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18523 ,'. P08T THIS'CARD NEAR FRONT OF.BUILDING PERMIT NUMBER CITY OF CUPERTINO ` 18523 _ INSPECTIO.N DIVISION JOB INSPECTION RECORD f� av7'- PERMIT EXPIRATION JOB ADDRESS�'o I2 ry ui o 4P kIj ` �F �� UNIT# ' LOT ' I •� � SS ' PERMIT EXPIRES IF WORK OWNER F Iko'w ONTRACTOR Ele.G .: IS NOT STARTED WITHIN ., - INSPECTION DATE I INSPECTOR INSPECTION RECORD 188 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION, UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED_PLANS AND CITY OF _ .PERMIT VA1.17TION CUPERTINO STANDARDS. GARAGE SLABS; POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED' UNDERGROUND /SLAB n 'Ply c�` PLUMBING - +•d ELECTRICAL . ISSUANCE DATE MECHANICAL' - BLDG E Ec PLG- MECR ❑ .: ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION 'VALUATION SIFT, PLUMBING - - MECHANICAL ELECTRICAL' - PERMIT To FRAMING INSULATION ST RIES - TYPE Co STR. OCC,GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED " " SR.CL FLOOR AREA TOTAL ACREACE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE- -+ DIAPHRAGM ' - I I THE CONSTRUCTION:TAX IS PAID ROOF SHEATHING BUILDING USE ,RES IND CDN PB Dlm, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED .FINALS DATE I INSP. ❑ ❑ - ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH sAN.n , PLUMBINGA' ELECT.ENERGY L TUBS 8SHOWER.PAN PLUMBING ENERGY TRACT NO, PARCEL NO.ry - MECHANICAL MECH.ENERGY - - ELECTRICAL ?Cc..aTI, w BUILDING ENERGY _ FRAMING ELECT.FINAL TEST ` 'ZONING ENG.SITE NO. INSULATION, - PLUMBING - t - , GAS TEST " ' GAS - - MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ` Y ❑ 'N❑ Y ❑ 'N❑. . . EXTERIOR SHEAR � � ELECTRICAL RELEASE FLODo ZONE AL.0C. INTERIOR SHEAR FIRE DEPT. Y❑ N❑ -Y ❑ N❑, SHEETROCK', GRADE' . FEE SUMMARY EXTERIOR LATH BUILDING - -. INTERIOR LATH TEMPORARY APPROVALS -BUILDING 'SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. .MICROFILM 'ARRANGE FOR INSPECTION BY PHONING 252-4505,` ELECTRIC • F ONE WORKING DAY BEFORE REQUIRED INSPECTION 0�. PLEASE GIVE JOB ADDRESS WHEN'PHONING: PLUMBING z — SEE PERMIT FOR EXPIRATION'DATE —I ; MECHANICAL IMPORTANT! consT.Tnx PLEASE READ REVERSE SIDE,BEFORE, CALLING FOR FINAL INSPECTION. TOTAL. . D OFFICE COPY `APPLICANT TO,FI,LL IN IN WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IUN FICA - PERMITNUMBER ' BUILDING '19 . APPLICATION,& PERMIT t;=" -8Jr�3 a IL ss T' 11 1� - (�I a L Fq S.fl'Lluµ- Ark. '2-07Z.. BUILDING-ELECTRICAL.PLUMBING-MECHANICAL i-- NAMER S 41 S PLAN CHECK VALIDATION S CI TY,I- PHONE2YD0 TY, ELECTRIC PERMIT . FEE L L sg2� `s croRs NAME OUTLETS-SWITCHES 10.00/1.00 NAME C I No yq 7 LIGHTING FIXTURES . .10.00/1.00 D CONTRACTOR'S' AODREss APPLIANCES--RESIDENTIAL 4.00 ' 25j oU �o PHONE Q25• $6(� PANELS 10.00 ARCHITECT - DATE OF APPLICATION " OR PANELS (OVER 200 AMP) 120.00 PLAN CHECK FEE P.C.No. . ENGINEER, LIC.No. SIGNS TRANS. 3.00 ARC. OP ENG. 1 ADDRESS Cr lw�4 VQ SPECIALCIRCUIT 5.00 . PERMIT VALIDATION LoSTVq j zip 1q025 EMP.METER OR POLE INS. 20.00 - � (��} nooeessTa - MOTORS ^� FEE SCH. � �wAccx vs� 9�/'S2p SERVICE CHANGE'- v 20.00 ��tt D _ y �_ �t v`JOkcic�.('' Foo LICENSED CONTRACTORS DECLARATION - E, i w I hereby affirm that I um licensed under provisions of Chapter,9 4� 1989 ISSUANCE DATE ¢ (commencing with Section 7000)of Division 3 of the Business and BLDG ELEC 'PLG. MECH. r H i Professions Code,and my license Is in full force and effect. _ .- z o m License Class - Lic.Number 9 m H w Date Contractor ❑ - ❑ ❑ CE ¢ w - ,OWNER-BUILDER DECLARATION BUILDING PERMIT X 3,LL y 1 hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION oat Law for the follow'ng reason.