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14021 POST THIS CARD NEAR FRONT OF BUILDING ' + CITY OF CUPERTINO Rb,IT NUMB INSPECTION DIVISION 14021 1� JOB INSPECTION RECORD v� 0Lic-4s RZ, PERMIT EXPIRATION JOB ADDRESS CHABOT. GALLERIES UNIT# LOT# PAUL ZUEGLER PERMIT EXPIRES IF WORK OWNER CONTRACTOR FESSENMEYER BLDRS IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM ' LAST CALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE i POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB p l � • c PLUMBING f� ELECTRICAL - Uti — iI SUANCE DATE MECHANICALSLDGV' ELECT. PLG. MECH. ❑A, ❑ ❑ 0 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT I, WOOD FLOOR INFORMATION s/Fr. PLUMBING vnwnno� MECHANICAL r ELECTRICALPERMIT To I .t7:1, t"C.: ",r,t- FRAMING sroRlEs TYPE coNSTR INSULATION , OCC,GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED . ROOF - S O.FT.FLOOR AREA' TOTAL ACREAGE DIAPHRAGM I. BUILDING USE M RES IND CON PB 0'." APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING TRACI'NO, PARCEL NO. GAS TEST MECHANICAL - ELECTRICAL FINALS DATE INSP. ACC DATE 'ACC.FILE NO. FRAMING - SAN # INSULATION PLUMBING zoNlNc ENG.SITE NO. GAS MECHANICAL FIRE SPRINK ENERGY T]A COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑ LATH—INTERIOR ELECTRICAL FLOOD ZONE A.L.UC. LATH—EXTERIOR - FIRE DEPT, Y❑ N❑ Yo N❑ SHEETROCK GRADE FEE SUMMARY S AR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F 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 r CALLING FOR FINAL INSPECTION. J C',� OFFICE COPY - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT.PEN ONLY 'BUI LDI PR JECT EN FICATION - PERMIT NUMBER ` aDILpING APPLICATION & PERMIT 14021 4 O 2 1 AoIR s.� C'd� -I H- r - 1 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNERS _ 30 3 PLAN CHECK VALIDATION V. ELECTRIC PERMIT FEE l ZIP ftSCJ PHON CONTRACTORS I UTLETS-SWITCHES-RECEP 10.00/1:00 ldISuC.No. ILIGHTING FIXTURES I .10.00/1.00 CONTRACTOR'S C'y4rl - APPLIANCES-RESIDENTIAL. 4.00 ZEss ]�f�'� JJ D Sx-ON PANELS 10.00 DATE OF APPLICATION OR RCNITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.O.NO. ENGINEER LIC.No. SIGNS TRANS. 3.00 ADDRESS Ervc. SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 �( J APPur cnrvs ADDRESS MOTORS SEE FEE SCH. ' SERVICE CHANGE 20.00 F o o LICENSED CONTRACTORS DECLARATION 00�u 1 hereby affirm that I am licensed under provisions of Chapter 9 L - ISSUANCE DATE z "' (commencing with Section 7000)of Division 3 of[he Business and - BLDG. ELECT. PLG. MECH. w to Professions Co and m license is in full foi{ccC�y�qs��LLe[j�ctY , ."],tt� ❑ Z.o H - &,cense Cla y Lic.Number V ZL 7 - ' ;} nl o r D Date Contractor y s a BUILDING PERMIT LE Mw OWNER-BUILDER DECLARATION INFORMATION wo 'MISC.- REFER TO ORD ;A w 1 hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. w 00j Law for the following reason. 7031.5,Business and Professions PERMIT ISSUANCE 10.00 �S-. .4.f1 , w Code'.Any city or county which requires a permit to construct,alter, O //�r��/ �v 2 M 4 0O Improve,demolish,or repair any structure,prior to its Issuance,also ELEC.CONTR. LIC.NO. ELEC. at o u requires the applicant for such permit to file a signed statement that TOTAL PERMIT T K m he is licensed pursuant to the provisions of the Contractor's License Fit Law(Chapter 9(commencing with Seotion 7000)of Division 3 ofthe ��1/7EQ4I L. 0 at Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE E F O rhe 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 penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars 1$500L): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 oce.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 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsare'not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SV STEM-OVER 4(EA) 2.00 BUILDING uSE builder will have the burden of proving that he did not build or im- RES IND CON PS Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ El ❑ 1:1 ❑ 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 SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ Iain exempt under Sec.-,B.&P.C.for this 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 1 hereby affirm that 1 have a certificate of consent to self-insure, - ZONING - ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy Cher p f 80q`iab.C, Policy N(I�Q7JT/J6PanY r in ilt4 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z Certified copy is filed wi01 the city inspection division. P: - MISC- REFER v TO ORD. ❑ N❑ ❑ N❑ . O PP cant v N PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > -FICATEEXEMPTION FROM WORKERS' UJ _ - - COMPPEE NSATION INSURANCE. PLG.CONTR. LIC.NO. PLG. d O '(This section need not be completed if the 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- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. w Date Applicant P BUILDING ..� PP ALTER OR ADD TO MECH. 5.00 ). m NOTICE yo APPLICANT: If,after making this Certificate sa F.z- FZ eruption,yof the dbecomesubject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK C7 provisions io the Labor Code, you dee forthwith comply with V such provisions or this permit shall be deemed revoked. , AIR HANDLING UNIT(TO 1Op00C.F.M.) 4.00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 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,Civ.C.L HEATING UNIT(TO 100,000.B.T.U.) 8.00 Lender's Name HEAT[NG U N IT ER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct.1 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 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEESCH. MECHANICAL above-mentioned properly 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 a way accrue- last said City in consequence of the PERMIT ISSUANCE 10,00 grant fthis perm . MECH.CONT. LIC.NO. MECH. TOTAL TOTAL 3S� reo pplic nt onlmclor Dale OFFICE COPY '