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16225 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 16226 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS ll�0. 'v W UNIT-9 _LOT# � PERMIT EXPIRES IF WORK owNEF (/J I I l/�_ 'eJ .CONTRACTOR // I� ,Q. - 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 PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAUUnTION GARAGE SLABS CUPERTINO STANDARDS. � - � POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED . ?- ,J UNDERGROUND /SLAB PLUMBING � - ELECTRICAL I. - ISSUANCE DATE MECHANICALPA ILUG ELECT. PLG. MECH. a a a ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED IC BUILDING.PERMIT WOOD FLOOR INFORMATION VALUATION ,$/FT., PLUMBING - city of ,� MECHANICAL cu . RMIT TO ELECTRICAL - PE _ 7� FRAMING I`'1 c1 INSULATION. - STORIES TYPE CONSTR. OCC,GROUP RES.UNI TS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - - , ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 5O FTFLOOR..FA TOTAL ACREAGE- DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING RES IND ILDCON OSEPB� I om. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED y FINALS DATE INSP. ❑ El ❑' ❑ E)ROUGH SANA ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY (FACT NO. PARCEL NO ' MECHANICAL MECH.ENERGY - \1 ELECTRICAL ' BUILDING ENERGY ACC Dare Acc FILE No FRAMING ELECT.FINAL TEST INSULATION PLUMBING- ZONING ENc.SITE NO. GAS TEST- GAS MECHANICAL FIRE SPRINK ENERGY T7 NP * ,-Z COVER NO WORK UNTIL ABOV SIGNED HEATING Y ❑ - N Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A,L UC. INTERIOR SHEAR FIRE DEPT. v ❑ N❑ Y ❑ N❑ SHEETROCKGRADE FEE SUMMARY ' EXTERIOR LATHPEsa BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS , SCRATCH COAT ELECTRIC .;Z PLAN CHECK GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUI[-DING IS NOT PERMITTED UNTI L BUILDING FINAL.IS SIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION•BY PHONING 252-4595,. ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING . 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - SEE PERMIT-FOR EXPIRATION DATE — MECHANICAL IMPORTANT! cousr.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY - I APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT I ENTI FICATION 'PERMIT NUMBER - aO1LDING 'APPLICATION &PERMIT ADDRESS �h 16225 1Oi2 I B 4031 BUILDING-ELECTRICAL-PLUMBING -MECHANICAL �''' OWNER'S NAME PLAN CHECK VALIDATION' /I .L QTY. ELECTRIC PERMIT FEE G {2Li(.F..� PHONE CONTRACTORSOUTLETS-SWITCHES-RECEP 10.00/1.00 dG'Ex , an, N-53-2—q7,19, LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S ADDRESS ��Cjtpai ,Ns: APPLIANCES-RESIDENTIAL 4.00' , PHONE SS �/ r PANELS s' 10.00 DATE OF APPLICATION ' OR RCHITECT PANELS (OVER ZOO AMPI 20,00 PLAN CHECK FEE P.C..NO. ENGINEER - - uc.No. SIGNS TRANS. - 3.00 ARCH.OR ADDRESS ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.08y- , t APPLICANTS MOTORS ADDRESS - SEE FEE SCH. SERVICE CHANGE 20.00 o ¢ z F o OLICENSCD CONTRACTORS DECLARATION a z w I hereby affirm that I am licensed under provisions of Chapter 9 n ISSUANCE DATE n ¢N (commencing with Section 7000)of Division 3 of the Business and - - BLDG. ELECT. -PLG. .' MECH. H H z Professions Code,and my license is in full force and effect. _ ❑ ❑ ❑ z o w - License Class Lic.Number or w Date Contractor ¢ x E -' Cft Of �Y."�n BUILDING PERMIT ¢ ¢ w OWNER-BUILDER DECLARATION INFORMATION a'x O; u y I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD IL o¢ Law for the following reason.(Sec.7031.5,Businessmhd Professions PERMIT ISSUANCE 1VALUATION $/FT. -0 Code:Any city or county which req uiresa permit _ ¢ ¢¢ p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. - CLIC.NO. ELEC. ra O¢ requires the applicant for such permit to file a signed statement that TOTAL p� w m" he is licensed pursuant to the provisions of the Contractor's License PERMIT TO H z i Law(Chapter 9(commeneiagwith Section 7000)of Division 3 oftbe eIfST ` ¢ Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE EiO ¢ F m the basis for the alleged exemption.Any violation of Section 703 L5' STORIES TYPE CONSTR. Le 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).): ❑ 1,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 are (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who'huilds or improves thereon,and who docs such work FIXTUR ES-PER TRAP 5,00 SO,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or int- GAS-EA.SYSTEM-OVER 4(EA,) 2.00 BUILDING USE prove for purpose of the RES IND 'CON PB Other . INDUSTRIALWASTE INTER. ,30.00 1' . ❑ ❑ 0 ❑ ❑ 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-4 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 a contractor(s)licensed pursuant to - theContractor'sLicenseLaw. SEWER-SANITARY-STORM EA,200ft/10.00 TRACT NO. PARCEL NO. ❑ Iamexemptander Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 - - I hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers'Compensation Insurance,or a certified ,ZONING ENG.HITT NO. thereof(Sec.3800,Lab.CJ. Policy Nu: Company Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY TR4 z'2 Cert i copy filed wit "Palle, division. O Applicant !i- MISC.- - - REFER TO ORD. - YE] IN . Y � N[] ~ _N PERMIT ISSUANCE 10.00 LU CERTIFICATE CUMPEN ATION INS FROM WORKERS' FLOOD ZONE A.L.UF.' CL COMPENSATION INSURANCE, PLG.CONTR. _ LIC.NO. _ PLG. ❑ ❑ F-1 ❑ CL Z hundred dollar, not he completed if the permit is for one TOTAL V N V N hundred dollars(8100).116.) U O 1 certify that in the perfornanre of the work for which this perQTV MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,Pshad not employ any person in any manner so as to Q L) become subject to the Workers'Compensation Laws of California. I - - y Date-Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } to NOTICE TO APPLICANT: If,after making this Certificate of Hx- Z emption,you should become subject to the Workers' on APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with 'FEE - U� such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.Nt) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10000C.RM.) 6.00 SEISMIC FEE - I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the perl'armance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's AddHEATI NG UN IT(OVER 100,000 B.T.U.)9,50 ELECTRIC ress I certify that l 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 (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to 'save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses wFuen PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue agamst,said City in consequence of the m of thispermil. MECH.CONT. LIG NO. MECH, TOTAL �Op tgnature of Applicant/Contractor Data - OFFICE COPY