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18054 (2) POST THIS CARD NEAR FRONT OF BUILDING ,PERMIT NUMBER CITY OF CUPERTINO 1 $054 INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS 90666 w ✓1CUNIT# LOT# PERMIT EXPIRATION PERMIT EXPIRES IF WORK OWNER QC - CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION NOTE: LASTCALLEDINSPECTION. ' LIFER ALL GRADING AND DRAINAGE SHALL BE,INSTALLED PR EGUNITE TO OOMPLY WITH THE APPROVED PLANS AND CITY OF PLRMIT VALIDATION CUPERTINO STANDARDS. ,� GARAGE SLABS � POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED /(Ol'/N UNDERGROUND /SLAB -1103 gsg(i PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL , HLDc ELECT. PLG. MEDIAJUL E] E] . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - BUILDING PERMIT (51.. INFORMATION WOOD FLOOR - �Y VALUATION s/FT. PLUMBING MECHANICAL ELECTRICAL 1ER6➢T To FRAMING I K-41 INSULATION STORIES, TYPE CONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF 1 NOTE:NO FINAL INSP.SHALL BE MADE BEFORESD FT P1.1011AREA 10TALACHEAGE, DIAPHRAGM F THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING Resjo4NDCON 11 El NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. Assessons PARCEL No ROUGH SAN.4 PLUMBING ELECT.ENERGY TUBS BSHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO MECHANICAL MECR ENERGY ELECTRICAL BUILDING ENERGY ACC.DATE ACC FILE NO FRAMING - ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING GAS TEST GAS MECHANICAL FIRE SPHINK ENERGY LIG p — COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y N(_] I I [:]' NEJ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A L U C. INTERIOR SHEAR FIRE DEPT. Y N0 10. NEJ 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 OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, 0- ELECTRIC " ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL 00 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 'BUI LDI NG PROJECT I DENT[FICATI ON PERMIT NUMBER aUILDtNG APPLICATION & PERMIT v 18054 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 1, OWNER'SPLAN CHECK VALIDATION NAMME / ae- Nak A X73 -jS ELECTRIC PERMIT FEE ONE NoMTRACTORs OUTLETS-SWITCHES-RECEP 10.00/1.00 'a-S 94 > LIC.NO.`(�LLIG IN FIXTURES 10.00/1.00 CADDRESS-ONTRACTOR/S//�y� PPLIA CES-RESIDENTIAL 4.00 V /9 l/"rpt- ONE I3q-(X� IO PANELS 10.00 DATE OF APPLICATION RCRRECT PLAN CHECK FEE .C.NO. O OR PANELS (OV 200 AMP) 20.00 _ ENGINEER r, LIC.No, SIGNS TRANS. 3.00 IJ noon'Ess ENO' SPECIAL CIRCUI 5.00 PERMIT VALIDATION \ , ZIP EMP.METER ORP E INS. 20.00 1 tel( APPLICANT rs MOTORS SEE FEE SCH. J AOOREss f, N_ y HIO I �q /s",t��yy`ry�� -dll J� SERVICE CHANGE 20.00 o x i Foo LICENSED CONTRACTORS DF.CLYRATION � a u w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE y z (commencing with Section 7000)of Division 3 of the Business and D m - BLDG. ELECT. PLG. MECH. F O z Professions Codc d license is in full force a t. ❑ ❑ ❑ z O'� - License Class - Lic.Number F - Uuw� / Contractor1 ). ¢_ m ¢a OWNIi R- UILDER DECLARATIO'N'�- ') BUILDING PERMIT d S MISC.- TO OR INFORMATION F y I hereby affirm that 1 ani exempt from the Contractor's License u O j Law for the following reason.(Sec.7031.5,Business and Professions VALUATION S/FT. I- - PERMIT ISSU 10.00 Code:Any city or county which requires permit to construct,alter. 