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16249 (3) J^ POST THIS CARD INEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO ` 16249 INSPECTION DIVISION ' JOB INSPECTION RECORD ; ��.y� �I( PERMIT EXPIRATION JOB ADDRESS ID341 t T ALi1L-1 `-' 'T UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DAT INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS.FROM NOTE: LASTCALL ED.INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION _ CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - PAID UNDERGROUND /SLAB PLUMBING8v . ELECTRICAL _ SEP G+ • ISSUANCE DATE - B c ELECT PLG. MECHANICAL MECR ; City Orcup ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD,FLOOR INFORMATION PLUMBING VAVATION SIFT. MECHANICAL-ELECTRICAL ' PERMIT TO FRAMING ' STORIES TYPE CONSTR. INSULATION - OCC.GHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.F1 FLooR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE . DIAPHRAGM - THE CONSTRUCTION TAX IS PAID. BUILDING USE : y ROOF SHEATHING RES IND CON PB Olt] 'APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ Q . ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST, ZONING ENG,SITE NO. INSULATION PLUMBING — GAS TEST - GAS MECHANICALFIRE SPRINK ENERGY T.ZQ r-Z-40 ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING y❑ NQ Y [:] N❑ EXTERIOR SHEAR ELECTRICAL RELEASE F LOOO Z�ONE INTERIOR SHEAR FIRE DEPT. Y❑ N❑ .Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING --+ INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE ? Er OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LUONE 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. G OFFICE COPY. APPj.ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY n' 801 LDI NG PROJECT I DENTI FICATION PERMIT NUMBER . BUILDING APPLICATION & PERMIT BUILDING-ELECTRICAL=PLUMBING-MECHANICAL 4 v OWNER'S PLAN CHECK VALIDATION �-� "AME .O OTY. ELECTRIC PERMIT FEE �•' po PHONE NAME ACTOf's UTLETS-SWITCHES-RECEP 10.00/1.00 YYY II LIC.NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTORSSS PPLIANCES-RESIDENTIAL 4.00 PHONE - PANELS 16.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. oRf�_ Cos' PANELS (OVER 200 AMPI 20.00 N ENGINEER 7�/�x LIC,No, SIGNS TRANS. 3.00 05 ARCH.OR ENG. PERMIT VALIDATION ADDRESS + SPECIAL'CIRCUIT 5.00 M {w a �' zlP EMP.METER OR POLE INS. 20.00 7 *,, APPUCANTs MOTORS SEE FEE SCH. 7 /Wy' ADDRESS [],Q SERVICE CHANGE 20. q I a1 wo O .LICENSED CONTRACTORS DFCLARATION ¢u I hereby affirm that 1 am licensed under provisions of Chaplet 9 ISSUANCE DATE Z . H c y (commencing with Section 7000)of Division 3 of the Business and LOG. ELECT: PLG. MECH. H m z Professions Code,and my license is in full force and effect. .y Z o 0License Class Lie.Number City O Capel L El ❑ o -o Date Contractor P, y E� BUILDING PERMIT - ¢ ¢ w u OWNER-BUILD17R DECLARATION INFORMATION w ;a w I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION FLLoa Law for the following reason(Sec.7031.5.Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county whichrequiresa permit to construct,aker, a at Q Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.N0. ELEC. oC / O¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO d w Se he is licensed pursuant to the provisions of the Contractor's License H z a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe i O business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE /v ¢ H $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant ma civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(8500).): ❑ 1,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 docs not apply to an owner of - 'M properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACR EAGE himself or through his own employees,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- GAS EASYSTEM-OVER 4(EA.) 200 builder will have the burden of proving that h - . . . me did not build or i - BUILDING USE ptpye for purpose of sale). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ tic n 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 IEA.) 1.00 contracts for such projects with a contraclor(s)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ 1 an exempt un Sea ,BAP.C,f roll WATER HEATER VV/VENT .6.00 Owner kDL L4 reason Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. RKERSC MPENSATION DECLARATION WATER TREATING EQUIP. 