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17049 1 .. POST THIS CARD NEAR.FRONT.OF BUILDING ✓' ' .• 'PERMIT�NUMBER I ' CITY 0FCUPERTIN0' : 17049 ,..; INSPECTION.DIVISION ; JOB INSPECTION'REC'ORD 4 PERMIT--EXPIRATION JOB ADDRESS (_ 0 ( Z� ,y �• - UNL7# ' -\LOT 1 CVI.i ntl.CeklP� : , ' PERMIT EXPIRES IF WORK.! / 'OWNER ,•Q e ,v4� ' :E14TRACTOR NOT'STARTED.WITHIN ' INSPECTION DATE INSPECTOR - INSPECTION RECORD 1180 DAYS OF�PERMITISSU .i FOUNDATION NOTE: - ANCE OR 180-DAYS FROM I - - .z LAST CALLED INSPECTION.?: LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED: - � 1 - f ` TO COMPLY WITH THE APPROVED PLANS AND CITY OF, PERMIT VALIDAnoN s PREGUNITE CUPERTINO STANDARDS GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB. �. PLUMBING ELECTRICAL - J' ISSUANCE DATE , MECHANICAL W - J - V_DG; . ELECT. PLG -ME❑CH, 7 " DO NOT POUR FLOOR UNTIL ABOVE_ HAS BEEN SIGNED •',; BUILDING PERMIT WOOD FLOOR - - INFORMATION • . i! PLUMBING •-VALCATION $SFT. "i - MECHANICAL ELECTRICAL TO ' ELECTRICAL.- � BCa� bK .��✓., W9LL ©�✓ Y .I - FRAMING �_/yg�y � INSULATION _ t ­15G R ` s RIES ' T1vP comsrR, r ` G - TU/Rim „ - 000.GHOUP NES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED MEI ROOF NOTE.NO FINAL INSP.SHALL BE MADE BEFORE 5° " FLooR AREA TOTALACREAGE ; DIAPHRATHE CONSTRUCTION TAXIS I . PAID GMI ,I " "i7`+✓� ROOF SHEATHING - REs" INou ILDcoa USE o+l r APPLY NO ROOFING UNTIL ABOVE HAS,BEEN`SIGNED'' ;FINALS'. ,: DATE INSP.' ❑ ❑ ❑ I ' ❑' } ' . ROUGH " . SAN* :. - - ASSESSORS PARCEL NO.., ' PLUMBING - ELECTt ENERGY• TU85.8 SHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO.� - - MECHANICAL MECH:ENERGY • ' ACC.DATE ACC FILE NO: • ' ELECTRICAL • BUILDING ENERGY FRAMING - ELECT:'FINAL TEST - ZONING ENG SITE No.,a „ INSULATION '�., PLUMBING �, GJ.. �?- , i `• GASYEST GAS ' MECHANICAL ; FIRESPRINK. ENERGY 124.~• v ry Y. ..ti COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ ❑ ❑ ❑' FLOOD ZONE ALU.C. ' EXTERIOR SHEAR•. ELECTRICAL'•RELEASE INTERIOR SHEAR FIRE DEPT.' YL ,NQ YL, mQl SHEETROCK" GRADE FEE SUMMARY EXTERIOR LATH BUILDING gUILOING' _� INTERIOR. LATH` TEMPORARY APPROVALS, SCRATCHCOAT ELECTRIC . L PLAN CHECK r GAS a, FEE NO TAPE ORTLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY . :SEISMIC FEE v OCCUPANCY OF BUILDING-IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. + w MICROFILM .7 ARRANGE-FOR+INSPECTION BY PHONING'252=4505 ELECTRIC �� ,. ONE,WORKING,DAY BEFORE REQUIRED INSPECTION ' I AY PLUMBING P z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION-DATE - ` MECHANICAL'r_` IMPORTANT! CONST. TAX _ „ a . PLEASE READ REVERSE.SIDE,BEF0 E R • ^ I•" dO' CALLING FOR FINAL INSPECTION. ' TOTAL ' ^y OFFICE COPY APPLICANT TO,FILL IN INFORMATION IT IN " D. - E BALL'PIN PEN ONLY BUILDING PROJECT IDENTIFICATION VW111t4p _ PERMIT NUMBER . _ BUILDING . A PLICA .ION,& ERMIT \ A RE55 BUILDING -ELECTRICAL-PLUMBING=MECHANICAL 7RESS207�� 17049 NAME • .PLAN CHECK VALIDATION QTY. ELECTRIC PERMIT FEE007 Na!3 NUME IC J� _ UTLETS-SWITCHES-RECEP 10.00/1.00 _ LIC.NO LIGHTING FIXTURES 10.00/1.00 " CONTRACTOR'S " A REss- PPLIANCES-RESIDENTIAL 4.00 //// •n RONE(�l PANELS 10.00 - DATE OF APPLICATION ' ARCHITECT y, r PLAN CHECK FEE P.C.N0. • OR -INEER - PANELS (OVER 200 AMP) 20.00 . . ENG , LIC.No. ISIGNS TRANS. '3.00 ARC H.OR ADDRESSENG. - - 'SPEOIALCIRCUIT - 5.00 ,,PERMIT VALIDATION •P- zip TEMP.METER OR POLE INS. 20.00 AADD Ess PPLICANT'S - ` MOTORS SEE FEE SCH. {{{ (VVJ • 6li/ : �IiI//!