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15677 POST THISCARD NEAR FRONT-OF BUILDING 'PERMIT NUMBER r CITY OF CUPERTINO 15677, INSPECTION DIVISION, JOB INSPECTION RECOROt . . PERMIT EXPIRATION JOB ADDRESSIO IoZ.3.AVE IUd�-j=E 5e UNIT# LOT# - - -? - - PERMIT EXPIRES IF WORK ' - OWNER .•�T LE !C ' ,@CT • -coNrRAcroa [�— Le, .�IS 'NOT STARTED WITHIN..- • INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU FOUNDATION - ANCE*OR 180'DAYS FROM NOTE: . LASTCALLED INSPECTION. UFER i ALL GRADING AND DRAINAGE SHALL BE INSTALLED P.REGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY,OF PERMIT VALIDATION. _ CUPERTINO STANDARDS. '.? GARAGE SLABS - .-^• POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 0. f RGR ND w✓ .. UNDE OU /SLAB PLUMBING ELECTRICAL' - Issu NCE DATE MECHANICAL - BLDG ELECT. , PLG: MECR o Ell ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION • WOOD FLOOR AV I F LUAT ON T. PLUMBING - MECHANICAL - y ELECTRICAL. ,A 6,IT G , FRAMING .I - ' STORILS TYPE CONSTR, INSULATION` F ' . OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so Fr.FLOOR AREA TOTAL ACREAGE . DIAPHRAGMTHE CONSTRUCTION TAX IS PAID ." 'p BUILDING'USE - ° ROOF SHEATHING - . ,- RES" �•t?CO".. � O,. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.. ASSESSDRSPAR�ELNo. ROUGH SAN.# PLUMBING . ' ELECT.ENERGY - - TRACT NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL--� MECH.ENERGY ACC.DATE ACO FILE No. . ELECTRICAL - BUILDING ENERGY , FRAMING ELECT.FINAL TEST ` ZONING ENG.SITE NO. ` 'INSULATION:. PLUMBING " GAS TEST GASy - FIRE SPRINK ENERGY T-]<' r MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "� "� FLOOD ZONE A.L.uc. { EXTERIOR SHEAR ELECTRICAL RELEASE - INTERIOR SHEAR - FIRE DEPT. °'� "� _Y ❑ NE] SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH ' BUILDING f INTERIOR LATH - TEMPORARY APPROVALS BGILOwc- SCRATCH COAT ELECTRIC - PLAN CHECK, ' ,1 I GAS FEE . ., . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE' OCCUPANCY OF,BUILDI NG IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR: MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505 ELECTRIC , F_ ONE ,WORKING.DAY BEFORE REQUIRED INSPECTION. Pcu'MewG. Olt i o�. -PLEASE GIVE JOB ADDRESS WHEN PHONING... w Z - MECHANICALS r — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! [C�NST.TAx PLEASE READ REVERSE ,SIDE BEFORE' CALLING FOR FINAL INSPECTION. OTAL r OFFICE COPY! :APPLICANT TO FILL IN INFORMATION.WITHIN RED LINES - USE BALL POINT'PEN ONLY BUILDING•P.ROJECT I DENTI FICATION PERMIT NUMBER • - BUILO,N APPLICATION & PERMIT M; 15677 a OpRE55 NG BU .\ILDING-ELECTRICAL-PLUMBING-MECHANICAL r OWNER'S , PLAN CHECK VALIDATION NAME ' DTV. ELECTRIC PERMIT I ONTRACTORS NaME OUTLETS-SWITCHES-RECEP 40.00/1.00In LIC.NO, �/ / LIGHTING FIXTURES 10.00/1.00 C,ONTRACTOR'S PPLIANCES-RESIDENTIAL 4.00, . _ .E PANELS 10.00DATE OF APPLICATIONORcwrecT PANELS (OVER 200 AMP) 20.00PLAN CHECK FEE P.0,NO. OR ` ENGINEER_, LIC.NO. IS TRANS. 3.00 ADDRESS ENG' • _ SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP 'EMP.METER OR POLE INS. 20.00 ADDRESS is MOTORS SEE FEE SCH. AooREss� � SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION a Z I hereby affirm Osnt'I am licensed under provisions of Chapter 9 - ISSUANCE DATE y a i (commencing with Section 7000)of Division 3 of the Busingss and _ BLDG., ELECT. PLG. MECH. F w Z Professions Coj�a n�711f license is in full❑ ••'in Lice is lasis �%S-��Lic.Numl, - 9 m r w Dafe Contractor a f - BUILDING PERMIT ¢ " ¢ a OWNER-BUILDER DECLARATION ¢ Cou - INFORMATION o MISC.