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16374 iI POST THIS CARD NEAR FRONT OF- Bb I LID ING —. PEHMIT NUMBIiH CITY OF CUPERTINO 16374 INSPECTION DIVISION JOB INSPECTION RECORD ..� ,,I,I _/ JOBADDRESS //000 /Vi WoL� 7CQ UNIT# PERMIT EXPIRATION_LOT# PERMIT EXPIRES IF'VVORK OWNER CONTRACTOR z=-74 trR.r IS NOT STARTED WITHIN 114SPECTION 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 ' TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLR5]IT VALIDATION PREGUNITE CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE on TE MECHANICAL AF'i, Bloc ELECT. PLG' . MECH V❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED h� 1 BUILDING PERMIT WOOD FLOOR sty INFORMATION ape\ inTION $ITT. e� PLUMBING MECHANICAL P[Rn+N ro ELECTRICAL FRAMING STUDIES TYPE LONSTR INSULATION - - DCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 FT FLOORAREA TOTAL ALREPG! ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE r• DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - +us IND CON PB on,El l APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALSDATE INSP. El El El ASSESSOHS PAHCEL NO ROUGH SANA PLUMBING ELECT.ENERGY TRACT NO vnHCr.L NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL - MECH.ENERGY ACC DATE ncc File No ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING GAS TEST - GAS FIRE$PRINK ENERGY LZa ' MECHANICAL Y ❑ NL v ❑ NEl COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE ALuc EXTERIOR SHEAR ELECTRICAL RELEASE v NL v L N INTERIOR SHEAR FIRE DEPT. L 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 OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC I � ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING l-� OPLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — 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 BUI LDI NG PROJECT IDENTIFICATION -PERMIT NUMBER BAUILOHNG PDRESS APPLICATION & PERMIT 1 7 a DREss u I 1 O�O `\I .�OI� �� , /q BUILDING-ELECTRICAL-PLUMBING-MECHANICAL I OWNER'S `l IIIIII�� PLAN CHECK VALIDATION rvAM �ac <arc rvE QTY. ELECTRIC PERMIT FEE CONTRACT O 5 rvA /('�I b7 OUTLETS-SWITCHES-RECEP 10.00/1.00 I�LQV /eG�C.No.�"/Oa L� LIGHTING FIXTURES 10.00/1.00 ,/a CONTRACTOR's PPLIANCES-RESIDENTIAL 4.00 A�°o s 61 - - �SJSJ•V I=HONEZ/3 6 SVq/ PANELS 10.00 PATE OF APPLICATION .. ARCHITECT PLAN CHECK FEE P.C.NO. DR PANELS (OVER 200 AMP) 20.00 ENGINEER -u - c.rvo. SIGNS TRANS. . 3.00 ADOAESs ENGSPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP. METER OR POLE INS. 20.00 APPLICANT'$ MOTORS ' SEE FEE SCR. ADDRESS ' SERVICE CHANGE 20.00 '02 LICENSE II CONTRACTORS DECLARATION a u 1 hereby affirm that I am licensed under provisions of Chapter 9 PA ISSUANCE DATE y a N (commencing with Section 7000)of Division 3 of the Business and ELECT. PLG. MECH. Professions Code nd license is in full forvvgrhyRI�e�teE11// License ss �-! Lic.Numb, ok�l / !Q� p r Date '[_� pp C: I actor T_�_oe-g-o +� �'7 �s ¢ a,w¢ OWNER-BUILDER DECLARA'PION `^�� sett IL ORMING PERMIT K 3 LL H I hereby affirm that I am exempt firm..the Contractor's License MISC.- REF ER TO ORD 0 INFORMATION .. Oj Law forth,followingreason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE VALUATION 6/FT. � - Code:Any city orcounty whichregRnesapermit toconstuct,ahcF, ¢Q p improve,demolish,nr repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. O 1, requires the applicant for Such permit to file a signed Statement that TOTAL % PERMIT TO u w m he is licensed pursuant to the provisions of the Contractor's License rzi Law(Chapter 9(commencing with Section 7000)of Division 3 of the C_76,!�7G7r Z i o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE the basis for lb,alleged exemption.Any violation W Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects to applicant o a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(5500).): ❑ 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 Intend,d or offered for sale (Sec. 7044. Business and Professions DRAIN$-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTALACREACE it sellor through his own,m Noyees,provided that such improve- ments are not intended or offered for sale.If,however.the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- BUILDING USE GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder,will have the burden of proving that he did not build or int- prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ I,as owner of the property,are 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 contractor(s)licensed pursuant m the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am cxclmpt sewer Sc,.-,B&P.C.for this - WATER HEATER W/VENT 6.00 reason Owner Dee WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm fiat I have a ee,ificate W consent to self-in%Ire, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy Ihmcof(Sc,.3800,Lab.C.).I'o0 No. Company 1 ❑ CetlilicJ copy is hereby tarnished. FIRE SPR WK ENERGY T 2 Z Z O Certilin_ I cypy j>_lyedh the city inspectimh Aivisiom. Applicant-been( MISC.- REFER TO ORD. Y ❑ N❑ Y El NEI �' CC 7-�CER'1'I I'ICA'I'Ih1POI°EXEMPTIFROM WORK 1:RS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.u.C. i QJ _ CO1iNSAT'ION INSURANCE URANCE PLG.CONTR. LIG NO. PLG. O. o (This section recd not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ No Z htmdrw dollars(4100)or hss.) U O 1 certify that in the performance of the work for which this Per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is seed, I shall mat employ any person is any manner sn as to U become subject to the Workers'Ccmpcnsef ion Laws of California. Lu Date-Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } tdil NOTICE TO APPL.ICAN'I': If,after making([its Certificate of Ex-emption.you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the labor Code, you must forthwith Comply with FEE U such provisions or this pond shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4,00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE I 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.0.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 �a Lender's Address ELECTRIC Iec,llfy that l hscoctd this application an d 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-COME(3 H.P.or 100,000 B.T.U.) 6.00 hereby authadee 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 m Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino 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 ranting of iS Permit. 1 MECH.CONT. LIC.NO. MECH. TOTAL TOTAL Sig ature of Applic t/Contra or Date OFFICE COPY