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18238 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 18238 INSPECTION DIVISION JOB INSPECTION RECORD / PERMIT�E XPIRATION ' JOB ADD ESS_/.� Q -��r�d" /�n'� UNIT#' LOT# � 1 - PERMIT'FXPIRES IF WORK OWNER a CONTRACTOR - IS NOT STARTED WITHIN ]INSPECTION DATE INSP CTOR INSPECTION RECORD + 18O 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 APPRO SAND CITY OF, `. 'PERLUTNAL1DATION. CUPERTINO STANDARDS.' GARAGE SLABS _ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL �•� ` UA 4T L L' L ISUANC UAfE MECHANICAL - - BLDG. LECT PLG, IZECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION _ PLUMBING VALUATION- SIFT' MECHANICALTLG�D/ U ELECTRICAL PERA TO ' FRAMING - ' Ze b'a o INSULATION STORIES Tv ECONSTR. OCC.GROUP RES UNITS J 1 � PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED I 50 IT FLOOR AREA TOTAL ACRE AGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID F k WLDING USE ROOF SHEATHING - es No . EON PB APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE . INSP. E:]_ ❑ ❑ ❑. ASSESSORS FARCE L NO'p': ROUGH SANA PLUMBING - ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY• - 1RAC7 NO 'AR CEL NO MECHANICAL MECH.ENERGY ACC.DATE ACG FILE NO ELECTRICAL BUILDING ENERGY - FRAMING ELECT.FINAL TEST TONING' ENG.SITE NO. • INSULATION -� PLUMBING - - GAS TEST GAS. ' MECHANICAL FIRE SPRINK - ENERGY 7.7. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y ❑ N0 ` ❑ NEI - EXTERIOR SHEAR ELECTRICAL RELEASE F LOOD,ZONE . A.L UCc INTERIOR SHEAR, FIRE DEPT. Y ❑ N❑ ` ❑ N SHEETROCK GRADE FEESUMMARY EXTERIOR LATH. BUILDING - - INTERIOR LATH TEMPORARY'APPROVALS'; BUILDING T 0 SCRATCH COAT JELECTRIC PLAN CHECK � GAS FEEL'"' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY - sElsMlc FEE I% 3 OCCUPANCY OF BU I LD I NG IS NOT PERM ITTED UNTI L BU I LDI NG F I NA L ISSIGN ED BY BU flif IN TOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �l ~O� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADI)RESS WHEN PHONING. J Z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX' 1�t _ PLEASE READ REVERSE SIDE BEFORE '" A CALLING FOR FINAL INSPECTION. : TAE OFFICE COPY —`: APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY v �y. BU I LDING PROJECT I DENTIFICATI ON .PERMIT NUMBER BUILDING APPLICATION & PERMIT ADDFttSS /0360 FAkA/1oME �: BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 18238 . OWNER'S PLAN CHECK VALIDATION NAME 197-Alrao /9, bsQEll//Ja9A� L 375 QTY. ELECTRIC PERMIT FEE PHONE CONTRACTOR'S NAME I UTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No. LIGHTING FI XTUR ES 10.00/1.00 DRESGTOR's ADPPLIANCES-RESIDENTIAL 4.00 CONTRACTOR 111 PHONE PANELS 10.00 DATE OF AP PLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE PA.NO: NGINEER LC.NO. SIGNS TRANS. ' 3.00 ADDRESS ENG. PERMIT CIRCUIT 5.00 PERMIT VALIDATION APP s ZIP EMP.METER OR POLE INS. 20.00 AOOHESSE59 . - MOTORS CH. • 6 F / SERVICE CHANGE - .00 -/}O- �VC�� - o O LICENSED CONTRACTORS DECLARATION aU.u I hereby affirm that I am licensed under provisions of Chapter 9 s ISSUANCEDATE y "' (commencing with Section 70001 of Div,mm 3 of the Business anti a EEC F D z Professions Code,and my license is in full force and effect. BLDG. LEC PLG. M❑ ❑ z o'2- License Class Lie.Number O m Dale Cnntracmr a Y BUILDING PERMIT ¢ a OWNER-BUILDER' DF-CLARAIION 0 0 INFORMATION w g 1 hereby affirm that I am exempt from lite Contractor's Li¢nsc MISC.- REFER TO ORD FLL00J Law for the following reason. 