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15959 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER' CITY .OF CUPERTINO INSPECTION DIVISION 595 ' JOB INSPECTION.RECORD PERMIT EXPIRATION I JOB ADDRESS �O L � -' UNIT# _LOT# I ' JJ PERMIT EXPIRES IF WORK , OWNER .L .C} Q(]M CONTRACTOR LL L46- IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF.PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: -LASTCALLED INSPECTION. UFER ALL GRADING'AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PREGUNITE CUPERTINO STANDARDS. - I GARAGE.SLABS J .r-•'• POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE UAT'E MECHANICAL IiLUG. 'ELECT. PLL,. .MECH,, ❑ I O '❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION PLUMBING WOOD FLOOR VALUATION. _$/FT. - , MECHANICAL ELECTRICAL PERMIT TU t . . n FRAMING . ' INSULATION - - STORIES TYPE CONSTR OCC.[ OUP -RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.PT,ELooR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDINGON USE ROOF SHEATHING RES IND CON PD, Otl- ' APPLY NO'ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 1 L," L L ASSESSORS PARCEL NO. RCUGH SANX PLUMBING - �( ELECT.ENERGY - TUBS&SHOWER PAN - PLUMBING ENERGY TRACTNO . PARCEL No MECHANICAL' - - MECH.ENERGY �• ELECTRICAL ACC OnrE ACC,FILE BUILDING ENERGY FRAMING' ELECT.FINAL TEST zoNlNc --ENG.SITE NO. INSULATION PLUMBING 'i GAS TEST_ GAS ' FIRE SPRINK ENERGY.LZE MECHANICAL' v N L N❑ �. O COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING w _ FLOOO ZONE ALUC EXTERIOR SHEAR ELECTRICAL RELEASE I L N❑INTERIOR SHEAR FIRE DEPT. Y --I NO SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING IN LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS •NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 11 ONE WORKING DAY BEFORE REQUIRED INSPECTION. O~� PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING zE'+ MECHANICAL - SEE PERMIT FOR EXPIRATION DATE•- IMPORTANT! 5. 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 s Bbl LDI MG PROJECT I DE TIFICATION -7 t / 1[ T - PERMIT NUMBER' .."un" APPLICATION & PERMIT 15959 ADDRESS i B BUILDING —ELECTRICAL—PLUMBING—MECHANICAL L OWNER' -PLAN CHECK VALIDATION QTY. ELECTRIC PERMIT FEE ory cDMERACT Rs1 UTLETS-SWITCHES-RECEP 10.00/1.00 uc. o, 1 Door LIGHTING FIXTURES 10.00/1.00 , A r- OR'S '7 `156PPLIANCES-RESIDENTIALA4.00 - 1 PHONE PANELS 10.00 DATE OF APPLICATION OR T PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.c.ND_ ENGINEER .. - uc.No. SIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5,00 - PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. - 20.00 �— APPLICANT'Eip,ADD ss MOTORS SEE FEE SCH. SERVICECHANGE 20.00 p _"_(I ,'02 LICENSED CONTRACTORS DIECLA RATION - U IF U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE a Z i (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PL MECH. H D Z Professions Co{IA d y license is in full for f t. ❑ ❑ ❑ Z o u"i -, Licens Clus S Con Number wr w Date Contractor s BUILDING PERMIT ¢ a w OWNER-BUILDER DIECLA RATION INFORMATION w o o.H I hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO OR u y' P VALUATION $/FT. F uyj Law for the followin8maxon.I1eo.7031,5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit,R,mi,Ir11C 1.aIle'. C2 <G improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. _ a D LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO F $ he is licensed pursuant to the provisions of the Contractor's License w z a Law(Chapter 9(commencingwith Section 70000of Division 3ofthe �� i 4 o Business and Professions Code)or that he is exempt therefrom andQTY. PLUMBING PERMIT FEE It H $ the basis for the alleged exemption.Any violation of Section7031.5 STORIES TYPE CONSTR, by any applicantforapermit subjects the applicant tuacivil penalty '.LTE -DRAT &YEN FATE (EA.) 5.00 of not more than five hundred dollars($500).1: O 1,as owner of the property,or my employees with wages as BACK L PRO T.DEVICE 4.00 OCC.GROUP RES.UNITS 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 Contractors License Law does not apply to an owner of property WhO huilds or improves nc�rern,and who does such work FIXTURES-PER TRAP S.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mems are not intended or offered mrsale,If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS V or improment is sold within one year of completion,[lie owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE- builder will have the burden of proving that he did not build or im- it. IND CON PB - OMe, PA prove for purpose of sale.). INDUSTRIAL WASTE INTER. 3 � ❑ 1,as owner of the property,am exclusively contracting with licensed contractors tD construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 0 CV 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.) 1.0 ' contracts for such Project,with a cnnlmrlctos)licensed pursuant to the Contractor's License SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. e LLaw. ❑ I am exempt under Sec.—,BAP.C.for this WATER HEATER W/VENT' aP_ reason Owner Dare WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WORKERS'COMPENSAI'ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate ofconseat to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sce.3800,Lab.C.). Policy No. Company Q ❑ Certified copy la y faro ed. FIRE SPRINK ENERGY T-24 Cer o 1 �1 wiD re cit 'I peal ion division. Z p p heanlC 'Q�M��,Rg .� MISC.- REFER TO ORD. q Y [] N❑ v � N❑ ~ r2 PERMIT ISSU NCE or- FLOOD ZONE A.L.U.C. — CERTIFICATE OF EXEMPTION FROM WORKERS' W COMPENSATION INSURANCE' uc.N PLG. Q4 Y N� v � CL o (This section need not be completed if the permit is for one TOTAL N ::) Z hundred dollars IS 100)or less.) L) O 1 certify that in the performance of the work for which this per- QTY. CHANICAL PERMIT FEE FEE SUMMARY LL )- mit is issued,I shall not employ any person in any manner so us to U become subject to the Workers'Compensation Laws of California. y Dam ApplicantALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT: If,after making this Certificate of Ex.. F- ? coalition,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 10=C.EM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency far EXHAUST HOOD(WITH DUCT) 5.00 - the Per of the work for which this permit is issued ISce. HEATING UNIT(TO 100,000 B.T.U.) 8.00 . MICROFILM 3097,Civ.C.). Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC - I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I 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 BOILER-COMP IOver 100,0008TW SEE FEE SCH. MECHANICAL t aboveanentionedproperty for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. - upertino against liabilities,judgments, costs and 7-09 coteCONST.TAX ay in any wa accrue against slid C'y in Lnnscote PERMIT ISSUANCE 10,00a gof chi m MECN.CONT. LIQNO. MECH.ff/ TOTAL TOTAL Sig alum o pp(cant/ ontractor - ate OFFICE COPY