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14629 (2) -�� POST THIS CARD NEAR-FRONT OF BUILDING PERMIT NUMBER ' CITY OF' CUPERTINO 14629 -INSPECTION DIVISION JOB INSPECTION RECORD �(7S_4t L iyB VS Avet4 / - PERMIT EXPIRATION JOB ADDR ESS UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER .'comrRnCTOR - C� L�6— IS NOT STARTED (WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180-DAYS OF PERMIT ISSU. ' FOUNDATION - ANCE OR 180 DAYS FROM NOTE: - LASTCALLED INSPECTION. - LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED' PREGUNPTE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERSxIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED � � � � �1'@.. �- -`r'_•_.� UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG ELECT, PLc MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION ,WOOD FLOOR VALUATION SIFT. PLUMBING _ MECHANICAL ' ELECTRICAL - - - PERMIT TO FRAMING ' STORIES TYPE CONSTR,• INSULATION `O -.Ot GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED �. I ., ROOF NOTE:NO FINAL INSP.SHALL BE BEE "I. FT FLOOR 1. AREA TO AL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ��11 00�� . -�`�tl' BUILDING USE ' ROOF SHEATHING " - AES IND CON PB olnr, • APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El El Q El 1:1 _ ASSESSORS PARCEL NO ROUGH SANA PLUMBING ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NDO PARCEL No , MECHANICAL MECH.ENERGY ELECTRICALACC,OATF ACC FILE NO BUILDING ENERGY . FRAMING ELECT.FINALTEST zorvmc ENG.SITE NO INSULATION PLUMBING , GAS TEST GAS FIRE SPRINK ENERGY T 2 MECR (CAL Y,Q N[] Y ❑ NQ ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLooD mNFA.L uc. , INTERIOR SHEAR. FIRE DEPT. - Y❑ NE) Yo HQ" ' SHEETROCK - . GRADE - FEE SUMMARY EXTERIOR LATHBUILDING PBNG INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC GAS - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. - MICROFILM LU ARRANGE FOR INSPECTION BY'PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING • z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! coNST:E PLEASE READ REVERSE SIDE BEFORECALLING FOR FINAL INSPECTION. TO OFFICE COPY _APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION - PERMTNUMBFR BUILDING APPLICATION & PERMIT 14629 ADDRESS (, it I ojS CnL S ap2� BUILDING —ELECTRICAL—PLUMBING—MECHANICAL OWNER' PLAN CHECK VALIDATION NAME /J - QTY. ELECTRIC PERMIT FEE Imo'{ ��5 PHD 53Sy , CONTRACTOR'S NXE Pb ff �� UTLETS-SWITCHES-RECEP 10.0011.00 /Y/ 1f�Lr(� LIC.N . LIGHTINGIFIXTURES 10.00/1,00 CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 A �$)$S/ /yam) f /J I/& 1 L� ( PNON /�8 a PANELS IO.OB DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMPI 20.00 'PLAN CHECK FEEP.C.NO. OR -„ ENGINEER - - - uc.rvo. SIGNS TRANS. - 3.00 ' ARCH.OR ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ADDRESS Tlp TEMP,METER OR POLE INS. 20.00 •-7�'`VJ APPLICANT rvs 'MOTORS SEE FEE SCH. �iC•0Y ADDRESS SERVICE CHANGE 20.00 S�ZZ w o O LICENSED CONTRACTORS DECLARATION a v w I hereby affirm that I um licensed under provisions of Chapter 9 ISSUANCE DATE y Q h (commencing with Section 7000)of Division 3 of he Basin•sand BLDG. ELECT. PLG. MECH, F y z Professions Co an license is in full fon kfflLB ❑ ❑ ❑ z o f2— License Class Lin.Number /4P'll 4 w w Ua[c ./. — Contractor_ a m v NE BUILDING PERMIT ¢ W¢ OWNER-BUILDER DECLARATION INFORMATION Ao >U MISC.— REFER TO ORD w g I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. LL N H u O j Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 - Code:Any city or county which requires.permit to Const, alter, ¢ ¢Q 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. i DLL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO wm he is licensed pursuant to the provisions of the Contractor's Licenseg/ _ rii Law(Chapter 9(commencing with Section 7000)ofDivision 3 oflhe ¢ Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE X the basis for the alleged exemption.Any violation of Section 7031.5 ,STORIES TYPE CONSTR. i$m by any applicant for a permit subjects the applicant oa civil Penally gLTER-DRAIN&VENT-WATER IEA.) 5.00 ' of not more than five hundred dollars($500).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 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 riot apply to an owner of Property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SD.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- mensarenotintendedorofferedforsole.if,however,the building GAS-EA.SYSTEM-I IN 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4' A.) - BUILDING USE builder will have the burden of proving that he did not build or an- RES IND CON PR Other prove for purpose of sale.). I INDUSTRIALWASTE INTE .3 . 0 C1 1,as owner of the property,am exclusively contracting with ED C1 ❑ ❑ C]licensed contractors to Construct the Project(Sec.7044,Business LAWN SPRINKLERS-I IN V.B. s 6. QV 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 W.00 Contracts for such projects with a contractors)licensed pursuant to the Contractor's License Caw. SEWER-SANITARY-STORME 00ft/10.00 / TRACT NO. PARCEL NO. ❑ lam exempt under Sec. .B.&P.C.forthis WATER HEATER W/VENT 6.00 Sd0 reason Owner Ume WATER SYSTEM - 5.00 ACC.DATE Ace.FILE No, WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of Consent to self-insam, ZONING ENG.SITE N0. or a certificate of Works 'Compenut Insurance, r u certified copy t 0, ab C.) /J�/ r Policy ora any 0 ❑ Cern ie opy is her by furnished. FIRE'SPRINK ENERGY T-24 Z ertifi copy is fir d with th�nspection division. MISC.- REFER TO ORD. Z Applicant (71. Y ❑ N❑ Y ❑ N❑ to PERMIT ISSUANCE 10.00 n FLOOD ZONE 'A.L.U.C. LU LU j CIiRTI ' OOMPH EXEMPTION FROM WORKERS' COMPIiNSATION INSURANCE - PLG.CONTR. LIC.NO. PLG. / CL O (This section need not be completed if the permit is liar ane TOTAL V❑ N❑ Y❑ N❑ D Z hundreddollar,(S 100)or IL•s,.I U OI certify that in the performance of the work for which this per- CITY. 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 the Workers'Compensation Laws of California. 0 y Daze Applicant ALTER OR ADD TO MECH. 5,00 BUILDING } to NO11CIi TO APPLICANT: If,after making this Certificate of lix- F Z 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 permit shall be deemed revoked. AIR HANDLING UNIT(TO 10OWC.F.M.) 4.00 CONSTRUCf10N LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1 hereby affirm drat 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.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00- Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4,00 r+ • information is correct.1 agree to comply with all city and countyPLUMBING a ordinances and state laws relating to building construction, and BOILER-COMP 13 H.P.or 100,000 B.T.U.)'6.00 hereby authorize representatives of this city to enter'upon file BOILER-COMP(Over 100,000 BTU)SEE FEE SCH, MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFERSO ORD.' upertino ,gams EabiI Bes,judgments, Costs and expense,which CONST.TAX m any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 ra ti afthisp i1. MECH.CONT. LIC.NO. MECH. / «� _ TOTALTOTAL Sig t reof Applicant/Contractor Date OFFICE COPY