2 ca ¢ o improve,demolish,ser repair any svuctur..prior to its is, ,,q also ELEC.CONTR- LIG N0. ELEC. LL requires the applicant for such penult to file a signed statement that TOTAL PERMIT TO w$ he n licensed pursuant to the provisions of the Contractor's License �'/ F z a Law(Chapter 9(commencingwithSection 7000)ofDivision3ofthe '•'i EGI-�1N ICJ1kL s 4 o Business and Professions Code)or that he is exempt therefrom and G PLUMBING PERMIT FEE re F-$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. d � by any applicant for a permit subjects the applicant to a civil penalty TER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wash us BA FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES:UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Profession' DRAI -FLOOR,ROOF,AREA,CON D. 5.00 Code:The Contractor's License Law does not apply OI an owner of Property who builds on impmvin thereon,and who docs such work FIXTURE -PER TRAP 5.00 Sp,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- GAS-EA.SV EM-11NC.40UTLETS 6.00 ments am not intended or offered for sale,IL however,the building or noprove nmtt is sold within one year of completion,the owner- GAS-EA.SVST -OVER 4 (EA.) 200 builder will have the burden of proving that he did not build or am- BUILDING USE prove for purpose of Sale.). INDUSTRIAL WAS INTER. 30.00 RES IND CON PB Omer ❑ 1,as owner of the property,ant exclueisdy contracting with � ❑ ❑ ❑ ❑ licanmd contractors to construct the Project(Sec. 7044, Business LAWN SPRINKLERS- INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code The Contractor's License Law does not apply. to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-O R 5(EA.) 1.00 contracts for such projects with a coutramono licensed pursuant to SEWER-SAN V-$TOR A.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ Iamczcmptunder Sce. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WORK ERS'COMPENSATION UECLA RAT ION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a cvnirea,of cousem to self-insiim, or a certificate of Workers'Compen tion Insu`vnce,or a c}•Ini led ZONING ENG.SITE NO. copy therq� 3y(p.La b,C.). f.LJO-fM�� f� PolicyN. conpany ❑ C,rtllled copy is h er, dluitha)i' FIRE SPRINK ENERGY T-24 Z 2 k�[Cert ilieJ �p y� 's fled ith I{ city inspection division. F O Ap mant�ld MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ fLN CERT I EICAI li or liX ISM FI'ION P MWORKERS PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPENSA'I'IONINSURANCE- PLG.CONTR. LIC NO. PLG. CIL ❑ (This section need not be completed if The permit is for one - tg. TOTAL Y❑ N❑ Y ❑ N❑ Z hundred dollurx(SIOOlor less) /� U O 1 certify that in the performance at the work foi 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 10 U become subject to the Workeri Compensation Laws o(Celi(ornia. O 0. naw Applicant - BUILDING >_ 00. NOl'ICE TO APPLICANT: 11,after making this Certificate of lis- ALTER OR ADD TO MECH. 5.00 ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you mud forlhwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that (here is a construction lending agency fur EXHAUST HOOD(WITH DUCT) 5.00 the performunce of the work for which this permit is issued(Sec. MICROFILM 3097,Gv.C.). HEATING UNIT(TO 100,000 B.T.U.) B4O0 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that I have read this application and stat,Ula(the above VENTILATION FAN (SINGLE) 4.00 information is cortect. 1 agree to comply with all city and county - PLUMBING ordinances and state laws ,dating to building construction, and BOILER-TOONP(3 H.P.or 100,000 B.T.U.) b:OB -0 hereby enthorire representatives of on city 1.es enter upon the g01 LER-COMP (Over 100,000 RTU)SEE FEE SCH. MECHANICAL > above-mentioned property For insp or this purposes. •D (We) agree to save, indemnify unit keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX ay 'n any way accrue against said City in consequence of the PERMIT ISSUANCE RT.6Q 2•Dv n1 of this P II. MECH.CONT. LIC.NO. MECH. �1PzCL�c�D7'TDtiI (y�143 f IQS tFC n �(oss TOTAL� ) •Db TOTAL .61D SE(l arc of Applicant/Contractor Date OFFICE COPY