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18860 (2) POSTTHIS'CARD NEAR FRONT OF BUILDING f PERMIT NUMBER CITY OF CUPERTINO 18860 INSPECTION DIVISION' JOB INSPECTION RECORD �f ///••• P PERMIT EXPIRATION JOB ADDRESS_I `-' ! • - UNIT# LOT# ' - PERMIT EXPIRES IF WORK (DIVINER' 'T'E-/,y CORER ETCH 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 BE INSTALLED• " - PREGUNITE - .TO COMPLY WITH THE APPROVED PLANS AND CITY OF PER,, VALIUAIION- _ CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING. ELECTRICAL ISSUANCE uAre --� MECHANICAL - BLDG ELccT Pu.. raecR. . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED [� BUILDING PERMIT WOOD FLOOR NOV. O2+'I S 3 9 INFORMATION VALUATION 5/FT. .PLUMBING MECHANICAL ' Citl"Of C`17Arfinf% ' ELECTRICAL -_ I _PER&IIT TO FRAMING INSULATION- STORIES TYPECONSTR ' OCC GROUP RES.UNITS. PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.IFFLOORAREA TOTAL ACREAGE Ile ' - ROOF NOTE:NOTINAL INSP.SHALL BE'MADE BEFORE , DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING Res INBUILDING USE D CON PB- 00— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ - ❑ ROUGH.' SAN.q _ ASSE SSORS PARC F.I.NO _ " PLUMBING - ELECT.ENERGY TRAcr NO_ PARCEL No. TUBS 8 SHOWER PAN PLUMBING ENERGY - MECHANICAL - MECH.ENERGY ACC.DATE ACC FILE NO, ELECTRICAL BUILDING ENERGY - FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. - INSULATION PLUMBING. GAS TEST GAS x MECHANICAL FIRE SPRINn•'' ENERGYT")a COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED.. HEATING - 'Y "0 ` ❑ "E] . . ..� _ EXTERIOR SHEAR ELECTRICAL RELEASE 2- FLOOOZONE 0.LUC. INTERIOR SHEAR FIRE DEPT_.., `'❑ �❑ Y ❑ N❑ • SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING . - A ,INTERIOR LATH - TEMPORARY APPROVALS - BUILDING SCRATCH COAT, I ELECTRIC - PLANCHECK GAS NO TAPE"OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY 'SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM" ARRANGE FOR INSPECTION BY PHONING 2524505, ELECTRIC , H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING" a ` O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z — SEE MECHANICAL'PERMIT FOR EXPIRATION DATE — ' IMPORTANT! CONST TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ' BUILDING PROJECT I DENT)FICATION ,PERMIT NUMBER BUILDINGAPPLICATION & PERMIT 18860 AURES$ I I ZS BUILDING - ELECTRICAL-PLUMBING-MECHANICAL !, 1 OWNER'S -$6 r, PLAN CHECK VALIDATION NAME \\ .�J 7 OTV. ELECTRIC PERMIT FEE t-oo T I-/J� PHONE COIMTERACTORS -71r1]Gl, UTLETS-SWITCHES-RECEP 10.00/1.00 NQw F LIO.NO LIGHTING FIXTURES 10.00/1.00 roNTRACTORs1 t -, a-6� -f�t7? PPLIANCES-RESIDENTIAL 4.00 ADORE �n� 1Y PRONE PANELS 10.00 DATE OF APPLICATION ARRCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC,No. ISIGNS TRANS. 3.00 ARCH.OR ENG. . PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT 5.00 ZIP TEMP.METER OR POLE INS. 20.00APPLIC �� aDDRE as MOTORS SEE FEE SCH. DOREss • SERVICE CHA 1 20.00 / V1 ¢ oi 0 o o LICENSED CON'I'RACIORS UBCLARATION - (�- a it sHi I hereby affirm that I am licensed under provisions of Chapter 9 rd nV (0.. mon ISSUANCE Dqs7E v, < a (commencing with Section 7000)of Divm 3 of the Business and BLDG. ELECT. LG.. MECH. L_ o i Pocl'esson"C d my license iv in full lirk�• B ` ❑ ❑ ❑ a: o 2 - License Class Lic.Number J R" C �I O Z r Date Contactor_(- CfIY of ruiorfjR� Q Y 2 J I ¢ ¢ a OWNERBUILDERDECLARATION BUILDING PERMIT A o d U - INFORMATION w g: LL 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER_ TO ORD a- O Low for the following reason.[Sec 703LA tlusincwvund PmfesSons �6•BO ,� VALUATION $/FT. � - J Code Any cfolity owing ocy which.