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13386 POST THIS CARD NEAR FRONT OF BUILDING Rn,IT NDn,BER CITY OF CUPERTINO 13386 INSPECTION DIVISION JOB INSPECTION RECORD i /', 'g PERMIT'E XPIRAYION JOBADDRESS //000 N' OL, UNIT# LOT# L," 6 PERMIT EXPIRES IF WORK OWNER T CONTRACTOR (��/'L o�crGET7E'�.� IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSP CTIONRECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM - 'I-If"5't S'CILf' 2A LAST CALLED INSPECTION. LIFER PREGUNITE PERMIT ALIOATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL —' ISSUANCE DATE MECHANICAL �7 �,[� �.-y� �O BLDG. ELECT. PLO. ME❑CR. �6d J YJ� ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PIERMIT WOOD FLOOR INFORMATION VALUATION $/FT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO G.-1r/i T��h WAIF, -_ _ _d„ I- FRAMING ,I'1'�' STORIES TYPE CONSTR. INSULATION OCC,GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF OFT FLOOR AR A LUi AL ACREAGE DIAPHRAGM BUILDING USE HES IND CON PR Umw APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 0 ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING TpgCI NO. PARCEL NO. GAS TEST MECHANICAL ACC.OATE ACC.FILE N0. ELECTRICAL FINALS DATE INSP. FRAMING SAN it ZONING ENG.SITE NO. INSULATION PLUMBING C' GAS FIRE SPRINK ENERGY T24 MECHANICAL Y ❑ N❑ Y [:] N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1 HEATING LATH-INTERIOR ELECTRICAL a000 ZONE aL.u.c. Y LATH-EXTERIOR FIRE DEPT. N� v �] N[] SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SW y 2-1-1{C BUILDING �• SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK F GAS EE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H 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. , _� OFEICECOPV _ _, ,LICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY PERMIT NUMBER BUI L'DING PROJECTlDENTIFICATION APPLICATION & PERMIT BUILDIN'10G „ OO /a . oC,� 13386 AopPEss V�I BUILDING - ELECTRICAL-PLUMBING-MECHANICAL Ow1NER'S _ PLAN CHECK VALIDATION NAME YUL� �r GTY. ELECTRIC PERMIT FEE 60 W �� 7- 2q /3079a ^. Home ACTORS ti LIT -SWITCHES-RECEP 10.00/1.00 RUDUP O 1 6L- C LIGHTING FIXTURES 10.00/1.00 I LIC.ND. I I o6 CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 ADDRESS �EA F.I+ILLSroAL@ qqLi U' PRONE T-7 -iCii PANELS 10.00 DATE OF APPLICATION C.NO. PLAN CHECK FEE P. ARCHITECT I.;}.� �1 _ M 1 PANELS (OVER 200 AMP) 20.00 OR TSI+1� ENGIN G."I G 8z2) SIGNS TRANS. 3.00 LIC.NO ARCH.OR ENG d©O (,(� D SPECIAL CIRCUIT S.OD PERMIT VALIDATION ADDRESS C ('S zIv EMP.METER OR POLE INS. 20.00 APPLICANTS r MOTORS SEE FEE SCH. + ADDRESS SERVICE CHANGE 20.00 w r o LICENSED CONTRACTORS DECLARATION a is I hereby affirm that I am licensed under provisions of Chapter 9 ISSIUANCE DATE w< (commencing with Section 7000)of Division 3 of the Business and City 1 BI: G V"ELECT. I PLG. MECH. r y Z Professions Code,and y license is in full force a effe I. b l'1 ❑ Is O w- License lass Lic.Number - ❑ ❑ ❑ D T F w Date 4 Comractor d < BUILDING PERMIT F u, rt w u OWNER-BUILDER DECLARATION INFORMATION w 3 LL N I herebyaffirm that I am exempt from the Contractor's License MISC.- REFER TO ORD p VALUATION $/FT. is V Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 t - Code:Any city or county which requires a permit to construct,alter e a ¢Q p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. O u requires the applicant for such permit to file a signet statement that TOTAL PERM] TO w m he is licensed pursuant to the provisions of the Contractors License F z i- Law(Chapter 9(commencingwith Section 7000)of Division 3 of tiled'TAy.CJ F/��T� F i Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE F 0 the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. c ; - by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not mom than five hundred dollars($500).): ❑ 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 for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5,00 Code:The Contractor's License Law dues not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP S.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-1 6.00 'sl numbs are not intended or offered for sale.If,however,the building 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 purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,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)hemald pursuant to SEWER-SA NITAR V-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ lam exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Data WATER SYSTEM 5.00 ACC.DATE ACC.FILENO. WORKF-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.CJ. Policy No. Company G/1Y101M RAA/LE �0 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certifd cisud GwNh t� city inspection division. MISC.- REFER TO ORD. y❑ N❑ y ❑ N❑ Applicant TT � N CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. LU > COMPENSATION INSURANCE PLG CONTR. LIC.NO. PLG. Y❑ N❑ Y❑ N❑ 0- O (This section need not be completed if the permit is for one TOTAL ::) Z hundred dollars IS 100)or less) L) 0 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 nob employ any person in any manner so as to Ow become subject to the Workers'Compensation Laws of California. BUILDING pOJ,4111 Dare Applicant ALTER OR ADD TO MECH. 5.00 } taA NOTICE TO APPLICANT. If,after making this Certificate of Ex- H ? caption,you should become subject to the Workeri 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 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE QM-� I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work lot which this permit is issued(Sec. HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ.CJ. Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC 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-COMPj3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and suite laws relating to building construction, and hereby authorize representatives of this city to enter upon the 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. Cupertino against liabilities,judgments, Costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in consequence of the Xgranting Of this permit. MECH.CONT, LIC.NO. MECH. 5,0 TOTAL TOTAL Signature of Appli nt/Contractor D'be OFFICE COPY �'j- FINAL GRADF' ROUTE SLIP File No. y,(/ Da Locati n y i Subject I ,r 3 Approved! J/. ��j Date Inspector i