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16233 �,POST THIS CARD NEAR FRONT•OF BUILDING PERMIT NUMBER -. CITY. OF CUPERTINO ' . , 16233 INSPECTION`DIVISION 'JOB INSPECTLQCORD PERMIT EXPIRATION JOB ADDRESS")v - 'V'V_ ?�`"� UNIT# � _LOT# �n C` - PERMIT' EXPIRES IF'WORK '° ~ OWNER • v l,!v•;i; coNTR ACT'oR VY THIN THIN INSPECTION DATE I INSPECTOR- INSFIECTIONRECORD 160 DAYS OFPERMIT ISS U- FOUNDATION • ._ ANCECOR 180 DAVS'FROM 'NOTE: ` - 'LAST CALLED INSPECTION.':: LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED ' TDCOMPLY WITH THE APPROVED PLANS AND CITY OF PE RMI r VALIDATON3 , PR EGUNITE" - CUPERTINO STANDARDS. { Al .� GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED- ew UNDERGROUND /SLAB PLUMBING - ry - �+ ELECTRICAL r AUG b ¢< !o', I ISSUANCE DATE • MECHANICAL - - - BLDG ' ELECT PLG.. . MECR.• ` f4ty Of'Cuperh OE p! 0 . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT ° INFORMATION PLUMBING - WOOD FLOOR - .VALLAIIo .. siF;T. MECHANICAL .. _ u,^ (i,-• ELECTRICAL - PERMrt o . FRAMING I INSULATION � � - � - ;STORIES `TYPE CONSTF•,'• 1 Q• .. e �` OCC.GROUP ' RESIUNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -ROOF .NOTE:NO FINAL INSP.SHALL BEVADE BEFORE so Er.EyooB AREA _roTAL ACREAce - I . DIAPHRAGM THE CONSTRUCTION TAX IS PAID ' BUILDING USE ROOF SHEATHING L RES` NO CON PB dm�^ APPLY:NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS' DATE INSP. E 0 '::E]+: 0, El ,., ASSESSORS PARCEL NO.-• i •ROUGH SANA PLUMBING ELECT:ENERGY 'TRACT NO. PARCEL NO. TUBS&SHOWER PAN - - PLUMBING'ENERGY. i 1. - MECHANICAL' MECH.ENERGY ELECTRICAL - BUILDING ENERGY -ACC.DATE ACC,PILE No. FRAMING '- - _ ELECT.FINAL TEST ZONING - ENG SITE No INSULATION - PLUMBING , - GAS'TEST _ - GAS. . MECHANICAL ' ., EWE SPRINK ENERGYT24 COVER NO WORK UNTIL`ABOVE HAS BEEN SIGNED HEATING " ' ❑ N ❑ • EXTERIOR-SHEAR ELECTRICAL RELEASE EL000;zorvE, A.L,u.a: dNTERIOR-SHEAR FIRE DEPT. El - "O Y ❑ ;°"❑° SHEETROCK i'' GRADE FEE SUMMARY EXTERIOR,LATH - ' - BUILDING INTERIOR.LATH : - - TEMPORARY APPROVALS eulLDwc SCRATCH COAT ELECTRIC ,2 PLAN CHECK _ ' GAS "FEE" ,4 NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED' OCCUPANCY - SEISMIC FEE ^, u OCCUPANCY OF'BUILDING-IS NOT PERMITTED DNTI L BUI LANG FINALS SIGNED BY.BUILDING INSPECTOR 'MICROFILM ARRANGE FOR. INSPECTION BY PHONING 252-4505 N ELECTRIC ONE WORKING DAY BEFORE REQUIRED,INSPECTION G� F PLUMBING 0 PLEASE GIVE'JOB ADDRESS WHEN PHONING. z SEE PERMIT FOR EXPIRATION DATE - u' MECHANICAL IMPORTANT., ! ' . CONST.TAX PLEASE READ REVERSE SIDE BEFORE ;e•; CALLING FOR,FINAL INSPECTION. TOTAL" `' OFFICE COOLY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY r BUILDING PROJECT I DENTI FICATI ON - - _ ,PERMIT NUMBER BUILDING 'APPLICATION & PERMIT 1,623,3 BADD UILLDD n �fqs 1 �� .. Peel[ BUILDING -ELECTRICAL-PLUMBING-MECHANICALPLAN CHECK VALIDATION /��I 04 ONE L53 IIO3 DTV ELECTRIC PERMIT FEEORS _ NAM 1 q UTLETS-SWITCHES-RECEP 10.00/1.00 L��J-Q �1 LIC,NO. H LIGHTING FIXTURES 10,00/1.00 Ano/n'e's')sTaR's // APPLIANCES-RESIDENTIAL 4.00 p ( PHONE Z U PANELS 10.00 DATE OF APPLICATION AOR RCHITECT DATE PANELS (OVER 200 AMP) 20.00 ' PLAN CHEDK FEE P.C.NO. ENGINEER f 1e-'£ia l+i 5P _ - YJ IAJypL',pC.r uc NO, SIGNS TRANS.. 3.00 l✓� ARLH.OR ENG. _ PERMIT VALIDATION 6 ADDRESS s SPECIAL CIRCUIT 5.00 ZIP EMP.METER OR POLE INS, r -29.80' - ' - - noon ssTs MOTORS SEE FEE SCH. - s �N�trl(�( Q a - SERVICE CHANGE 20.00 s wo o LICENSED CONTRACTORS UECL ION - a U i, 1 hereby affirm that 1 am licensed under provisions.(Clmpter9 L �• z w - ¢ u (commencing with Section 700 0)of Division 3 of the Business and ISSUANCE DATE B r w i Professions Code,and my license s in full force and effect LDG. ELECT. PLG. MECH.