(Set.y 031.ires Permi[toconstrucl. arslter, PERMIT ISSUANCE 2 2¢ p improve,demolish,or repair eny'strutlure,prior to its issuance,also ELEC.DDrvTR. LIQ NO. ELEC. nO¢ requires the applicant for such Permit to Ills a signed statcnanl that ,TOTAL/3•VQ PERMIT TO K he is licensed pursuant to the provisions of the Contractor's License ar z Q Law(Couple, Section 7000)of Division 3 ofthe i o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ r $ the basis for its,ulleged exemption.Any v ioliui.c uf8ection 7031.5 s STORIES TYPE CONSTR." o by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(S500)J: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE. 4.00 OCC.GROUP RES.UNITS sole compensation,will an the work,and the sMcture 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 property who builds or ins prove,Ihetenn,unit who docs such work FIXTURES.PER TRAP 5.00 50,FL FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not lotendedoroffered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 ' or improvement is sold within one year of compleflon,the owner- GAS-EA.SYSTEM'- 4 (EA.) 2.00 builder will Imve the hcoden of fronting Him he did not build or im. BUILDING USE Prove for purpose of sok.). RES IND CON PB Omer ❑ 1,as owner of the property,am exclusively contacting with INDUSTRIAL WASTE INTER. 30.00 ❑ I] ❑ ❑ ❑ licensed contactors 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 contrvctotls)licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00 lire Cnntmctor's License Law. TRACT NO. PARCEL NO. ❑ tum evempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00 reason owner ])ate WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. W'ORKERS'COMPENSA'IION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate tit consent to scl6insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy lhemm'(Sec.3800,Lab.CJ. - - Policy No. Company O ❑ 'Cerlmed copy is hereby furnished. Z Z Cl Certified copy is tiled with the city inipeclion division. FIRE SPRINK ENERGY T�]a FO Applicant MISC.- REFER TO ORD. Y E] N❑ Y ❑ NQ CC D CERT[FICA'I'F OIs EXEME1'ION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > Co NPENSATION INSURANCE PLG.coHTR. LIC.rv0. PLG. IL 0 (' This section ced not be, completed it the (wand is for one TOTAL Y❑ N❑ Y ❑ NEI bemdred dollars IS 100)or Icssj U O 1 certify that in the performance of the work for which this per- Qtr MECHANICAL'PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to Ow become,subject to the Workers'Compensation Laws of California: y Dale Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } to NOTICE 'TO APPLICANT: If,after making this Certificate of Ex- F ? emption,you Should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the lahor Cock, you Rmst fiulhwilh comply with FEE U such provisions or this Permit shall he deemed revoked. AIR HANDLING UNIT(TO 10MCF.M.) 4.00 CONST'RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MOCEM.) 6.00 SEISMIC FEE 1 hereby affirm that mere is a emollinuctum)ending 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.T.U.) , 8.00 Lender's Nana HEATING UNIT(OVER 100,000 B.T.U.)9.50 OO Lender's Address ELECTRIC I certify that I have read this application and lute that the zhcve VENTI LATIONTAN (SINGLE) 4.00 _ ,. information n coraco. I agree to comply with all city ucti county BOILER-COW(3 H.P.or 1D0,D00 B.T.U.) 6.00 PLUMBING ordinances and state laws relating c to building construction, and hereby authorize represenmtives of this city to enter upon the BOILER-COMP (Over 11X1,000 BTU)SEE FEE SCH. MECHANICAL above c6tioned property lot inspection pugsoset , (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX By in any wayt ilacerue again Said City in consequence of the PERMIT ISSUANCE 10,00 ranting of 1 1p nnll' MECH.CONT. LIQNO. MECH. tITOTAL - 'ate `7 TOTAL ✓J Blgna�Apph nal/Contractor Dulc OFFICE COPY