(Sec.70" 5,Businessand Professions PERMIT ISSUANCE VALUATION $/FT. 10.00 Ew>E Code: e,,city or county which requiresapermitmconstrudalter, - rp Q st Ilnprove,demOU", or repair any"r (actore,pr lW to ILS ISSnaDCe,aIs. ELEC.CONTE. - LIC.NO. �� ELEC E�/}• u m m ac req uirea the applicant Car such permit to file a signed statomen[that TOTAL he i5 licensed pursuant to the provisions of the Contractor License PERMIT TO Hit LawI IT her 9(commencing with Sveh. 7000)ofDivision3 of the - e 4 o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT . FEE C ¢ I- [he basis for the alleged ezemp[ion.Any violation of Section 7031.5 STORIES TYPE CON R. a3 � by any applicant fora permit subjects theappliCam loacivil penalty ALTER-DRAIN ` of nal more"So five hundred dollars IS500).):. (EA.) 5.00 - - ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00. their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License Law does not apply to an owner of _ property who builds or improves thereon,and,who dues such work FIXTURES-PER TRAP 5.00 himself or through his own employees,provided that such improve so.Pr.FLOOR AREA TOTAL ACREAGE mems are not munuded'or offered for sale,l C however,the building GAS-EA.SYSTEM-11NC.40UTLETS 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 O I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 - 1:1 1:1 1:1 11:1 ❑ . 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 ofproperty who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.). 1.00 ' contracts forsuch projects with a contractors)licensed pursuant to - theContractor'sLicenseLaw. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec,- ,BARC.for this reason - - WATER HEATER'W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE. ACC.FILE NO. WORKF.RS'COMPF:NSA1'ION DECLARATION WATER TREATING EQUIP. 5.00 1 Hereby affirm 1 Co certificate Insurance,or certified ' or n certificate of 3900,Workers'Compensation Insuralice,or a certified ZONING ENG.SITE N0. - copy thereof(Set.3 Co pangLab.C.). -- Policy No, Co ❑ Certified copy is hereby furnished. Z Z ❑ Certified copy i5 filed with the city inspection divisinn. FIRE SPRINK ENERGY T-Z4 Applicant MISC.- - REFER TO ORD. Y❑ N❑ Y Q .�` N❑ 'cr m • CERTIFICATE OF EI EMPTION FROM WORKERS' PERMIT ISSUANCE ' 10.00 FLOOD ZONE A.L.u.c. L COMPENSATION INSURANCE PLG.CONTE. uC.NO. pLG fl. O (This sectionneednot be completed if the permit is for one - TOTAL Y❑' N❑ V[:] N❑ Z hundred dollars($100)ar less) L) O I certify that in the performance of the work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY IL U mit is issued,I shall not employ aI p•son in any I nner so as to becol�e subleci to the Workers'C p at L' sofCali" Iia. } y Uate-a•io�•1�9 Applicant 6 'ALTER OR,ADD TO MECH.'e 5.00 ' BUILDING m NOTICG TO AP LICANT: I , ter making Is her it'care of Ez- F ? emption;you should become subject to Ore Workers'Compensation APPLIANCE 5.00 . PLAN CHECK provisions of the Labor Code, you most forthwith comply with U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,ODOC.EM.) 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 3097,Civ,CJ, HEATING UNIT(TO 100,000 B.T.U.) , 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I cerlify.that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct and I agree to comply with all city county BOILER-COMPQ H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state lows relating to building construction,c, and - hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. above-mentioned property for inspection purposes. MECHANICAL ' (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which' - CONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE '10.00 rami MECH.CONT. LIG NO.' MECH. - Sagr(dtureofApplicamiContractor - Date- TOTAL � OFFICE COPY