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15924 •POST THIS CARD NEAR FRONT OF BUILDING, PERMIT NUMBER 7`'.. CITY OF CUPERTINO 1 x924 INSPECTION DIVISION JOB INSPECTION RECORD L� I ' "' dL� ^� /0 3-V— PERMIT'EXPIRATI ON JOB ADDRESS '�.0�-Z3 + W W �J UNIT# _LOT# ` PERMIT EXPIRES IF WORK OWNER. PE •`r 0 CONTEACTOR L,rJ 4" 8.( IS NOT STARTED WITHIN INSCTION. DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ' - ANCE OR 180 DAYS FROM _ NOTE: LASTCALLED INSPECTION. ; LIFER - - ALL,GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE • TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION-, CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED + - ;;. • -••. UNDERGROUND /SLAB PLUMBING ±- ELECTRICAL X' 2 ISSUANCE DATE MECHANICAL, ? v ELECT.I PLG. MECH. - ❑ , - ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR INFORMATION_ PLUMBING" - VAwAnoN' BIFT. MECHANICAL ELECTRICAL PERMIT TO FRAMING I G STORIES TYPE CONSTR. , ' INSULATION OCC GROUP HES UNITS 1p PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED D N 50.FT FLOU AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADEBEFOR11 + �� DIAPHRAGM .THE CONSTRUCTION TAX IS PAID JV `�. BUILDING USE ROOF SHEATHING t` Pe Q LN L 'OL APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS .-DATE INS ASSESSORS PARCEL NO, . ROUGH A SANA _ PLUMBING - /- ELECT,ENERGY - TUBS&SHOWER PAN PLUMBING ENERGY - • ` TRACT No. PARCEr No MECHANICAL MECR ENERGX - I ACC.DATE ACG FILE NO ELECTRICAL BUILDING ENERGY , FRAMING ' 7. 'U- &' ELECT.FINAL TEST ZONING ENG.SITE.PI INSULATION - PLUMBING' - ,' GAS TEST GAS FIRE SPRINK ENERGY T.24 MECHANICAL -( Y E NL v 1. NO ` COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' EXTERI :SHEA; ELECTRICAL RELEASE f.L DZONE A.L.0 C. INTERIOFIRE DEPT. Y L NL. v L SHEETR - GRADE - FEE SUMMARY EXTERIBUILDING , INTERIOTEMPORARY APPROVAL BUILDING . SCRATCELECTRIC PLAN CHECK - G . FEE AS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - - - SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED.UNTIL BUILDING FINALISSIGNED BYBUILDING INSPECTOR. MICROFILM . ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING .1 0� PLEASE GIVE JOB ADDRESS WHEN PHONING.- — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL. 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 PROJ6CT IDENTIFICATION _ -PERMIT NUMBER SULLDLIG APPLICATION & PERMIT " 1 5924 [� rj j� LDING — ELECTRICAL—PLUMBING—MECHANICAL .. OWN R' NAME r PLAN CHECK VALIDATION ' DTV. ELECTRIC PERMIT FEE ONTn CTOR'S rvaM� 1 OUTLETS-SWITCHES-RECEP 10.00/1.00 t} LIC.No. LIGHTING FIXTURES 10.00/1.00 CONTRACTORS k PPLIANCES-RESIDENTIAL 4,00 Sr PHONE PANELS '10.00 GATE OF APPLICATION'S ORn—ITECT PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE F.C.NO. NGINEER LIC,NO. SIGNS TRANS. - 3.00 noo cis ENG' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION Zip EMP. METER OR POLE INS. 20.00 noon ssrs MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 f D o LICENSED CONTRACTORS DECLARATION 4 ¢v w I herebyaffirm that I am licensed under rnvis' ns of Chu ler 9 Q l2 IS UANCE DATE H C m (Commencing with Section 7000)of Dwisio 3 the sines,and BLDG. ELECT. PLG. -'MECH. r y i Professions c,s d license is Nin full f z O w- Licens las Lic. umber F m r w Date Conlracto - �' i a c OWNER-BUILDER DECLARATION M a OWNER- BUILDING PERMIT - 060 INFORMATION w ;,y 1 hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO ORD u D j Law for the following reason.