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15598 -POST THIS CARD NEAR FRONT OF BUILDING t Y. -PERMIT NUMBER CITY. OF. CUPERTINO "; 5 598 • � INSPECTION.DIVISION JOB INSPECTION RECORD S/a R-14 p � ` . �O / ! ;^.•re.PERMIT EXPIRATION, 'JOB ADDRESS /O/a.3 �✓ (/1/o L'F�' uNlr# _LOT# - PERMIT EXPIRES IF WORK OWNER cocC rev_ '(,.tom. CONTRACTOR /vCp IS NOT STARTED WITHIN INSPECTION DATE ANSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT NOTE: ISSU- FOUNDATION - ANCE OR 180 DAYS FROM - UFER � - ,�' � ALL GRADING AND DRAINAGE SHALL BJ= INSTALLED LASTCALLEO INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF PEHMIT VALIDATION CUPERTINO STANDARDS. ^ ,� • GARAGE SLABS � . . - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - - - \.3•,,. (:_ UNDERGROUN •/SLAB PLUMBING - ELECTRICAL ISSUANCE DATE MECHANICAL BLDG i ELECT -PLG. MECR ❑ ❑ l ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT - INFORMATION WOOD FLOOR VALUATION $/FT. PLUMBING - MECHANICAL ELECTRICAL! PERMIT TO FRAMING 1a� INSULATION sroulEs TYPE coNsrR 1t J . 00C GROUP RESITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED@ �0 i ROOF NOTEI NO FINAL INSP.SHALL BE MAD F RE ... E*,ELOOR AREA TOTAL ACREAGE ' DIAPHRAGM • + THE CONSTRUCTION TAX IS PAID 1. �d4' - ROOF,SHEATHING RES IND ILO`OON usEPB DO— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ 0 0 El ASSESSORS PARCEL NO ROUGH SAN.a PLUMBING - - ELECT.ENERGY eaa TNOARCEI,NO TUBS&SHOWER PAN - PLUMBING ENERGYE ;1 - ; t MECHANICAL MECH.ENERGY r •'+'"i" `P' "i°`""� < T ELECTRICAL ',3p . r BUILDING ENERGY « RccwOATe+-P•; „ Acc:PreENo - FRAMING ELECT.FINAL TEST _roNING ENG.SITE NO. INSULATION PLUMBING - - GAS TEST - - GAS - MECHANICAL FIRE SPRING ENERGY T24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING `'0 NO ` E NED ELECTRICAL RELEASE FLOOO'ZONE AL.U.0 EXTERIOR SHEAR _ _ - INTERIOR SHEAR FIRE DEPT. vl0 ': NQ Y ❑ .,,N❑ . SHEETROCK GRADE i ' FEE.SUMMARY - EXTERIOR LATH BUILDING INTERIOR LATH - TEMPORARY APPROVALS - iPByl�;�iyG»''�• -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 IS SIGNED BY BUILDING INSPECTOR. 'MICROFILM LU ARRANGE FOR INSPECTION BY PHONING-252-4505; ELECTRIC I q.. ' FONE WORKING DAY BEFORE REQUIRED INSPECTION'. PLUMawc /o ' 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. '. ZMECHANICAL AP — SEE PERMIT FOR EXPIRATION DATE - c IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION .-PERMIT NUMBER - -} I, Ano El APPLICATIONI Al 11 .& PERMIT s o BUILDING - ELECTRICAL-PLUMBING-'MECHANICAL' ,s '` I �j NAME PLAN CHECK VALIDATION NAMI 'jzZWCL5<5 QTY. ELECTRIC PERMIT FEEPHONE j ^ , CONTRACTOR'S NAME ,r p OUTLETS-SWITCHES'-RECEP 10.00/1.00 6AIA160 1rAm,O IC:ry /� LIGHTING FIXTURES 10.00/1.00 -' CONTRACTOR s �� S0. 4f/L.6a4D 4L41 % ' APPLIANCES-RESIDENTIAL � 4.00 ADDRESS �( �jI/ - y 'P EE3*, aQ - PANELS 10.00 DATE OF APPLICATION d AW PLAN CHECK FEE P.C',NO. OR , PANELS.IOV ER 200 AMP) . 20.00 -. ENGINEER - - LIC.NO. SI GN TRANS 3.00 ARCH,OR ADDRESS ENG. - SPECIAL CIRCUIT 1 5.00 PER MIT VALI DATION ZIP EMP.METER OR POLE INS. "' 20.00 APPLICANT'S y, /�, ,'MOTORS . , - SEE FEE SCH. �jyu„�^�� �j ADGR E55 /� 'A,, s w/- -D y' `YN/ SERVICE.CHANGE 20.00 022 F O o ' '. LICENSED CONTRACTORS DECLARATION I ain w I hereby affirm that I am licensed under provisions aper 2 oioof Chapter 9 ISSUANCE DATE ! w ¢n (Commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. PLG. MECH. H w i Professions Cade an y license is gr full force and a fegt. ❑ ❑ r o z w o - License lass_(;-'-3�Lia Number 4r-2 - Date Contractor ¢ ¢ w a - OWNER-BUILDER DECLARATION BUILDING PERMIT a o a. o - INFORMATION La 3 m 1 hereby affirm,that 1 am exempt from the Contractor's License MISC.