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14541 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY BUILDING PROJECT I DENTI FICATI ON PERMIT NUMBER BOILOING APPLICATION & PERMIT �[�� AooREss J �f-� BUILDING—ELECTRICAL—PLUMBING—MECHANICAL f� I OWNER'S rt.IH..LdL) _ PLAN CHECK VALIDATION PRONE CITY, ELECTRIC PERMIT FEE//lLd� •- �� ,f CONTRACTOR'S ' NAME �� UTLETS-SWITCHES-RECEP 10.00/1.00 'e11L//' 6'F}fQ•/sfµ{�Q� LIC.No.4/d77&,/ LIGHTING FIXTURES 10.00/1.00 r-DNREAcroR's aO - PPLIANCES-RESIDENTIAL 4.00 /51OR67Ess --a� ' Q 'HONE,37�i-3o9 PANELS 10.00 DATE OF APPLICATION ARCHITECTANELS (OVER 200 AMPI 20,00 PLAN CHECK FEE P.QNO. ENGINEER LIC.No. ISIGNS TRANS. 3.00 ADDRESSSS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 A ADORE MOTORS SEE FEE /f ORE ES$ SCH. SERVICE CHANGE 20.00 p 'woo LICENSED CONTRACTORS DECLARATION a i U I hereby,ffmt that 1 am licensed under pronisiolu of Chapter 9 ISSUANCE GATE H a (commencing with Section 7000)of Division 3 al the Business and BLDG. ELECT. PLG. MECH. r as z Professions Cod' fy license is in full for yydyf(� z O License C.la _ Lie.Number yd / /4 E, z F Date Contractor f a x M '0� BUILDING PERMIT ¢ ¢ a -OWNER-BUILDER UF.CL,\RATI ¢ a U INFORMATION wr 1 hereby affirn that I am exempt from the Contractor's License MISC.- REFER TO ORD u olaw for the following reason.(Sea 703 L5,Business and Professions VALUATION S/FT. _ PERMIT ISSUANCE 10.00 Code:Any city.,county which reyuireea p prior it to comuanc ,alsr, impr¢ ¢ FO requonshe applicant forreli iranyrmit to fide Poorto Its issuance,that ELEC.CONTE. LIC_NO. ELEC. C, DLL reyuirn the applicant(or such permit 10 Ok a Signe)statement that TOTAL -PERMIT TO K $m he is licensed pursuant to the provisions of the Conravlor's License dFz Law(Chapter 9(commencing with Section 7000)ofl)ivision 3 ofthe 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ r the basis for the alleged exemption.Any violation of Section 703 L5 STORIES TYPE CONSTR. a ; by amy applicant fur a Permit subject,the applicant 19 a civil penalty ALTER-DRAIN -WATER IEA.15.0 of not more than five hundred dollars(5500).P ❑ I,as owner of the property.or my employees with wages as BACK FLOW PROTECT. DEVICE OCC.GROUP RES.UNITS their sole compensation,will du the work,and the structure is not intended or offered for safe (See. 7044, Businv and Prolusions DRAINS-FLOOR,ROOF,AREA,COND. 5.9.0 Code:The Contractor's License law does not apply to an owner of 00 property who huilds or improves thereon,and who docs such work FIXTURES-PER TRAP FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improvo - menus arenot intended or offered for sak.If,however.the building GAS-EA.SYSTEM-11NC.40UTL 6.00 9,improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 (EA.) BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Omer ' prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ 1,as owner of the property,am exclusively contracting withEl licensed contractors to construct the project(Sea 7144,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORSPARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improve,thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractors)licmised pursuant to the Ccutricmr's Liemse L.W. - SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,BAP.C.fon this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKS RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-invue' ZONING ENG.SITE NO. u a certificate oLnsvmm, Workers'Compensation I ,or a certified copy thereof(Sec.3800,Lab.C.lm� _p. Policy No. Company c�Ad GBJJ O ❑ Cerlilied ropy is herby fu fished. FIRESPRINK