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17069 POST THIJMRD.NEAR FRONT OF BUILDING •, PERMIT NUMBER C.IOF CUPERTINO 17069 INSPECTION DIVISION . JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS �.��3 �`O! 9T'tt' UNIT# LOT# PERMIT EXPIRES IF WORK OWNER �cL�n-CS CONTRACTOR �rkCVA C� IS NOT STARTED WITHIN - INSPECTION DATE INSPECTOR INSPECTIO RECORD 180 DAYS OF PERMIT ISSU-,. FOUNDATIONANCE OR 180 DAYS FROM .NOTE: - LASTCALLED INSPECTION. UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PREGUNITE _ CUPERTINO STANDARDS. GARAGE SLABS /r _, / POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 7 ' UNDERGROUND /SLAB PLUMBING ELECTRICAL isSUANCE DATE MECHANICAL - at "r DG ELLEEC�T. PLO MECH. F-1El❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION SIFT. t PLUMBING MECHANICAL - PERMIT To ELECTRICAL - FRAMING INSULATION STORIES' TYP. 'ONSTR " - � ,. UCC GROUP H_FS UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.FT.FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE r ' .' DIAPHRAGM THE CONSTRUCTION TAX IS PAID, +. i BUILDING USE ROOF SHEATHING RES IND CON PB Omni El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. SE EL El SSORS.PAHCEL NO ROUGH SAN.# ' . 1 PLUMBING _ ELECT.ENERGY ` TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT No PARCEL NO MECHANICAL MECR ENERGY - FILE No ELECTRICAL - BUILDING ENERGY nCc•DATe Acc. FRAMING ELECT,FINAL TEST "INSULATION PLUMBING ZONING ' ENG.SITE No. GAS TEST GAB + FIRE SPRINK ENERGY T.za MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE . FLOODZONE A.LUC. INTERIOR SHEAR FIRE DEPT. Y❑ NO YC N❑: SHEETROCK GRADE FEESUMMARY EXTERIOR LATH BUILDING . INTERIOR LATH TEMPORARY APPROVALS BUILDING " SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY I SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRICLU o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE = IMPORTANT! CONST.rnx I . PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION." TOTAL 6A ADO; OFFICE COPY • i APPLICAPUT.TO FILL IN INF MATION WITHIN RED LINES - USE LL POINT PEN ONLY •~BUILDING PROJECT I DENTIFI N 'PERMIT NUMBER ADIRESG�OI N, w�pE APPLICATION & PE MIT -, 7069 ADDRESS i44* BUILDING =ELECTRICAL-PLUMBING-MECHANICAL OWNER'S r PLAN CHECK VALIDATION "" �1{e'r QTY. ELECTRIC PERMIT FEE PHONE CONTRACTOR s OUTLETS-SW ITCHES-RECEP '10.0011.00 N ME L 41AGl,PI (/lill LIC.ry LIGHTI NG FIXTURES 10.00/1.00 Z�PUtI CONTRACTOR'S Ca Nrl4 �(z PPLIANCES-RESIDENTIAL 4.00 PHO �� J(.il7falO PANELS 10.00 I2,S- I DATE OF APPLICATION ARCHITECTPANELS (OVER ZOO AMP) 20.00 'PLAN CHECK FEE P.C.,NO. OR ENGI R Ic.NO. SIGNS TRANS. 3.00 AR.OR Enc' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS U , ZIP rEMP.METER OR POLE INS. 20.00 APPLICANTSMOTORS SEE FEE SCH. ADDRESS p , y, SERVICE CHANGE - 20.00 o O ' LICENSED CONTRACTORS DECLARATION-aL.Zc I 4 K la 7. : r i,U I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE < z (commencing with Section 7000)of Division13 of the Business and G. ELECT. PLG. MECH. D i Professions Code,an I my license is in full fa •'ny f ❑ ��y-I/ ❑ ❑ License Clppppppss Lic.NumbeL] - rot Q w r w Datc__J_/.(N _Cnnlracwr a a¢ ¢ I NER-BUILDER DECLARATION BUILDING PERMIT D 2 w U REFER TO ORD - INFORMATION wLL s- 1 hereby affirm that I am exempt from the Contractor's License MISC.- VALUATION $/FT. F u m¢ Law for the following reason.(Sea 703 L5,Business and Professions PERMIT ISSUANCE 10.00 �Q(/ Cade'.Any city or county which requircsu permit loconslnmL atleq K s-2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. D u requires the applicant for such permit to Ole a signed statement that TOTAL 6�, PERMIT TI a. whe is licensed pursuant to the provisions of the Contractor's License rzi Law(Chapter 9(eonsmencingwilh Suction 7000)of Division 3 oflhe a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE � c the basis for the alleged exemption.Any violation of Section 7031.5 IIDR14S TYPE ONSTR. sgmby any applicant for a permit subjects the applicant toacivil penalty gLTER-DRAIN&VENT-WATER IEA.) 5.00 of not more than five hundred dollars(5500).). ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES,UNITS []let' sole compensalion,will do the work,and the structure is not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Coder The Contractor's License Law does not apply to an owner of property who builds Or Improves thereon,and who does such work FIXTURES-PER TRAP 5,00 SO.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-I INC.4 OUTLETS 6.00 or tnlprovenlent is snld within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or int' RES IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30,00 O 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 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5111A.) 1.00 contracts for such projects with a contractool)licensed pursuant to the COO Eli License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Ser.-,B.&VU.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COM PENSATION DECLARATION WATER TREATING EQUIP, 5.00 - I hereby affirm that I have a certificate of consent to self-insure. ZONING or a certificate of Workers'Come cion nsu Duce,or a cert' 'ed ENG.SITE N0. Copy thereof!sec.3800,Loh.Cd - « Policy No. Company phi'_ Q O CIed cop Is he b wished. FIRE SPRINK ENERGY T24 Z Z ❑ Ce co i. f d,/with the city inspection division. MISC.- REFER TO ORD. 'y❑ N❑ y ❑ N❑ p Applicant . ~ w PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. - CERTIFICA'1'17 OF IiXEMPTION FROM WORKERS' L >_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL 0 (This section need not he completed if the permit is for one TOTAL V[:] N❑ V ❑ N❑ 0 Z hundred dollars($1001 or less.) V O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H "tit is issued,1 Shall not employ any person in any manner so as to OIU become subject to the Workers'Compensation Laws of C.fl'conda. BUILDING Date Applicant ALTER OR ADD TO MECH. 5.00 } m NOTICE:*10 APPLICANT: If,after making this Certificate of Iix- F Z cmption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provtsmax of the Labor Code, you must forthwith comply with FEE V such provisions Or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.)- 4.00 CONSTRUCTION LENDINGAGBNCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a' construction lending agency I'or 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 Lenderi Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I Certify that I have read this application and stale(fiat the above I VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all city and countyPLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3H.P.or100,000B.T.U.) 6.00 hereby authorize representatives of this city to enu•r upon (he BOILER-COMP (Over 100,000 BTU1 SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. -(We) agree to save, indemnify and keep harmless the City or MISC.- REFER TO ORD. upertino against It iii' judgments, costs and expenses which - CONST.TAX in any w c gainst said City in consequence of the PERMIT ISSUANCE 10.00 D OTi r 1, MECH.CONT. LIC.NO. MECH. I I TOTAL . TOTAL �,QO signxureot pplicant/Contractor Vale OFFICE COPY