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14449 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY ,OFCUPERTINO 1.4449 . INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS 10123 N WOLFE ROAD - UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER •MRS. FIELDS CONTRACTOR FEDERAL, SIGN - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - -NOTE: ANCE OR 180 DAYS FROM LIFER � � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLE DINSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF -PERMIT VALIDATION CUPERTINO STANDARDS. GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED X+ ' UNDERGROUND /SLAB PLUMBING ELECTRICAL - ISSUANCE LATE ' MECHANICAL - BLOC ELECT. PLC. MECH. ❑ ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT • WOOD FLOOR - INFORMATION VALUATION '0 SIFT. PLUMBING MECHANICAL ELECTRICAL - PERMIT To FRAMING sroRlEs Tuve comsrR INSULATION . OCC CHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS 8EEN SIGNED .• - ROOF NOTE:NO FINAL INSP.SH41_1139 MADE BEFORE SO FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM THE'CONSTRUCTION TAX lkf AID BUILDING USE ROOF SHEATHING RES (ND CON PB 0m0, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ - ❑ C] ❑ ROUGH SAN.N - ASSESSORS PARCEL NO. PLUMBING - ELECT..ENERGY' - TUBS&SHOWER.PAN PLUMBING ENERGY TRACT NO PARCErNO MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC DATE ACC FILE NO FRAMING. ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATIONPLUMBING GAS TEST GAS MECHANICAL FwESPRINN ENERGY r as COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v E] " N[] EXTERIOR SHEAR' ELECTRICAL RELEASE FLOOD ZONE A,L.0 c, INTERIOR SHEAR FIRE DEPT. I Y N� v ❑ NO SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH. BUILDING- . U INTERIOR LATH TEMPORARY APPROVALS - BUILDING V Y. ._•� SCRATCH COAT' ELECTRIC PLAN CHECK GAS FEE ✓` r NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED occuPANcv SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUI LDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN.PHONING. I� MECHANICAL -'SEE -'SEE PERMIT FOR,EXPI RATION DATE.- IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE " TOTAL CALLING FOR FINAL INSPECTION. i OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY e BUILDING PROJECT IDENTIFICATION PERMIT NUMBER mrLDING APPLICATION & PERMIT A ^ (� ADOREss/D ` 4 4 9 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S !/ PLAN CHECK VALIDATION OTY. ELECTRIC PERMIT FEE .' �✓�Y/ �J. PHONE NANMERACTORs UTLETS-SWITCHES-RECEP 10.00/1.00 c // (..+_�; / �.uc.No. LIGHTING FIXTURES 10.00/1.00 ZIDDRRESS/S�TOR'S �,'��Q /J/J^ PPLIANCES-RESIDENTIAL 4.00 (�`/��H-!�/� (��'r PHGNE.�919.9 PANELS - 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) - 20.00 PLAN-CHECK FEE P.C.NO. ENGINEER LIC,No, IGNS TRANS. 3.00 ADDDR'ESS ENG' SPECIALCIRCUIT 5.00 PERM�pty�710N nP APPLICANT'S EMP.METER OR POLE INS. 20.00 "(( ADDRESS /02G .�i(��J/LfLIEL- MOTORS SEE FEE SCH. SERVICE CHANGES 20.00 w o a LICENSED CONTRACTORS DECLARATION _Q I hereby affirm that I ani licensed under provisions of Chapter 9 y Z ISSUANCE DATE < (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. H y i Professions Code nd m � ase is in full fort n ❑ ❑ ❑ ❑ Z 0 , - License Chas /- Liu.Numh-r 4 L w Date Conrracl ya ¢ ¢ w OWNER-BUILDER DECLARATBUILDING PERMIT ION X ;LL U H I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION VALUATION $/FT. H u o J Law for the following reason.(Sec.703 L5,Business and Professions PERMIT ISSUANCE 10.00 ,A Code:Any city cr county which requires permit to construct,alter, C/-' /7 'p-,.Y , oO ¢ Q. QO O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. Q{J 2/C�'�/ p u requires the applicant for such permit to file a signed statement that _ TOTAL PERMIT TO 6 W pt a- he is licensed pursuant t0 the provisions of lire Contractors License ri > Law(Chapter 9(cotnmenciagwith Section 7000)of Division 3 ofthe ¢ o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ r $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. i3 by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not mom titan five hundred dollars(5500).): ❑ 1,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 and Professions DRAINS-FLOOR,ROOF,AR EA,GOND. 5.00 Code:Tire Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work F IXTUR ES.PER TRAP 5.00 SQ.FT.FLOOR AREA TOTAL ACREAGE nt himself or through his own employees,provided that such improve- mesamnotintendedoroffered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or int- BUILDING USE prove for purpose orsale.). INDUSTRIAL WASTE INTER.' 30.00 RES IND CON PS Omar ❑ I,as owner of the property,am exclusively contracting with 1 El E• 1:1 11 licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- i INC 5 V.B. 6,00 ASSESSORS PARCEL NO. and Professions Code The Contractor's License Law does not amply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.), 1.00 contracts forsuch projects with a contractorts)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. _❑ I 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 NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-instim. or a certificate of Workers'Compensation InsuruncD ortified ZONING ENG.SITE NO. -'�=• copy thereof lSec.3800,LaN Policy No. party i f _ Q Ce,ified copy¢ 2 yfumisheJ FIRE SPRINK ENERGY T 24 n Certifi�)) 'drr11i Nh inspection division. � O Applicant / 1 /` � � MISC.- REFER TO ORD. v0 NE] v ❑ No � y CERTIFICATE OP EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU COMPENSATION INSURANCE. PLG.CONTR. LIC.NO. PLG, CLZ( This section need not be completed if the permit is for one TOTAL Y E] N� Y❑, NE] U O hundred dollurs(SI00)or less. I certify that in the performance of the work for which this,per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- 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 California. Date Applicant ALTER OR ADD TO MECH. 5,00 BUILDING 30 } Go NOTICE TO APPLICANT: If,after making this Certificate of Ex. Z emplion,you should become subject to the Workers'Compensation APPLIANCE 1- provisions of the labor Code, you must forthwith comply with 5.00 PLAN CHECK U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=11F.M.) 4.00 FEE ,��-•� CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 110,000C.F.M.) 6.00 SEISMIC FEE a.0 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.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lenders Name - HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address - ELECTRIC I certify that 1 have read thisapplication and state that the above VENTILATION FAN (SINGLE) 4.00 • information is y correct. I agree to comply with all city and county PLUMBING ordinances and stale laws relating m BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 building construction, m hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) ago, o ave, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino a st iSIT ilit ies,jud Giants,costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX ay an 7 ay GGc a again said City in consequence Of the ra t Of I s - Y MECH.CONT. LIC.NO. MECH. C TOTAL TOTAL eo Signatur o A 11 St/ Nor Datc OFFICE COPY