ENERGY T.24 z Z / ❑ Certire �X the city inspection division. MISC,- REFER TO ORD. OZ APPlionf_ � - rNv0 N[] � CERTIFICATE OF EXEMPTION SROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE LT—C a. W 7 COMPENSATION INSURANCE PLGICONTR. LIC.NO. PLG. CL o '(his section need not be completed if the permit is for one 'TOTAL (�� V N� V IN[] = Z hundred doll...IS 100)or less.) U O 1 certify that in the perfomnance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL U par s earned,I shall not employ any person in any manner so as to become subject to the Workers Compenswion Laws of California. O d Date Applie.nt BUILDING >_ ran NOTICE 'f0 APPLICANT: If,alter making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 ♦— ? eruption,you should become subject to the Workers'CmnfpsmRHi.n APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with FEE U such provisions ar this permit shall be deemed revoked. AIR HANDLING UNIT ITO 10MOC.F.M.) 4.00 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.F.M.) 6.00 SEISMIC FEE ' I hemby affirm Out then, is a ori,ruction landing 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 ID0,000 B.T.U.) 8.00 Lender's Name H EATI N G UN IT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC 'I certify that I have read this application and stat,that the above VENTILATION.FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COA'IP(3 H.P.or 100,0008.T.U.) 6.00 hereby authorize representatives of this city to enter Inion the BOILER-COMP (Oxer 100,000 BTU)SEE FEE SCH. above mentioned properly for inspection pumosL-s. MECHANICAL (W,) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 1000 CONST.TAX ily any way accrue a Inst said City in consequence of the an n oflh.pe Y . MECH.CONT. LIC,NO. MECH. TOTAL TOTAL ISign A is rector Date OFFICE COPY l . I POST-THIS CARD NEAR FRONT OF BUILDING PERMIT NUMEER CITY OF CUPERTINO 14541 INSPECTION DIVISION JOB INSPECTION RECORD I PERMIT EXPIRATION'' -- JOB ADDRESS FAIRWOODS CT. UNIT# LOT# PERMIT EXPIRES IF WORK OWNER HILDA WONG - CONTRACTOR CALIF. EA�THWORKS IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMITISSU-, FOUNDATION ANCE.OR 180 DAYS FROM NOTE: - UFER. - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION, CUPERTINO.STANDARDS " GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING �,c-L•, i ELECTRICAL - I ANCE DATE MECHANICAL Q Loc. ELECT, - PLG. MECFI. { n ' ❑ 0 ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED IauaolNc PERMIT WOOD FLOOR UU MATION PLUMBING �Ilory SIFT. MECHANICAL y ELECTRICAL PERMIT TO FRAMING INSULATIONSTORIES TYPE CON5TR, ♦ . � OCC GROUP RES.UNITS t PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SOFT FLOOR AREA TOTALFCEEAGE" DIAPHRAGM - •• THE CONSTRUCTION TAX IS PAID _ BUILDING USE ROOF SHEATHING. RCs IND CON PB 0"— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 L ❑ ❑ L ASSE55OR5 PARCEL NO. ROUGH SAN.# PLUMBING ELECT.ENERGY ' CT NO. PARCEL NOA TUBS&SHOWER PAN PLUMBING ENERGY TR' MECHANICAL - MECH.ENERGY, ACG DATE ACC FILE NO, ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINALTEST - ZONING ENG.SITE N0. INSULATION PLUMBING GAS TEST GAS I MECHANICAL aa FIRE SPgINK ENET-� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING I El N ❑ 24 A. . EXTERIOR SHEAR ' ELECTRICAL RELEASE FLOOD ZONE L UC. INTERIOR SHEAR FIRE DEPT, - Y❑ N❑ v L "� 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 JOICCUPANCY - SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR'INSPECTION'BY PHONING 252-4505, ELECTRIC T F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — { IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE DOPY