�✓ SERVICE CHANGE 20.00 j ). ' 02 ' LICENSED CONTRACTORS'DECLARATION ____ a i w I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000)of Division 3-of the Business and a,A DG. ELECT. 'PLG. MECH. y.,y i Professions Code,and my license is in full force and effect. .-. 1:1 • z o w- License Class - Lia Number WML 4 va r�. Date Contractor - a m s - - l,1Cy Ut,CUperW BUILDING PERMIT ¢ ¢ w a ' OWN(:R-BUILDER UBCLARATION INFORMATION ` O ' O M - REFER RD x I hereb affirm that I am exempt TSC. O O w 3 Y mpC from the Contractor's License �- r VALUATION S/FT: u o ¢ Law for the following reason(Sec.requires a',Business and Professions _ 10.00 E - � PERMIT ISSUANCE - ' Code:Any city or county which require.a permit[o construct,alter, ¢ ¢ ¢ 00 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. . ELEC. i w m¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO r he is licensed pursuant to iheprovisions of the Contractor's License FzIn Law(Chapter9(commencing with Section 7000)ofDivision 3 of the v i o Business and Professions Code)or that he is exempt therefrom and QTY. PWMBING PERMIT .FEE (e� t- the basis for the alleged exemption.Any violation of Section 7031.5 I TO IES .TYPE ONSTfl.- e- a applicant fora permit subjects,the applicant to a civil penally - IN EN -WATER EA _ o 4 t mom than five hundred dollars(5500)J: ALTER DRA &V TWAT ( .) 5.00 - 1'as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE. 4.00 occ.GROUP RES!UNITS . X4 I sole compensation,will do the work,and the structure is not - - ' i ended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of - properly who builds or improves"thereon,Bad whodoes such work', FIXTURES-PER TRAP 5.00 tB® SQ FT.FLOOR AREA TOTAL ACREAGE r himself or through his'own-employees,provided that such improve- - mems are not intended or offered for sale.if,Imweveq the building GAS-EA.SYSTEM-1 INC.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 im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. . 30.00 RES IND -cON. Pa Other a El Las owner of the property,am exclusively'contracting with IT EY El ❑ ❑ licensed contractors to construct the project(Sec.%7044,Business LAWN SPRINKLERS r 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of properly 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 SEWER-SANITARY-STORME 200ft 10.00 the Contractor's License Law. A. / TRACT NO. PARCEL NO, -O lam exempt undei Sec ,B.&P.C.I'o(this WATER HEATER W/VENT " . '6.00 on "Owner Dale _ WATER SYSTEM 5.00 ACC.DATE ' ACC.FILE NO. WORKEKS'COMPENSATION DECLARATION WATER TREATING EQUIP.- 5.00 - 1 hereby affirm that I have a certificate of consent to self-insure. ,. ZONING' 4 or B certificate of Workers Compensation Insurance,or a certified ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). Policy No. Company - , Q Certified copy is hereby(prnished. - FIRE SPRINK ENERGY T-24 Z 2 Certified' copy ,is fled with the city inspeclimT division. ❑ ❑ ❑ ❑ A licant_ _ r " MISC.