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10566 POST THIS CARD NEAR FRONT OF BUILDING, PERMITNUMBER ' CITY OF CUPERTINO 1 fi5�6 INSPECTION DIVISION JOB INSPECTION RECORD - r,,r�� PERMIT EXPIRATION .i JOB ADDRESS �o�aL3dLF� AA UNIT# _•LOT# PERMIT EXPIRES IF.WORK I ' OWNER pe-11b, AL CONTRACTOR E E' L', IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTIONRECORD 180 DAYS OF PERMIT ISSU- ' FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. . LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED' TO COMPLY WITH THE APPROVED PLANS AND CITY OF reHn+rt VALIDATION PREGUNITE - CUPERTINO STANDARDS. _ GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED '.UNDERGROUND /SLAB PLUMBING ELECTRICAL - - ISSUANCE DATE' MECHANICAL BLDG ELECT, PLG. MECH. !, . .❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR _ VALUATION s/FT. PLUMBING' MECHANICAL Ok Oc�7 Sip 6-o.S. U Q� ELECTRICAL � 'E - » OI�lPERMIT TO • • FRAMING roRles TYPE coNSTH INSULATION . iz-s-strsh dy OCC GROUP RES.UNITS �•-- PLACE NO SUBF.LOOR UNTIL ABOVE HAS BEEN SIGNED ' so Er,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 Om,= APPLYNO ROOFING UNTIL ABOVE HAS BEEN: El El SIGNED FINALS DATE INSP.—. ElASSESSORS PARCEL NO. ROUGH SAMA PLUMBING ELECT,ENERGY TRACT NO. PARCEL NO TUBS&SHOWER PAN _ .PLUMBING ENERGY MECHANICAL MECH. ENERGY ELECTRICAL BUILDING ENERGY ACC.DATE ACC tRILE NO FRAMING' - - ELECT.FINAL TEST ZONING ENG.SITE No. INSULATION PLUMBING ' GAS TEST GAS FIRE SPRINK ENERGY T 2a MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ NE ❑ N[] FLOOD ZONE A UC. EXTERIOR SHEAR ELECTRICAL RELEASE Y ❑ No Q No, INTERIOR SHEAR FIRE DEPT. SHEETROCK 1GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COATELECTRIC PLAN CH. GAS FEE - SI` NO TAPE OR PLASTER UNTIL`ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC SEE I OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAUISSIGNED BY BUILDING INSPECTOR'. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LU WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING i O� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z ffECCHAL + - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! x PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. _ - OFFICE COPY, . APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT-PEN ONLY ` a_ " ''BIUI LDING PROJECT I DENTI FIC TION PERMIT NUMBER- .. BDLLDIND 'APPLICATION &"PERMIT M 1 �� (9/ BUILDING—ELECTRICAL—PLUMBING — ECHANICAL I iso 9�/ o9a N 'S PLAN CHECK VALIDATION ""M f OTY. - ELECTRIC PERMIT FEE nd a M + a.UNE 1,x,3 s✓: � CONTRACTOR'S OUTLETS-SWITCHES-RECEP 10.00/1.00 Nr 1 L � rk)-er ` /1 C,No. a�p 3. LIGHTING FIXTURES 10.00/1.00 •. CONTRACTOR'S JAPPLIANCES-RESIDENTIAL- 4.00 ADDRESS qq/� �f/ PHONE pL95 V/r4 PANELS - 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. O. OR ENGINEER ' uc.No. SIGNS TRANS. 3.00 ARCH.OR ENO. SPECIAL CIRCUIT 5.00PERMIT VALIDATION ADDRESS ZIP TEMP.METER OR POLE,INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESS SERV ICECHANGE 20.00 / ,02 0o LICENSED CONTRACTORS DECLARATION ¢'o 0 1 hereby affirm that I am licensed'under provisions of Chapter 9 CE DATE ¢ z w (Commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. so y i Professions Code,and my license is in full force and effect. ❑ ❑ ❑ z 0 m — License ClessCdl3f3a, o Lie.Number - caw H w Dam' Contractor H BUILDING PERMIT ic >'¢ ¢ OWNER-BUILDER DECLARATION INFORMATION wa: - MISC.— REFER TO ORD g u 1 hereby afflr r that I am exempt from the Contractor's License VALUATION $/FT. r .. 0 ¢ Law for the following reason.(See.7031.5,Businessand Professions PERMIT ISSUANCE .10.00 Code:Any city or county which requires a permit to construct,alter, re to Q 0 Improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. - ELEC. O¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO o. w m¢ he is licensed pursuant to the provisions of the Contractor's License H z a Law(Chapter9(commencingwith Section 7000)of Division3 4 0 Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE (E the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE GONSTfl. to by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).1: ❑ I,as owner of the property,or my employees with wages as - BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their 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 50.FT.FLODR AREA TOTAL ACREAGE himself or through his own employees;provided that such improve- . ments are not intended or offered for safe.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 • or improvement is sold within one year of completion,the owner- builder will have the burden of proving thathe did GAS-EA.SYSTEM-OVER 4(EA.) 2.00 euaDlrvG USE not build or im- RES IND CON PB 4 Omar prove for purpose of sale.). INDUSTRIALWASTE INTER. .30.00 ❑- I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑' ❑ licensed 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 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 contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lamexemplunder Sec. .B.&P.C.fortpis WATER HEATER W/VENT - 6.00 ` reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that I have a certificate of consent to set Flnsure, : ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or u certified copy thereof(Sec.3800,Lab.C.). ^ Policy No ompany ° - - Q ❑ Certiiedcopy.is hereby furnished. I FIRE SPRINK ENERGY T-24 Z Z A Certified,copy is Bled with the city 'mspeelioo division. MISC.- REFER TO ORD. Y N Y N C) Applicant ❑ "❑ ❑ ❑ F $ PERMIT ISSUANCE . 0 FLOOD ZONE A.L.uc. CERTIEICATI30F fiXEA1PTION FROM WORKERS' DJ > COMPENSAT'ION INSURANCE PLG.CONTR. LIC.NO. CL O (Phis section need not be completed if the permit is for one AL % V❑ N❑ YE] N❑ 2 hundred dollars IS 100)or ICs,.) r� U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT6$` Y F Q FEE SUMMARY LL h mit is issued,I.shall not employ any person in any manner so as to VV Ow become subject m the Workers'Compensation,Laws of California. BUILDING Date Applicant ALTER OR ADD TO MECH. NOTICE. TO'APPLICANT: If,after making this Certificate of F.x- - f— ? emption,you should become subject to the Workers'Compensation APPLIANCE. .00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with FEE U Such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO l0,OD0 C.F.M.) .-490 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10000GRM.) 6.00 SEISMIC FEE' I hereby affirm that there is a construction lending agency for 25 EXHAUST HOOD (WITH DUCT) • —SBO , the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 7 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that l have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING „r•' ordinances and state laws relating to building construction, and e,( hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. ,MECHANICAL V 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 y in cons edce of the PERMIT ISSUANCE 49(00 /�- M antingof ispermil. MECH.CONT. LIG NO. TOTAL - D TOTAL ig ore ofstiplicart/Cont Date OFFICE COPY