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14813 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO �� • INSPECTION.DIVISION 1481.3, JOB INSPECTION REC ,,/ ''PERMIT EXPIRATION ' JOB ADDRESS IIQ� A/ 6f/aL FS O N _LOT# PERMIT EXPIRES IF WORK OWNER ��yL�'C.G�C..f - . 'CONTRACTOR e0�1S7 - IS NOT STARTED WITHIN INS CTION DATE I INSPECTOR ASPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUND_ATI NOTE:, ANCE OR 180 DAYS FROM ' LEER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE -TO COMPLY WITH THE APPROVED PLANS AND CIT/OF PERMIT,VALIDATION CUPERTINO STANDARDS. - G. RAGESLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 6 for T0- (,QC -1r. EI are4L ' UNDERGROUND /SLAB 1-2/89 PLUMBING I.1, ELECTRICAL ISSUANCE DATE MECHANICAL eLD� ELEcr.T PLG. MECR 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT wilo INFORMATION WOOD FLOOR =Qf?_9$_� apV�✓g VALUA ON $IFT. PLUMBING _}7-,f✓l,� MECHANICAL - __ (oma Sr� - — "r nT TO ELECTRICAL FRAMING R��`�'��• //-�0`✓,G' - STORIES TYPE CONSTR INSULATION - OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 'ROOF NOTE:NO FINAL INSP.SHALLBE MADE BEFORE SO FT FLOOR AREA TOTAL ACREAGE . DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - � RES IND- CON Pe om., . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ El ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO. PARCEL NO TUBS&SHOWERPAN PLUMBING ENERGY- MECHANICAL - MECR ENERGY ELECTRICAL - ACC DATE ACC.FILE NO. BUILDING ENERGY - FRAMING ELECT.FINAL TEST ' ZONING ENG.SITE NO. INSULATION PLUMBING GAS TEST GAS - - - MECHANICALFIRESPRINK ENERGY L]a �-� Y ❑ NEl' ,Y ❑ N❑, COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR � ELECTRICAL RELEASE I FLOOD ZONE AL UC. INTERIOR SHEAR - FIRE DEPT. - Y❑ wEIY ❑ N❑ SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH. BUILDING INTERIOR LATHTEMPORARY APPROVAL S BUILDING l�� SCRATCH COATELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �� ONE WORKING DAY BEFORE REQUIRED INSPECTION. 11 PLUMBINGI o PLEASE GIVE JOB ADDRESS WHEN PHONING. "- z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE xN TOTAL CALLING FOR FINAL INSPECTION. 7 � OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES'-.USE BALL POINT PEN ONLY r � NUI LDING PROJEFT IDENTIFICATION - - PERMIT NUMBER l a IL ING APPLICATION& PERMIT AIDES) nor -�coo i t %BUILDING14813 I 'Z r -ELECTRICAL—PLUMBING—MECHANICALOWNER'S rF�'�� PLAN CHECK VALIDATION NAME -/ '1y�r lELECTRIC PERMIT FEE ; III CONTRACT0. �'er✓Glers PHDNE !/ NAME omy OUTLETS-SWITCHES-RECEP 10.00/1.00 Q,uc.rvo. LIGHTING FIXTURES 10.00/1.00 .DDRE , 3d4-344-414q d4-311 �y�1 .y1 APPLIANCES-RESIDENTIAL 4.00 ADDRESS, � ��'-�F�� - 1� I 1 . Q AQX PHONE - PANELS- - 10.00 DATE OF APPLICA•TION ggcqrtECT PANELS (OVER 200 AMP) 20.00 pq �ry �' PLAN CHECK FEE- P.C.NO. 1117h11.) $(°Q, uc.No. a' SIGNS TRANS. 3.00 ARCH,Go ENG, OOgFaa 'S J, A SPECIALCIRCUIT 5,00 PERMIT VALIDATION l n EMP.METER OR POLE INS. 20.00 APPLICANT aoogsss � MOTORS � SEE FEE SCH: • SERVICE CHANGE 20,00 - .7//Q /�,a- wo o LICENSED CONTRACTORS DECLARATION - VVV ?( U ,x U U 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE - w a u (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. .PLG. MECH. H D z Professions Codwad my license is In full forG�.�/�Q,cjfFf{_ - z zO License�"lass Lie.Number—21L_'IQ(,�_ m F c Dalc_��contractor E4, ❑ ❑ ❑ g ¢w OWNCR-BUILDER DECLARATION BUILDING PERMIT E ;IL H I hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO ORD INFORMATION u_ o j Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 1 VALUATION $/FT. Code'.Any city orcounty which requires a permit to construct,alter, Vs/ 2 ¢ Q 0O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. rN 1Q !s&r?