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15234 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15234 ' INSPECTION DIVISION . ' JOB.INSPEC"fION RECORD F . ` PERMIT EXPIRATION JOB ADDRESS 10101 Wolfe Road UNIT# _LOT# PERMIT EXPIRES IF WORK .OWNER Sears Financial CONTRACTOR - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION - - .NOTE: LASTCALLED INSPECTION.OR 180 DAYS FROM , ' UFER - ALL GRADING AND DRAINAGE'SHALL BE INSTALLED e PR EG UNLTE TO COMPLY WITH THE APPROVED'PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SCABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 6_ 9_8- - w9 •.YI-Q- _ UNDERGROUND /SLAB PLUMBING _• ELECTRICAL - ISSUANCE LATE MECHANICAL .BLGc:. I-,. MECH. ❑ ELECT Po El ±❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION PLUMBING vALunnpwN SIFT. MECHANICAL ELECTRICAL - PERMIT TO FRAMING INSULATION STORIES TYPE CONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO FT.FLOOR AREA -TOTAL ACREAGE' ROOF NOTE:NO FINAL INSP.SHALL'BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND CON PB 0"" ' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.# ASSESSORS PARCEL NO ' PLUMBING - ' ELECT.ENERGY ~ 1 HACT NO, PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ' ELECTRICAL ACC DATE ACC.FILE NO '. BUILDING ENERGY - FRAMING ELECT.FINALTEST INSULATION PLUMBING ZONING ENG,SITE NO. GAS TEST ' - GAS I MECHANICAL FIHE SPRINK ENERGY T 24 - ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ ❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE AL UC. Ulm INTERIOR SHEAR - FIRE DEPT. Y E] N❑ v❑ N❑ SHEETROCK _ o - GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATHTEMPORARY APPROVALS BUILDING , SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY. PHONING 252-4505, ELECTRIC ''. F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. Z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL Y 0 CONST.TAX IMPORTANT!. , .,err. PLEASE READ REVERSE SIDE BE '" x { CALLING FOR FINAL INSPECTION, TOTAL OFFICE COPY APnICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION -PERMIT NUMBER' r, BUILDING APPLICATION & PERMIT 176 ADDSE5 [ p 45 1 ` J �D (OI •,.N/6� G BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'5 PLAN CHECK VALIDATION NnME I S S ✓ g.L_vAellE'� QTY- ELECTRIC PERMIT FEE CONTRACTOR'S NAME (y / OUTLETS-SWITCHES-RECEP 10.00/1.00. L( 6 kst G(.G��1 uc.ND. LIGHTING FIXTURES _ 10.00/1.00 COADDRESSSS NTEDR's PPLIANCES-RESIDENTIAL 4.00 ® -J PHDNE PANELS 10.00 - "DATE OF APPLICATION, ARCHITECT - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C:NO. O OR ENGINEER ' - LIC.NO. SIGNS TRANS. � - . 3.00 ADDRESS ENG SPECIAL CIRCUIT 5.00 - PERMIT VALIDATION nv TEMP.METER OR POLE INS. 20.00 - APPLICANT'S MOTORS SEE FEE SCH. ADDRESS .. - .,. SERVICE CHANGE aimloo woo LICENSED CONTRACTORS DECLARATION VV - <u r~a I hereby affirm that I am licensed under provisions of Chapter 9 \� ISSUANCE DATE H 2 w (commencing with Section 7000)Of Division 3 of the Business and _ BLDG. ELECTPL . G. ,MECH, H m i LProfessions Code am my license is in full fur pe e t - X� 0 .❑ o Z wr - icense Cla - 'Lia Numbe hh(i � .L IIP O Date �� Contra rub YA pw_- . -BUILDING PERMIT E K w a OWNER-BUILDER DECLARATION INFORMATION oa MISC.- REFER TO ORD E g u w I hereby affirm that I am exempt from the Contractor's License VALUATION -$/FT. r LL o j Law for the following reason.(Sec.703 1.5,Business and Professions PERMIT ISSUANCE -}(}BB Code:Any city or county which requires a permit to construct,alter, ac improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. u requites the applicant for such permit to file a signed statement that TOTAL /J 'S� �-•PERMIT TO u w m he is licensed pursuant to the provisions of the Contractor's License Hzi Law(Chapter 9(commencingwhh Section 7000)of Division 3 oflhe rt Business and ProfessionsCode)or[hal he is exempt therefrom and QTY. PLUMBING PERMIT FEE r -- r m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. La by any applicant for a permit subjects the applicant boa civil penalty ALTER-DRAIN -WATER IEA.) 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 OCC.GROUP RES.UNITS, sole 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 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 TOTAL ACREAGE himself or through Kis own employees,provided that such mGAS-EA.SYSTEM-11NC improve- '�•. me s are not intended or offered for sale.If,however,the building .40UTLETS 6.00 .. or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE , builder will have the burden of proving that he did not build or im- RES IND CON PB Other- 0 prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed Contractors to construct the project(Sec.7044,BusinessLAWN 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 contractor(s)licensed pursuant to SEWER-SANITAR V-STORM EA.200ft/10.00 the Contract.,',License Law. TRACT NO. PARCEL NO. ❑ 1 am exempt under Sec.-,B.&P.C.I'or this WATER HEATER W/VENT 6.00 ' reason Owner Date WATER SYSTEM 5.00 . ACC.DATE ACC.FILE N0. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP.. 5.00 I hereby affirm that I have a certificate ofconsent to self-insure, ZONING ;ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified r...p copy thereof(Sec.3800,Lab.0 I l Policy No. Company a14lGYLCyr Y- 51<rX Q ❑ Certified copy is hereby fumished.k)d 1.77J--W- -X e FIRE SPRINK ENERGY T 24 Z Z ❑ Certified op is fit w''�u( he city inspection division. Applicant T MISC.- REFER TO ORD. YC] NEIY ❑ `N❑ Hy PERMIT ISSUANCE 10.00 - FLOOD ZONE A.L.u.c. Ir CERTI CATE OP EXEMPTION FROM WORKERS' LI > COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG. CL 0 fThis section need not be completed if the permit is for one TOTAL Y❑ N❑ y❑ N❑ D Z hundred dollars(S 100)or less) 0 O 1 certify that in the performance of the work for which this Per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H out is issued,I shall not employ any person in any manner so as to OW become subject to the Workers'Compensation Laws of California. d Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } m NOTICE TO APPLICANT: If,after making this Certificate of Ex- emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE C..1 Such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO'10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000CEM.) 6.00 SEISMIC FEE 1 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,Ch,.C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UN IT(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 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 Rol hereby authorize representatives of this city to enter upon the BOILER-COMP 10ver 100,000 BTU)SEE FEE$CH. 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 rapt) g of this permit '\ MECH.CONT. LIC.NO. MECH. TOTAL TOTAL S ure of Applica t/Contractor Date OFFICE COPY /