5.00 r I hereby affirm that have a certificate ofconsent to self-insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a cerlil'ied copy thereoffSec.3800,Lxb.C- Policy No. Company Q ❑ Certified copy is hereby furnished. - FIRESPRINK ENERGYT-24 Z 2 ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. O Applicant Y❑ N❑ Y ❑ N❑ ~ H PERMIT ISSUANCE 10.00 FLOODZONE. A.L.U.C. K - CIi R'I'IFICATE OF EXEMPTION FROM WORKERS' W COMPENSATION INSURANCE PLG.CONTE. LIC.NO: PLG. Y❑ N❑ Y❑ N❑ 0 This section need not be completed if the permit is for one, TOTAL hundred dollars IS 100)or less.) C) O 1 certify that in the performance of the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY LL H mil is issued,I shall not employ any person in any manner so as to U become subject to lire Workers'Compensation Laws of California. Cut Datc Applicant ALTER OR ADD TO MECH. 5.00 , BUILDING } to NOTICE.TO"APPLICANT: If,after making this Certificate of Ex- F Z - emplion,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 permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IQOOOC.F.M.) 6.00 SEISMIC FEE 37r50 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(Ste. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 , Lender's Name HEATING UNIT(OVER 100,000B.T.U.0.50 ELECTRIC -" - - Lender's Address I certify that I have read this application and suite that the above VENTILATION FAN (SINGLE) 4:00 information is correct. I agree to comply with all city and countyPLUMBING ordinances and slate laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEEFEESCH. MECHANICAL above-mentioned property for inspection purposes. - ;(We)'agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Comer tino against liabilities,judgments, costs and expenses which CONST.TAX May any way acct agumst•smd City in conseq once Of the PERMIT ISSUANCE 10.00 rent g' f thif ptrmi. MECH.CONT. LIQ NO. MECH. / - TOTAL TOTAL n/y� Sig a re of Applic [ on[mctor Late I OFFICE COPY ru6I YHw UAnu INEAH FHUN f OF BUILDING NUMbI,I CITY OF CUPERTINO 16249 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS Jt�91—l (- _C� UNIT# _LOT# PERMIT EXPIRES IF WORK OWNLH •II%�) V curvTHacroH �CC.-'G('✓✓ IS NOT STARTED WITHIN INSPECTION I DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU" FOUNDATION ANCE OR 180 DAYS FROM NOTE: LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLIINII VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB LQ%%J-5g1FSi0t6> Fr112sGigw -A _ n- PLUMBING lU�7-�� FVame vq;z Iwcy PAII /� Uo rFht ELECTRICAL twih . E O F ISSUANCE OAIE MECHANICAL oGoIce QYec� IN(ofik eo olk h Deer vEG. mL l 0 El 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED B 10 UILOING PERMIT WOOD FLOOR le:- INFORMATION PLUMBING VALUATION s/FT. MECHANICAL E i- Wril n �-!� rEElenr TO ELECTRICAL NG INSULATION /a, 7• C sT°r°Es TYPE corvsn+ ucc r,I+oIIPmns Is PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNTO ROOF OTE:NO FINAL INSP.SHALL BE MADE BEFORE ° I FuroH nnLn TWAT A NI .I • THE CO STRUCTION TAX IS PAID DIAPHRAGM �` �l.l t"ICd /e / UW� t+ulwl cuss ROOF SHEATHING D d d I+LS Iry o c ON PIT un', APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. L L—0-13 El ROUGH SAN.a ASSE SSOHS PAIH]E L NO PLUMBING ELECT.ENERGY +NaCl NO YAHf"[LNO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY I ACC DATE ACC.FILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONING ENG SITE NO. GAS TEST GAS FIRE SPNWK ENLHOI T 2 MECHANICAL v L NL Y L NQ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING fLUOU II)Nk ALUC. EXTERIOR SHEAR ELECTRICAL REtlEASE -$a INTERIOR SHEAR FIRE DEPT. a4. v❑ NL v L n❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH IBUILDING v BUILDING ' INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED occuagNCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, „ ELECTRIC w '' r F ONE WORKING DAY BEFORE REQUIRED INSPECTION. l� PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. 'tt. — SEE PERMIT FOR EXPIRATION DATE — _ p. MECHANICAL CO IMPORTANT,! NST.TAX _. 1 t '1!i�rtt Jr+KIK�iC.l�r [I PLEASE READ REVERSE SIDE BEFORE 4:�1w�iI;V''1 }E I � CALLING FOR FINAL INSPECTION. TOTAL APPLICANTS POSTING COPY