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17406 (4) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 7406 INSPECTION DIVISION �JOB INSPECTION RECORD ' . JOB ADDRESS O •T `� J - bo AT 2 -2-0 UNIT# LOT# c ..'ER XP;RATyON. ' . I \- ` PERMIT:EXPIRES IF WORK OWNER \- �I SP „ S' CONTRACTOR ^e W� 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 PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS " POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - �-" 26 UNDERGROUND /SLAB 1� PLUMBING J• M N�J� �` ELECTRICAL cm of cuparfino ISSUANCE DATE MECHANICAL BLDG ELECT I ,PLG. MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR - INFORMATION PLUMBING y VALUATION 2.-/ . �OQJ MECHANICAL f yr. p/ �P� O ERMIT T 40 ELECTRICAL C. ?. • 'IIa 6 tii i442 - FRAMING 77•! O $TOHIEB TYPE CONSTR, INSULATION f�-'zj-�(^ {� Y.�vnt fta } ONly 4S s a!No- opered QVC, ket{QJ A1C . ' orur RES urvrts PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED I '�rh^.' • $0.FT FLOOR AREA 'TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE t /coos DIAPHRAGM THE CONSTRUCTION TAX IS PAID *l RES INDUILOPB O CON USE ❑ El [I . •y f ROOF SHEATHING ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ED ASSESSORS PARC EL NO - • ROUGH SANA PLUMBING IV ELECT.ENE9GY TRACT NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL7:0— MECH.ENERGY ACC DATE ACC cILE No ELECTRICAL BUILDING ENERGY - FRAMING ELECT.FINAL TEST zoNiNc ENG.SITE NO. INSULATION PLUMBING - - GAS TEST GAS MECHANICAL - FIRE SPRINK ENERGY T-24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y - NE] Y E] NE] FLOOD ZONE A U.C. EXTERIOR SHEAR - ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. Y[:] NCl Y L' N� 'SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK �I GAS - - FEE _ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - - SEISMIC FEE 1 OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR: MICROFILM w ARRANGE FOR INSPECTION BY..PHONfNG 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0� PLEASE GIVE-JOB ADDRESS WHEN PHONING. �1 Z MECHANICAL - SEE PERMIT.FOR EXPIRATION DATE - 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 hU(L'OING PROJECT I DENTIFICATI ON PERMIT NUMBER • .OILDING APPLICATION & PERMIT ADORt 17406 7E 7� W3� s. p n!Z j1'.- BUILDING - ELECTRICAL-PLUMBING-MECHANICAL OW�N�ER�'S/J �o VALIDATION AM �s3�Q2��rtS (� DTV. ELECTRIC PERMIT FEE ' V PHONE CONTRACTOR'S r(1 3 AME OUTLETS-SWITCHES-RECEP 10.00/7.00 7{ �V LIGHTING FIXTURES L' 10.00/1.00 i CONTRACTOR'S p3 APPLIANCES-RESIDENTIA 4.00 7R/E55 /O HONE PANELW-V_11170.00 DATEOFAPPLICATION r ARCHITECT - • PLAN CHECK FEE P.C.NO. OR heh,/nd,/i� I, PANELS OVER 20 AMP) 20.00 - ErvGIN ER r• q LIC.No,GL ,! SIGNS TRANS. 3.00 MICH.OR ENCr.^C�J /./fR// // ra/j /• SP ECIAL CI RCUIT x S.00 PERMIT VALIDATION ADOREsa G(kJ_ Cj?_4i\ tl -W ,f �D ZIP EMP.METER OR POLE NS. 20,00 -Z L APPucANrs MOTORS SEE FEE SCH, a�1 "� � 7ao s . DEf�z/h Igo SERVICE CHANGE PAC1,11EY0.00 F o O LICENSED CONTRACTORS DECLARATION Ell U 1 hereby affirm that I um licensed wWcr provisions of Chapter 9 G ISSUANCE DATE y Q w (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. PLG. MECH. r H z Professions Code d my license is in full forey rw fllfci�.�.pp ❑ - z O m - Liccnsc�Clpss_ Lic.Nwnhcr `7f1s5�fL O w Uale�/[ � Contractor s E_/fj}...�� yTtj yL Own ¢ y E -� r ^-��w BUILDING PERMIT ¢ ¢ m < O NER-BUILDER DECLARATION INFORMATION O A. 0 MISC.- REFER TO ORD X 3. u H 1 hereby affirm that I anI exenl pl from the Contractor's License VALUATION $/F ac Ic ¢ Law for the following rearm.