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16388 POST THIS CARD NEAR FRONT OF BUILDING PERMITNUMBER CITOOF CUPERTINO 6388 INSPECTION DIVISION JOB INSPECTION RECORD 2 y 0 1 - PERMIT EXPIRATION JOB • JOB ADDRESS /D ' L3 �,I Wp D �d UNIT# _LOT# �ERMIT E 'XPIR"FIRES IF WORK OWNER C G� �• coNrRncroR -r� e IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD •lBU DAYS OF PERMIT ISSU. FOUNDATION I - ANCE OR 180 DAYS FROM NOTE: ' UFER - � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PPRMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' UNDERGROUND /SLAB , PLUMBING ELECTRICAL - ISSUANCE'DATE MECHANICAL - BLDG ELECT.I PLC, MECR. ❑' ❑ El ' 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION " PLUMBING .WOOD FLOOR VALUATION STET. MECHANICAL ELECTRICAL PERMIT TO FRAMING - �L- INSULATION PAI- STORIES T PE CONSTR.OCT . OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 'rifu Mil: 5p.Fl,FLOOH AIFF.A TOTAL ACREAGE - ROOF I-NOTE:NO FINAL INSP.SHA L BE MA FORE .' DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING RES IND BUILCCON USE 00— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.N ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY ' TUBS&SHOWER PAN PLUMBINGTRACT NO, PARCEL NO.,ENERGY � �,T• MECHANICAL MECH.ENERGY ELECTRICALBUILDING ENERGY, ACC.DATE ACC FILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONINGEND SITE NO. J GAS TEST _ GAS MECHANICAL FIRE SP RINK ENERGY T 14 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ ' N Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A.L.uc INTERIOR SHEAR FIRE DEPT. Y❑ .N❑ Y ❑ ,N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR•LATH. ISUILDING - BUILDING tl INTERIOR 'LATH TEMPORARY APPROVALS - SCRATCH COAT ELECTRIC PLAN CHECK GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ' SEISMIC FEE 'I OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ` � ' ONE'WORKING DAY BEFORE REQUIRED INSPECTION. . PLUMBING j • 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL 04' — SEE PERMIT FOR;EXPIRATION DATE — , IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE h TOTAL o'r • CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION,WITHIN REDLINES.-•USE BALL POINT PEN ONLY BUILDING PROJECT I DENTI FIC -PERMIT NUMBER `- 6AOOILQING/ / 3 O APPLICATION & PET DRESS AL .6388 BUILDING ELECTRICAL-PLUMBING'-MECHANIC OWrvER ' 'PLAN CHECK VALIDATION Ave y .J.7 3�9 QTY ELECTRIC PERMIT FEE OS"/ PMONE , NA�ME�RA°T--OR��sLL I / A/ UTLETS-SWITCHES-RECEP 10.00/1.00 7 rEhJ 4 Slee-I Aife�e.No.�6 3„/' LIGHTING FIXTURES 10.00/1.00 1p -74� CONTRACTORS [ APPLIANCES-RESIDENTIAL' 4.00 V J LT PHONE a2y -0966 PANELS 10.00 DATE OF AP PLICATION ORRcmTECT - PANELS (OVER 200 AMP) 20.00 ' PLAN CHECK FEE PG:NO. ENGINEER LIC,NO SIGNS TRANS. 3.00 ARCH.OR ADDRESS ENG. SPECIALCIRCUIT 5.00 „ PERMIT VALI DATION ZIP TEMP.METER OR POLE INS., 20.00 noo ssrs MOTORS SEE-FEE SCH. + SERVICE CHANGE 20,00 0 0 LICENSED CONTRACTORS DECLARATION au I hereby affirm that I am licensed under provisions of Chapter 9 Z i PAIDISSUANCE DATE "- y Q y (Commencing with Section 7000)of Division 3 of the Business and LOU. ELECT.. PLG. MECH. z oO License Cis CoJ•,and''rr�� license is in full force nd ejjffe L :❑ ❑ - ❑ ❑- w License Class ��y20 Lie.Number '1� �? -'-'--- ' 1 w r w Date Cnntmctorr4,a,. OCT 71900 'ar S, or a OWNER-BUILDER DECLARATION BUILDING PERMIT - o m" MISC.- RD INFORMATION w ; y I hereby affirm that I am exempt From the Contractor's License VALUATION S/FT. a LL O Q Law for the following reason.