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18583 P05T THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 18583 INSPECTIOWDIVISION JOB INSPECTION RECORD 4� S �'p 'p / � b. PERMIT EXPIRATION - JOB ADDRESS /df�-% N W"O (�F �.� UNIT# LOT# , - PERMIT EXPIRES IF WORK. OWNER D, eS -CONTRACTOR IV �- E, 6 IS NOT STARTED WITHIN 'INSPECTION DATE 1 INSPECTORNSPECTION RECORD 180,DAYS OF PERMIT ISSU:l FOUNDATION, - +. . .ANCE OR .180 DAYS FROM: NOTE: ' 'h1" � f " LASTCALLED INSPECTION. UFER - - ALL GRADING AND DRAINAGE SHALL'BE INSTALLED -•h' PREGUNITE. - _ TO COMPLY WITH THE APPROVED;PLANS AND CITY OF PERnIIT VALIDATION, - GARAGE SLABS CUPERTINO STANDARDS. ®A� _ , POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PAM. . �', +' • -? UNDERGROUND /SLABsee AL3 g�9� PLUMBING ' ' E` "•�.' >n�L .IR E"'C- l I ` ELECTRICAL - _ , ISSUANCE UAT -' MECHANICAL BLOC.-. ELf.Ecrr PLL'. MECH. a ❑, ;4 ;❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT ,( ,j ,. INFORMATION WOOD FLOOR: vALunINFOsIFT. PLUMBING ,. - , MECHANICAL - ELECTRICAL - PERFBT To D�lf FRAMING INSULATION - sroRles -Tv ECONSTR. OCC GROUP R - RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED .ROOF' - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so Er.FLooR AREA TOTAL ACREAGE DIAPHRAGM _ THE CONSTRUCTION TAX IS PAID - BUILDING USE ROOF SHEATHING " ,_ 1,•�'.. A,a RES,!,IND CON PB •Oma,', APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED' FINALS DATE INSP. ❑ 0 , ❑ - E •❑ ASSESSORS PARCEL NO. ROUGH SAN.p <., PLUMBING ELECT.ENERGY �• r. '" (TRACT NO. , PARCEL NO `• 1 TUBS&-SHOWER PAN PLUMBING,ENERGY, MECHANICAL MECH.ENERGY, ' ELECTRICAL BUILDING ENERGY - ACC.DATE ACC.FILE NO. ' 'FRAMING - - ELECT.FINAL TEST , INSULATION � PLUMBING ZONING ENCSITE NO, GAS TEST GAS MEGHAN I CGAL FIRE SERINK ENERGY T2< COVER NO WORK UNTIL. HE ABOVE HAS BEEN SIGNED ATING - " 10 c N❑ ° NF] ' EXTERIOR-SHEAR' - �- - ELECTRICAL RELEASE FLOOD zorvEA,Luc. p . INTERIOR SHEAR FI RE DE PT` } vEl rv❑ Y NEI . SHEETROCK'' GRADE - - FEE SUMMARY ` EXTERIOR LATH - BUILDING T .BUILDING .INTERIOR CATH `.TEMPORARY APPROVALS ' 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 FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM . ARRANGE,FOR INSPECTION BY PHONING 252-4505 ELECTRIC . ' Iw—�y ONE�WORKINGDA'Y BEFORE REQUIRED`INSPECTION. R O PLUMBING O � V Z PLEASE GIVE JOB ADDRESS WHEN PHONING. SEE PERMIT FOR EXPIRATION DATE —. MECHANICAL . IMPORTANT! coNST'TAX PLEASE READ REVERSE SIDE BEFORE TOTAL Q; DO CALLING FOR FINAL INSPECTION' OFFICE`COPV APPLICANT TO FILL' IN 'INFORMATION WIT.HIN'RED;LINES'= USE:BALL POINT PEN ONLY PERMITNUMBER �' - BUILDING.PROJECT I DENTI FICA TIO -gppLICATION & PERMIT - ' BUIZDING 1 R R ADDRESS /-� - �I - BUILDING -ELECTRICAL-PLUMBING-MECHANICAL ' f oWNERs - r� NAd r - QTY. ELECTRIC PERMIT '. FEE PLAN CHECK VALIDATION s CONTRACTOR'S - NAME � OUTLETS-'SWITCHES-RECEP. 