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14726 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14726 INSPECTION DIVISION JOB INSPECTION RECORD ' {^( PERMIT EXPIRATION JOB ADDRESS//Q�CL�_(QIa�.F_� ' t� UNIT# _LOT# p PERMIT EXPIRES IF WORK OWNERZz ,7 y �/T� CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATIONANCE 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 VALIDA ION CUPERTINO STANDARDS. GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING �� . �• f ELECTRICAL ISSUANCE DATE NLDG ELECT ELG. MEC- MECHANICAL ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDBUIL ING PERMIT iL fg✓ .INFORMATION • - WOOD FLOOR VALUATION S/FT. PLUMBING . t n( MECHANICAL `�I^ PeRNui ro ELECTRICAL FRAMING STORIES TYPE CONSTR, INSULATION OCC SHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE s° Fr FwoR ARLA TOTALACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID HUILOI use ROOF SHEATHING RES IND CON ory Pe om.. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT No PARCEL No TUBS&SHOWER PAN PLUMBING ENERGY MECHANICALMECH.ENERGY ACC,DA TE ACL FILE NO ELECTRICAL BUILDING ENERGY FRAMING - ELECT.FINAL TEST ZONING ENG SITE NO INSULATION PLUMBING 1 _ GAS TEST GAS "RE// ' RE ST'RINK ENERGY T.]G MECHANICAL v ❑ NEl v ❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING . FLOOD LONE AL.0 C. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. v� N� vL DE) SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LU. ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLurnewG SO?JI 00 PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL — SEE PERMIT FOR EXPIRATION DATE — 0,-0.', IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ,BUILDING PROJECT IDENTIFICATION PERMIT NUMBER _ BUILDING ' APPLICATION & PERMIT ADDRESS. - �, BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 14726 OWNERS'--� r Y IAV Y"--�� PLAN CHECK VALIDATION NAME h/DY OTV. ELECTRIC PERMIT FEE /GP -OSS CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 NAME n 2 g4 Op��-, )G�t1d G✓J�j� LIGHTING FIXTURES 10.00/1.00 A;pvz LJDx 4115 �a PPLIANCES-RESIDENTIAL 4.00 - RL10G. OA IRON -,31kJ PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS IOVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIG.No, SIGNS TRANS. 3.00 ADR, Ervc' SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION ADDRESS ss ZIP EMP.METER OR POLE INS. 20.00 APPLICANTS j J LJ - X .�`aU/. � �� MOTORS SEE FEE SCH. APPLICANT I� ALL, 5 SERVICE CHANGE 20.00 nJf p 02 LICENSED CONTRACTORS DECLARATION ✓/ P��a Q U UI hereby aff nn that I am licensed under provisions of Chapter 9 ISSUANCE GATE v~i<H IconnnenLing with Section 70001 of Division 3 of the Business and BLDG. ELECT, PLG. MECH. H N z PrC`,Oxyy'��as��CpppQQQ��{1f�d Y cea is in full force d effect. Pi z oto' Live h. YliY3� ..Nu for L}Y'�_ ❑ ❑ C-]� o z F Ume E4d- Contmdor 1- _ H , - Yr1�G /'IIC0.� BUILDING PERMIT ¢ a re ¢ OWNER-BUILDER DECLARATION 0 0 " - MISC.- REFER TO ORD INFORMATION w3 IL h I hereby affirm that 1 am exempt from the Contractor's License LL o ¢ law I'nr the following reason.(Sec 7031.5,Businees.nd Professions PERMIT ISSUANCE 10.00 VALUATION SIFT. � - Code:Any city or county which reyuiresa permit loconstruct,alteq reQ s-0 Improve',demolish,or repair any structure,prior to Its issuance,also SLED.CONTR. LIC.NO. ELEC. La O ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO m u LL he is licensed pursuant to the provisions of the Contractor's License w � p to A Law(Chapter 9(commencingwish Section 7000)nf Division 3ol'file P¢'�0 Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE re $ the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TYPE CONSTR. o ; by any applicant for a permit subjects the applicant loa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($5001.): ❑ Las owner of lire property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their Sale 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 &oo Code:The Contractor's License does ocs not apply to an owner M properly who builds or improves aw do s and who docs such work FIXTURES-PER TRAP 5.00 so.Fr.FLUOR AREA roraL ACREAGE himself or through his own employees.provided that such improve- means are not intended or offered for sale.If.however.file building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 or improvement Is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4(EAJ) 2.00 BUIL61NU USE M1older will have the burden of proving that he did not build or im prove for purpose of sale). INDUSTRIAL WASTE INTETiVV+ 30.00 RES IND CON PB orae. ❑ I,as owner of lire property,ant exclusively con tmcling with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. s •.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-O 1.00 n contracts for such projects with a comracmus)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.2001 /10!00 x, TRACT NO. PARCEL NO. 0 I am exempt under Sec. .B.&P.C.for fills WATER HEATER W/VENT n'hl to 6.00 maswt Owner Date WATER SYSTEM " 5.00ACe.OATE ACC.FILE NO. WORK E RS'COM PENSATION DI!CLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate or Workers'Cu nt sensation IInnsun/ran'cry^e.or u certitied O Certified copy is h ereby furnished. FIRE SPRINK ENERGY T-24 Ce ieJ o y is til J h i t oily nu a fy o�t division. Zz %c- banl(Pry MISC- REFER TO ORD. Y0 N❑ Y❑ N❑ O n pgcam CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 0.00 FLOOD ZONE A.L.U.C. LU _ COMPENSATION'INSURANCE G. ONTR.. u .NO I PLG. ��X Y❑ N❑ Y ❑ N❑ CIL. O (This vection need not be completed if the permit h for one TOTAL EN D Z hundred dollars IS 100)or less.) I U O 1 certify that in the performance of fire work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mil is issued,I shall not employ any person in any manner so as to Ow become Subject to the Workers'Compensation Laws of California. BUILDING Dale Applicant ALTER OR ADD TO MECH. 5.00 E } N NOTICE'f0 AIWLICANI': If,after making this Certificate of L's- NOTICE Z cmption,You should become subject to the Workers'ComPensanon APPLIANCE +[� aL 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply will, FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)000QF.M.) 4.00 CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER,IQ0(30QEM.) 6.00 /-W SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH�DUCT) _,6:_00 lo the perrmancc of the ark for which this pcnnil is issued(Sec. - MICROFILM 3097,Civ.C.). `� HEATING UNIT UTO 100,000 B.T�:UI)"B.00 Lender's Name HEATING NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify(hut l have road(Ink.pplicaticn and xfate that the ubovo VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all city and county BOILER-CDMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ��r DO ordinances and slum laws relating to building construction, and hereby aulhoriee representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL �,00 .hove-mentioned property for inspection purpose. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperlino against liabilities,judgments, costs and expenses which 0 00 CONST.TAX any way accrue against Said City is consequence of the PERMIT ISSUANCE 10.00 man vgof this pel 'L ECN CONT. LIC.NO. MECH. urti 3 I I 53 31 TOT 7,OD TOTAL dature of Applicant/Contractor Dale Del �,'L'(/7 If C OFFICE COPY