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16849 POST THIS CAR D.NEAR FRONT OFBUILDING PERMIT NUMBER CITY 0F .QRERTIN0 16$49 -j _ ` Y INSPECTION DIVISION JOB INSPECTION RECORD I� 15?, PERMIT PERMIT EX�RATION� JOB ADDRESS l o` i:):) %.3 ,I,_�uF UNIT# LOT# J PERMIT EXPIRES IF WORK ;I OWNER I 'l= UI E. coNrHacToa IS NOT STARTED WITHIN ' - INSPECTION DATE INSPECTOR INSP CTIO RECORD 180 DAYS OF PE RMIT;ISSU FOUNDATION-' "ANCE OR 180 DAYS FROM NOTE: .LAST CALLED INSPECTIOW LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT.VALIDATION PREGUNITE - - CUPERTINO STANDARDS. ' GARAGE SLABS ... PAID POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB MAY1`'1989 �„•}(, f}' PLUMBING .. CI oA`CDpBlno,'" ELECTRICAL - ISSUANCt DATE BLDG ELECT. PCG. . 'MECH: MECHANICAL'• - - 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $JET. , PLUMBING . MECHANICAL 1 ELECTRICAL PERMIT TO , � - .' - FRAMING ,. STORIES. TVPE CONSTR. INSULATION .. .. , OCC,GHOUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $o ET FLOOR AREA TOTAL'ACREAGE- ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE �:� DIAPHRAGM 'THE CONSTRUCTION TAX IS PAID. 'D4: .v ' .. , BUILDING USE ROOF SHEATHING - - Res IND +c0 PB 00— a APPLY NO ROOFING UNTIL.ABOVE HAS BEEN SIGNED FINALS DATE INSP., ❑ ABSE050 SPAHCEL NO ROUGH SAN.# • 1 PLUMBING - - ELECT.ENERGY C S •..I • TRACT NO - PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGYof rHRQ 4001 Acc.oarE _ACC.Elle NO, ELECTRICAL BUILDING ENERGY FRAMING - ELECT.FINAL TEST, ZONING ENG SITE-N0. INSULATION, PLUMBING GAS TEST GAS_ MECHANICAL EIRE SPRINK ENERGY r-za 7 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING •°* ° �11 ` EXTERIOR SHEAR ELECTRICAL RELEASE — FLOOD ZONE A.L U.Co INTERIOR SHEAR FIRE DEPT. ,v�. "� v ❑ : N❑ GRADE FEE SUMMARY SHEETROCK 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'- OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING I NSPECTOR. MICROFILM, 'ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC (/�Da IJJ ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBwG Z MECHANICAL — SEE PERMIT FOR EXP.IRATION'DATE;- �U IMPORTANT!., coNST.TAX PLEASE READ REVERSE SIDE BEFORE ' s�" TOTAL' 6' CALLING FOR FINAL OFFICE COPY • APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ' BUILDING PROJECT IDENTIFICATION .PERMITNUMBER,- r Rom P APPLICATION & PERMIT ' 68 /� (� zQ l Z• I / �d " to �UI�40AG -ELECTRICAL-PLUMBING-MECHANICAL ,t 0 y'J . PLAN CHECK VALIDATION OTY. ELECTRIC PERMIT FEE ^NONE CONTgAC R'S UTLETS-SWITCHES-RECEP 10.00/1.00 !9,;00 LIC.No, LIGHTING FIXTURES 10.00/1.00 k .2- ` I r,ONTHACTOR'S ADDRESS PPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 ARCHITECT DATE OF APPLICATION' ORPANELS IOVER 200 AMP) 2000 PLAN CHECK FEE P.C.NO. . ENGINEER ' LOC.NO, SIGNS TRANS. 3.00 (G�Cb, AR, S - SPECIAL CIRCUIT 5.00 I'� ADDRESS ENc. PERMIT VALIDATION APPLICANZIP EMP.METER OR POLE INS. 20.00 ADDRESS TS MOTORS SEE FEE SCR. T SERVICE CHANGE 20.00 VCelP '02 LICENSF-D CONTRACTORS DECLARATION1 1 Q in v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE 4 1� w a w (commencing with Section 7000)of Division 3 of the Business andMAY - y0 7 z Professions Code,anti my license Is in full force and effect. BLDG. ELECT. PLG. I MECH. z 0 2 - License Class-Lia Number. 11r 2 „ -_ I°a Dateril l Of CIIpBIf1110 Lel( i Contractor Q M at J R ¢ w a OWNIi R-B UILDF,R DECLARATION BUILDING PERMIT U MISC.- REFER TO ORD INFORMATION R ;' H I hereby affirm that I am exempt from the Contractor's License u O< Law for the following reason(Seo.TO' 1.5,Business and Professions VALUATION S/FT. r - PERMIT ISSUANCE 10.00 w Y Code:Any mty or county which requiresu permit to caretrucL alter, O ¢ ar ¢0 improve,demolish,or repair any stn¢fpre,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. a 0 0: requires the applicant for such permit to file a signed statement that TOTAL (�� PERMIT TO X he is licensed pursuant to the provisions ollhe Contractor's License .Hza Lin (Chapter9(rommencingwith Sce[ion 70001of Division3ol'the � F x 0 Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢t- o the basis for the alleged exemption.Any violation of Section 7031.