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17312 POST.THIS CARD 'NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 1731'2 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS �� Cd -6'�U1 UNIT# _LOT# - PERMIT EXPIRES IF WORK - OWNER' a'; -e-� CONTRAOOR cl VA, 1 - IS NOT STARTED WITHIN INSPECTI N DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION NOTE: ' LASTCALLEDINTIO.N ON. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE .TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT vnuoa noN GARAGE SLABS CUPERTINO STANDARDS. _ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED " . - . , - - .2 f UNDERGROUND /SLAB FEB lWi PLUMBING f ELECTRICAL - Offtelfin ,SSUANCE'DATE ' ECHANICAL RUbG ELECT PIA.. MICE, 1:1 ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED I BUILDING PERMIT WOOD FLOOR - INFORMATION ,VALUATION $ITT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL' FRAMING INSULATION - _ - s CRIES TYPE CONSTR, OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE " ELooR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ' ROOF SHEATHING y RES mti CON pa '00", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED .FINALS DATE INSP. ❑ ❑ ' ❑ ❑ 0 ASSESSORS PARCEL NO. ROUGH sAN.a ' PLUMBING ELECT.ENERGY TRACT Na. PARCEL No TUBS&SHOWER PAN - PLUMBING ENERGY - MECHANICAL MECH.ENERGY . ELECTRICAL BUILDING ENERGY - ACC OnTc• ACC.En:E No. FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO, INSULATION PLUMBING GASTEST GAS , MECHANICAL EIRE SPRINK ENERGY TL24 'COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - - Y ❑ "❑ Y E3 "❑ EXTERIOR SHEAR - ELECTRICAL RELEASE . 'EL000 ZONE aL.u.c. 'INTERIOR SHEAR FIRE DEPT. - Y❑ N❑ Y ❑ N❑ SHEETROCK. GRADE - FEESUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS , BUILDING SCRATCH COAT ELECTRIC - PLAN CHECK GAS .. FEE i NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. - SEISMIC"FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, 'ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. , PLUMBING PLEASE GIVE JOB-ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT!. CONST.TAX PLEASE READ REVERSE SIDE BEFORE '" CALLING FOR FINAL INSPECTION. TOTAL. �DA OFFICE COPY APPLICANT TO FILL IN INFORMATION.WITHIN RED,LINES - USE BALL POINT PEN ONLY ' w B"I LDI NG PROJECT I DENTI FXATION - -PERMIT NUMBER BUIL.IND APPLICATION & PERMIT " ADD.raY�OOV <fC.(/ , 1731 2 UILDING-ELECTRICAL-PLUMBING-MECHANICAL NAME 's NAME ' PLAN CHECK VALIDATION ' QTY. " ELECTRIC PERMIT FEE PHONE NOAme ACTOR OUTLETS-SWITCHES-RECEP ,10.00/1.00 .H LC.NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTOR' ' AOOREaa' �� APPLIANCES-RESIDENTIAL 4.00 PHONE 95/ PANELS 10.00 DATE OF APP LICATIO N a. DRR HrrecT PANELS (OVER 200 AMP) h 20.00 - PLAN CHECK FEE P.0"No. ENGINEER Sec.NO ' SIGNS TRANS. 3.00 _ ADDRESS ENG, - PERMIT VALIDATION ADDflsss SPECIAL CIRCUIT 5.00 - '" ZIP EMP.METER OR POLE INS. 20.00 ADDRESRTS SS . MOTORS SEE FEE SCH. 1 SERVICE CHANGE 20.00 O¢ 2 ,00 LICENSED CONTRACTORS DECLARATION a U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE ' w¢ y (commencing with Section 7000)of.Division 3 of the Business andFEn G. ELECT. PLG. -MECH. F y- Professions Co Sand my mense is N full fort and f l� IW ho I o i y o License Class Lia N full f V ft]' F ^r J Uat Contractor ty ot�BB�}�� 1 . ¢ ¢ w a - 'OWNER-BUILDER DECLARATION - �� '�•`�� BUILDING PERMIT _ C ar ° INFORMATION X ; N I hereby affirm that I a traxempt from the Contractor's License MISC-- REFER TO ORD I, O j Law for the following reason.(See.7031.5,Businessand Professions VALUATION $/FT. - g PERMIT ISSUANCE 10.00 � w0 Code:Any city or county which requiresa permit to construct,alter, ac ¢ o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. -LIC.NO. ELEC. - m¢ requires the applicant for such permit to file a signed statement that TOTAL W PERMIT TO A w he is licensed pursuant to the provisions OCthe Contractor's License - Fi,Q Law(Chapter 9(commencing with Section 7000)of Uivision 3 ofthe E¢ D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ 1-.m the basis for the alleged exemption.Any violation of Section 7031.5 S ORIES TYPE CONSTR. n ;.-- by any applicant for a permitsubjects the applicant toe civil penalty ALTER-DRAIN (EA.15.00 of not more Ihan five hundred dollars($500).1: - ❑ Las owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 'OCC.GROUP RES.UNITS their-sole1compensation,will do tire work,and the structure is snot as intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,ARE&COND. 5.00 Code: 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.FLOOfl AREA TOTAL ACREAGE himself.r through his own employees,provided that such improve- malasarenotintendedorOfferedforsale.If,however,the building _ GAS-EA.SYSTEM-i1NC.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.). RES , IND' CON PB Other' ❑ 1,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 . 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 3y t0 an owner of property 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 the Contractor's License Law., SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL No: ❑ lam exempt under Sea ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Uute WATER SYSTEM - . '5.00 ACC.DATE ACC.FILE NO. WORKE RS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that I have a certificate of consent to self-insure, - - - or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab C.). r � Policy NO. Company Y1 - ❑ edified cropy is etch fur ish - yy FIRE SPRINK ENERGY T 24 Z Z Certiflcl, c i I'fed with the city inspection division. F 0 pplicu - MISC.- -REFER TO ORD,. v N❑ "Y ❑ IN w PERMIT ISSUANCE 10.00 � - CF: IFICATF OP EXEMPTION FROM WORKERS'LidCOMPEMAFLOOD ZONE A.LU.C. > (This Section need not beTcompleed if the is for one PLG.CONTR. LIC.IC.NO. T LG CL Q OTAL Y N� V N❑, CL ::) Z hundred dollars(S 100).,less.) - - U O 1 certify that in the performance of the work for which this per- QTY ' MECHANICAL PERMIT FEE FEE SUMMARY LL I-' mit is issued,I shall not employ any person in any manner so as to O Q become subject to the Workers'Compensation Laws of California. y Date Applicant BUILDING } N NOTICE TO APPLICANT, If,after making this Certificate sa Ex of ALTER OR ADD TO MECH. 5.00 Z emption,you should become subject m the Workers'Compensation' APPLIANCE - 5.0.0 PLAN CHECK such i.e io the Labor Code, you must forthwith comply with FEE U , such provisions Or this pormit shall be deemed revoked'. AIR HANDLING UNIT(TO 10,000GF.Nt.) 4.00 " CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IQOOOC.F.M.) 6.00 'SEISMIC FEE 1 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 Y 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 ,o10, ' Lender'sName '' HEATING UNIT 100,000 B.T.U.)9.50 Lenders Address ELECTRIC I certify that I 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 and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives ec this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL hereby authorize properlyforinspection purposes. .. - Lap (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. - upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE' CONST.TAX . may10.00 in any way accrue against said City in consequence of the Z.0 - ranting of this pe nm. AMECH,CONT. LIC.NO. MECH. ' TOTA dp TOTAL ' � _ DD ( atgno Kant/Craclo Onlr a e -f- OFFICE COPY