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16114 • POST THIS CARD NEAR.FRONT OF BUILDING PERMIT NUMBER7. ' ;: CITY OF CUPERT.INO 16114: ~ INSPECTION DIVISION . JOB INSPECTION RECORD .PERMIT EXPIRATION JOB ADDRESS I1W1 KNi1_ - UNIT i* LOT# - i'' 4 PERMIT EXPIRES IF WORK rtt ,u e, . 8vthUG OWNER CONTRACTOR IS NOT STARTED WITHIN; INSPECTIONDATE INSPECTOR INSPECTION RECORD 7 180 DAYS OF,PERMIT ISSU�; ' ANCE 6R'180 DAYS FROM , FOUNDATION - NOTE:, LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OFveRn+;i.vALlDnnoN " CUPERTINO STANDARDS. - - GARAGE SLABS ,- < 3 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /,SLABAUO I ' PLUMBING ! 1 . ELECTRICAL - C111118—d" ISSUANCE LATE ULDG. ELECT. PLG. �MEER' MECHANICAL' - El El EY: DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR - VALUATION SIFT. . PLUMBING - MECHANICAL - PeemIT ro ELECTRICAL - FRAMING STORIES TYPE CONSTR, INSULATION . OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ 50.FT.FLOOR ANF.A TITHL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE - THE CONSTRUCTION TAX IS PAID DIAPHRAGM BUILDING USE ROOF SHEATHING RES .'IND . CDN PB 0111- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE • INSP. ❑. ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SANA ' PLUMBING ELECT.ENERGY ' . TRACI NO. PARCEL NO. TUBS B SHOWER PAN PLUMBING ENERGY, , MECHANICAL - MECH.ENERGY ' ,; ACC,DATE ACC,FILE NO. ELECTRICAL ./j - BUILDING ENERGY , FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION - PLUMBING*• ; ' GAS TEST GAS - FIRESPRINK ENERGY T49 MECHANICAL - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HFLOOOZONE A._L UC, EATING ,N❑ [:]. N❑ EXTERIOR SHEAR ELECTRICAL RELEASE Z',S' " INTERIOR SHEAR FIRE DEPT. v N� v.L N❑ SHEETROCK - GRADE. FEE SUMMARY EXTERI OR-LATH.''. - - BUILDING BUILDING INTERIOR LATH - TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK - GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ' IELECTRIC . LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN,PHONING. Z MECHANICAL ' - SEE PERMIT FOR EXPIRATION DATE - , - ' IMPORTANT! CONST.TAX PLEASE'READ REVERSE SIDE BEFORE Ry+ r�'F ° TOTAL "CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT.PEN ONLY BUI LOI NG PRO.) T I TI FIC TI .PERMIT NUMBER /1 ao` s APPLICATION & PERMIT 1 6'11 /� e" lle0IVBUILDING—ELECTRICAL—PLUMBING—MECHANICAL ._• I I '} ki OWN 'S PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE ��• PHONE .• .. NAAMTRacroR's 9 ' UTLETS-SWITCHES-RECEP 10.00/1.00 9X /N e UC.NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'Sfrom - APP LIANCES-RESI DENT IAL 4.00 4 h ADDRESS �1 J - rLt V/.DPHONE35—Z' Z PANELS - " 10.00 r ., DATE OF APPLICATION° ARCHITECT !�N LeA-AMI!P PANELS (OVER 200 AMP)" 20.00 PLAN CHECK FEE P,C:NO. DR ENGINEER ua No. SIGNS TRANS. 3.00 , ADDRESS E"G, - SPECIALCIRCVIT 5.00 PERMIT VALIDATION . ZIP EMP.METER-OR POLE INS. 20,00 ADDRESS TS MOTORS SEE FEE SCH. t/\ISI IVIy I/—�✓ SERVICE CHANGE - 20.00 �jl lo��c� O '02 LICENSED CONTRACTORS DECLARATION - a U v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE I h C w (commencing with Section 7000)of Division 3o the Business and PA BLDG, ELECT. PLG. MECH. O n- Professions Cod• red m license is N full fore Lu'. z ,tn Licens I Lic. umbe _ L - ❑ ❑ ❑." ZH O Uate� Contractor puG 101988 y s BUILDING PERMIT e, Q w OWNER-BUILDER DEO 10 INFORMATION X3 3 LL_ I hereby affirm that 1 am exempt from the Contractor's License MISC.— R VALUATION S/FT. r Oa Law for the following reason.