10.00/1.00 .1 , LIC.N1 0. (.I(Z , LIGHTING FIXTURES '10.00/1.00 CO`TRAIFTOH'S ADDRESS -/' ,�f G APPLIANCES-RESIDENTIAL - 4.00 - .7 b✓N NE / 72S/SI: PANELS . '510.00 • DATE OF APPLICATION a ` ARCHITEci PLAN CHECK FEE . P.C.NO. OR - ' PANELS (OVER 200 AMP) ,' � � 20.00 f ENGINEER - _ z UC,NO, SIGNS TRANS. 3.00 ARCH.OR ENG. - PERMIT VALIpATION ADDRESS - +. SPECIAL CIRCUIT , 5.00 -1 ZIP EMP.METER OR POLE INS! 20.00 - ADDRas rs 'o MOTORS SEE FEE SCH. t SERVICE CHANGE r 20.00 �IICL 09 ) LICFNSEU CONTRACTORS DECLARATION La ,Q .I hereby affirmltlm[I,am licensed under provisions of Chapter 9 Z w h .' ,ISSUANCE DATE' ` n e (commencing with Section 7000)of Division 3 of the Business and - 7Professions Code,,/CItril t`icense is in full for yQ f W�- .BLDG. ELECTi 'PLG. `MECH. zz z,_ p' License Cl s' k+ y Lic:Number' `j�r ` 0 m j Date dj Contractor � �' M M IE a: OWNER-BUILDER DECLARATION' - " BUILDING PERMIT ' - o A ° - • - " INFORMATION w ; e- I hereby.effimn that I ari,exemptfrom the Contractor's License MISC.- REFER TO ORD , VALUATION $/FT. , u O J, ; Law for the following reason. Sec.7031.5,Business and Professions 10.00 H.- g ( PERMIT ISSUANCE " •', Code:Any city or county which regmiresa permit to construct,alteq I R ¢4 p improve;demolish,or repair any tincture prior to Its issuance,also ELEC.CONTR. LIC.NO. ELEC. •" " e. D¢ ' requires the applicant for such permit to file a signed statement that " - TOTAL - r X m u PERMIT TO, he is licensed 9( opursuant to(commencing withS Section of 000)ontracmr's License _ ,.x / s r r Law(Chapter 9(wmmencing witlt Section 7000)of Dlvision3 of the x {V v. `.• IIS `'� Business and Professions Code)or that he is exempt therefrom and QTY. . PLUMBING PERMIT FEE ' GGG `�-1 JJ 90 ¢.r o` the basis for the alleged exemption.Any,violation of Section.7031.5 _ + STORIES TYPE ONSTR:', n 3'm by any applicantfor a permit subjects the applicant to a civil penally 1 • of not more than fivehundred dollars(S500L) . ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,'as owner oPlhe property,of my employees with wages as OCC.GROUP -RES.UNITS BACKF LOW'PROTECT:DEVICE . X4.00 - $ their sole compensation,will do the work,and the structure is not - intended or offered for sale-(See. 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 buildsor improves thereon,and who does such work FIXTURES-PER TRAP 5.00 T4.11 SD.FL FLOOR AREA 'iTOTAL ACREAGE'` himself or through his own employees,provided that such Improve- , - _ mems are not intended or offered for sale.If,however,the building , GAS-EA.SVSTEM-1 OUTLETS 6.00 OD or improvement Is sold.wilhin one'year of completion,the owner- "' builder wilPhave the burden of proving that he did not build or int- GAS-EA.SYSTEM-OVER 4(EA:) 2.00 BUILDING- RES ]NO CON , PB • Other prove for purpose of sale.). ' .. INDUSTRIAL WASTE INTER.. , 30.00 F-1 ❑, .❑ ❑, ❑ . ❑ 1,as owner of nae propeily,am exclusively contracting with - licensed contractors to construct,the'project(Sec.7044,Business LAWN SPRINKLERS-1 INO5 V.B. 6.00 ' n ASSESSORS PARCEL NO. 