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16013 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER �: • �'�= CITY OF CUPERTINO 16013 INSPECTION DIVISION JOB INSPECTION RECORD - OP /6zz(e A- 'PERMIT EXPIRATION JOB ADDRESS_/o/� j2L s UNIT# LOOnT# PERMIT EXPIRES IF WORK , OWNER CONTRACTOR .Ld! 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 BEINSTALLED PREGUNITETO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS .�,,,,..,. t POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL 'ISSUANCE On TE MECHANICAL BLDG ELECT PLG. MECM 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT ww,, INFORMATION Oat)WOOD FLOOR !' t) VALUATION SIFT. PLUMBING ' MECHANICAL t^1 S ELECTRICAL PERMIT TO FRAMING Ot CO I, INSULATION X INSULATION STORIES TYPE CONSTR OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' SO.FT FLOOR AFEA TOTAL ACREAGE I ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAIDON ' aw LOI USE ROOF SHEATHING RES IND❑ ❑ ❑ F-1 ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO RCUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO, PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC.FILE NO. ELECTRICAL BUILDING ENERGY ' FRAMING ELECT.FINAL TEST INSULATION - PLUMBING ZONING ENG SITE,NO. GAS TEST GAS FIRE SPRINK ENERGY L]< MECHANICAL Y ❑ N[ Y ❑ NEI COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE 0.LUC. EXTERIOR SHEAR ELECTRICAL RELEASE ' INTERIOR SHEAR FIRE DEPT. v N� Y ❑ N SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVAL9v BUILDING SCRATCH COAT ELECTRIC PLAN CHECK ••�� GAS FEE V� - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE.FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. I — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL p !tea CALLING FOR FINAL INSPECTION. r OFFICE COPY i APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENTI FICATION PERMIT NUMBER -u AooREss/O/ ULFE 8, APPLICATION & PERMIT 1 601 3 Q 419A AKS BUILDING-ELECTRICAL-PLUMBING-MECHANICAL I OWNERS NAME �r �K195z PLAN CHECK VALIDATION I►�BCfA� REGOK3)S Tj,11G C // 'I OTV- ELECTRIC PERMIT FEE CONTRACTOR'S F UTLETS-SWITCHES-RECEP 10.00/1.00 /J 6`1461161151 1.1.1. �' .f.+��p'S LIGHTING FIXTURES-10 00/1 00 CONTRACTOW5 Al�5� - APPLIANCES-RESIDENTIAL 4.00 10.00 I.I PHONE (�ty��J//. ARCHITECT � �- •�� PANELS DATE OF APPLICATION OR ENGINEER PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. uc.rv0. SIGNS TRANS. 3.00 ARCH.OR ENG. AooRESs SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zlv EMP.METER OR,POLE INS. 20.00 APPLICANT'S aooREss MOTORS SEE FEE SCH. z SERVICE CHANGE 20.00 0¢z /✓0 G a/. '02 LICENSED CONTRACTORS DECLARATION ri w 1 hereby affirm that I am licensed under provisionsof Chapter9 Q$ (commencing with Section 7000)of Division 3 of the Business and ISSUANCE DATE F w 2 PmfCssiow COJV's�d C¢ns¢is in lull fa •nrW.�jfyt� BLDG. ELECT. PLG. MECH. z0 i License lass ['� Lic.Numbe P��y'T1 , 2 w to Date Cnntracto G,�.- ❑ ❑ ❑ ❑ - a ¢w OWNER-BUILDER DECLARATION BUILDING PERMIT w 3 LL H 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD I FORMATION FLL0 < Law torthe l'ollowingreason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE gy� TION $/FT. ac u. Code:Any oily or county which requires a permit to construct,alter, 10.00 "T-�a-o a X 4 0 improve,dcomlish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. i 0, requires the applicant for such permit Oh file a signed statement that TOTAL Y w he i,licensed puaaan[10 the provisions of the(]nnlrnClOrs License Co ERM - - rii Law(Chapter 9(Commencing with Section 7000)of Division 3oflhu V 46.- i f 4 o Business and Professions Code)or that be is exempt therefrom and OTV. PLUMBING PERMIT F O, nI[ o the basis for the alleged exemption Any violation of Section 7031.5 STORIES TYPE CONSTR. 