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17901 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF•'CUPERTINO 17901 ..• ,INSPECTION DIVISION JOB INSPECTION RECORD . J (PERMIT EXPIRATION JOBADDRESS ( © � ZZ N'� � �-UNITAL _LOT# " `, O PERMIT EXPIRES IF WORK OWNER CONTRACTOR -pay S e.Ci IS NOT STARTED WITHIN. INSPECTION DATE INSPECTOR IINSPECTION RECORD 180 DAYS OF PERMIT ISSU. _ FOUNDATION , . ANCE'OR 180 DAYS FROM NOTE: UFER .ALL GRADING AND DRAINAGE LASTCALLED INSPECTION.SHALL BE INSTALLED, " PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION GARAGE SLABS CUPERTINO STANDARDS, PAID POUR NO CONCRETEVS BEEN SIGNED MAY 1 *11989 . UNDERGROUND /SLAB - PLUMBING of. f.{y ,,s ' ;s 1' t•A {4{n ✓�G`}f. " ELECTRICAL - cls �U(1B1tIDU ISSUANCE DATE V-� MECHANICAL BLDG. LECT _ PLO. . MECH. ❑.. . . ❑ .❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR vALunnoN SIFT. PLUMBING MECHANICAL. ' ELECTRICAL _ _ /r PERM rr° FRAMING INSULATION STORIES ,TYPE CONSTR . - OCC GROUP FES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED I; • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE—, 10.IT FLOOR ARIA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING 1 RES INBDuu DCON USE O APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑' ❑ ASSESSORS PARCEL NO ROUGH SAN.# - PLUMBING ELECT.ENERGY ,k. TRACT NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY - MECHANICAL MECH.ENERGY ACC.DATE ACC,FILE NO, ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION - PLUMBING ` GAS TEST GAS' .. FIRE'SPRINK ENERGY T,ZJ " MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 'Y ❑ N❑ Y ❑ N❑' -�' . . EXTERIOR SHEAR � ELECTRICAL RELEASE FLOOD ZONE ALU.0. INTERIOR SHEAR - FIRE DEPT. ' Y❑ N❑ .1 ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS euI I. 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 FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM `' ,,rrbb ' ELECTRIC ^L4V ' ARRANGE FOR INSPECTION BY PHONING 252-4505, �+ FLU ONE WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING j O 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. ' Z — SEE PERMIT FOR EXPIRATION DATE MECHANICAL ' IMPORTANT! CONST.rax= PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION., TOTAL �g OFFICE COPY d{ APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDE TI FICA N - - PERMIT NUMBER BUILDING 7AD]7 BUILDING APPLICATION & PERMIT ` ADif' 17901,1 V �D - ELECTRICAL-PLUMBING-MECHANICAL 17 ofO 1 OWNE 'S PLAN CHECK VALIDATION N"Ma -{' OTY. ELECTRIC PERMIT FEE . /✓ /-PHONE CONTRACTORS/J,,//// � q UTLET -SWITCHES-RECEP 10.00(1.00 KV10 /'r/ x Ic.No. LIGHTISNG FIXTURES 10.00/1.00 CONTVIACTORS PPLIANCES-RESIDENTIAL 4.00 ADD Ess _ -, N PHONE 7 P6�7b PANELS ) 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.N0, OR ENGINEER LIC.NO, SIGNS TRANS. 1 3.00 ARCH,OR NG. SPECIALCIRCUIT 5,00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPOCANT'S MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 r; ��I"`0•1. V��� woo LICENSED CONTRACTORS DECLARATION u I.herebyaffirmtbul I am licensed und"t� er9 & U 0 ( •QQ ISSUANCE DATE w Q y (commencing with Section 7000)of Diviand BLDG. ELECT. PLG. MECH. H i Professions Code�1•'�nJ I' arse is in full T z o w- License Class_`-Lia Numb ❑ ❑, ❑ 9 „�s H w Date Conlmcmry' e a i I Il - MAY 1 '� 1989 BUILDING PERMIT rc ¢w a OWNER-BUILDER R-BUILDER DECLARATION INFORMATION o A u REFER TO ORD w I hereby affirm that I am exempt from the Contractor's License MISC.- - Y' p VALUATION $/FT. Huoj Law forthefollowingmasoach requires a permit to Professions PERMIT ISSUANCE .00 LI9p ,4 Code:Any city or cat my which requirese permit to construct,alter, a ¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC. O. ELEC. 0 M requires the applicant for such permit to file a signed statement that IT OTAL �d VV PERMIT TO n w m' he is licensed pursuant to the provisions of the Contractor's License Hii Law(Chapter 9(commencing with Section 7000)o(Division 3 ofthe a Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ ro the basis for the alleged exemption.Any violation ofSection 7031.5 1 STORIES TYPE CONSTR. a, !-a by any applicant fora pemtitsubjecls the applicant to a civil penally ALTER-DRAIN -WATER IEA.) 5.00 r of not more than five hundred dollars(8500).): ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the sfracture is not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 - Code:The Contractor's License Law does not apply to an owner of • property who builds or improves thereon,and who docs such work F IXTUR ES-PER TRAP 5.00 SO.FT:FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mimsarcnotintendedorofferedforsale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold 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 im- RES IND CON PB Other prove for purposeof sale.). INDUSTRIAL WASTE INTER. 30.00 C] ❑ , El Cl El1.as owner of the property,am exclusively contracting with 11 licensed conlmclori 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-OV ER 5(EA.) 1.00 contracts for such projects with a CDOIeacoci licensed pursuant to the Contractor's License Law. SEWER-SAN ITAR V-STORM EA.200ft/10.00 TRACT NO. PARCEL No. ❑ I am exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 , reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP: 5.00 1 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(See.3800,Lab.CJ. 'I Policy No. ' Company y O ❑ Certified copy is hereby: � /' A FIRE SPRINK ENERGY T 24 FZ A'a'Scanol-hied copy is dad wit city s tin Jivisiott. MISC.• REFER TO ORD. ❑ ❑ ❑ ❑ O T ✓x...✓ V N V N iT CIiRTIFICTIi OF�1PTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.O. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. 1 0 (This section need not be completed if the permit is For one TOTAL Y❑ N❑ Y❑ No 0 Z hundred dollars(8100)or less.) U O .I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,1 shall not employ any person In any manner sous to U become subject to the Workers'Compensation Laws of California. O w Date-Applicant ALTER OR ADD TO MECH. . 5.00 BUILDING } 0 NOTICE TO APPLICANT: If,after making this Certificmv of E.- 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 10f.10DC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 101000C.EM.) 6.00 SEISMIC FEE 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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ.C.). Lender's Name HEATING UNIT(OVER 100,000 B:T.U.)9.50 ELECTRIC �1 Lender's Address 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 . 'BOILER-CONfl(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and slate laws relating to building construction, and hereby authorize representatives of this city to enter upon file BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX ay in any way accrue against said City in coms'equ ee of the PERMIT ISSUANCE 10.00 ranting of this permit - IECH.'CONT. LIC.NO. MECH, C - TOT"`. TOTAL ISignaturcol[AppitcantlContractor a, Date f v - OFFICE COPY