(Sec.7031.5,Businessand Professions VALUATION S/FT. - w PERMIT ISSUANCE 10.00 Yf Code:Any city or county which requires permit tnconsVuct.alter, ¢ K Q D Improve,demolish,or repair any stNClure,prior to Its Issuance,aIs. ELEC.CONTR. LIC.N0. ELEC. y as m u requires the applicant for such permit to file a signed statement that TOTAL - PERMIT TO he is licensed pursuant to the provisions of the Contractors License pp 6r- Res � F z a Law(Chapter 9(commencing with Sed ion 7000)of lJivislon3 of the LA tT 4 D Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ rm the basis for the alleged exemption.Any violation ofSedion 7031.5 STORIES TYPE CONSTR. ag - byany applicant for a permit subjects IIIc applicant to a civil penally ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred della,,($500).): ❑ I,as owner of the property,nr my employees Will wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.urvlTS 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,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 docs such work FIXTURES-PER TRAP 5,00 —� SO.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintended 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.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or int. BUILDING u5ERES Other for purpose of sale). IND CON PB OINDUSTRIAL WASTE INTER. 30.00 -� ❑ 1.d as owner of the property,he exclusively .7044, ins with licensed contractors to construct the priced La 7044, Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. 1:1 El El and Professions Code:The Contractor's s License Law docs not apply to tr owner of property who Aa co tr improves Insed p.and who LAWN SPRINKLERS,OVER 5(EA.) 1,.00 contracts lctor's projects with o ennlnnror(sl licensed purxtmnl M the Contractor's License SCC, SEWER-SANITARY STORM EWER-SANITARV-STORM EA .00 TRACT NO. PARCEL NO. ❑ I nm exempt under SCC,-, fln this reason WATER HEATER W{VET4T' 6. Owner Date WATER SYSTEM 5 ACC.DATE ACC.FILE NO. WORKERS'COMPFNSA'I'ION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that I have a Certificate of con,mtt to mlGinsuru, AD or a certlfcate of Workers'Compensation Insunmec,or a ceffied 0 ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab C.). Policy No. Company O ❑ Certified copy is hereby furnished z 2 �Certified copy is fled with the city inspection AivisimFIRE SPRINK ENERGY T-24 MISC.- REFER TO ORD. O Applicant .V N[:]El N cr6�~ va — GIiRTII'IGATIi OP EXEMPT ION FROM WORK IiRS' PERMIT ISSUANCE 1'$66 FLOOD ZONE . A.L.U.C. LU COMPENSATION INSURANCE GX Ta. PLG. (CL ClThis Section need not he Completed it rhe permit is for one 'TOTAL Y N� Y[J NE] hundred dollars(8100)or less,) U O 1 certify that in the performance of rise work for which Itis per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any person in any uemmcr,o us to O become subject to the Workers'Compensation Laws at California. - 0 y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } m NOTICE TO APPLICANT: If,after making this Certificate of lix- H ? emption,you should become subject to the Workers*Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must t0Tthwith Comply with FEE f..1 such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 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. - MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,006 B.T.U.) 8.00 Lender's Name H EATING UNIT(OVER 100,000 B.T.U.)9.50 Lenders Address - ELECTRIC I certify that I have read(his application and state that the above VENTILATION FAN (SINGLE) - 4.00 O information is correct I agree to comply with all city and county PLUMBING Ov ordinances and state laws relating to building construction. and BOILER-COMP(3 H.P.-or100,0008.T.U.) 6.00 hereby authorize representatives of This city to enter upon the BOILER-COMP(Over 100,000 BTUISEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (W elagrce•to�sase,yhdemnify and keep harmless the City of MISC.- REFER TO ORD. gpfrtnola ai st IyTlflfitleee��,judgments, casts and expenses which PERMIT ISSUANCE 10.001CONST.TAX 6Y in'an way/5ccruehs''nst said City in consequence of the ranting 0 Ill p>errmit. MECH.CONT. LIC.NO. MECH. v TOTAL TOTAL Signature of Applicant/Contractor Date OFFICE COPY