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17579 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO ' 17579 INSPECTION.DIVISION " . JOB INSPECTION RECORD ,PERMIT EXPIRATION JOB ADDRESS' p-:C 4-v,, -7- _LOT# - / PERMIT EXPIRES IF WORK OWNER O �. �- .h CONTRACTOR l ec IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 18o DAYS OF PERMIT ISSU. FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LAST CALLEDINSPECTION. UFER . ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF, PERMfI VALIDATION CUPERTINO STANDARDS. - GARAGE SLABS � � I .SI "-� �("' ', POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED r� UNDERGROUND"/SLAB APR 1 b 1989 �lfl � i,l ��' PLUMBING -� vi ELECTRICAL ISSUANCE DATE MECHANICAL BLDG E}L}E-CST, PLG. MECH.� 7FI'Xj-,I LJ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION V Ab{lAtl N_-�� SIFT. PLUMBING . MECHANICAL ELECTRICALPERMIT TO " ` FRAMING 5a� INSULATION STORIES TYPECONSTR, OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $O,Gi ILOOR AREA TOTALACREAG! ROOF' NOTE:NO C SHALL BE MADE BEFORE DIAPHRAGM � THE CONSTRUCTION TAX IS PAID BUILDING USE. ROOF SHEATHING - - RES 9ND CON PB 0"", .APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS . DATE . INSP. L L L ED ASSES5UR5PARCELNO ROUGH SAN.M -- PLUMBING ELECT.ENERGY TRACT NO, I PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY " MECHANICAL,- MECH.ENERGY . . . ELECTRICAL - BUILDING ENERGY � •'ACCDATE. ACCFILE NO FRAMING - ELECT.FINAL TEST. INSULATION PLUMBING ZONING ENG.STTE NO, GAS TEST MECHANICAL FIRRSPRINK ENEFGY.T@G COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y "�` EXTERIOR SHEAR ELECTRICAL RELEASE " . FLOOOZONE A.Luc. INTERIOR SHEAR* FIRE DEPT. vo NL YL NL, SHEETROCK GRADE . , FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY'APPROVALS - - Bu1LDI 7,60 SCRATCH COAT ELECTRIC . - - GAS FEE 4 h`f p.^ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC EE 1 ,91l OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUI LDING IN SP T�R:^ICROFI M ' ARRANGE FOR INSPECTION BY PHONING 252-4505, E sC C xvl H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PL MBING • a PLEASE GIVE JOB ADDRESS WHEN PHONING. Z AMEHANCAL SEE PERMIT'FOR EXPIRATION DATEIMPORTANT! TAX PLEASE READ REVERSE SIDE BEFORE TOT •CALLING FOR FINAL INSPECTION. OFFICE COPY. APPLICANT TO FILL-IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY PERMIT NUMBER ';'9UILDING PROJECT IDENTIFICATION 'APPLICATION PERMIT ADDRESS - - 1 ,7579 AooREs/O 9,91 /VTv vC BUILDING-ELECTRICAL-PLUMBING-MECHANICAL „✓4as OWNER'S ,./F PLAN CHECK VALIDATION NAME QTY. ELECTRIC'PERMIT FEE PRONE ' CONTRACTOR'S NAME 1 UTLETS-SWITCHES-RECEP 10.00/1.00 �� &:4 Llc.rvo. rO r/ LIGHTING FIXTURES 10.00/1.00 - CONTR CTOms - PPLIANCES-RESIDENTIAL 4.00 ADryD1RESS es'� 1T GL% � � PHDNE PANELS 10.00 PATE OF APPLICATION ARCHITECT OR - - PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.No. r SIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION,' - ZIP EMP.METER OR POLE INS. 20.00 ADDRESS T Ar$ MOTORS SEE FEE SCH. T - ADDRESS � ;;O /- t. . �6s -7 G'J SERVICE CHANGE 20.00 �1y'f o o i1 LICEN CONTRACT RS DECLARATION t4� < u v 1 hereby affirm that lam licensed under provisions of Chapter9 ABY ISSUANCE DATE Z w (commencing with Section 7000)of Division 3 of ifie Business and BLDG. ELECT. PLG. MECH. Ni Professions Code and t license is in full fore f t � ❑ ❑ Z, o�,- License Cass 1 Lie.Number p� �(p E r ll Dale C'ontraclor UI� YI �UpQI'11t1U P L f BUILDING PERMIT 2 w¢ OWNER-BUILDER DECLARATION INFORMATION DAca MISC.