$ STORIES TYPE CONSTR. a ;ro ty any applicant for a permit subjects the applicant m a civil penalty of not more than five hundred dollars(5500).): I ALTER-DRAIN -WATER (EA.) 5.00 1Ltp, - ❑ I,as owner of the property or my empbyees with wages as BACK FLOW PROTECT. DEVICE L00 (heir sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 5.00 Lt-,00 Code:The Contractor's License Law does not apply to all owner of property who builds or improves thereon,and who does such work 1 FIXTURES-PER TRAP 5.00 m SO.FT.FLOOR AREA TOTAL ACREAGE himself re through his own employeyees,s,provided that such improve- 0�-F menis are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4OUTLETS 6.00 Or improvement is sold within one year of completion;the owner- ho holder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose . INDUSTRIAL WASTE INTER. 30.00 REs IND CON PB Omer, ❑ 1,as owner of the property,am exclusively contracting with - licensed contractors to construct the project(Sec 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSO P RCEL NO. and Professions Code:The Contractor's License Law docs not apply to an owner of property who bunds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contra tors)licensed Pursuant to the Contractors Lic rase w. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ 1 Jilt excmp I B.&P.C.,ou this reason WATER HEATER W/VENT 6.00 Owner // Date WATER SYSTEM 5.00 "`- ` OR- RS'COMPENSATION DECLARATION ACC.DATE ACG FILE N0. WATER TREATING EO 3iQb 1 hereby affirm that I have a cert ificnte of consent to self-insure, o'a certificate of Workers'Compensation Insurance,or a certified '.ZONING ENG.SITE NO. co ,v thereof(Sec.3800,Lab.C.). Polic!'No. Company C) ❑ Welalfied copy is hereby furnished. FIRE gPflINK ENERGY T-24 Z Z ❑ Gertified copy is Filed with the city inspection division. F: O Applicant MISC.- REFER TO ORD. V0 N� v0 IN cc CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 ' LCI FLOOD ZONE A.L.U.C. LU Q. O (Thin section nod not beTION comple INSURANCE ePermil is for one PLG.CONTfl. LIC.NO. TOTAL {LW Y❑ N V ❑ N LD Z hundred dollars(S 100)or less.) U O I certify that in the performance of the work far which this Per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. Date-y Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >_ NOT to NOTICE TO APPLICANT: It,al'Icr making this Certil icule of fix- I I F Z emption,you should become subject to the Workers'Compensation - APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with U FEE such provisions or Itis permit shall be deemed revoked AIR HANDLING UNIT TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 SEISMIC FEE 308 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 (p Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 1 certify that 1 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 PLUMBING ordinances orad serer laws relating to building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 hereby entioned rapresent:dives of Hhis city to enter upon the BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL above mentioned property for inspe f ion pu ity to. (We) agree m save, indemnify and kee harmless the City of MISC.- REFER TO ORD. rUL mayinCupertino against I'' il' s figments, c t5 and expenses which CONST.TAX (J ay in any way cnstXidC in consequence of the PERMIT ISSUANCE 10.00 OD 4 / ranting of(hi9 2-9, MECH.CONT. LIC.NO. MECH. I TOTAL` t 00 TOTAL `Li• Signator pli n )ontr' Uate OFFICE COPY