(Sec.7031.5,Businessnnd Professions PERMIT ISSUANCE 10.00 /��••• N�40 Code;Any city or county which requiresapermit toconstruct,alter, yO/�rj �Li 2 2 ¢ 0 improve,demolish,or repair any structure,prior IG its issuance,also ELEC.CONTE. LIC.NO. ELEC. / T E Ca u requires the applicant for such pennit to file a signed atutemcnt that - TOTAL L PERMIT TO e w m he is licensed pursuant to the provisions of the Contractor's License F z a Law(Chapter9(commencingwith Section 7000)of Division 3 ofthe 4 o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢t- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. u S by any applicant for a permit subjects the applicant tuxcivil penalty ofnot more than five hundred dollars(5500).). ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,as owner of the properly,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 ` r„2 intended or offered for sale (Sec. 7044, Business and Professions ! DRAINS-F OOF,AREA,COND. 5.00 I%L Code:The Contractor's License Low does not apply to an owner of property who builds or improves lhefeon,and W110 tI005511Ch work21&FIXTURES- ER TRAP 50 SO.FTA.FLOOfl AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- �OQ oS mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE -�, builder will have the burden of proving that he did not build or int- RES IND CON PB Omer prove for purpose of thed. INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑ ❑ L as owner of the property,he exclusively rn044,lug with licensed contractors tore construct Contractor's project(Sec. 7044,Business apply LAWN SPRINKLERS-1 INC5 V.B. 6.00 - ASSESSORS PARCEL NO. and Professions Coda The Conbuilds 's License Law does not apply to tr owner of property who builds t r improves thereon,and who ' LAWN SPRINKLERS-OVER 5 (EA.) .1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 � the Contractor's License Law. TRACT N0. PARCEL N0. ❑ l um exempt under Sec. ,R4p.C.I'or this , WATER HEATER W/VENT 6.00 reason Owner Date • WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKF.RS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 1 hereby affirm that 1 have a certificate of consent to self-insure, - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof IScc.3X00,Lab.C.I Policy No. Company O ❑ Cert m l cc Py ishereby fur he FIRESPRINK ENERGY T 24 Cc c Ia if" I IY ision. MISC.- REFER TO ORD. Z p APPltcCc _ _ _ Y N❑ Y ❑ N❑ � y CERTIFICA'T'E OI'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. UJ > COMPENSATION INSURANCE PLG.CONTE. _ LIC.NO. PLG. CL 0 CI his section recd not be completed if the pennit is for one TIG Y❑ N❑ Y ❑ N❑ hundred dollars IS 100)or less.) U O 1 certify that in the performance of the work for which this per, DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued,I Shall not employ any person in:cry Inanrer so as to O w become subject to Ote Workers'Compensation Laws of California. -- y Dale Applicant ALTER OR ADD TO MECH.P 5.00 r BUILDING I } to NOTICE TO APPLICAN"P If,utter making this Certificate of La- ? emption,you should become subject to the Workers'Compensalion APPLIANCE 5.00 PLAN CHFipK provisIORS of the Labor Code, you must forthwith comply with FEE �' " f,J such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MOC F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10=C.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(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Na A I/ HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that I have read this application and slate that thea VENTILATION FAN (SINGLE) 4.00 ordinances n correct 1 agree to comply with all only and wuand PLUMBING r ordinances and slate lows relating m building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.1 6.00 1, hereby authorize representatives of this city to enter upon tiro BOILER-COMP 1O.,100,000 BTU)SEE FEE SCH. MECHANICAL00 r Dp above-mentioned property for inspection purposes, (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperfino against.liabilities,j udgmenls, costs and expenses which CONST.TAX m any wayaccrue against said City in consequence of the PERMIT ISSUANCE ,10.00 L-oD n (this peon' MECH.CONT. LIC.NO, MECH. Torq ,L. ,OD TOTAL p Sigiffater,of Applman ontractor Da OFFICE COPY