- REFER TO ORD. - y ry Y N ~ M+ PERMIT ISSUANCE 10.00 eD FLOOD ZONE A.LILC. Li i",CERTIFICATE EXEMPTION FROM WORKERS' xl W � �� °'' COMPENSATION INSURANCE PLG.CONTR. . . LIC.N0. PLG. , ,p . " 11 17 .(This section need.not be completed if the permit Is for one TOTAL ZD- YE] N❑. Y O NQ Z hundred dollars IS 100)or less.) I - .0 O I certify that in the'performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY IL I- mit is issued,1 shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. - ' U 0. Date Applicant I . ALTER OR ADD TO MECH. 5.00 BUILDING } m NOTICE TO APPLICANT: If,after making this Certificate of Ex- � 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, FEE U such provisions or this permit shall be deemed revoked. AIR.HANDLING UNIT(TO 10MC.F.M.) 4,00 _ CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000C.RM.) 6.00 SEISMIC FEE , I bareby, 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 UN IT(OVER 100,000 BJ.U.)9.50 I ' ELECTRIC Lender's Address - I cerlify that I have read IN,application Brittonic that the above VENTILATION FAN (SINGLET 4,00 information is correct,,l agree to comply with all city,.,.county PLUMBING d---r" I0 ordinances and stale-laws relating tobuilding 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 (Over100,000BTU)SEEFEESCH. MECHANICAL above-mentioned properly for immiction,purposes. , -'(We) agree to save,,indemnify and keeph'ermicss the City o6 MISC.- •REFER TO ORD. • :x' Cupertino against 'abilities, gments, costs and expenses which - CONST..TAX' l may a wu ue a st said Cit .PERMIT ISSUANCE 10.00 ra g thi Y,in con que e of4he - MECH.CONT. LIC NO. MECH. ` �.r- TOTAL U TOTAL ' S' nate o Apr0an[/Contractor OFFICECOPY ' , 1 ic X11 �_ ; I ` � � ` � \ j�',�� ri` rr r•1 �- i 14 I ''- F rI, 1 I* J I'�,�i ll'. v(" . j � rJja 11-- ��.fi LL � - - - I.',. -� I�/'{� I _ '+;�•�'�-�, �i ` ' j, ' FiC•.IJ l , - - ' j, 4 / +" f i I r� I • s �L-, •S _ I>, vrc`l� -( •- %� ,' - -{ v _. , - ` 31 a n�� a "t t� L CJI i� , __ �, �i 4�•°t � � j a tiC JLr' ,r f=. E{I�y 1i `- - - - I F✓F n f —� i iJ J s-G r1 ;ri to ^ •r-, : .. �- ..� - ``� � 1f 5G •� :5�ssvG}h-rJ:t+ I __ yn�y, ill - _ ; r•' , 2° II r _ r' --� AI_c r_ a" - I�� .��lfry APPROVED n ` i ,� I� { '1 , _ 4 - i / ✓c�z -716) ACCORDANCE WITH THE CITY OF D� CUPERTINO CODES AND ORDINANCES �K „' I ' � 1 DATErPa,,s SIGN' D f — j a � C ,�.j,c1 , i _ x - �_ JThis set specicsGns MUST �D��/ G L D ��be kept t z I ti•n�s nd it is un• j. i�_ y _ lawful t0 m.4e any C+12nRaS C. a:' r-Xi�t-"+t !'•'is.�i r• �.�=-L_;r+ 't h��r i=• ". D e;�ti:ns +' AN Q G on same w•rh u. w ta �i�n `mum�t =� — -- E n — -- - r the bu�mm.� cap... C j f t t.nl�. G� . J _ c �a t The s g , h p:_n n pecii,rations '" J I - �j�( �4,t��t �'i ._ }� yf_j BLDG. INSPECTION DEPARTMENT SHALL N(ii be i c d i -- 1 �i �, G= mit cr t, ba an I� i C111' OF CUPERTINQ approval of P+e v o r:n ar any provisions Ii of any City O,d•nance or Slate Law. \III \\ -/ SCALE: �lp APPROVED BY: DRAWN BY I DATE: ( yS - 9 REVI5ED OFFICE COPY -r. PL. DRAWING NUMBER It X]4 MINED ON NO.IO c[AARMIM