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16684 4 •POST•THIS DNEARFRONTOF ,BUILDING; -PERM IT NUMBER - ,., CIT�OF CUPERTINO 16f 84 . a INSPECTION DIVISION JOB INSPECTION"RECORD s ERMIT EI 1'' 9 •PXPIRATION r JOB ADDRESS . /0/_'g 1�p V"r yy�l -FL ' � {UNITI _LOT# • s PERMIT EXPIRES IF.WORK OWNER CUNTRACTOR.',1A4— z AS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 100 ogvs of PERMir.lssu ^ FOUNDATION'. '' ANCE'OR 180 DAY&FROM �. NOTE: LAST CALLED INSPECT ION.' UFER :.^ - - ALL-GRADING AND DRAINAGE SHALL BE-INSTALLED ' { TO COMPLY;WITH THE APPROVED PLANS AND'CITY OF' PERMIT VALIDATION PR EGUNITE - .CUPERTINO STANDARDS..' . "' ' . ' GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I" UNDERGROUND /SLAB . PLUMBING I '. r f :.�.: :'+�`%. • ELECTRICALISSUANCE DATE -+ MECHANICAL •^ I BLDG. ELECT PLO. MECH. I DO'NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED •l' BUILDING PERMIT ` r WOOD'FLOOR - - A`© INFORMATION VALUATION S/FT. ,PLUMBING,. i n �9a ' MECHANICAL ELECTRICAL " - PERMIT TO - . . FRAMING, Uf�CUUU � • 'INSULATION '- - - 'Isro les rvPEcoNeTR. , OCC.GROUP RESIUNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED / • '�" P r ` SO.FT.FLOOR AREA TOTAL ACREAGE.; • „.� ROOF ' ' NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM ' THE CONSTRUCTION TAX IS PAID . J , BUILDING USE ROOF SHEATHING. _ HES❑ INDI❑ ❑N, ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BE EN'SIGNED FINALS DATE INSP. .ASSessoFS PAR CEL NO ROUGH SAN.k PLUMBING " ELECT.ENERGY- ' TRACT NO. PARCEL NO .. TUBS 8 SHOWER PAN I' ' PLUMBING ENERGY - MECHANICAL MECH.ENERGY. Acc.oarE Acc.FILE No. 1 ELECTRICAL BUILDING ENERGY FRAMING," ..•I - ELECT.FINAL TEST / ZONING ENG.SITE NO INSULATION , PLUMBING � - `. , GAS TEST e - GAS _ MEGHANICALt ` • ,,FIRE SPRINK ENERGS',T-04 .. • -V ❑ El ❑ N V : ::NE]' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - -.• '• ' ��', `' EXTERIOR SHEAR. ELECTRICAURELEASE FLOOD ZONE A.L C. I FIRE DEPT. NTERIOR*SHEAR - I • - v❑ "❑ v.� "❑ ;Y SHEETROCK 5 GRADE _ FEESUMMARY EXTERIOR LATH IBUILDING • INTERIOR LATH - SEMPORARYAPPROVAL$:+ • ' BUILDING: 4 z SCRATCH COAT JELECTRIC - . PLAN CHECK y, GAS. . FEE . ".. NO TAPE OR PLASTER UNTIL.ABOVE HAS BEEN SIGNED JOCCURANCY ' L'' sEISMIc'FEE OCCUPANCY OF BU I LDING IS NOT PERMITTED UNTI L BUI LDING F INAL'IS SIGNED BY BUI LDINGINSPECTOR. MICROFILM ARRANGE FOR I'NSPECTIONPBY'.PHON•ING 252-4505, ELECTRIC 0 ONE.WORKING DAY BEFORE REQUIRED INSPECTION PLUMBING• I' N PHONI PLEASE GIVE dOB ADDRESS WHE NG. ' Z ., . MECHANICAL — SEE PERMIT FOR'EXPIRATION'DATE I Alf ' IMPORTANT! coNsr.TAX PLEASE READ REVERSE SIDE'BEFORE I • 5 ' . ' a w TOTAL " CALLING FOR FINAL INSPECTION•. OFFICE COPY ' 4PPLICANT'TO FILL IN INF ATION WITHIN RED LINES - USE LL POINT PEN ONLY BUILDING'PROJECT IDENTIFIC - - PERMIT NUMBER . BUILDING, . APPLICATION& PEWIT 16184" Q n ADaflsss BUILDING -ELECTRICAL—PLUMBING—MECHANICAL 16618 CWrvER's - PLAN CHECK VALIDATION - - • - " QTY. ELECTRIC PERMIT FEE_ ' LOT, ,.PHONE t CONTRACT. 5' ' NAm I UTLETS -SWITCHES-RECEP 10.00/1.00 No. LIGHTING FIXTURES- 10.00/1.00 , r-DOTRAc .fls - - APPLIANCES-RESIDENTIAL 4.00 ' ADDRESS /'IL 1 - `� `- .,+ �� ( D ' JI1N PHONE) SISf' - PANELS 10.00 GATE OF APPLICATION'�i ARCHITECT, PLAN CHECK FEE - P.C..NO: on PANELS (OVER 200 AMPI 20.00 - ENGINEER + ' .:uc.rvo: + ' SIGNS TRANS. - , 3.00 AARCH.OR DDRESS ENG. .. - + l SPECIAL CIRCUIT '5.00 PERMIT VALIDATION ' _ - zIP TEMP.METER OR POLE INS. 20.00 -- APPLmArvrs ADDRESS _ - { MOTORS - SEE FEE SCH . . * SERVICE CHANGE 2000 o o LICENSED CONTRACTORS DECLARATION' +_ ( J •�7�OQ 3' a Ea v, •I hereby affirm that I am licensed:under provisions of Chaptea9 .ISS ANCE'bATE ` h <i (commencing with Section 7000)of Division 3 of the Businessand - BLDG. ELECT. PLG. MECH. I- H i Professions Cod an license is in full forre7W �fayy, ❑ e oi W o License CI ss' Lia Numbe /r . w H j Date Contractor a s - to. '- - BUILDING PERMIT ' w u WN OER BUILDER DECLARATION : INFORMATION EA. o a - t REFER TO ORD X ; FH . 1 hereby'affirm that I am exempt from the Contract.,,a License MISC.