(Sec.7031.5,Business and ProCcaeione - PERMIT ISSUANCE 10.00 Hy 0 improve, Code:Any city or county which requiresa permit to construct,alien, Q KQa, requiresde mpplic,Or feral!anyourit titre,prior n its issuance,talsohat ELEC.CONTR. LIC.NO. ELEQ y O,LL requires the applicant for such recti)to file a Signed statement that - TOTAL PERMITTO a, m he is licensed pursuant to the provisions of the Contractor's License - r z¢ Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe ��•� - 5 4 O Business and Professions Code)or that be is exempt therefrom and QTY. PLUMBING PERMIT FEE r m,' the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. or It by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(5500).): ❑ 1,as owner of the property,or my employees with wages as GROUP BACKFLOW PROTECT. DEVICE' 4.00 OCC. RES.UNITS their sole compensation,will do 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 CwHoutor's License Law does not apply to ad owlicr of - property who builds or Improves thereon,and who does such work FIXTURES-PER TRAP _ 5.00 ' SQ.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such Improve. - me ats are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11INC.4 OUTLETS 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 sale.). r .RES IND CON PB Other INDUSTRIAL WASTE INTER, 30.00 ❑ L as owner s the property, exclusively contracting with ❑ ❑ ❑ ❑ ❑ 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 dues not apply " to tr owner of property who builds tr improves thereon,and whot to LAWN SPRINKLERS-OVER 5(EA1) 1.00 contracts is for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's axe License Ser. TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&BC.for this reason WATER HEATER W/VENT _. 6.00 Owner _ Date WATER SYSTEM -5.00 ALC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 - _ 1 hereby affirm that I have a certificate ofconsent to self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof�(S�e�c�.3�fl00,Lab.CJ. Policy NnQaPU9�JCompany PQC171C .I.EIIKDChI$a�l " Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z X Certified copy is Filed with the city inspection division. , .FO Applicant MISC.-• REFER TO ORD. v ❑ K ❑ ❑N v N CC CERTIFICATE OF EXFMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.O.' IL > (This section eN noN huTco completed if INSURANCE PLG.CONTR. permit is for one - ua LG IL No. - TOTAL' V❑, •N-NE] ❑' NC] ::3Z hundreddollars(SUKEmless) UEA O .I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY UL I- mit is issued,I shall not employ any person in any manner so as to O W become subject to theMorkers'Compensation Laws of California. y Date APPlicant ALTER OR ADD TO MECH. 5.00 Om BUILDING } N NOTICE TO APPLICANT: If,after making this Certificate of F;x- 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 10AMC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1 hereby affirm that (here 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,Cre.C.). ; HEATING UNIT(TO 100,000 B.T.U.) 5.00 _ Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)Lender's Address ELECTRIC 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 I PLUMBING �\ ordinances and state,laws relating to building construction, and BOILER-COMP(3HY.of 100,000 B.T.U.) 6.00 hereby 3LIenti orid representatives inspoL this city to enter upon the BOI LER-COMP(Over 100,000 RTU)SEE FEE SCA. MECHANICAL 0 above-mentioned properly forinsre of purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 L•� " CONST.TAX, may In any way accrue against said City In consequence of the _ Wt Of this Penni). _ MECH.CONT. LIC.N0. MECH. o TOTAL p0 TOTAL CI? 0� Signature of Applicamt,UolkknictortDate OFFICE COPY