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16887 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO , 16887 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS_�D � JEE- � C�P� UNIT# _LOT# PERMIT EXPIRES IF WORK n OWNER L CONTRACTOR 2 / �'D 41, A, IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: - LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF -r PERMIT VALIDATION CUPERTINO STANDARDS: �I^^ GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL *ISSUANCE onrE MECHANICAL - oc ELEcr vLc. MECH ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR INFORMATION ' PLUMBING VALUATION SrFT. MECHANICAL 00 ELECTRICAL - - PERMIT TO FRAMING - - it ` K I INSULATIONSTORIES TYPE CONSTR. OCC.GROUP RES.UNTS - f g Ol uperjuno PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED � ROOFNOTE:NO FINAL INSP.SHALL BE MADE BEFORE sD.F*.FLoaT AnEA TOTAL.Acu tinct ,':j• DIAPHRAGM THE CONSTRUCTION TAX IS PAID - ROOF SHEATHING I LD use RES INDG CON PB DNI, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED • FINALSDATE INSP. El El 13 El El ROUGH SAN:p nssessoas PARCEL NO' PLUMBING ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY - TRACT NO vARCEL No MECHANICAL MECH.ENERGY ELECTRICALBUILDING ENERGY -ACC DATE Acc FILENO FRAMING ELECT.FINAL TEST INSULATION PLUMBING zoNlNc "NI srE NO. GAS TEST GAS - ' MECHANICAL - .FIRE SPRINK ENERGY T.7a COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y'❑ N❑ v ❑ N❑• EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE ALITC, INTERIOR SHEAR FI RE DEPT. Y❑ N❑ Y ❑ N❑ SHEETROCK - GRADE EXTERIOR LATH - FEE SUMMARY BUILDING INTERIOR LATH TEMPORARY APPROVALS- BUILDING UJ 11 SCRATCH COAT - ELECTRIC PLAN CHECK / ••�� GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC.FEE X OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILURIVU INALIS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC O�• ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - _ MECHANICAL I IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL 3� OFFICE COPY ' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .f BUI LDI NG PROJECT I DENTI FICATION PERMIT NUMBER - Il BUILDING APPLICATION & PERMIT 688 1 7 ADDRESS f v H v BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE / PHONE Nome"cross UTLETS-SWITCHES-RECEP 10.00/1.00 c uc.No. (J LIGHTING FIXTURES 10.00/1.00 CONTRACTOR S - AooREPPLIANCES-RESIDENTIAL 4.00 _ s ! rJ PHONE PANELS 10,00 DATE OF APPLICATION OR ARCHITECT PANELS (OVER 200 AMP) 20.06 PLAN CHECK FEE C:NO. ENGINEER LIC,NO. SIGNS TRANS. 3.00 noxa Ess ENc' SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS- 20.00 ADDRESS S AMOTORS SEE FEE SCH. ORE SERVICE CHANGE 20.00 �¢ 2 o o LICENSED CONTRACTORS DECLARATION ^ r,y.l a i U I hereby affirm that I am licensed under provisions of Chapter 9 ,�'11L},J ISSUANCE DApE y a m (commencing with Section 7000)of Division 3 of the Business and pG. ELECT. PLG. MECH. H D z Professions Cale,a I Iny icons,ix in full force and effect. oi m o License Class ) Lic.Number�'� ) L/ 88 y r Date_f�Z.f _Contmgor A O a Y BUILDING PERMIT M ¢w OWNER-BUILDER DECLARATION INFORMATION w ;LL J 1 hereby affirm that I am exempt from the Contractor's'License MISC.- RD FLLoj Law forum following rearms.(Sec.7031.5,Businessaud Professions PERMIT ISSUANCE VALUATION Q $/FT. Code:Any city orcounly which requires a pcnnit to construct,alter, 10.00 D `� SE D¢0 Improve,demolish,or repair any structure,prior to Its Issuance,also ELEC CONTR. LIC.NO. ELEC. C/(/•O ¢ requires the applicant for such permit to file a signed statement that TOTAL e. w m m he is licensed pursuant to the provisions of the Contractor's License PER MIT TO HiQ Law(Chapter 9(commencing With Section 7000)uf Division 3 fthe 4 D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE L ¢ H m [hc basis for the alleged exemption.Any violation of Section 7031.5 STOFU S TYPE CONSTR. Ate - by any applicant for a permit subjects the applicant loo civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($5001.): ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will Jo the work,and the structure is not intended or offered for sale (Sec. 7044, Business and PoRssions DRAINS-FLOOR,ROOF,AREA,COND, 5.00 Code:The Contractor's License Law does not apply to an owner of -� Property who builds or Improves Ihe¢mn,and who docs such work FIXTURES-PER TRAP 5.66 50,FT.FLOOR AREA TOTAL ACREAGE himself or through Isis own employees,provided that such improve- mems are not intended or offered for sale.If.however,the building GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion.the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have One,burden of proving that he did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND El El 1:1 CON PB Other I,as owner of the property,um exclusively contracting with RE Ellicensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSOR$PARCEL NO. and Professions Codec The Contractor's License Law does not apply _ to an owner of property who builds or improves thereon,and,wbo LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contmetorls)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C.for this reason WATER HEATER W/VENT 6.00 Owner Dale WATER SYSTEM - 5.00. ACC.DATE ACC.FILE NO. WORK EIiS'ContvlirvSA")'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby of iren that I have a certificate of oosenl toself-insure or o cetlificate of Workers Com ensation .umncu,or a cati F. I ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab. Policy No., . in ❑ Cotlil'ieJc I's is y ural FIRE SPRINK ENERGY T-24 Z z ❑ Certified up til [h, cSy inspection division. F p Applicantrn-yl �i MISC.- REFER TO ORD. v � IN Y � N� 0.7 y CERTIFICA'If:Of:EXENIM ION FROM WORKERSPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C, W COMM NSATION INSURANCE PLG.CONTE. LIC.NO. PLG. d o (This section need not be completed if the permit i_, for one - TOTAL v 1:1 N El Y 1 N ::) Z hundred dollars IS 1(0)or co,)I U O I certify that in the performance of the work for which this per- QT,. MECHANICAL PERMIT FEE FEE SUMMARY W U mit is issued,1 shall not employ any Davin in any manner..as to beano,subject to Hue Workers'Com nsu ion 1;las of Cnlilbmia. U R DateICANI m_( A- o, ALTER OR ADD TO MECH. 5.00 BUILDING 3 Q } m NOTICE'I'O AI'I'LApplic If,a r ma ng nus Ocatc of Bx- 1 G F.. ? cmptlon,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 11 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 10=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1 S� 1 hereby afflrin 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.TU ) 800 Lender's Name . . . Lender's Address HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that 1 have read this application unit state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and elate laws rotating m building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby aullmrize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. above-mentioned property for inspection urposex. - MECHANICAL (We) agree to save, Inde nfy a ocp harmless the Clty of MISC.- REFER TO ORD. Cupertino agai liabili' ,judg cost's and expenses which CONST.TAX 'stay in any ay ac against Id city in consequence of line PERMIT ISSUANCE 10.00 "Boling Of nis pu ! MECH.CONT. LIC.NO. MECH. TOTAL TOTAL �j Sign lar o plicaN/Contractor Date 3 3. , OFFICE COPY