70315,Businessand Profess ions PERMIT ISSUANCE VALUATION S/FT. Code:Any city or county which requires a permit to construct,alter, is I� C 2¢ improve,demolish,or repair any someone,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. glom L ¢ requires the applicant for such permit to file a signed statement that TOTAL lJ PERMIT TO w $ m he is liecosed pursuant to the provisions of the Contractor's License I Lw(Chapter 9(commencing with Section 7000)of Division 3 of the s 4 o Business and Professions Cod,)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE ¢ F the basis for the alleged exemption.Any violation of Sectiun 7031.5 STORIES F TYPECONSIR, u by any applicant ford permit subjects the applicant tnacivil penalty of not more than five hundred dollars 15500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the struqure is not intended or,offered for sale (Svc. 7044. Busine,s and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License Law does not apply to an owner of _ property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SFT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- O. motsare not intended oroffered for sale.If,however,fila building GAS-EA.SYSTEM-'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 the burden of proving that he did not build or ins- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 - REs IND cON -PB,. omar 40( I,u owner of the property,ant uxclusivcly contracting with LiK ❑ ❑ ❑ ❑ licensed contretors to construct the project tSec.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-OV ER 5(EA.) 1.00 contracts tor such projects with a conlmeto Ks)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 reaum owner Date WATER SYSTEM 5.00 ACO.DATF ACC.FILE NO. AIORKERS'CO�11PENSAT10N DECLARATIONWATER TREATIN G EQUIP. 5.00 s I hereby affirm that I have a cert nicam oI consent to self-in,mre. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thsrc.ffSec.3800,Lab C.). Policy No. Company O ❑ Certified copy is herchy furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is fled with the city inspection division. MISC- REFER TO ORD. F O Applicant Y❑ N❑ V ❑ IN CCN CERTI1:1CATE 0171:X Ii M I'1'IO N 17 ROM WO R K Ii RS' PERMIT ISSUANCE, 10.00 FLOODZONE A.L.U.O. W COh1PENSA7fIDN INSURANCE PLG.CONTR. LIC.N0. PLG. ❑ ❑ ❑ ❑ -? Z (This section need not be completed if the Permit is for one - TOTAL Y N Y N hundred dollars IS 100)or less I FEE SUMMARY U•O 1 certify that in the performance of the work for which this per- QTY- MECHANICAL PERMIT FEE LL U mit is issued,I shall not employ any-person in any manner so a to O w beemn•yIbycl to the Workers- too L�w/ffCalilornia. B_ D°te04I-�Appl'°a"t-�""'�"/le'v' -' ALTER OR ADD TO MECH. 5.00 BUILDING } rn NO]IC t O APPLICANT': IT after making this Certificate of Ex- Z emption;you should become subject to the Worken'Compensation APPLIANCE 5.00 PLAN CHECK D provisions of the Labor Code, you must forthwith comply with 5 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)000C.F.M.) 4.00 FEE CONSTRUCTION LENDING AGE NCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE '103 1 hereby affirm that there is a constructionlending 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. - Lender's Name HEATING UNIT(OV ER 100,000 . 9.50 Lender's Address � ELECTRIC '1 v I certify that l have,cud this aPphutiun and state that We above VENTILATION FAN (SINGLE) 4.00 information is comet. I agree to comply with all city and county PLUMBING !� ordinances and stale laws relating to building construction, and BOILF.A-CCMaP(3 H.P.or 100,000 B.T.U.1 6.00 hereby selhurite representatives of this city to enter apo, the BOILER-COMP (Over 100,000 BTU)SEE FEE SDH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- - REFER TO ORD. uN,.tin. against liabilities,judgments, tests and oxpenas,which PERMIT ISSUANCE 10.00 CONST.TAX lay in any way acenm against said City in consequence of the rant in of(his Pen it MECH.COWL LIC.NOt MECH. e ��awivn�� TOTAL TOTAL Signature of Applicant/Cmshactur .-4 Date OFFICE COPY