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15748 (2) I POST THIS CARD NEAR FRONT OF BUILDING PERMITNUMSER i CITY OF CUPERTINO 15748 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION I JOB ADDRESS 'w ✓C` UNIT# LOT# PERMIT EXPIRES IF WORK OWNER Z CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. ' UFER ALL GRADING'AND DRAINAGE SHALL 6E INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF - PLHMFT VALIDATION CUPERTINO STANDARDS, GARAGE SLABS - ---- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - �v UNDERGROUND /SLAB' PLUMBING ' ELECTRICALISSUANCE DATE MECHANICAL muTc ELECT. PLP, MecR. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION s/FT. PLUMBING p _ MECHANICAL ELECTRICAL ' ' - PERMIT To FRAMING - Mc INSULATION _ STOHIES TYPE CONSTR. ' DCC SHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF NOTE:NO FINALINSR SHALL BE MADE BEFOSO FT FLOOR AREA TOIALACRCAGET THE CONSTRUCTION TAX IS PAID Qw� DIAPHRAGM suuolNO USE ROOF SHEATHING 9� INo LON PR III— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE N 7 1:1 El 3 E ROUGH ' SAN,# v 11duAl SSESSORSPARCELNO PLUMBING ELECT.ENERGY - TUBS 8 SHOWER PAN � PLUMBING ENERGY TRACT NO. PARCEL No. MECHANICAL - MECH.'ENERGY ELECTRICAL BUILDING ENERGY ACC.DATE ACC:FILE NO FRAMING ELECT.FINAL TEST - zoNlNr ENG.SITE No. ' INSULATION PLUMBING ' GAS TEST GAS FIRE INK ENERGY i 74 MECHANICAL Y ❑ L NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING IND . EXTERIOR SHEAR .ELECTRICAL RELEASE ' FLOOD ZONE LA.L UC. INTERIOR SHEAR' FIRE DEPT. Y❑ NL _ ° L No SHEETROCK GRADE,' FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATHTEMPORARY APPROVALS BUILDING ` SCRATCH COAT ELECTRIC PLAN CHECK ' T GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC O� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - MECHANICAL 02 / - SEE PERMIT FOR EXPIRATION DATE - l IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY _ _ I APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY BU I LDING PROJECT I DENTIFICATI ON •PERMIT NUMBER ' BUILDING APPLICATION & PERMIT 15748 � ] ADDRESS / L� 061 6ORgrh< C� A�77 BUILDING —ELECTRICAL—PLUMBING—MECHANICAL OWNERS PLAN CHECK VALIDATION "AME fto" CITY. ELECTRIC PERMIT FEE ((J� vHonE —03 NAME nncioRs OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.NO. - LIGHTING FIXTURES 10.00/1.00 CONTRACTOR SS PPLIANCES-RESIDENTIAL 4.00 NT A PHONE PANELS 10.00 DATE OF APPLICATION - OR PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE .QiNO. ENGINEER - ` uc.No. SIGNS TRANS. 3.00 ADDRESIS ENG' SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ziv TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESSOREss SERVICE CHANGE 20.00 w¢ EO O� LICENSED CONTRACTORS DECLARATION - G ii U I hereby affirm that 1 am licensed under provisiore of Chapter 9 ISSUANCE DATE a, rt a (commencing with Section 7000)of Divisiwh 3 of the Business and BLDG. ELECT. PLG. MECH. F o i Professions Code,and my license is in full force and effect. E] ❑ ❑ z o,� — License Class Lic.Number 2 Z — Date Coninctor FNH_ Y BUILDING PERMIT ¢ a, w u OWNER-BUILDER DECLARATION w ;a F. 1 hereby satire the I am exempt from sLc Contractor's Licerue MISC.— REFER TO ORD INFORMATION Fo. o Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION {/FT. Code:Any city or county which requires a permit toconstruct,allet, ¢< p improve,demoli>h,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. r o¢ requires the applicant for such permit to rile a signed statement that TOTAL n re$ he is licensed pursuant to the provisions of the Contractor's License PERMIT 1� FZa UR,(Chapter 9(CtmnCRCin,.ith Section 700(1of Divisian3 o fthe i o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ H the basis for the alleged exemption.Any violation of Section 7031.5w. STORIES TYPE CONSTR. by applicant fore permit Subjects the anttocivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not of masromme than five hundred donors(S500).): ❑ I,as owner of the property, employees y,or my with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sena compensal ion,will du the work and the structure a 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 property who builds or improves Omrcon,and who docs such work FIXTURES-PER TRAP 5.00 sa FT.FLOOR AREA TOTAL ACREAGE himself or through his own employe,provided that such improve- mentsarenotintendedorenteredfursale.If.however,the budding GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 or improvement Is sold within tine year of completion, the owner builder will have the burden of proving that he did not build or ins- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE Prove for purpose of sale.). RES IND CON PB Other P,w,as owner of the property,an, exclusively comfac ing with INDUSTRIAL WASTE INTER. 30.00 licerued contractors to construct the project(Sec.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-OVER 5(EA.) 1.00 - contracts for such projects with a contrachaps)licensed pursuant to the Contractor's Llccosa Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lamexempt under ec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 Owner— Date? �qJj WATER SYSTEM 5.00 ACG GATE ACC.FILE NO. WORKERS'COMPENSA'1'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby offimn that I have o certificate til consent lD seltainwre, or a cenificale of Workers'Compensation Insurance,or a certil ied ZONING ENG.SITE NO. copy thermf(See.3800,Iab.C.). Policy No. Company O ❑ Certified copy is hereby fumishal. en ERGY T 24 $PRINK EN Z 2 ❑ Certified Copy a tiled won.with the city inspection divisiNEIN N� O Applicant MISC.- REFER TO ORD. v y CER'TFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.0 OOZONE A.L.U.C. LL > COMPENSATION INSURANCE PLG.CONTR, LIC.NO. PLG. pp�� CL0 (This section need not Ise cumpleled if the permit is for one TOTAL yav❑ N� v MN C] CJ O hundred dollars IS 100)or Tess.) 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL mit is issued,I shall not employ any person in any manner o as to become subject to the Workers'C'omperomwn Wws of California. 0 a 11arc Applicant ALTER OR ADD TO MECH. 5.00 BUILDING )E_ N NOTICE TO APPLICANT'. If,after making this Certificate of ltx- 2 emption,you should become wbject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.U) 4.00 CONSTRUCTION LI?NDINC AGENCY AIR HANDLING UNIT(OVER 10pWCE1d) 6.00 SEISMIC FEE 1 hereby affirm that there is a construcrian handing ugcrey for EXHAUST HOOD (WITH DUCT) 5.00 the perfummnce of the work for which this permit is issued(Sec. MICROFILM / 3097,CicC). HEATING UNIT ITO 100,000 B.T.U.) Lenders Name Lender's Address HEATING UNIT(OVER 100,DOOB.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 correct. I agree to comply with all city and County PLUMBING ordinances and state laws relatiog lo building construction, and BOILER-COMvP(3 H.P.or 100,000 B.T.U.) 6.00 1 hereby euthonee rtpreselnatives of the city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL oC/ alwvc-mcnliuncd pruperry for inspection purposCs. (We) agree tit save, indemnify and keep harmless the City of MISC.- * REFER TO ORD. . upertino against liabilities judgments, costs and expcnms which CONST.TAX ay in any way ace a against said ity in consequence of the PERMIT ISSUANCE ,1.00.80 tiling of th C[a MECH.CONT. LIC.NO. MECH, TOTAL a� TOTAL Slgnalur!of Pplcant Conrractor vote OFFICE COPY