(Sec.703 t.5,Businessand Professions PERMIT ISSUANCE ' Code:Any city or,county which requires u permit to construct,al ter, QQ Q Q Improve,demolish,Or repair any Structure,prior to Its issuance,alio ELEC.CONTR. LIC.NO. ELE G O W requires the applicant for such permit to file a signed statement that V106�E �' TOTAL ©1 ID' PERMIT TO - s wS he is licensed pursuant to the provisions of the Contractor's License , r z r Law(Chupwr 9(commencing with Section 7000)of Division 3 ofthe p ' a Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE Eio H$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for permit Subjects the applicant toacivil penalty ALTER-DRAIN&VENT-WATER IEA.15.00 of not more than five hundred dollars(8500).): 0 I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00OCC.GROUP RES.UNITS , their sole compensation,will do the work,and the structure is not r - - intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Cade: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 SC.FT FLOOR AREA TOTAL ACREAGE himself or through his own employees:provided that such improve- mems are no(intended or offered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or an- RES IND CON PB Omer prove forpurpose,of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the properly,am exclusively'contracting with 1-1 Cl 1:1 1:1 El licensed 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 does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 h , contracts for such projects with.contmcmoo licensed pursuant to SEWER-SANITARY-STORM EA200ft/1000 the Contractor's License Law.. - . . TRACT NO. PARCEL NO. ❑', I am exempt under Sec.—,,ITAT.C.for this WATER HEATER W/VENT 6.00 - - reason Owner -Date WATER SYSTEM 5.00 ACC.DATE Ace.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that I have a certificate ofconsent to sell=insure, - - or a certificate of Workers Compensation Insurance,or a certified 20NING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). Policy No. Company ❑ Certified copy is hereby Forms[ FIRE SPANK - ENERGY T-24 yx Ce t n, ,.is flGqyy�y}ith t cit inspection division. ZZO ApPh'can p �dt"6 y p MISC.- REFER TO ORD. y ❑ N❑ Y ❑ ,N❑ !r to CE�OI'EXEMPTION FROM WORKERS, PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. COMPPNSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O (This section need not be completed if the permit is for one TOTAL - V❑ 'N❑ Y ❑ N❑ Z) Z hundred dollars IS 100)or less.) FEE SUMMARY V O 1 certifythat in the performance of the work for which this per- OTV. MECHANICAL PERMIT FEE LL H mit is issued,I shall not employ any person any manner is to U become subject to the WCompensation Laws of California. UJ Date—Applicant ALTER OR ADD TO MECH., 5.00 BUILDING } y NOTICE TO APPLICANT: If,alter making this Certificate of Ex- " ? emption,you should become subject to the Workers'Compensation APPLIANCE .r 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with, AIR HANDLING UNIT(TO 10 FEE f,) - such provisions or this permit shall be deemed revoked. =C.F.M,) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.EM.) 6.00 I SEISMIC FEE 1,her affirm that there is a construction lending agency for EXHAUST HOOD(WITHDUCT) 5.00 " Lite performance of the work I'or which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.1 B.00 MICROFILM Lead,r'sYC.1. .- 7D•ICS Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that l have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and one laws relating m building construction, and BOILER-COMP(3H.P.or 100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,0008TU)SEE FEESCH. MECHANICAL above-mentioned property for inspection purposes., " (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. ' upertino against liabilities,judgments, costs and expenses which CONST.TAX ay in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00, . tU1RY Was 7,�Peee4t ^O_ MECH.CONT. - LIC.NO. TOTAL IC/F1ClJolf{sOp icon/CO frac l- 1 / _ TOTAL I OFFICE COPY