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18306 (2) POST THIS CARD NEAR FRONT OF BUILDING - PERMIT NUMBER CITY OF* CUPERTINO 18306 INSPECTION DIVISION JOB INSPECTION RECORD {/ ,��-,,/ PERMIT EXPIRATION JOB ADDRESS-// ( : 0A� 1"' V 5�IPNIT# _LOT# PERMIT EXPIRES IF WORK OWNER .20' U.ld CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERm vAv ALIUATroN GARAGE SLABS "tet CUPERTINO STANDARDS. IRAQ �- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ! c UNDERGROUND /SLAB JUL (I PLUMBING ALL, J .41A. ELECTRICAL j� ISSUANCE DATE OLOG ELECT PLG. MECH MECHANICAL ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR vnuin noN SIFT. PLUMBING MECHANICAL ELECTRICAL FRAMING - !a INSULATION _ /STE) - TYPE CONSTR t C7, e1-i 1'� Cl R PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE $O FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING ON USE ROOF SHEATHING lO lO E]CON PR om.r APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. Ei ❑ ROUGH SAN.k ASSESSORS PARCEL NO - PLUMBING ELECT.ENERGY iRgCi NO PARCEL NO TUBSBSHOWER PAN PLUMBING ENERGY r MECHANICAL MECH, ENERGY I, (IMI ELECTRICAL BUILDING ENERQYe D ACC DATE qcc caE;No FRAMING ELECT.FINAL TEST�l B , I ZONINGINSULATION - PLUMBING P, ENG.SITE NO. GAS TEST GAS q 40� r FIRE SPRINK -ENERGY T 2a MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N ` ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOUR LUNE A L U C INTERIOR SHEAR FIRE DEPT. Y❑ N❑ Y ❑ No SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING T Op SCRATCH COAT 1ELEETRIC PLAN CHECK GAS- FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISS"IGNED BY BUILDING INSPECTOR. MICROFILM - ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 66 o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. ' PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. I Z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL 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 BU LD1 NG PROJECT 1 DENT[FICATI ON - PERMIT NUMBER aUILDING APPLICATION & PERMIT O ANDRE s BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S , PLAN CHECK VALIDATION NAM (vyYIGLv QTY. ELECTRIC PERMIT FEE PNONF 'J_-14' 4- CONTRACTOR AME AOT Rs UTLETS-SWITCHES-RECEP 10.00/1.00 LIC.NO. LIGHTING FIXTURES 10.00/1.00 CCONTRACTORS ADDRESSPPLIANCES-RESIDENTIAL 4.00 ODNTRA PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER LIC,NO. SIGNS TRANS. 3.00 ARCH.OR ADDRESS ENG. SPECIAL CIRCUIT 5.0D PERMIT VALIDATION AZIP EMP. METER OR POLE INS. 20.00 MOTORS SEE FEE SCH.ADDRESS JJ / IiWI}4r;y� SERVICE CHANGE 20.00 s w Q = Hoo LICENSED CONTRACTORS DECLARATION < v v 1 hereby affirm that I am licensed under provisions of Chapter 9ISSUANCE DATE vo G (commencing with Section 7000)of Division 3 of the Business and -- .BLDGELECT. PLG. MECH. H w z Professions Code,and my license is in full force and effect. - ❑ ❑ ❑ ❑ z O m - License Class Lia Number o m Ute Contractor Gill of NepaQ BUILDING PERMIT re a OWNER-BUILDER DECLARATION o d " INFORMATION w 13: LL H I hereby as irm that I am exempt from the Contractor's License MISC.- REFER TO ORD u o j Law for the followings I a..fS mgt from m he Co tract Professions VALUATION $/FT. r _ PERMIT ISSUANCE 10.00 Code.Any city or county which requires a permit to construct,alter, Q2 improve,demolish,or repair any structure,prior to its issuance,also ELECT CONTR. LIC.NO ELEC. O¢ y hires the applicant for such permit to file a signed 511rtcmenl[hal TOTAL r PERU JO / u w m u nhe is licensed pursuant to the provisions of the Contractor's License L 1J\ � I, H z a Law.(Chapter 9(commencing with Section 7000)of Division 3 oftlm �/ E F o Business and Professions Code)Or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE * Vr IS F_ $ the basis for the alleged exemption.Any violation of Section 7031.5 / TO _-TYPECONST ag by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 O a GR u 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 bends or Improves thereon,and who does shelf work FIXTURES-PER TRAP 5.00 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,tum budding GAS-EA.SYSTEM-I1NC.4OUTLETS 6.00 or improvement is sold within one year of amlplelion,the owner- GAS EASYSTEM OVER 4 (EA) 2.00 builder will have the burden of proving that h - . - . e did not build or am- BUILDING USE RES IND CON PB Other Prove For Purpose th sale.)' INDUSTRIAL WASTE INTER. 30.00 JP L uss owner of the properly,um exclusively contracting with licensed contractors -t construct the project La 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code-perry Contractor's License Law Hees not apply co an owner of properly who builds t r improves thereon. who . LAWN SPRINKLERS-OVER 5 (EA.) 1.00 x contracts Gorsuch projects with convaclaAsl licensed ud pursuant pursuant m the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ larae cm I I der Sec. 11& C.for Ibis reason WATER HEATER W/VENT 6.00 ' O _ Da . -7 - WATER SYSTEM 5.00 ACC.DATE ACO.FILE NO. WORKERS'COMPENSA'rION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby infirm shat I have u certificate of consent to sell-incus, or a certificate of-Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof'(Sec.3800•Lab.C.). II N.. Company O ❑ Certified copy is hereby famished. FIRE SPRINK ENERGY T 24 z Z ❑ Certified copy is fled with the city inspection division. FO Applicant MISC.- REFER TO ORD. YE3 NEl Y [:) NEI � N CERTIFICATE OF EXEMPTION I7ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE AL.U.C. L COMPHNSATION INSURANCE PLC.CONTR. LIC.NO. PLG. CL O ('This section aced not be completed if the permit is for one TOTAL Y ED N❑ Y F] N ::I Z hundred delta,,1$100)or It,J L) O 1 certify that in the performance of Om work For which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY IL F- mit is issued,I shall not employ any person in:my manner so as to O W become subject to the Workers'Compensation Laws of California. D. Dat` Applicant ALTER OR ADD TO MECH. 5.00 BUILDING j� �� >_ So NOTICE TO APPLICANT: If.utter..king this Certificate of Fs- F ? emption,you should become subject to Ora Workers Compensation APPLIANCE 5.00 PLAN CHECK U r visions of the tb sbor Code, you must forthwith comply with FEE permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000C.F.M.) 6.00 SEISMIC FEE 1 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,Cif,C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 I.ender's Name Lender's Address HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I Certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 Information is rotate(. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances formatio and store laws relating m building construction, and hereby authorentionize representatives ec This city to enter upon Ih` BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL hereby In authored property for inspection lids purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD, upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way aecme again. ''d City in consequence of the nu in, fl is " /t��/ MECH.CONT. LIC.NO. MECH. V TOTAL TOTAL U na ore f pplican out actor Date I' OFFICE COPY ��