- REFER TO ORD X ;u uHi I hereby affirm that I am exempt from the Contractor's License VAI.UATIO S/FT. H LL04 Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE - 10.00 sop s70 Code:Any city or county which requires a permit to construct,alter, ¢ 2 Q Q improve,demolish,or repair any structure,prior 10 its issuance,also ELEC.CONTR. LIC N0. LEC. Ib�Iy LL requires the applicant for such permit to file a signed statement Chet T TAL I �• O PERMIT TO w$ he is licensed pursuant to lire provisions of the Contractor's License I SI�-j N Fii Law(Chapter 9(commencing with Section 70000of0ivislon3of the - ¢ Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING ERMIT FEE re=$ the basis for the alleged exemption.Any violation of Section 7031.5 1 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as Owner of the property,or my employees with wages as - BACK FLOW PROTECT. DEVICE 4.00 DEC.GROUP REB.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to air owner of property who builds or improves thereon,and who dues such work FIXTURES-PER TRAP 5.00 S6 FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-l 6,00 menus are'not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner- GAS,EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- prove for purpose of sale.). I INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB 'Omer ❑ 1,as owner of the properly,am exclusively contracting with 13. ❑ ❑ ❑ J❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO" and Professions Code:The Contractor's license Law does not apply to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 Contra•ts m for such projects with a contractors)licensed pursuant I e actor's Licensgtaw. SEWER-SANITARY-STORM EA.200ft/10.00 . TRACT NO. PARCEL NO, l am exempt under Sec. ,tl&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Bate WATER SYSTEM 5.00 ACC.DATE ACG FILE NO. WRIiRS'COMPENS'ATION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affirm that I havc�cerI li IIf IreOnsent l0 self-insure, ZONING ENG.SITE NO. or a certificate Of Workers'Co Pon I mac,or' certified copy thereof(Sec 3800,Lfsb�y �� Policy No, mp JJJIIa��I . O ❑iCertilied , «l bpfuinished. FIRE SPRINK ENERGY T@< Z 2 •QI Certifie - �y'$"'f11ell with the cityinsp clime division. ' MISC.- REFER TO ORD. O Applicant Y ❑ N❑ V ❑ N❑ LU 1' � E stn PERMIT ISSUANCE , 10.00 FLOOD ZONE A.L.U.C. F IC' . - W 7 � OMPENSATION ON ION FROM WORKERS'NSURANCE PLG.CONTR. LIC.NO. PLG. CL O "lion need not be conquered if tiro permit is for one TOTAL Y❑ N❑ Y❑ N❑ 0 hundred dollars($100)or less.) - U / I certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY mit is issued,I shall not employ any person in any Rmnner so as to OW become suhjectto the Workers'Compensation Laws of California. BUILDIN •� •� (16 Date Applicant ALTER OR ADD TO MECH. 5.00 /¢ } N NOTICE TO APPLICAN"r: If,after making this Cerlificule of Fx- ? emption,you should become subject t0 the Workeri Compensation APPLIANCE 5.00 PLAN HECK provisions of the Labor Code, you must forthwith comply with FEE 12,/s U such provisions or this Penult shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 �•-� CONSTRUCTION LIiNDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMICFEE FJ 0 1 hereby affirm that there is.'construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFI M 3097,Civ.C.). Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.5 E CTRIC U0 Lender's Addresss ' I cerlily Ihul 1 have read this application and ,are that the above VENTILATION FAN (SINGLE) 4.0 information is correct. 1 agree to Co ly with all city and County PL MBING S J'PT BOILER-CON?(3 H.P.or 100,000 B.T.U.) 6.00 ordinances and state laws realm building construction, and hereby authorize represeplat`-ev p this - m enter upon the BOILER-COMP (Over 100,000BTU)SEE FEESCH. ME HANICAL above-mentioned grope y n pec purposes. ' (We) agree to, ,ri a and keep harmless the City of MISC.• r REFER TO ORD. upether,ago �I'K tin udgmenls, costs and expenses which CON T T.TAX Xay ir,i iw against said City in consequence of the PERMIT ISSUANCE10.00 - ranll�. "& MECH.CONT. LIG NO. MECH. TOTAL TO out Factor Date OFFICE COPY