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16004 I POST THIS CARD NEAR FRONT OF BUILDING PeRMIr NUMBER :.CITY OF .CUPERTINO 1600,E INSPECTION DIVISION JOB INSPECTION RECORD 3. PERMIT EXPIRATION JOB ADDRESS /v`i • �/,, J-�, _ UNIT# _LOT# n PERMIT EXPIRES IF WORK OWNER SCl t�iGB' pp' CONTRACTOR t?j Le36-- IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 18oDAYSUIPERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM r NOTE: UFER � � � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAL DATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB r PLUMBING ) 7� C ELECTRICAL - �DAN DATE MECHANICAL BLDG LECT. PLG. MECH pplD ❑ ❑ Cil . ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR t� ( � 8� INFORMATION VALUATION SIFT. PLUMBING MECHANICAL Of CDP �I00 ELECTRICAL Peamrt To FRAMING INSULATION STORIES TYPE CONSTR. r OCC G19UP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sD.Fr FLDOR arEA rarA,.ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID A _ SUILDM•G USE ROOF SHEATHING Res IN ♦ CON Pe Om., APPLY'NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.k ASSESSUS PARCEL No PLUMBING ELECT.ENERGY 7HACT No. PARCEL No. TUBS S SHOWER PAN - - PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE ACC,FILE NO. FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONING ENG.SITE NO. GAS TEST GAS FIRE SPRINK ENERGY nza MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 1 Y "� Y.� "� EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD LONE A.L U.0 INTERIOR SHEAR FIRE DEPT. Y ❑ N❑ Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING 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 FINALISSIGNEDBY B UILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC \� FO� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING.. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.rax 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 .- BU LDI NG PROJECT 1 DENTI FICATI ON PERMIT NUMBER - ' BUILDING D APPLICATION & PERMIT 16004 AD RE55 ��///)GFF V✓� ILDING-ELECTRICAL-PLUMBING-MECHANICAL E 's PLAN CHECK VALIDATION &VC.e QTY. ELECTRIC PERMIT FEE G/ vHorvE N RAc;oRs 9 ��Q�?� UTLETS-SWITCHES-RECEP 10.00/1.00 ._ L. No.�Y,?631V' LIGHTING FIXTURES 10.00/1.00 n news sena APPLIANCES-RESIDENTIAL 4.00 PHONE b-L/�TJQ PANELS 10.00 DATE OF APPLICATION' ORCNITELT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.NO. - SIGNS TRANS. 3.00 ADDRESS ENG' SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 w o o LICFNSP.D CONTRACTORS DECLARATION 'Q u s~- 1 hereby affirm that I am licenstd under provis' sof Chapter 9 I ISSUANCE DATE H Q n (commencing with Section 70001 of Division 3 the sinCss and BLDG. ELECT. PLG. MECH. F N a, Professions C a license is in full z o A - License las. Lic.Num be _ ❑ ❑ ❑ Cr - ° Date ' Cc"tracmr _ yew ¢ y s BUILDING PERMIT rc ¢ ¢ - OWNER-BUILDER D. LA ATION S, s O INFORMATION E w I hereby affirm that I am exempt from the Contractors License MISC.- REFER TO ORD 3 u y P VALUATION $/FT. FLL0 < Law for the following reason.(Sec.703L5,IfusinessanJ Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to construct,alter, re ¢ ¢ 0 improve,demolish,or repair any structure,prior to its isuunce,also ELEC.CONTE. LIC.NO. ELEC. III ° LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO u w m he is licensed pursuant to the provisions of the Contractors License - p F z a Law(Chopter9Commencing with Section 7000)of Dlvlsion 3 oflhe LO 4° Business and Professions Code)cur that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ I-m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. u ; � byany applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.CROUP 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,AREA,COND. 5. Code'.The Contractor's License Law does not apply to an owner of properly who builds or improves(hereon,and who does such work FIXTURES-PER TRAP 5.00 2 FT.FLOOR PREP TOTAL ACREAGE himself or through his own employees,provided that such improve- ments arenot intended oroffered for Sale.If,however,the building GAS-EA.SYSTEM-111NC.40UTLETS or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) V BUILDING USE builder will have the burden of proving that he did not build or ire- RES IND CON PB Orhar prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30. . ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ lice nsed 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 docs not apply H, an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor([)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.2001t/10.00 TRACT NO. PARCEL NO. 17 1 am exempt under Sec. B.&P.C.for this WATER HEATER W#vL&4TFLJ54J 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, WORKERS'COMPENSAI'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure, or a certificay3LAI.O.). 'C n uoteCdom Insurance,ora celaitied ZONING ENG.SITE NO. copy thereof(Se,PDlicy No. '❑ etlifi $ funished. FIRESPRINK ENERGY T-Z4 Z Z �ertififi d. ith the city inspection division. O Applicant MISC.- REFER TO ORD. Y ❑ N❑. Y ❑' N❑ _ M y CER ItEIATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.0 LU > COMPENSATION INSURANCE t L R! IC.NO PLG. 9 Q (J Y❑ N❑ V❑ N❑ 1 D (This section Reed not be completed if the permit is for one i TOTAL O' � Z hundred dollars(S 100)or less.) L) O 1 certify that in the performance of tire work for which this per- DTV MECHANICAL PERMIT FEE FEE SUMMARY - LL H mil is issued,1 shall not employ any person in any ntarner so as to U become subject to the Workers'Compensation Laws of California. 0 y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } m NOTICE l'O APPLICANT': If,after making this Certificate of Ex- f- Z emptian,you should become subject to the Workers'Compensation APPLIANCE 5.00 rFEE provisions of the Labor Code, you must forthwith comply with U such provisions or this permit shell be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH'DUCT) 5.00 Ilic 3097,Civ.C.1�c` of the work for which Wis permit is issued(Sec. 4HEATING UNIT(TO 100,000 B.T.U.) 8.00 ,�.�yy�rLender's NaEATI NG UNIT(OVER 100,000 B.T.U.)9.50 pl[..Lender's AddressI certify that l have read this application and stale that the aboveENTILATION'FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, andOILER-COMP(3H.P.or100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon theOILER-COMP(Over 100,OGDBTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposesWe) agree o save, indemnify and keep harmless the City ofISC.- REFER TO ORD. upe no I rest Iia 'ties,judgments, costs and expanses which PERMIT ISSUANCE 10.00 CONST.TAX toy i way C e against said City in consequence of t e fthisr MECH.CONT. LIC.NO. MECH. 7�St- TOTAL TOTAL ignalur of cant/Contractor Date OFFICE,COPY