— u Lw forthe following reason (Sec. Pe's 's "VALUATION $/FT.o ¢ PERMIT 10.00. N0 Code:Any city or county which requiresa permit toconslruct,alter, Q Q Q Q Improve,demolish,Or repair any structure,prior to Its Issuance,also ELEC.CONTR. LIC.NO. ELEC. I H D ¢ rqulres the applicant for such permit to file a signed Statement that TOTAL w PERMIT TO$u he is licensed pursuant to the provisions of the Contractor's License Hzi Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe - - - ' ¢' Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT` ry FEE ¢ o the basis for lite alleged exemption,Any violation of Section 7031.5 STORIES TYPE CONSTR. r by any applicant for a permit subjects theapplicant to a civil penalty i l+ -DRAIN -WATER`IEA.) of Out more than five hundred.dollars($500t): ALTER5.00 ❑' I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE - 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not - intended or offered Or 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 F IXTUR ES-PER TRAP '� SQ FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve. meats are not intended or offered for sale:If,however,the building ? GAS:EA.SYSTEM-11NC.4 OUTLETS,GAO or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA.) 200 builder will have the burden of proving that he did not build or im- . . BUILDING USE prove for purpose.of sale.). INDUSTRIALWASTE INTER. 30.00 RES IND CON PB Other ❑, I,as owner of(he property,am exclusively contracting with - - ❑ +❑ ❑. ❑ ❑ licensed contractors in construct the proiectl sea 7044„Business LAWN SPRINKLERS- 1'INC 5 V.B. - 6.00 *'6 e' ASSESSORS PARCEL NO, and.Professions Code:The Contractor's License Law docs not apply _ * to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.1 1 contracts for such projects with a contractors)license(]pursuant to SEWER-SANITARY-STORM Eq.200ft/1M .e3 T NO. PARCEL NO. the Contractor's License Law. 1� ❑ lam exempt under See. ,B.&P,C:for this WgTER HEATER W/VENT' ' 6.0 0� , reason f Owner - 'Date WATER SYSTEM y 5.00 - ACC.DATE'- ACC.FILE NO. woRKERs'coMPliNsnTloN urcl.nRnnoN WATER TREATING EQUIP. 5.00 I hereby uffirni that I have a certificate of consent 1.self-insure; ZONING or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO. copy thereof(Sc,.3800,Lab.CJ. r Policy No. CompanY O ❑ Certified copy is hereby furnished, FIRE,SPRINKi ENERG.YT-24 Z Z' . ❑ Certified copy is fled with the city ins peetion'division. REFER TO ORD. O Applicant MISC--.. V❑ N❑ V ❑ N. toPERMIT ISSUANCE - �ArBO FLooD zoNE A.L U.C. cc C F:RT 11'I CA'1'11;OF EXEMPTION PROM WO R K Ii Rs' LU COMPENSATION INSU RANCB PL OTR. IC. PLG. Y❑ N❑ Y•❑ N❑ CL O (This Section need not be connpleted if the permit is for one q . TOTAL-� Z hundred dollars($100)or less.) - + V O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE ,FEE SUMMARY LL F mtt is issued,I shall not employ any erson in any mmnner so as to - - I U heedi�ie suti1' to the Workers Co ens' ion La C 1' n'u. _ - y -- Uatd_U zL_L'__Anplicanyq,� gLTER OR ADD TO MECH. 5.00 BUILDING } m NOTI-17 TTbb APPPL ICANT: f,a r making this Certificate of Fx- L.. ?• ernption;you shout become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK to visions of the Labor Code, you,must forthwith comply with AIR HANDLING UNIT FEE C„) p such provisions or this permit shall be deemed revoked. (TO 10MC.F.M.) . 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER'1O=C.F.M.) 6.00 SEISMIC FEE a 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• MICROFILM i 3097,CR.C.). (TO 100,000 B.T.U.) 8.00 Lendeds Name - - - IH EATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC - Lender'sAddress ' I certify that l hove read thisapl,Lalion and state that(lie above VENTILATION FAN (SINGLE) 4.00 Diminution is correct.1 agree to comply with all city and countyPLUMBING Li ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 �. hereby authorize representatives of this city, to enter upon the BOILER-COMP Over 100,000 BTU)SEE FEE SCH, MECHANICAL above-mentioned properly Ibr,inspection purposes.' (we) agree to Save, indemnify and keep harmless the City of MISC.- Cupertino ISC.-upertino again f liabii tiev,judgments; costs and expenses,which 'CONST:TAX ay in any accrue against surd City in consequence of the PERMIT ISSUANCE - 10.00 tantin8 oft r MECH.CONT. ' LIC.NO. MECH. J o� ,, TDTAL TOTAL Sig of Applicant/Contractor Dale .OFFIGE'COPY