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16251 4 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBfa CITY OF CUPERTINO 16251 ' INSPECTION,DIV ISION JOB INSPECTION RECORD "S�z /odJ--L3 PERMIT EXPIRATION ' JOB ADDRESS�C��3 N, WOE_�Lr /?43 UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER SSC.-G"V L}L(` CONTRACTOR L� IS NOT STARTED WITHIN -I INSPECTION DATE INSPECTOR INSPECT N RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION A— OR 180 DAYS FROM.' NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE-SHALL BE INSTALLED PR EG UNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. - GARAGE SLABS " POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ' PLUMBING ELECTRICAL. ISSUANCE DATE MECHANICAL BLuc. ELECt. PLc. MECR ❑ ❑ ❑ a . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD.FLOOR VALUATION sift. - PLUMBING MECHANICAL ELECTRICAL PERMIT TO FRAMING 4,66—. INSULATION - D sruRlEs TwEcorvsTH. P OCC;,GROUP qES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED Aub 1AREA .GrAL ACRFACE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEWQq� DIV DIAPHRAGM - THE CONSTRUCTIONTAX IS PAID G��1 ` BUILDING USE ROOF SHEATHING ' Res IND" LON 'PB Ow.- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El ❑ ❑ ❑ 0 F ASSESSORS PAHCEL NO ROUGH SANA 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 ZONING ENG.SITE No� INSULATION PLUMBING ' GAS TEST - GAS FIRE SPRINK ENERGY 124 MECHANICAL YE] rvEl Y [] NQ, COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD zoNE _ ALu.c. INTERIOR SHEAR - FIRE DEPT. ' Yo No ❑ ,. �o: " SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH - TEMPORARY APPROVALS . SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY.OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM - ARRANGE FOR INSPECTION'BY PHONING 252-4505, ELECTRIC ELI WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O� PLEASE GIVE..JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! CONST. TAX PLEASE READ REVERSE SIDE BEFORE. TOTAL' 'CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY " BUI LDING PRO C71D IFICATIO I PERMIT NUMBER - 9DILDING APPLICATION & PERMIT [�1 AOORESs �J I 7 CA 022 BUILDING—ELECTRICAL—PLUMBING—MECHANICAL 1" OwrNS PLAN CHECK VALIDATION NASA Ta 1T7A� CITY. ELECTRIC PERMIT FEE Iffj��oNTRa` r`JcrpoIIR.IsK—.G ll��-AX—�.//��(ul�/.�5 JakTLETS- ITCHES-RECEP 10.00/1.00 �' •�`-� ' VAS P�(Mj3/u� S 10.00/1.00 . r- NTnagggg666c6Ton's�• 1 ,EyY. �Kf PPLIANCES-RESIDENTIAL 4.00 AU PHONE J NELS 10.00 DATE OF APPLICATION onCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.'NO. ENGINEER uc.No. SIGNS TRANS. 3.00 ADDRESS cera SPECIALCIRCUIT 5.00' PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 Woo LICENSED CONTRACTORS DECLARATION Q/ Q ¢ u I hereby affirm that 1 am licensed under provisions of Chapter Y - ISSUANCE DATE [commencing with Section 7000)of Division 3 of a itsine and BLDG. ELECT. PLG. MECH. r an z Professions e, y license is in full ❑ z o w— Licens•C s Lie.Number _ — - o m;', Datey�j/�— Contractor _ a y s '�/ - BUILDING PERMIT ¢ ¢ w OWNER-BUILDER DECLARATION INFORMATION o a MISC.- REFER TO ORD w g LL H I hereby allium that I am exempt from the Cnnrractor's License VALUATION $/FT. H a. o j Law for the following reason.(Sec.7031.5,Rusinessand Professions PERMIT ISSUANCE 10.00 Code'.Any city or county which requires a permit to construct,alter, ¢ Z; ELEC.CONTR. LIC.NO. ¢ ¢0 improve,Demolish,or repair any structure,prior In its issuance,also ELEC. D ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO ca n w Re w he is licensed pursuant to the provisions of the Contractor's License z a Law(Chapter 9(commencing with Section 70001 of DivisioR3 of the E 4 0 Business and Profcssions Code)or that he is exempt therefrom and PLUMBING PERMIT FEE ¢ H o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. dam by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than five hundred dollars 155001.1: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP REB.UNITS their sole compensation,will Jo 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's License Law does not apply to an owner of properly who builds or improves thereon,and who floes such work FIXTURES-PER TRAP 588 SO.FT,FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- GAS-EA.SYSTEM-11NC.40UTLETS 6.00 at mes are not intended mothered for sale.If,however,the building or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 (EA.) BUILDING USE build,,will have the burden of proving that h - . . e did riot build or int- RES IND CON PB Omer prove for purpose of sale J. INDUSTRIAL WASTE INTER. ,00 ax^? ❑ I,as owner of Dm property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ lieenwd contractors to construct the project(See.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. ASSESSORS PARCEL NO. and Professions Code:'I'he Contracmr's License Law does not apply 10 an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IE .00 contracts]or such projects with a contractor(s)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.2 0ft/10 AVUA TRACT NO. PARCEL NO. O I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT MP —' reasmi Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WORKF-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to sell'-insure, - ZONING ENG.SITE NO. or a certificate of Workers Compensation Insurance,or u certified copy thereof(Sec.3800,Lab.C.). Policy. a. Company - eltfieit OP it he by is ed. FIRESPRINK ENERGY T-24 Z Z �s pp Cry i I u is led ' act' n division. MISC.- REFER TO ORD. v ❑ ry❑ v [:3 No ~ rnPERMIT ISSUANCE —' FLooD zoNE A.L.u.C. CIiRTIf1.'�l�CAT'Ii OP EXEMPTION FROM W KERS' - UJ r" COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. )O p1J Y❑ IN[3 Y ❑ N d ❑ O IT section need not he completed if the permit is (or one TOTAL oC ::) Z hundred dollars(E 100)or less.) U O 1 certify that in Ore performance of the work for which this per. CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL I— mit is issued,I shall riot employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. O w BUILDING. d Date Applicant ALTER OR ADD TO MECH. 5.00 } to NOTICE TO APPLICANT: If,after making this Certificate of E.:: H ? cmption,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 10=CF.M) 4.00 -CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.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,Civ. of the work for which this permit is issued(Sec HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's No Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify flux 1,have read this opplicalion and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING Q ordinances and stale laws relating to building construction, and BOILER-COMP(3 H.P.or 100,0008.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP Maer 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep he nn lees the City of MISC,- REFER TO ORD, Cupertino against liabilities,judgments, casts and expenses which CONST.TAX may in any way acerun against said City in consegn ncey of thin PERMIT ISSUANCE 10.00 r ngof)yi� . ^ � /� MECH.CONT. LIC.NO. MECH. TOTAL ((,•�yHH/ `O/'YO�(YJ TOTAL Si alureof Applicant nnlractor Dole OFFICE COPY