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8699 POST THIS CARD NEAR FRONT OF BUILDING I PERMIT NUMBER 0 CITY OF CUPERTINO � �� INSPECTION DIVISION JOB INSPECTION REC D PERMIT EXPIRATION of B JOADDRESS /✓ O� Zvx/ UNI LOT# - PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSIRptMON DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATIOFJ LASTCALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL - Is UANC DATE BLD ELECT. PLG. MECH. MECHANICAL _ El E DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION WOOD FLOOR ALUATION $IFT. PLUMBING �2�j�1, MECHANICAL i ERMIi TO ELECTRICAL FRAMING -� DRIES TAPE CONSTR. INSULATION OCC,CROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED S. FT.FLooRAREA TGTALACREAGE ROOF DIAPHRAGM HUILOING USE HES IND CON VB Olnn El El El El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASP SSESSORSPARCEL NO. ROUGH PLUMBING TNACI NO. PARCEL NO. GAS TEST MECHANICAL ACC.OAiE ACC.FILE NQ ELECTRICAL FINALS DATE INSP. ' FRAMING SAN it ZONING ENG.SITE NO. INSULATION PLUMBING ' GAS FIRE SPRINK ENERGY T 2 MECHANICAL Y Nv ❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A,L.UA. LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEPT. �❑ N� �❑ rv❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING _/I Si, FIREWALLS ELECTRICPLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ' "' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING • O� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY i APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT P ONLY BUILDING PROJECT IDENTIFICATION . PERMIT NUMBER euuolNc APPLICATION & PERMIT 8699 x AOOwEs1`O 10S AJ- LINE IZ BUILDING - ELECTRICAL-PLUMBING-MECHANICAL ,y CANER'S V PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE ✓, S l+ PHONE NAME ANrRAcroR's NAUTLETS-SWITCHES-RECEP 10.00/1.00 p Tr tr/U- � �I uc...3855(6GSS LIGHTING FIXTURES 10.00/1.00 ADDRESS RESCToes DDAPPLIANCES-RESIDENTIAL 4.00 CONTRA PHONE 29 PANELS 10.00 DATE OF APPLICATION OR PANELS (OVER 200 AMPI 20,00 PLAN CHECK FEE P.C.NO. DR ENGIyCIj/�R uc.No. SIGNS TRANS. 3.00 ARCH.OR 54G. SPECIALCIRCUIT 5,00 PERMIT VALIDATION Aoo ZIP ITEMP.METER OR POLE INS. 20.00 APPucnNT' MOTORS SEE FEE SCH. Aoo ' SERVICE CHANGE 2000. / 6 Cs/ 002- LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 ?JU ��tlti a U u I hereby affirm that I am licensed under provisions of Chapter 9 T ISSUANCE DATE V m a w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. N F z Professions Code,andt 19y license is in fall(oil ynd of ec-1 /v Qf C��Dgt( 0 z o L - icense Class -Y_7_Lie Number SfaoSWni - IRO ❑ cipo IO ❑ 4 z w Date 5-2. -$S Contractor%�-9V"p. City of Cupe a y s BUILDING PERMIT w OWNHR-BUILDER DECLARATION INFORMATION uAxi LL H 1 hereby uf[lrm that I am exempt from the Contractors License MISC.- REFER TO ORD a- 0 4 Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE �0 _ s/ALUATIG9y_ $/FT. r - Code:Any city or county which requires a permit toconstruc(.alter, 1iyDp(L!L-Jr aa s-IO improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. EOEC. 3 _C aa 0 LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO A w m he is licensed pursuant to the provisions of the Contractors License � / H z r Low(Chapter 9 fcommencingwilli Section 7000)of Division 3 ofthe p / fi--�/ a Business and Professions Code)or that Ile is exempt therefrom and QTY. PLUMBING PERMIT FEE D the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TYPE CONSTR. i by any applicant for a permit subjects the applicant ton civil penalty of not more than five hundred dollar., ALTER-DRAIN -WATER IEA.) 5.00 s ❑ I,as owner of the property,or my employees with wages 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 I'or sale ISce. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Cody.'The Contractor's License Law does not apply to an owner of property who builds or improves(hereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT,FLOOR AREA TOTAL ACREAGE • men is re through his own employees,provided that such improve. marts ma not intended his or offered employees, or provided that such building GAS-EA.SYSTEM-11NC.40UTLETS 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 on. prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ 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 of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ I am exempt under Sec. .B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5,00 ACC.DATE ACG FILE NO. WORKERS'COMPIENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate al Consent to self-imam, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy gff5 3R0 ob.C. 1�- I'olicY'rti anY �TOr IO -S'T'/' O ❑ Ceail, i rere fur shed. FIRE SPRINK ENERGY T-24 Z Z ❑ Certi t -try inspection division. MISC.- REFER TO ORD. y N y N 'jr,- O Apphcan ❑ ❑ ❑ ❑ CC T C;R [FICA] OI°(EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. LJ > CO PENSA7'ION INSURANCE: PLG.CONTR. LIC.NO. PLG. CL o' 1'rhis section need not he completed if the permit is for one TOTAL v❑ N❑ Y❑ N❑ -0 Z hundred dollars IS 100)or less.) U O 1 certify that i the performance of the work Inr which th - OTY MECHANICAL PERMIT FEE FEE SUMMARY LL H mil is issu� Ia11 not employ any person in any manner s.".Per o U bee i to the Workers'Ccome It at on Laws of California. a"Av w Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING '7��1• } y NOT ;'1'O APPLICANT: If,after making this Certificate Of Lx F ? em ion,you should beco1 vsubject to the Workers'Compensation qpP LIANCE 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 10=CF.NL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10A000.RM.) 6.00 SEISMIC FEE I herebyaffirm [lost (ere is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 thfo e perrmance work for which this permit is Issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lenders Ad esu /J HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC -CJ]1 �+ 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 of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SEH. MECHANICAL above-mentioned property for inspection purposes. (Wgree to save, indemnify a yep harmless the City of MISE.- REFER TO ORD. Cupe I inst liabilities,judgm is costs and expenses which CONST.TAX ma y 'rue ai st aid City in consequence of the PERMIT ISSUANCE 10,00 8 n MECH.CONT. LIC.NO. MECH. �� 9A }y- °T"` TOTAL 'g ature of plicant/Contractor Dale- OFFICE COPY