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14883C. POST THIS CARD NEAR FRONT OF BUILDING ' CITY ,OF CUPERTINO, INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS I�L:J \IB�1 -�IIIY� UNIT _LOT# • OWNER CONTRACTOR PERMIT NUMBER 14883 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- 1BO DAYS FROM LASTCALLED INSPECTION. - INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATIONANCE,OR NOTE: ALL GRADING AND DRAINAGE SHALL BE -INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CIT' OF CUPERTINO STANDARDS, LIFER PREGUNITE PERMIT VALIDATION �• ,.✓/J� fD6 ISSUANCE DATE GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING. •- ELECTRICAL MECHANICAL - - BLDG. ELFCT.PLC. El MECH 4 ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION ' 'WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO '~ FRAMING - INSULATION - STORIES TYPE CONSTR. loco GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAXIS PAID SO FT n.00R AREA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING- BUILDING USE RES IND .CON PB 011— ElEl El 1:1 El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATEP. ROUGH SAN.# ASSESSORS PARCEL NO PLUMBING ELECT. ENERGY TUBS &SHOWER PAN PLUMBING ENERGY rRAcr No. PARCEL NO MECHANICAL - MECH.ENERGY B I= ELECTRICAL BUILDING ENERGY CitlAcc GATE ACC. FILE NO. FRAMING ELECT. FINAL TEST INSULATION PLUMBING �^ ZONING ENG. SITE NO. GAS TEST GAS _ MECH NICAL FIRE SPRINK Y ❑ N❑ ENERGY T.24 Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE - FLOOD ZONE Y ❑ N❑ A.I. U C.. Y ❑ N❑ .INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE 7 FEE SUMMARY EXTERIOR LATH - BUILDING jlp BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE ' GAS - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. ARRANGE FOR INSPECTION BY PHONING 252.4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. LUo� PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE.PERMIT FOR EXPIRATION DATE - MICROFILM ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL 0 OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY ^ BUILDING PROJECT IDENTIFICATION APPLICATION &PERMIT BUILDING — ELECTRICAL— PLUMBING — MECHANICAL PERMIT NUMBER r. 14883 BUILDING DflESS u vrxiF V Qr OwNEN' NA/MISE//��/ / /�•V I PHO it OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION CONTRACTOR 'S /7✓ uc.N (J ) UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S AOORESS' 0� PROry APPLIANCES • RESIDENTIAL 4.00 PANELS 10.00 ARCHITECT OR ENGINEER LIC. NO. PANELS (OVER 200 AMP) 20.00 PLAN CHECKFEE .C. NO. ISIGNS TRANS. 3.00 ADDDR'ESS ErvG ZIP SPECIAL CIRCUIT 5.00 PERMIT VALIDATION - ISSUA CE DA E UA fi TEMP. METER OR POLE INS. 20.00 APPLICDOR ANT APPLICA MOTORS SEE FEE SCH. SERVICECHANGE 20.00 LICENSED CONTRACTORS DECLARATION that I nm licensed under provisions of Chapter a 9 I hereby g with (commencing with Section 7000) of Division 3 of the Business and limtession5 C(1�s. ,,'yy��kay license is Ill full fl1 /� License CWss (,..}-y_ LiC. NumM1er ( Dat L'�_ COntrel:lOr OWNER-BUILDIiR DECLARATION I hereby affirm that 1 sm exempt from the Cons and Fr License owingrcason.(hrequires a pousiaeesend Professions Law for Any Code: Any city or [or my which requires a permit m construct, alter, improve, AemDlish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000) of Division 3 oflhe- Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pemnit subjects the applicant loa civil penalty of not more than five hundred dollars (S500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation• will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and ProfessionsDRAINS•FLOOR, Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mentsarenotintendedorofferedforsale. If, however, the building or improv puma is sold within one year of completion, the owner builder will have the burden of proving that he did not build or im- prove for purpose ors:de.). ❑ 1, as owner of the property, am exclusively contracting with licensed canlractors to construct the project (Sec. 7044, Business and Professions Code: Thu Conluctor's License Lew does not 'apply to an owner of properly who builds or improves thereon, and who cm)tracts for such projects with a contmctar(s) licensed pursuant to the Contractor's License Law. ❑ Iwo exennpl under See ,B.&P.C. for this reasonWATER BLDG. ELECT. ❑ ❑ PLG. MECH. ❑ BUILDING T IT INFORMATION MISC. — REFER TO ORD VALUATION SIFT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO p ^� QTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN -WATER (EA.) 5.00 BACK FLOW PROTECT. DEVICE 0 OCC. GROUP RES. UNITS ROOF, AREA,C .00 FIXTURES - PER TRAP D SO, FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM -1INC. 40 0 GAS - EA. SYSTEM - OVER 4 ( A.) BUILDING USE RES No CON PB Other ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. � 0 LAWN SPRINKLERS • 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 (EA.) 1.00 SEWER -SANITARY -STORM EA. 200ft/10.00 n TRACT NO, PARCEL NO. HEATER W/VENT 6.00 00 Ownern Date WORK ERS'COM PENSATION DECLARATION I hereby affirm that I have a certificate ofcunsent lomlf-insure, or a certificate of Workers' Compensation InsuranSe, or a certificJ Cup, II .. 00 Lab.C.). Yw-,yp/,}— PoIIcY Co tpany - ❑ Cerrhied copy ash eby tarnished. 'Iicoy is fled Willi the cit�inspectimn division. Pp Seat C t" Q'1�� WATER SYSTEM 5.00 �— ACC.DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 ZONING ENG. SITE NO. FIRE SPRINK V ❑ N❑ ENERGY T-29 Y ❑ N❑ MISC.- REFER TO ORD. n CERT ICATI:01° EXEMPTION 17ROM WORKERS' COMPENSATION INSURANCE (This section need not he completed if the permit is for one hundred dollars (E 100) or less.) 1 certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Dale ApplicantALTER NOTICE 'I'O APPLICANT'. If, after making this Certificate of Ex- emption, you should M1ecome subject to the Workers' Compensation provisions of the Labor Code, you Most forthwith comply with such provisions or this permit shall be deenned revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there.is a construction ]Coding agency lin the performance of 01e' work for which this permit is issued (Sec. 3097• Cie.C.). Lender's Name PERMIT ISSUANCE 10.00 ,id FLOOD ZONE Y ❑ N❑ A.L.U.C. V El A, F-1 PLG. CONTR. LIC. NO. PLG. TOTAL ! OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING OR ADD TO MECH. 5.00 APPLIANCE _ 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10)000C.F.M.) 4.00 AIR HANDLING UNIT (OVER I0,000C.F.M.) 6.00 SEISMIC FEE EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC PLUMBINGT +/ 60 I' Lender's Address I certify that l have read this application and stale that the above information is correct. I agree to comply with all city and county Ordinances and stale laws relating to building construction, and hereby authorize representatives of this City to enter upon the shove -mentioned properly for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any wa accrue against said City in consequence of the ranti of this p mit VENTILATION FAN (SINGLE) 4.00 BOILER- OOMP Q H.P. or 100,000 B.T.U.) 6.00 801 LER-COMP lover 100.000 BTU) SEE FEE SCH. MECHANICAL 'MISC. - REFER TO ORD. CONST. TAX PERMIT ISSUANCE 10.00 MECH.CONT. LIC. NO. MECH. TOTAL TOTAL Sign of ppI1CJnI/CnatraClOr Date OFFICE COPY