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16318 (2) I (, , 'POST THIS CARD NEAR FRONT OF, BUILDING � PERMIT NUMBER Y CIT*DF CUPERTINO "INSPECTION DIVISION 1631 "R . yy. JOB INSPECTION RECORD \ (r ( CPERMIT EXPIRATION JOB ADDRESS l.l��J�L - �-'f UNIT# LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR - - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF'PERMITISSU FOUNDATION - ANCE OR ... DAYS,FROM NOTE: LAST CALLED INSPECTION. UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE '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 til; PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG ELECT PLG. MECH. � � � ' El E 1:1 e' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDUILDING PAID BIN ORMATIONT WOOD FLOOR p VALUATION siET. PLUMBING OCT 211988 ar "• MECHANICAL ELECTRICAL - 7 ER IT TO City of Cupertin . i:� = i I's� FRAMING. , INSULATION - sroRlEs TYPE COs TH OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - I - ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so rr PLood nra;A TOTAI.ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID dUILUI USE ROOF SHEATHING Res Irvo CON vd ON.. ; APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 ❑ El I] ❑ A SSESSORS PARCEL NO ROUGH ' SAN.q PLUMBING ELECT.ENERGY - ' TRACT+NO, .PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ncc.PILE No FRAMING - - ELECT.FINAL TEST ZONING ENG.SITE NO. . INSULATION' PLUMBING �_ GASTEST GAS - MECHANICAL _/p— EIRESPHINIc ENERGY T 2 NE] ❑ "o COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - FLOOD EXTERIOR SHEAR ELECTRICAL RELEASE —16- ] v L_zoNE ALu,c. INTERIOR SHEAR FIRE DEPT. - v N� N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING 0= INTERIOR LATH TEMPORARY APPROVALS BUILDING 3 ,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 UNTI L BUILDING FINAL IS SIGNED BY SUI LDING INSPECTOR. -r .. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H 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. l OFFICECOPY ": ri APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY • BUILDING PROJECT I DENTI FICA .PERMIT NUMBER 8 ILDiNG 1 y o APPLICATION & PE ,. '� 631 p e ADDRESS © LJ ^ 1 4 10 IJ`ryV BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S ��� PLAN CHECK VALIDATION NAME 6Y11 DTV. ELECTRIC PERMIT FEEFP Lf�I (nb � ' lJC/� DIJ Ir1UL � ONF 1 CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00 NAME oW NJ� LID.NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTORS OMTA hag C f�a1 APPLIANCES-RESIDENTIAL 4.00 ADD Ess C x[I �SQI G p� ONE q A9 bv? PANELS 10.00 PATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK'FEE P.C.yNO. OR / ` ENGINEER ` n �( IS NO S'�c 1 L� SIGNS TRANS. 3.00 ARCH,OR ENG` W SPECIAL CIRCUIT S,OO PERMIT VALIDATION ADDRESS // 77 q IL ETP. 1 ;0k zip Vtl 7 EMP.METER OR POLE INS.. 20.00 -{• �(�,m ADDRESS I�7�/ MOTORS SEE FEE SCH. v- ' • ' "� ' ADDRESS ) -S-ol WAvb 4Z SERVICE CHANGE 20.00 +Ulal l� Foo LICENSED CONTRACTORS DECLARATION - - a u u I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE N a N (commencing with Section 7000)of Division 3 of the Business and BLD ELECT. PLG. MECH, H O z Professions Code,and my license is in full force and effect. ❑ ❑ ❑ Z,O vMi- License Class Lic.Number Q z: DDate Contractor i2 f a w CT BUILDING PERMIT ¢ w¢ OWNER-BUILDER DECLARATION INFORMATION O REFER TO ORD E ;e N. I hereby affirm (hat I am exempt from the Contractor's License MISC.- a VALUATION $/FT. te u o a Law Cor the following reason,11ce,7031.5,Business and Professions PERMIT ISSUANCEIR IQ Code:Any city or countywhich requires a permit to construct, IV� /�(1!\ rt i o improve,demolish,or repair any structure,prior to its issuance,also ELEC.DONTR. LIQ NO. ELEC. V halal O a requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO E $ he is licensed pursuant to the provisions of the Contractor's License Hit Law fChaplcr9(commoncingwith Scdlon 7000)oCUivision3oflhu IN mrr , ¢ Business and Professions Code)or that he is exempt therefrom and CITU. PLUMBING PERMIT FEE ¢ r0 the basis for the alleged exemption.Any viola)ion of Section 7031.5 STORIES TYPE CONSTR. a ,;� by any applicant for a permit subjects the applicant to acivil penahy ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).1: ❑ I,as owner of the properly,or my employees with wages as IBACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS -� their sole compensation,will do the work,end the structure is not 0 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 Property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SD.Fr.FLOOR AREA TOTAL ACRE AGE . himreself or through his own employees,provided that such improve- menisare not intended orOffed(oriole.If,however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 h or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA.) 2.00 BUILDING USE s builder will have tire .e burden of proving that he did not build or am.. S IND CON PB OtM1ee pr a for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES �, 1,as owner ol'the property,am exclusively contracting with 11 El 1-1 A licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. OT 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 contractods)licensed puritans to SEWER-SANITARY-STORM EA.200tt/10.00 TRACT NO, PARCEL NO. the Contractors License Low. O l am exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 reason V Owner Dare WATER SYSTEM 5.00 -ACC.DATE ACC.FILENO. qWORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 J I hereby affirm that 1 have a certificate or consent to scl Ginsure, ZONING ENG.SITE NO. or a certificate of Workers Compensation Insurance,or a certified copy thereof(See.3800,Lab.C.).I �. MI. Policy No. Company 711 Q ❑ Cetlilled c0 is heroby fUlmlShed. � - FIRE SPRINK ENERGY T24 Z 2 ❑ Certified y y Fred evty inspection division. MISC. REFER TO ORD. O Applicant � c Y N Y NEI � - PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. (r - CERTIFICATEOF EXEMPTION FROM WORKERS' _ - UJ > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PIG. 1 TOTAL Y❑ N❑ V 0 N� =1Z (This section need not be completed if the permit is for one hundred dollars IS 1001 or less.) (.1 O I certify thea in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY U. become is issued,I shall not employ any person in any manner So as to O W become subject to the Workers'Compeasation Laws of California. BUILDING Z Daae Applicant ALTER OR ADD TO MECH. 5.00 -I } y NOTICE TO APPLICANT: If,after looking this Certificate of Ex- F ? empaion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK Provisions of the Labor Code, you must forthwith comply with FEE V such provisions or this permit shallAIR HANDLING UNIT(TO 10 be deemed revoked. ,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 SEISMIC FEE q '75 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 Name HEATING UNIT(OVER 100,000 B.T.1.1.19.50 ELECTRIC) Lender's Address I certify that I 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 BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00IMECHAN PLUMBING Ordinances and slate laws relating 10 building construction, and hereby authorize representatives of this city to enter upon late BOILER-COMP (Over 100,000 BTUI SEE FEE SCH, ICALabove-mentioned property Porins ofthi purposes.(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino a ins) liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00CONST.TAX ay in an way accrt ainst said City in consequence of the ranting is IT it. MECH.CONT. LIC.NO. MECH.' r,J, TorAL TOTAL �5 Sign u pP cant o ractor Data - 96Af OFFICE COPY C