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17337 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO' INSPECTION DIVISION , 173.37. JOB'INSPECTION RECORD ^ • `� � a - PERMIT EXPIRATION IT# LOT# JOB ADDRESS PERMIT EXPIRES IF WORK OWNER, GO 'e �' „ CONTRACTOR '� �;( -us ` IS NOT'STARTED WITHIN, INSPECTION DATE 11 INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE:- � LIFER � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMP LY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION , CUPERTIN0 STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB MAR, .4190 ° PLUMBING City -at M��__1.__ i ELECTRICAL - , �� ISSUANCE DATE .� MECHANICAL a DG ELECT I PLG. . MECH. ' ❑ ❑ ❑. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ,_ - BUILDING PERMIT INFORMATION PLUMBING WOOD FLOOR 7— „' SIFT. _ � V MECHANICAL' - ELECTRICAL ECHANICAL' •ELECTRICAL PERMIT TO FRAMING ��— INSULATION STORI S TYPE CONSTR. OCC.GROUP HES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO FT FLOOR AREA TOTAL ACREAGE • • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 1 DIAPHRAGM THE CONSTRUCTION TAX IS PAID , BUILDING USE ROOF SHEATHING - HES IND CON PR 01111I APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ' ❑ ❑ - ❑ ED ❑ A5SE5SORS PARCEL NO. ROUGH SANA - PLUMBING - ELECT.ENERGY TUBSB SHOWER PAN PLUMBING ENERGY TRAGI NO. PARCEL NO - MECHANICAL MECH.ENERGY - + 'ACC DATE ACC.FILE NO. ' ELECTRICAL - BUILDING ENERGY - FRAMING ELECT.FINAL TEST ZONING -ENG.SITE NO, INSULATION PLUMBING - GAS TEST - - GAS MECHANICAL - - FIRE SFRINK ENERGY r.}E COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING. - - Y,E] NE] Y [D, N❑ EXTERIOR SHEAR - � ELECTRICAL RELEASE FLOOD ZONE A L U C. INTERIOR SHEAR FIRE DEPT. Y❑ N❑ Y Lam. N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING �L ^ BUILDING INTERIOR LATH TEMPORARY APPROVAL 63C� SCRATCH COAT ELECTRIC PLAN CHECK - GAS .. .. FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEEZJ OCCUPANCY OF BUILDING IS NOT PERMITTED UNTILBUILDING FINAL.ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC. LU � ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. , SEE,PERMIT FOR EXPIRATION DATE - MECHANICAL. IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE., TOTAL < CALLING FOR FINAL INSPECTION. . OFFICE COPY , APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .BU4LOINGPROJECT I DENTI FI ATJON PERMITNUMBER DL Ce vj APPLICATION & PERMIT A1.DDRESS . 733 ADDRESSDRESS - I 1 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 3 1 7 OwNER'S PLAN CHECK VALIDATION NAME DTV. ELECTRIC PERMIT FEE NT PNONE2S2" /b CONTRACTORS rvaMELL UTLETS-SWITCHES-RECEP 10.00/1.00 v u,C.Na' LIGHTING FIXTURES, 10.00/1.00 CU.TRA TORTS ADDREss p7 _ PPLIANCES-RESIDENTIAL 4.00 S10 PRDNC Z>!dM PANELS 10.00 DATE OF APPLICATION A HITECT Aeg � PLAN CHECK FEE P.C.NO:' DR �'I7�7 / PANELS (OVER 200 AMP) 20.00 ENGINEER uc.NO SIGNS TRANS. 3.00 VRCH.OR ADDRESS ENG. - SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zip EMP.METER OR POLE INS. 20.00 ADDRRESSESS MOTORS SEE FEE SCH.S�ft 3-z ADD' .• '� �� SERVICE CHANGE 20.00 o o •LICENSED CONTRACTORS DECLARATI N a i w I hereby off rte that I um licensed under provisions of Chapter 9 F - ISSUANCE DATE naw lcommencing with Section 70001 of Division 3 nl'the Business and B G. ELECT. PLG. MECIL 0 N z Professions s cense is in full for and t9 ❑ ❑ ❑ z o,n - License�-C��iiss Lia Number o m- o Datc ,a( Contractor hu.....if�� W 7 V .�,q �E, wMo/111 A a m s -a /'- - City BUILDING PERMIT a o n a OWNER-BUILDER DECLARATION INFORMATION X 3 y I hereby affirm that 1 am exempt from the Contractors License MISC.- REFER TO OR w VALUATION !UFT. LL O a Law for the following reason.