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16101 POST THI ARD NEAR FRONT OF BUILDING PERMIT NUMBER CIW OF CUPERTINO 16101 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION J06 ADDRESS UNIT# SLOT# �� ^`��m,+F n,-F . „ v PERMIT EXPIRES IF WORK ' OWNER .IDVwL ��L(,� colvrRAcroR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION FTECORD 180 DAYS OF PERMIT ISSU FOUNDATIONANCE OR 180 DAYS FROM _ NOTE: LIFER INSPECTION. � ALL GRADING AND DRAINAGE SHALL BE INSTALLEDw PR EGUNITE TO COMPLY WITH THEAPPROVED PLANS AND CITY OF PERMIT AUDATIONI CUPERTINO STANDARDS. s d GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED �!, •. ��, i�!' i �••� UNDERGROUND /SLAB - PLUMBING L`.:�'• ' --„_'� ELECTRICAL ISSUANCE DATE MECHANICALLUc ELECT PLG. MECH. AUGH _ ❑ I ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED City 0Un—pert 00 BUILDING PERMIT INFORMATION WOOD FLOOR VAI,UATION $/FT. PLUMBING - MECHANICAL ' 17 ELECTRICAL - PERMIT To FRAMING INSULATION STICHIES TYPE CONS TR OCC,GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50,FT,FLUOR AREA TOTAL ACREA(.E ' ROOF' NOTE:NO FINAL INSP.SHALL BE MADE BEFORE , +/ DIAPHRAGM THECONSTRUCTION TAX IS PAID ROOF SHEATHING - ,. RES IND Lo`OUSE PH_ 00", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ 0 ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN* PLUMBING - ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO� I MECHANICAL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT,FINAL TEST ZONING ENG SITE NO. ' INSULATION PLUMBING GAS TEST GAS MECHANICAL FIRE SHRINK ENERGY T24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y•0 ."[] ° NE] EXTERIOR SHEAR ELECTRICAL RELEASE FLO DZONE A.L UC INTERIOR SHEAR FIRE DEPT. N❑ I Y ❑ N❑ SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING L SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE' NO TAPE OR PLASTER UNTIL ABOVE.HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 0 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z 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 r• r Is APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE LL POINT PEN ONLY .. _ BUILDING PROJECT IDENTI FIC ' i ROILDING tCo P S /o Poe APPLICATION & P PERMITNUMBER IT 1.6101 AOORESS O/Z3 4 �� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL L OWNER'S NAME PLAN CHECK VALIDATION OTV. . ELECTRIC PERMIT FEE ��ssS' DNE CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No. LIGHTING FIXTURES 10,00/1.00 (� CONTRACTOR'S /,Lia APPLIANCES-RESIDENTIAL 4.00 ADDRESS >f z9- 66 PANELS 10.00 DATE OF APPLICATION OARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGINEER O LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG, SPECIALCIRCUIT 5.00 PERMIT VALIDATION (/ ` �/��s ZIP EMP,METER OR POLE INS. 20.00 noonEssTS�O Q�✓�4+/GCT MOTORS SEE FEE SCH. J 7fN�l 7Nyj( 4/AI CA SERVICE CHANGE 20.00 ySERVICE CHANGE 20.00 1i 1 /x/�/��'�' IS o LICENSED CONTRACTORS DECLARATION `119 1 BL,j C F AID- .U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE yam (commencing with Section 7000)of Division 3 of the Business and LDG. E ECT PLG. MECH. r w z Professions Co pppppp}I�nylicense is in full for g g❑ ❑ ❑ z o m - License Class -Y}-L_Ypl.ia Number�L o m r Date n Conuactor� 6 a Y 2 �Qt� BUILDING PERMIT a ¢ w OWNER-BUILDER DECLA I n INFORMATION X O n N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO O D 3 y p VALUATION S/FT. Ia u o v, Law for the following reason.(Sec,7031.5,Businessund Professions PERMIT ISSUANCE •}e;00 Code:Any city or county which inquires a permit to construct,alter, - Is 3 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. EIEC. n w0¢ requires the applicant for such permit to file a Signed statement That TOTAL PEflMIT TO m m he is licensed pursuant to the provisions ol'the Contractor's License I- z a Law(Chapter 9(.nimencing with Section 7000)of Division 3 ofthe Business and Professions Code)or that be is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ - the basis for the alleged exemption.Any violation of Section 7031.5 -STORIES TYPE CONSTR. n ; - 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($500)): Cl I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. 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,AREA,COND. 5.00 Code'.The Contractor,License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve meets are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Other for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-I 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 it contractorts)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exem pt under Scc. ,HAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Dare WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPHNSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affnm that 1 have a certificate of consent to self-insure, ZONING ENG.SITE NO. /� grt`iifi='c'fatcS�oyff�W�pooJ�rr�kkyeerss'�' 'C'om��peensssatiioonn InsurancAe,,Imrna certified roll. '�FJtw.+YurtlWnY JWrk IM� A Q ❑4 lthi yish Clay L,cMwd. FIRE SPRINK ENERGY T-24 Z O AP/{rp/�tat e c Py' iK vuth the c' i peclion division. MISC.- REFER TO ORD. y❑ N❑ v❑ N❑ PERMIT ISSUANCE 10.00 � I CERTI hICA'I'E -IiX1iMPTION P h1 WORKERS' FLOOD ZONE A.L.u.C. W COM P"NSATION INSURANCE PLG.CONTR. LIC.NO. PLG. y❑ N C] Y❑ N❑ Z his section need not he completed if the permit is for one TOTAL h red dollars IS 100)or Icss) C„) O I rufy that in the performance of the work for which this per. OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- a Is issued,I shall not employ any person in any manner so as to O w Ime subject to thApp e Workers'Compensation Laws of California. t I ant ALTER OR ADD TO MECH. 5.00 BUILDING >_ to r ICE TO APPLICANT: If,after making this Certificate of Ex- F 2 I tion,you should become Subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK j inions of the Labor Code, you most forthwith comply with FEE C..1 provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 I If CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 1g000C.EM.) 6.00 SEISMIC FEE hereby affirm that there Is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 6.00 MICROFILM 7,CivCm 4� iJer's Address der's Names HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC iFFn . I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) .4.00 Br..ation is correct. I agree to comply with all city and county PLUMBING finmrces and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 [[e by authorize representatives of this city to enter upon the se-mentioned property for inspection purposes. , g01 LER-COMP(Over 100.000 BTU)SEE FEE SCM. MECHANICAL 'n b I(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. , Perri against 'abili' s,judgment sts and expenses which PERMIT ISSUANCE 10.00 CONST.TAX iy a y way ccr against sai Cil in consequence of the ling Ibis Bern MECH.CONT. LIC.NO. MECH. I ?-.F-78P GO TOTAL TOTAL F/-� ia ore of Ap icant/Contractor Date _ 1✓V I OFFICE COPY