- REFER TO ORD u o ¢ Law for the following reason.(Sec.7031.5,Busines's and Professions VALUATION $/FT. r - wJ Code:Any city or county whichrequiresa permit toconstruct,alter, PERMIT ISSUANCE 10.00 se ¢ ¢ 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR.' LIC.NO. ELEC. - o a, requires the applicant for such permit to file a signed statement that TOTAL- O' a w $ he Is licensed pursuant to the provisions of the Contractors License PERMIT TO r z a Law(Chapter 9(commencingwlOn Section 7000)of Division 3 ofthe p �/p/�� �' " z D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FE% V ¢ I-m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a3 � by any applicant for a permit subjects the applicant to a civil penalty. gLTEfl-DRAIN&VENT-W . ATER (EA.)_ 5 of not more than five hundmd dollars($500).1: - ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE'/ 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,AREA,COND. 5.0 - - Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such workFIXTURES-PER TRAP 5.00 . �a,d0 SD.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedorofferedforsale.If,however,the building IGAS-EA.SYSTEM-11NC.4 OUTLETS 6.00 - or improvement Is sold within one year of completion,the owner- - builder will have the burden of proving that he did not build or Ino- GAS-EA.SYSTEM-OVER 4'(EA.) 2.00 BUILDING USE prove for purpose ofssale.). INDUSTRIAL WASTE INTER. 30.00 RES - IND CON Pe noon ❑.,1,as owner of the property,aim 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. ❑ I am exempt under Sea ,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 - I hereby affirm thatChave a certificate of consent to self-insure, -or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy there f cc 500,Lab;C.L� �L, - Pore N Company Q ❑ Certified co yrs hereby furnished. - FIRE SPRINK ENERGY T-24 ' F ZO pF CertrF py"is tiled win ihe'city inspyclion division. MISC.- REFER TO ORD. � ','- Y❑ N❑ v ❑ N❑ A �cunl./(/y�{{1 CC W CERTIFICATE OF EXEMPTION FROM.WORKERS' PERMIT ISSUANCE - - - 10.00 /Z-Qd FLOOD ZONE A.L.U.C.- LU > COMPENSATION INSURANCE, PLG.CONTR, PLG. CL Q (This section need not be' completed if"lne permit is for ane �' (,O Q� B pZ, TOTAL ZZ,!/d Y,❑ N❑ Y ❑ IN Z) Z hundred dollars IS 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 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. Q. Date Applicant ALTER OR ADD TO MECH- 5,00 . BUILDING } N NOTICE TO APPLICANT'. If,after.making this Certificate of Ex- 5.00 PFEE ? emption,you should-become subject W the Workers'Compensation APPLIANCE - provisions of the Labor Code, you must forthwith comply with suh provisions or this permit shall be deemed revoked. AIR HANDLING UNIT'(TO 10P00QF.M.) 4.00CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10p000.F.M.) 6.00 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.3097',Civ.C.). '" HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's NaHEATING UNIT(OVER 100,000 B.T.U.)9.50Lender's Address''I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information Is correct.I agree to complywith all city and county - ordinances and.state laws relating.to building construction, and BOILER-COMP 13 H.P.or 100,000 B.T.U.) 6.00 ' L/ hereby authorize representatives of this city to enter-upon.tfro ,r above-mentioned property for inspection purposes. .. BOI LER-COMP (Over 100,000 STU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of " MISC.- REFER TO ORD. uper.ORD against liabilities,judgments, costs and expenses Which PERMIT ISSUANCE 10:00 CONST.TAX ay any way accrue against said City in consequence of the ra n of s p trait MECH.CONT, LIC.NO. MECH.' /��(/ TOTAL TOTAL $' ature ot Applicant/Contractor Dale OFFICE COPY' .