(Sec.7031.5,Business and Professions - PERMIT ISSUANCE 10.00. d , Oa Code: e,y city or county whiny structure, p permit Construct,alter, Q Q Q a L ImpIOVC,demolish,o!repair any$t NetnrL',pr10!t1)IIS ISSpa11CC,aISU ELEC.CONTR. LID.NO. ELEC. o LL requires the applicant for such permit to file a signed statement that TOTAL w2 he is licensed pursuant to the provisions of the Contractor's License PERMIT TO orza Law(Chapter 9(commencing with Section 7000)ofDivision 3 offle 4 o Business and Professions Code)or that he is exempt therefrom and QTV. PLUMBING PERMIT FEE -5 s $ the basis for the alleged exemption.Any violation of Section 7031.$ STORILS TYPE CONSTR. n ; - by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN&VENT-WATER (EA.) 5,00 of not more than five hundred dollars(8500)): ' ❑ 1,as owner of the property,or my employees with wage's 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 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 property who builds"or improves thereon,and who does such work FIXTU R ES,PE R TRAP 5.00 Sa FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- • ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or improvement is sold within one year of Completion,life owner. GAS-EA.SYSTEM-OVER 4(EA.) 2.00 . - builder will have the burden of proving that he did not build or im- BUILDING USE RES IND CON PB CO., prove for purpose of tlfcp INDUSTRIAL WASTE INTERN ' 30.00 ❑ d as owner rs the property,he exclusively.7G44,Business with ❑ .❑ ❑ ❑ ❑ licensed contractors od :The Contrconstruct actor's project(See.La. does not apply LAWN SPRINKLERS-1INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions grope ty Contractors License Luw docs not apply to tr owner of property who huilds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 Contracts for such cense L with a contractor(s)licensed pursuant In SEWER-SANITARY-STORM EA.200ft/10.00 the Col am exe License Law. TRACT NO. PARCEL NO. ❑ lam exempbunder Sec.-,IL&P.C.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 1 hereby affirm that I have a certificate of consent to set Ginsum, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO, copy there (Sec•]�00,Lab.C.l. ��([-- `� - . Polic Compuny_�q A ' QCerTTTT1111MMffffled c555SSSpy is hereby farms e � FIRE SPRINK _ ENERGY T-29 Z Z Cerlifird ropy is tiled wish the city_ inspection division. MISC.- REFER TO ORD. O Applicant _ Y ❑" N❑ Y ❑ N❑ ~ va PERMIT ISSUANCE 10.00 LU - CERTIFICATE01:EXEMPTION FROM WORKERS' - FLOOD ZONE A.L.U.L. CL COMPENSATION INSU if life PLG.CONTR. LIC.No. PLG. Y❑ N❑ Y❑ N❑ 0 Z rafe section nee) not be completed if the permit is.for, TOTAL hundred dollars f5100)or less.) , A L) O 1 certify that in the performance of the work for which this per. GTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F- mit is issued,',1 shall not employ any person in any manner sn as to OW become subject to tire Workers'Compensation Laws of California. - G• Dale Applicant BUILDING 5.00 } N NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 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 V such provisions or this per of it shall be deemed revoked. AIR HANDLING UNIT(TO 10MOCF.M-) 4.00 FEE -M, CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10=C.FM.) 6.00 SEISMIC FEE rX0 I hereby affirm drat there is a construction lending agency for EXHAUST HOOD)WITH DUCT) 5.00 - the performance of the work f, w 'eh'fhis permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ.C). Lender's Name HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that l have minillIiistippliestim,andsmte that the above VENTILATION FAN (SINGLE) 4,00 information is correct. I agree to comply with all city uuA county PLUMBING ordinances and state laws relating to building construction, and BOILER-OOMP(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 for inspection purposes. (We) agree to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT-ISSUANCE 10.00 CONST.TAX ay in an way necrue against said Ciye in consequence of the rantin 1h pCrof MECH.CONT. LIC.NO. MECH. TOTAL TOTAL �•' Sig tore pplicant/Contractor 1 e E OFFICE COPY