- REFER TO ORD w ;a H 1 he affirm Ilial I am exempt from the Contractor's License - VALUATION S/FT. or u o j Law for the following reason(Sea 7031.5,Business and Professions PERMIT ISSUANCE 10.00 Code:Any city or county whichrequiresa permit to Construct,alter,. - ac ra Q 2 Improve,demolish,or repair any structure,prior it)Its issuance,also ELEC. LIC.NO. ELEC. G u requires the applicant for such permit to file a signed statement that TOTAL �p w he Is licensed pursuant ERMIT TO to the of lire Contractor's License E - au z i Law(Chapter 9 fcommencing with Section 7000)of Division 3 ofthe B - a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT rc r $ the basis for the alleged exemption.Any violation of Section 7031.5 IES TYPE CONSTR. by any applicant for a permit,subjects the applicant to a Civil penalty ALTER-DRAIN -WATER (EA.) 5.00 _ of not more than five hundred dollars(S500)J: ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OUP REB.UNITS their sole compensation,will do the work,and the structure is not 0. intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5:90 M Code:The Contractor's License Law does not apply to an owner of properly who builds Or improves thereon,and who does such work FIXTURES-PER TRAP Sao so.FT FLOOR AREA TOTAL ACREAGE menta are not hde ownemployees,for sale. IL ed ever,hat such improve- GAS-EA.SYSTEM-11NC.4 OUTLETS 6.00 mems are nae intended or offered for sole.IL however,the building or improvement is sob within one year of completion,the owner- GAS EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the harden of proving that -he did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 - RES IND CON PB Other ❑ 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 SEWER-SANITARY-STORM EA.200ft/ lire Contractor's License.Law. TRACT NO. PARCEL NO. ❑ lute exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT - 6 reason Owner Date WATER SYSTEM 9:90 1 -- ACC.GATE ACC.FILE NO. - WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. •5.00 1 hereby affirm that I have a certificate of consent in self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.. copy ehemof(Sec.3900,Lxb.C.). Policy No. Company O ❑ y is hereby furnish FIRE SPRINK ENERGY T-24 Z Z Cer'i py isefiled with city inspec ' n division. O Applicar�a..�- -G��- -� MISC. REFER TO ORD. Y ❑ N❑ Y ❑ N❑ rn ,CERTIFICATE OF IiXfiMPT 10N FROM WORKERS' PERMIT ISSUANCE •19700/ FLOOD ZONE A.L-U.6. Lu COMJTNSATION INSURANCE PLG.CONTE. LIC.NO. PLG 1 . y❑ N❑ v C] N❑ O ('This section need not be completed It the permit is for one TOTAL Z) Z hundred dollars($100)or less.) U O 1 certify that in the performance Of the work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any nm nner so as to U become subject to the Workers'Compensation Laws of California. D.y Date - Applicant ALTER OR ADD TO MECH: 5.00 BUILDING } CO NOTICE TO APPLICANT: If,after making this Certificate of Ex- , I'- ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith Comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M,) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10POOC.F.M.)-6.00 SEISMIC FEE. I 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. HEATING UNIT(TO 100,000 B.T.U.) 6.00 MICROFILM 3097,Civ.C.). Leader's Name - Lender's Address HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC I certify that I 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 - PLUMBING urdirlances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 s hereby authorize representative's of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCM. MECHANICAL (We) a to save, indemnify and keep harmless the City of MISC.- . REFER TO ORD. uperti ag' not liabilities,jun nts, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX I any ay accrue agar t aid Cily in conscyuence of[he go is pmiL MECH.CONT. LIC.NO. MECH. TOTAL TOTAL gra re of Applicant/Cont cror Dare OFFICE COPY