 1 ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION PLUMBING WOOD FLOOR VALUATION SIFT. MECHANICAL ELECTRICAL - I&TO 1u,� FRAMING eL - �Ec INSULATION _ STORIES. -- TYPE CONST OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO FT FLOOR AREA TOTAL ACRFAce ' DIAPHRAGM THE CONSTRUCTION TAX IS PAID aulLom USE ROOF SHEATHING � Hes IND CON . ve olr., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. E- ❑ E] ❑ ROUGH SAN.p ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY . _ TUBS&SHOWER PAN PLUMBING ENERGY TRACT NOPARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC GATE ACC.FILL NO, FRAMING ELECT.FINAL TEST - INSULATION PLUMBING ZONING ENG.SITE NO. • GAS TEST - GAS MECHANICAL FIRE SPRINK ENERGY T 14 /i • COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [3 'N[] I Y ❑ NF] EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE A L U C INTERIOR SHEAR FIRE DEPT. Y❑ N❑ Y ❑ N❑ SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ' ELECTRIC PLAN CHECK ' GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTEDU NTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM EWER ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z° 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. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER APPLICATION & PERMIT BUILDINGADDRESS 1818 9 ADDRESS - + BUILDING-ELECTRICAL-PLUMBING-MECHANICAL '�R • OWNERPLAN CHECK VALIDATION NAME OTY. ELECTRIC PERMIT FEE _ PHONE CNAMCON ACTo s, p y OUTLETS-SWITCHES-RECEP 10.00/1.00 /v 1160,4- uC.NO.JO /Z LIGHTING FIXTURES -10.00/1.00 CONT ACTOR',7 6 � �,/ PPLIANCES-RESIDENTIAL 4.00 aooREss ✓/VsY ' PHO O 2, PANEL$ 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO.- OR ENGINEER LIC.NO. SIGNS TRANS. 3.00 AARCH.OR DDRESS ENG SPECIAL CIRCUIT .5j 00 - PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT - MOTORS SEE FEE SCH. - SERVICE CHANGE _ _ '20.00 w o o LICENSED CONTRACTORS DECLARATION 8"y 'I ��✓ a La I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE H (commencing with Section 7000)of Division 3 of the Business and Q a 8 BLD ELECT. PLG. MECH. M u, H N a Professions Co>d� license is in full for f y - ❑ ❑ - ❑ z o m- Professions Class �%' sec. infall 9 y Date-C.1 ¢ ¢ a OWNER DECLARA'fl�N '�• -` BUILDING PERMIT ¢ w v INFORMATION X 3 LL H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD m VALUATION SIFT. I u o J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 mN Code:Any city orcounty which requires a permit to ter, - ¢ ¢¢o improve,demolish,or repair any structure,prior to its issuuncc,also ELEC.CONTR, LIC.NO. ELEC. a0 u requires the applicant for such permit to file a signed statement that TOTAL PER TO E $ he is licensed pursuant to the provisions of the Contractor's License CV H z r Law(Chapter 9(commencingwith Section 7000)of Division 3 oftbe i 4 Qo Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE R� ¢ 1-$ Ole basis for the alleged exemption.Any violation of$ection 7031.5 STORIES TYPE CONST a 3 by any applicant for a pemlit subjects the applicant too civil penalty of not more than five hundred dollars($500).F. ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their ate compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5,00 Code:The Contract.,',License Law docs not apply to an owner of properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 50,FT.FLOOR AREA TOTAL ACREAGE himself Tnsarr not hrough ownemployees,for sale. 1i,ed that however,the improve- GAS-EA.SYSTEM-1 6.00 meats are not immndM or offered for sale.If,however,the budding or improvement is sold within One year of completion,Ow owner- GAS-EASYSTEM-OVER 4 (EA) 200 builder will have the burden of proving But h . . . e did not build or int- BUILDING USE prove 1for,aso nee of sale,). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ L as owner of the properly,he exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors: I construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The builds Contractor's License Law does not apply to owner of property who builds or improves thereon,and who LAWN SPR INKLER$-OVER 5(EA.) 1.00 contracts Comsat such ts Lwithucontrucdm(a)IicenscA purxusntm SEWER-SANITARY-STORM EA.200tt/10.00 the Contractor's License SLc. TRACT NO. PARCEL N0. ❑ lam exempt under Sec. ,B.&Poco fur this WATER HEATER W/VENT 6.00 - reas'.n Owner [)ate WATER SYSTEM 5.00 ACC.DATE ACO,FILE N0. WORKERS'COM PENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-iosun' ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance or a cernilied copy Iher BLab,C.1. Ny5• Policy No� Pany� O ❑ Certified y re byfurnished. FIRE SPRINK ENERGY T-24 Z A Ol.�S-ertifie Iled wi I• y inspection Division. MISC.- REFER TO ORD. PPln.mt jir_ Y [:] NV [:] N❑ ❑ CC w Ci RI'IFICOlr EXEMPTION WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. W > COMPIiNOINSURANCE PLC.CONTR. LIC.N0. _PLG. ' CL O (This section need not be completed if the permit is for one TOTAL Y❑' N❑ Y ❑ IN❑ 0 Z hundred dollars IS 100)or less I U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY W I. mit is issued,1 shall not employ any person in any manner so as to V + become subject to the Workers'Comperod ion Laws of California. O W Datc Applicant BUILDING a ALTER OR ADD TO MECH. 5.00 } m NOTICE TO APPLICANT: 11,after making this Certificate of Ex. F ? emption,you should become subject to the Workers'Compensal ion 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=C.F.M.) 4.00 CONSTRUCTION LANDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 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. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lenders Address HEATI NO UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state tam the above VENTILATION FAN S1194)) 4.00 information is correct. I agree to comply with all city and county g01LER•COMP19#tP.or'1 ,000B.T.U.1 6.00 p PLUMBING - ordinances and slate laws relating to building cons(ruclion, and hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL QO above-mentioned property for inspection purposes. (We) oree7o save, inde y and keep harmless the City of MISC.- REFER TO ORD. cupLW.fA u gmenu, costs and expenses which pERM1T ISSUANCE 10,00 Z,v CONST.TAX maya' s[ said City in consequence of therm0MENL LIC.NO. MECH. .Zg, TOTALTOTALSignctor Date 4 7/ OFFICE COPY