- ❑ •❑ 0 Z m W License Class Lia Number - f11Pf 1' Date Contractor O� ¢ u � aBUILDING PERMIT ¢ e w ¢ OWNER-BUILDER DECLARATION wO a LiINFORMATION ; N 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO w o¢- Law for the following reason,(Sec.7031.5,Business and Professions VALUATION $/FT. I- - g PERMIT ISSUANCE � M�� Code:Any city or county whichtequiresa permit to construct.alter, 40700 I' rt c ¢O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. - LIC.NO. ELEG �]. - 0¢ requires the applicant for such permit to file a signed slaterneut that TOTAL, a(f -�� PERMIT TO e w m y he is licensed pursuant to the provisions of the Contractor's License _FZ Law(Chapter 9(commencing with Section 7000)of Division 3ofthe L-v E4 o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE M$_S the basis for the alleged exemption.Any violation of Section 7031.$ 1 STORIES TYPE CONSTR. n; � by any applicant fora permit subjects the applicant toacivil penally ALTER-GRAIN&VENT-WATER IEA.) 5.00 of not more than five hundred dollars($500)J: - ❑ 1,as owner of-the properly,or my employees will'wages as BACK F LOW PROTECT.,DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (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 properly who builds or improves thereon,and who does such work FIXTURES,PER TRAP ` 5.00 So.PT.FLOOR AREA TOTAL AcflEAGE himself or through his own employees,provided that such improve- mentsarenotintended or offered fofsale.if,however,the building ' GAS-EA.SYSTEM-11NC.40UTLETS 8.00 or improvement is sold within one year of completion,the owner- - builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE - provefor purposeofsale.). INDUSTRIAL WASTE INTER. 30.D0 RES IND CON. PB Omer ❑ 1,as owner of the property,ant exclusively contracting with [3 0 licensed contractors to construct the Pr(tj.t IS". 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 toanowner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 ' contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C.for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE N0. WORKF'RS'COMPI:NSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofconscri to self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. ropy there f,,(($$pp Lab C.1. ..1.^ . ' Policy,No.�Zmpan y�( ❑ Certified copy is hereby fumisheil' Z Z Cerl ifiFIRE SPRINK ENERGY T-24eJ copy is file) w' he city inspection Jivision� O plicum��E_ �.-- MISE.- REFER TO ORD. N Y [] N� T CERTIFICATE OF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. . d O (This section need not be completed if the permit is for one TOTAL Z hundred dollars($100).,]...,1 L) O I certify that in the performance of the work for which this per- DTV MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any person in any manners.as to become subject to the Workeri Compensation Laws of California. Go y Dale Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } to NOTICE TO APPLICANT: II',after making this Certificate of Ex- F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE ,. I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance 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'Narn Lender's Address HEATING UNIT(OVER 100,990 B.T.U.)9.50 ELECTRIC da•oo �~ 1 certify that I hove read this application and state that the above VENTILATION FAN (SINGLE) 4.00 .- 0 information is correct. 1 agree to comply with all city and county BOILER-DOMP(3 H.P.Or 100,000 B.T.U.) 6.00 PLUMBING ordinances inances and slate laws relating to building construction, and zj `�ye hereby authorize representatives of this city to enter upon the COMP'IOver t00,W0 BTU)BEE FEE SEH. t r above-mentioned property for inspection purposes. BOILER- MECHANICAL (Wo) agree to save, indemnity and keep harmless the City of MISC.- REFER TO ORD. - Cupertino against liabilities,judgments, costs and expenses which - - CONST.TAX may in any yJ y Ie unit said City in co uence of the PERMIT ISSUANCE 10.00 ranting t is MECH.CONT. - LIC.NO. MECH. TOTAL SigmUllreof AOpfkadlC tor/ V Date b - TOTAL o0 OFFICE COPY