3 by any applicant for a permit s,ihj,,t,the applic:ml to a civil penalty of not .as oth v,so five hundred dollars($500).): JR R-DRAIN -WATER (EA.) 5.00 ❑ I,as owner of the property,or my employees with wages asFLOW PROTECT.DEVICE (heir sole cotnpenealion,will do(he work,Wal the structure is riot 4.00 OCC.GROUP RES.UNITE intended or offered for sale(Sec. 7044, Business and ProfessionsS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does riot apply to an owner of F who builds or improves thereon,and who Anes such workRES-PER TRAP 5.00 s0.Pr.FLOOR AReA TOTAL ACREAGE himself or through his own employees,provided that such improve. mems are not intended or offered for sale.IL however,the buddingA.SVSTEM-11NC.40UTL ETS 6.00or improvement Is sold witlhln one your of completion,the owner- builder will have the burden of proving then h¢did not build or int- EA.SYSTEM-OVER 4(EA.) 2.00ING USE prove for purpose ofsale.l. TRIAL WASTE INTER. 30.00 INo CON PB Omer. ❑ I,as owner ot'the property,am exclusively contracting with' IN ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business SPR INK LERS-1 INC 5 V.B. 6,00and Profession,Code:The COntracmis License Law does not apply ASSESSORSPARCEL NO. to an owner of property who builds or imprves thereon,and who SPRINKLERS-OVER 5 (EA.) 1.00contracts for such projects with o contaetods)licensed pursuant to the Contractor's License Law. -SANITARY-STORM EA.200ft/10.00 TRACTNoPARCEL NO. tea❑m l am exempt under Sec. .if.&P.C.Ior thisR HEATER W/VENTOwner6.00Date R SYSTEM 5.00 ACC.DATE ACC.FILE N0. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 hereby affirm that 1 have a certificate ofconsent to scll-immut. or a certificate of Workersm or do Insuance,o a certr Doll h ZONING ENG.SITE NO. COPY Ther��z��1$$��yf ji�L /p� ,{ Policy NLY/W/!/'{rMllp 1i A--/ � [ U Certi('ied copy is hereby furnished. +L=- ZZ Ce l�ii�' is Icd +lltl- the�gyry�spe' is' FIRE,PRINK ENERGY T-24 FO Apllcanl-/ MISC- REFER TO ORD. YE] N[] Y N[] N CERTIFICATE Of:EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 LU > COMPENSATION INSURANCE PLG.CONTR. FLOOD ZONE A.L.U.C. C p LIC.NO. PLG. Z) Z (This d Clado need nbe completed i(the permit is for one TOTAL Y❑ N❑ Y❑ NF U Q hundredcert dollars in tale tintless.)' I I certify that h the performance pees work for which Do per. OTV FEE SUMMARY 0 U mit is issued, I shall not employ any person in any of California.is to MECHANICAL PERMIT FEE (] W become subject to the Workers'Compensation Laws of California. Co. Dale Applicant ALTER OR ADD TO MECH, 5.00 BUILDING 7p� } to NOTICE: 1'O APPLICANT: If,after making this Certificate of E:x- F- ? emptiom you should become subject to the Workers'Compensation APPLIANCE provisions of the Labor Code, you must forlhwilh comply with 5.00 PLAN CHECK L fir' U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=1C.F.M.) 4.00 FEE t�- CONSTRUC'I'DON LENDING AGENCY AIR HANDLING UNITIOVER 10=C.F.M.) 6.00 SEISMIC FEE S Q I hereby affirm that (here is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of tire work for which this permit is issued(Sec. 3097,Civ.C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender'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 state that the above VENTILATION FAN (SINGLE) 4.00 information is Correct, I agree In comply with all city and wanly PLUMBING ordinances and stale laws relating to building construction, and BOILER-CO MPI3H.P.or100,000B.T.U.) 6.00 hereby authorize representatives Of this'eity to enter upon the above-mentioned property for inspection purposes. BOI LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep hatrnless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way oue a sl said Ci in consequence of the PERMIT ISSUANCE 10.00 r oflhi permmit MECH.CONT. LIC.NO. MECH. \/ icr ?9 TOTAL .TOTAL btf�Gm ^ Sgna(ureofApplicant/ ontrac(or to OFFICE COPY