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16663 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER ;- �r CITY OF CUPERTINO 1666 . INSPECTION DIVISION JOBINSPECTION RECORD • _ PERMIT EXPIRATION JOB ADDRESS IIA-2-1 C Lr^AQ— C'7 UNIT# LOT# ^ I _ � �` PERMIT EXPIRES IF•WORK OWNER h CONTRACTOR N - T[,. . 7cy-cs 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 VAUOAyON CUPERTINO STANDARDS. - GARAGESLABS - I POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED' UNDERGROUND /SLAB PLUMBING p ELECTRICAL I$$U ANCE DATE MECHANICAL 7BLUG ELECT 1, PLG, NECK 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED �dY•° BUILDING PERMIT ' TION WOOD FLOOR VALUATION SIFT. PLUMBING - "' MECHANICAL PERMIT TO ELECTRICAL - - FRAMING INSULATION STORIES TYPE CONSTR. . _ .0 OCC.GHCUP - RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN-SIGNED l/ /4/ f'WA' ��- O.FT,FLOOR AREA TOTALACNEAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE .. DIAPHRAGM THE'CONSTRUCTION TAX IS PAID T BUILDING V$E ROOF SHEATHING Res IND' CON PB om.. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ 0' ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.N PLUMBING , ELECT.ENERGY ' _ TRACT N0: PARCEL NO TUBS&SHOWER PAN •/ Q' PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL ACC DATE ACC FILE NO. -/ �� BUILDING ENERGY, FRAMING - /- ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION PLUMBING ' GAS TEST GAS I -FIRE SPRINK 'ENERGYIT.ZA MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE ',p Luc. INTERIOR SHEAR - FIRE DEPT. I /` YF No Y•L NL SHEETROCK - GRADE - FEE SUMMARY , EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK. f1�— GAS FEE Q NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY,. SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM' R ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRICvi4L ` 1J ONE 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 BEFOREf CALLING FOR FINAL'INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY • BUILDING PROJEC7IDENTI IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION &'PERMIT ADDRESS .I L �� BUILDING—ELECTRICAL—PLUMBING—MECHANICAL _. . 16663 OWNER'S PLAN CHECK VALIDATION NAME N TY. ELECTRIC PERMIT FEE � Q. O NAMERAcroR's UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1,00 15-0 CoNTRAC709S Q1' PPLIANCES-RESIDENTIAL 4.00 rrls� PHONE — PANELS IO.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.N0.' DR PANELS (OVER 200 AMP) 20.00 ENGINEER L.C.NO. SIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT - 5.00 ZIPEMP.METER OR POLE INS. 20.00 PERMIT VALIDATION P L�✓C.YNµ-'-.� • APPucArvr'sFt MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 o o' LICENSED CONTRACTORS DECLARATION a�u G Lbeiehy aftimn that I am licensed under provisions of Chapter 9 ,SSU CE DATE °1 (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. aA r y i Professions CodWqd my license is in full for e' ❑ ❑ ❑ ❑ 0 2 m p License Class Loc. actor-_ _ A Duce Contractor C ¢ x f -1 - ILDING PERMIT ¢ ¢w¢ OWNER=BUILDER DECLARATION INFORMATION wD > ea REFER TO ORD a. N I hereby affirm that 1 am exempt from the Contractor's License MISC.— Vy ION SIFT. a. LawLaw for the following reason.(Sec.7031.5,Business Professions PERMIT ISSUANCE Q,\�_ ON Code:Any city or county which requires a permit to construct,alter, �a Qa, Q 0 Improve,demolish,of repair any structure,prior to its Issuance,also ELEC.CONTR. LIC.NO ELEC. G LL requires the applicant for such permit to file a signed statement that OTAL f PERMIT TO u w es w he is licensed pursuant to the provisions of the Contractor's License Fi> Law(Chapter 9(commencing with Section 7000)of Division 3 of the s i ao Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE /tiTA rd_17 ¢ 1- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a3 _ by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA) 5.00 of not more than five hundred dollars($5000- ❑ I,as owner of the property,or my employees with wages asggCK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS F 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 does not apply to an owner of _ properly who builds Or improves thereon,and who does such work FIXTURES-PER TRAP 5A0 SO:FT.FLOOR AREA TOTAL ACREAGE •' 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-I1NC.40UTLETS 6,00 or improvement is sold within one year Of Completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE Owner- builder will have the burden of proving that he did not build or im- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑, I,as owner of the property,am 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 dues not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 6(EA.) 1.00 contracts for such projects Law.with a conuactol{s)licensed pursuant to the Contractor's License LSEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I um exempt under Sec. B,&P.C.I'or this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACCP GATE ACC:FILE NO. 'WORKERS'COMPENSATION DECLARATION WATER.TREATING EQUIP. 5.00 ' I hereby affirm that 1 have a-certificate ofconsent to sell-insure, ZONING or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO. copy thereof(Sec.3800,L.DC Policy No. Company 0c copy is hereby-! nlShed. FIRE SPH INK ENERGY T 24 Z Z C [i ry is fI w t Ili city inspection Division. MISC. v• REFER TO ORD. N Y❑ ❑ ❑ N❑ O Applicant _ ~ w PERMIT ISSUANCE FLOOD ZONE A.L.U.C. 2 — CERTIFICATE E EATIO ION FROM WORKERS' aQ COM Get be om INSURANCE PLG.CONTR. I0.N0 TOTAL ✓ Y❑ N❑ Y ❑ N❑ 7) Z hundred section S10 not be completed if file permit is for One hundreJ dollars(S 100)or IcssJ U O 1 certify Ihat in the performance of the work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL f• mit is issued,I shall'not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. /p Ed ApplicantALTER OR ADD TO MECH. 5.00 BUILDING- / T } ul NOTICE TO APPLICANT: If,after making this Certificate of Ex- F Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK G✓ provisions of the Labor Code, you must forthwith comply with FEE G U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10=12--F.M.) 4.00 �r CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000 ORM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the 3097LCw.C.) MICROFILM cc o!the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 , . p Lender's Name HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 } Lender's Address - ELECTRIC vi ( certify lhatl have read this application and state that theabove VENTILATION FAN (SINGLE) .A.00 44/9-0 information is correct. I agree to comply with all city and countyPLUMBING ordinances and state 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 (Owr100,000BTU)SEEFEESCH. MECHANICAL above mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which ti CONST.TAX ay in any way accrue against said City in consequence of[he PERMIT ISSUANCE mnling of lh is Permit MECH.CONT. - LIC.NO. MECH. TDTAL /�p 5� TOTAL I gnature of Applican[/Contractor Dale- OFFICE COPY