-0 n w ms requires the applicant for such permit to file a signed statement that TOTAL y `J he is licensed pursuant to file provisions of the Contractor's License PERMIT TO H z ¢ Law(Chapter 9(commencing with Section 7000)of Division 3011m, ii ve E o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT R6[p8 AT� f ¢ H the basis for the alleged exemption.Any violation of Section 7031.5 ��II�V��' STORIES-. TYPE CONSTR. ag by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN IEA.) of not more than five hundred dollars($500)J: - ❑ I,as owner of the,property,or my employees with wages as BACK FLOW"PR 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 se Lo 704e Business and Professions DRAINS-FLOOR,ROOF,AR EA,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- •, ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1ANC.4 OUTLETS 6.00 or improvement is sold within one year ofcompletion,the owner- i builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER BUILDING USE prove 1,aso neeose of theJ. INDUSTRIAL WASTE INTER. '30.00 RES' IND 'CON PB Omer ❑ d 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 contracts for such projects with a contractnts)licensed pursuant Io - theContractor'sLicenseLaw. - SEWER-SANITARY-STORM EA.200ft/10.00 ' Tggcr NO. PARCEL NO. ❑ I am exempt under Sec. ,BAP.C.I'or this reason WATER HEATER W/VENT - 6.00 - Owner - Uute WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, WORKF-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. ' 5.00 _ I hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers'Compensation Insurance,or u certified _ ZONING ENG.SITE NO. copy theor f_5e,�,,�SQQ� ab.CJ. - . . PQliry Nol4D�1�3CCl1�1 any-Lug�fL C-4 ' O Ug Ce fit'ied copy is hereby furnished. FIRE SPRINK ENERGYT-24 Z� 'Cerllfled py ,is f with the city inspection division. � 0 Applicant , - MISC.- REFER TO ORD, v.,❑ N v ❑ N❑' CCN CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE - 10.00 FLOOD ZONE q.L.U.C., LU COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. a'0 - (This section need.not be completed if f u, pernil is for one - TOTAL 'Y❑ N❑ K❑ N❑ Z hundred dollars($100)orless.) U 0 . 1 certify that in the perforinance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY .LL I- 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. 0 ALTER OR ADD TO MECH. 5.00 BUILDING Dale Applicant Z / d0 } NOTICE TO APPLICANT', If,after making this Certificate of Ex- emption,you should become subject to the Workers'CompenSulma APPLIANCE 5.00 - PLAN CHECK provisions of the Labor Code, you must forthwith comply with U- such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10XDCF.M.) 4.00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER t0,000CEM.) 6.00 SEISMIC FEE ( a 1 hereby uIfirm 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 Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 . ELECTRIC o .1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is street. 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 _ above-mentioned property for inspection purposes.' BOILER-COMP(Over 100,000 RTUI SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX toy in any.way accrue against said City in conseq nee of the PERMIT ISSUANCE 10.00 - rantingofthispermi. MECH.CONT. LIC.NO. MECH. 1 nt `f//9/O O TOTAL TOTAL as S'/�//1 YYY Signature of Appl cant/Contractor Uate OFFICE'COPY ,