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16394 I POST THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER CITY OF CUPERTINO 16394 INSPECTION DIVISION JOB -INSPECTION RECORD ' RE S.�V� �V -/d'"'�c PERMIT EXPIRATION JOB ADO '— UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ' ANCE OR 180 DAYS FROM , FOUNDATION NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF POmvT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS `"'�✓ ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB i .- PLUMBING •� ' , ELECTRICAL ISSUANCE OAT MECHANICAL BLDG ELECT I PLG MEC. ❑ ❑ 0 ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL H 11 TO ELECTRICAL pp/ FRAMING - g, , STORIES TYPE CONSID INSULATION pA e ' GI+OUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SF-p • ROOF, NOTE:NO FINAL INSP.SHALL BE MADE BFe q OOR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID G�� BUILDING USE ROOF SHEATHING 'Res wO CON Pe oP'.. ED 0 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. SE '� ABSESSOHSPAHGEL NO ROUGH SAN,N PLUMBING ELECT.ENERGY THACI NOA PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE, ACC.FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENC SITE NO. INSULATION PLUMBING 0_27 GAS TEST GAS FIRE SPRINK ENERGY i.lA MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE PLooO IoNE aLuc INTERIOR SHEAR FIRE DEPT. - v N[] v N❑ 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 LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC • ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Dt� 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. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I DENTI FICATION .PERMIT NUMBER. B.ILDiNG APPLICATION & PERMIT 16 3 9 4 AD RE55 t V N - ol FE R� BUILDING—ELECTRICAL—PLUMBING—MECHANICAL ., /1 OWNER'S /� PLAN CHECK VALIDATION ME ( OTV. ELECTRIC PERMIT FEE ONE CONTRACTOR �y �l UTLETS-SWITCHES-RECEP 10.00/1.00 �^, ,`I LIGHTING FIXTURES 10.00/1.00 tT oNrRac /� YV� � 1�x� RV APP e, LIANCES-RESIDENTIAL 4.00 ' ^� npoRESsj��1�IT ��x ltlM � . PH ME b— I PANELS 10.00 DATE OF APPLICATIOia ORCHrtECTPANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.No. SIGNS TRANS. 3.00 ARCH.OR ENG' SPECIAL CIRCUIT S.QQ PERMIT VALIDATION ADDRESS ZIP EMP.METER OR POLE INS. 20,00 APPucaNrs MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 ,00 LICENSED CONTRACTORS DECLARATION G o U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE mi (commencing with Section 7000)of Division 3 otitic Puniness and BLDG. ELECT. PLG. MECH. Professions Co u y license is in full - 1'c o C,m o Licenlass Lic.Nmnher Q m J Date-" Contractor BUILDING PERMIT 5 ir w ¢ OWNR-BUILDER ECLARATION ED o a U MISC.— REFER TO ORD INFORMATION w ; 0 m I hereby affirm that 1 son exempt from the inc,S.ctnr's License VALUATION FLLoJ Law for the following reason.(Sec.7031.5.Bgsincss and Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to construct,alter, 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. D ¢ requires the applicant for such per it to file a signed statement that TOTAL PERMIT TO n w m he is licensed pursuant to the provisions of the Contractor's License �1 r z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe La� a Business and Professions Cod0 or that Ile is exempt therefrom and OTV. PLUMBING PERMIT FEE Z,halls for Ore alleged exemption.Any violation ofSection 7031.5 STORIES TYPE CONSTR. d by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars 155001.1: ❑ 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 lira work,and One structure Is not intended or offered for sale flet. 7044. Business and prof essiom DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law dues not applyto an owner of property who builds or improves Omreon.and who does such work FIXTURES-PER TRAP SO.FT.FLOORAREA TOTALACREAGE r• himself'or bough his own employees,provided that such improve- . D GAS-EA.SYSTEM-11NC.40UTLETS 6.00 Q mems are not intended or offered lifeline IL Ila levuq the budding r improvement will is sold within one year of I completion,ion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) BUILDING USE I builder will have the burden of proving that he did not buil)or ire' RES IND CON RB Omer prove for purpose ofsale.). INDUSTRIAL WASTE I NTER. 31.0 . 1:1 El El El ❑ 11I,as owner of the property,tun exclusively conlracling with Iicmised contractors to construct IIIe project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. ASSESSORS PARCEL NO. �S(f and Professions Code:'I'he Contractor's License Law does not apply to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5 IEA. .00 Q contracts for such projects with a contractor(s)licensed pursuant to 1^ me Contraclnr's License Law. SEWER-SANITARY-STORM EA.200ft/ 1 TRACT NO, PARCEL NO. U) ❑ lam excmptunder Sec. .B.&P.C.for Oris WATER HEATER W/VENT 0 reason Owner Dare WATER SYSTEM 5.00 ACC.OATE ACG FILE NO. WORKERS'COMPIiNSA'I'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby AGrm that I have a certificate of consent In sCIFmoure. ZONING ENG.SITE NO. or a certificate oFW orkers'Compensalufa Insurance,or a certified _A copy thereof(Sec 3800,Lab.C].L 1 I _ kW � . Policy No. Cuntpany�/tTTI O ❑ Qertilied copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z q/Certifed copy is filed with the city inspection division. AMISC.- REFER TO ORD. pplicam Y ❑ N❑ [:]Y NE] i w CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE FLOOo ZONE A.L.0 c. LU > COMPFNSATION INSURANCE. PLG.CONTE. LIC.NO. PLG. CL O if section need not be completed if the permit is for one TOTAL Y❑ N❑ Y❑ N❑ 0 Z hundred dollar,IS 100)or less.) U O I certify that in the performance of he work for which thio per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY IL H mit is issued,I shall not employ any person in any manner so as to 0Ubecome subject to the Workers'Coln pensxlion Laws of California. BUILDING D. nate Applicant ALTER OR ADD TO MECH. 5.00 } W NOTICE TO APPLICANT: If,after making Ibis Certif'icute of Ex- rZ eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE (..1 such provisions or this permit shall he demned revoked. AIR HANDLING UNIT(TO 10SMC.F.M.) 4.00 CONSTRuc'DoN LENDING AGENCY AIR HANDLING UNIT(OVER 10p000.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(See. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,CN.C.l. Lender's Name HEATING UNIT(OVER 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 ,fq� information is correct. I agree it)comply with all city and counlY PLUMBING or dinances and state laws relating Io building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.1 6.00 hereby autlicame representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTUI SEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmer, the City of MISC.- REFER TO ORD. uperlino against liabilities,judgments, costs and expenses which CONST.TAX lay in ny way accrue agai said City in consequence of the PERMIT ISSUANCE 10.00 rantin this permit. MECH.CONT. LIG NO. MECH. q TOTAL TOTAL immune of Applicant/Contractor Date OFFICE COPY