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16626 POST THI RD NEAR FRONT OF-BUILDING ' • PERMIT NUMBER - - dR OF CUPERTllN0 16626 INSPECTION DIVISION ' JOB INSPECTION RECORD t_d/G PERMIT EXPIRATION JOB ADDRESS &/d3 A/ IUo LFA 2A UNIT# -_LOT# -� PERMIT, EXPIRES IF WORK OWNER ., coNrRAcroRIS NOT STARTED WITHIN I SPECTION DATE INSPECTOR INSPECTION RECORDiao onv5 of PERMIT Issu . ANCE OR. 180 DAYS FROM FOUNDATION NOTE: " LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAS7 CALLEDINSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PF;PMuT VALIDATION CUPERTINO.STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL - ISSUANCE DATE MECHANICAL - - aux; ELECT. Pu;. ME - .0�- 0 - ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR '12Al INFORMATION l _ VALUATION S/FU, PLUMBING - MECHANICAL 1 ♦•'� " M ��� PERM"'I ELECTRICAL FRAMING i STOR ES TYPE CONSTR INSULATION OCC.GROUP RES UNITS 4 PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.Fr,FLOOR AREA, TOTAL ncBCAoe•. II, • DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND CCN PB O'l— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ElO El 0 El A55LSSURS PARCEL NO ROUGH SAN.4 - PLUMBING ELECT.ENERGY TRACI NO PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL - MECH.ENERGY ELECTRICAL A" DATE ACC FILE NO.. �. BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING. ENG.SITE NO. ; INSULATION PLUMBING 4 GAS TEST GAS - MECHANICAL FIRE SPRNK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING N� ❑ `"� FLOOD LONE A U C EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. YE] NOfl ❑ N❑ SHEETROCK GRADE FEESUMMARY EXTERIOR LATH BUILDING • .INTERIOR LATH TEMPORARY APPROVALS - BUILDING SCRATCH COATELECTRIC PLAN CHECK - GAS - •FEE ' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTE" D D UNTIL BUILDING FINAL ISSIGNEBY BUILDING INSPECTOR. MICROFILM I. ARRANGE FOR INSPECTION BY PHONING 252-4505, ELEc7alc. I- 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 ;i.c'" r, TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INF MATION WITHIN 1, -,,;D LINES - US LL POINT PEN ONLY BUILDING PPQOJECTIDENTIFI N -PERMIT - - BUILDING PPLaCATION & P JT C[,` [,` ADDRES C aiGU y V BUILDING-ELECTRICAL-PLUMBING-MECHANICAL DINNER PLAN CHECK VALIDATION NA ��-7 �y� CITY. ELECTRIC PERMIT FEE .xkr &r PHDNraxr�/ 3 CONT CTOR'S UTLETS-SWITCHES-RECEP 10.00/1.00 NAME uc.No. LIGHTING FIXTURES' 10,00/1.00 CONTRACTOR'5 PPLIANCES-RESIDENTIAL 4.00 ADDRESS PHONE PANELS N 10.00 DATE OF APPLICATIO ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE PNO. .C. OR ENGINEER LIC,NO. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT 5.06 PERMIT VALIDATION ADDRESS ZIP EMP.METER OR POLE INS. 20 00Q - APPLICANTS MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 - 1 0 woo LICIiNSBU CONTRACTORS DECLARATION `fs/ ec B,w I hereby affirm that I am licensed under provisions of Chapter 9 \\\IBSO -NCE DATE s- < (commencing with Section 7000)of Division 3 of the Business and ` G. ELECT. PLG. MECH. r7 i Professions Code,and my license is in full force and effect ❑ ❑ ' 0. - License Class Lie.Number - 9 w Date.Contractor. BUILDING PERMIT i :w u OWNER-BUILDER DECLARATION INFORMATION w3 LL I- I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD LLo¢ Law for the followingreason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE VALUATION w✓+ Code:Any city orcounty whlchre0eiresa permittoconslruet,alleq 6 ea Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. Ort requires the applicant for such permit to file a signed statement Ihat TOTAL PERMIT TO 1 ' w $ he is licensed pursuant to the provisions of the Contractor's License zi Law(Chapter 9(commencing with Section 7000)of Division 3 of the I L7 a Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE [SQ � I Y r c the basis for Ilse alleged exemption.Any violation of$ection 7031.5 ST IES TYPE CONSTR. a; m by any applicant fora permit subjects the applicant toucivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($5001.): ❑ I,as owner of the property,or my employees with wages as - BACK FLOW PROTECT.DEVICE 4.00 C.GROUP 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 Contractor's License Law does not apply to an owner of - •r property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP- 5.00 .FLOOR AREA TOTAL ACREAGE -. himself or through his own employees,provided[list such improve- GAS-EA.SYSTEM-11NC.40UTLETS 8.00 meats are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner- - GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDINGOSE builder will have the burden of proving that he did not build or im- RES IND CON PB Other pr' for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 0 El E I,as owner cat the property,um exclusively conlradiny with tic "sed contractors to construct the project(Sec. 7044,Business LAWN SPR IN KLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not apply , . to an owner o1property 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 'Law. SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's LicenseTRACT NO. PARCEL NO. ❑ lam Cxemptunder Scc. ,B.&P.C.for this WATER HEATER W/VENT 6.00 ' reason OwnerDare WATER SYSTEM 5.00 ACC.DATE ACC.FILE No. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab CJ. Policy No. Company Q [1 Certified copy is hereby furnished. - FIRE SPRINK ENERGY T 24 Z 2 ❑ Certified copy is filed with the city inspection division. MISC- REFER TO ORD. yE] No y E] NC] Applicant F-' - FL PERMIT ISSUANCE 10.00 OOO ZONE A.L.U.C. Ir - CERTIFICATEOF 17XEMPTION FROM WORKERS' LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. - PLG. Y E] N Y Q N EL O (This section need not be completed if the permit is for one TOTAL D Z hundred dollars01001 or less.) U O 1 certify that in the performance of the work for which this Per- CITY . MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to O U, become subject to the Workers'Compensation Laws of California. BUILDING Date Applicant ALTER OR ADD TO MECH. 5.00 } So NOTICE TO APPLICANT: If,atter making this Certificate of Z emption,you should become subject to the Workers'Conspensmion JAPPLIANCE 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 1OA000.F.M.1 4.00 CONSTRUCTION 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 of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.001MICROFILM 3097,Civ.C.). Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.501 ELECTRIC C � Lender's Address I certify that l have read'this application and state that the above VENTILATION FAN (SINGLE) 4.00 PLUMBING information is correct. I agree to comply with all city and county BOILER'COMP(3 H.P.or 100,000 B.T.U.) 6.00 - ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP (Ovar 100,000 BTU)SEE FEESCH. 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 which CONST.TAX may in any way accrue agams Said City in consequence of the PERMIT ISSUANCE 10.00 r tiMECH f0 �»'t MECH.CONT. uC.NO. TOTAL TOTAL S na a of Applicant/Contractor ate OFFICE COPY ° ELECTRIC RVICE NOTICE', OFFICE COPY BUILDIN.�JSPECTOR'S NOTICE CITY DF CUPERTINO "19— To 19TO 4 ! 1 Yoo'ore hereby authorized to Connect electrical service for n p, - �Owner.or Tenant r At �• ' Slze of Wires ' Size o45wltch . "�I'�°� No of Wires - - - I MAcr'.Load Voltage Phase ' I tK.W. Voltage . i Healing Load yQ _ it Light I lo_New Service - Reconnect 1 Noy.of Meters More Seivice Heat 120__Three Wire No.of Add.Meters Power Three Phase Move Meier�' •i, ©w ELECTRICAL I1,45PECTOR I