'I 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'-OVER15(EA.) 1.00 contracts for such projects with a contractors)hcerised pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. 0 ,1 am exempt under Sec. ',B.&P.C.for this , D - ?- reason WATER HEATER W/VENT 6.00 - ' owner '- Date WATER SYSTEM: 5.00 - - - •' ACCDATE - ACC.FILE NO. WORK ERS'COMPENSATION DECLARATIONWgTER TREATING EQUIP. 5.00 5 .- 1 hereby affirm that I have a ertificate of consent to self-insu're, _ t or a certificate of Workers'Compensation insurance,or a certified w v ZONING, -•„ENG.SITE NO."• copy thereof(Sec.3800,Lah.C.). _ r Policy No. Company' - 'Q ❑ Certified copy is hereby furnished * - FIRE SHRINK ENERGY T24 Z Z ❑ Certified copy is,filed with the'city mspeetion'division. - t O Appucam - MISC. REFER TO ORD. 4i❑' IN v.❑• IN ~ ?� PERMIT ISSUANCE' 10.00 ` a CERTIFICATE OF EXF-MPTION FROM WORKERS'r .G.0 FLOOD ZONE A.L u C. ' 'W -, COMPENSATION INSURANCE PL ONTR. LIC.NO/ s.- PLG." _ D- O - (This'section need not be 'completed if thepermtI for one 4NP - [ TOTAL 30.00 =YIN '/❑ N❑' D'Z hundred dollars(S 100)or Tess.) . e P • 1 - U O - I 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 "on in any manner su as to ` O W, hero uhf t Workers'Co en Ron Laws /Cul'(o 'o. -. Dale jLj licam m BUILDING a =-� , ALTER OR ADD TO MECH.' - 5.00 - } N NOTICE TO APPLICANT: If,a cr making this Certificate of-Ex- (.-.'Z emption,you should become subject to the'Wotkers'Compensation APPLIANCE S 5.00 I provisions of the Labor Code, you must;forthwith comply with PLAN CHECK" ' - FEE .V such provisions or this permit shall be deemed revoked._ AIR HANDLING UNIT(T0'10000C.F.M.) '4.00 - CONSTRUCTION.LENDING AGENCY - AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 ._ SEISMIC FEE I•hereby offer, that there Is a construction lending agency for EXHAUST'HOOD.(WITH DUCT), :. 5.00 0 the performance of the work for which this permit is issued(Sec. - - MICROFILM - 3097,CIvC). HEATING UNIT(TO 100,000BT.U.) ' 8.00 Lender's Nome HEATING UN ER 100,000 B.T.U.)9.50 ` I'' O,., Lender's Address ELECTRIC n, l certify that l have-read this application and state that the above VENTILATION FAN4SINGLE) r 400 ' 'l Information is correct. 1 agree R comply with all city and county - - PLUMBING �- ��D ordinances and slate laws relating to building:construction, and BOILER-'BOILERH.P.Or 100,000 B.T.U.). 600 - hereby authorize representatives of this city to.enter upon the BOILER-COMP (Over 100,000 HTUI BEE FEE SCH MECHANICAL above-mentioned property for inspection purposes. a (We) agtee to save Indemnify and keep harmless the City of MISC.- REFER TO ORD. - Caper Into against liabilities,judgments costs and expenses which - PERMIT ISSUANCE - ,10 00 x' CONST-"TAX '9. may to ah waccrue against said City in of the '� tanhng [h' e ermit 1 MECH.CONT LIC.NO. ' - "E"Lt TOTATOTAL30OD ^+ I.., atura oica);t/Contractor Date - ' ti 0FFICE COPY '