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17317 (2) -5 POST.THIS CARD NEAR FRONT OF BUILDING -.�•� . '•-PERMIT NUMBER ` - CITY OFEUPERTINO 17317 INSPECTION DIVISION ` JOB INSPECTION RECORD. PERMIT EXPIRATION JOB ADDRESS_ . UNIT# LOT# PERMIT EXPIRES IF'WOR K 1 _� owivER " �+ Ze {A" L e, CONTRACTOR •c IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. 'LEER + ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PREGUNITE CUPERTINO STANDARDS. GARAGE SLABS• - + - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - C � " UNDERGROUND /'SLAB .. FEB 2 81999 PLUMBING . �p (1�� ELECTRICAL} - W� cupw -w ISSUANCE oATE MECHANICAL - .WDO I ELECT,1. yyP-17G11. MECH. . - - El ElSISI ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED- BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION S/FT. � � - MECHANICAL - _ ELECTRICAL FRAMING - - W1 Kg INSULATION STORIES YPE CONSTR. - -� OCC,GHO P RES.UNITS, PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa.ET FEDaH AREA TOTAL ACREAGE •, DIAPHRAGM - THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - +. HES IND CON PB O'l- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.' ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO, ✓ 'ROUGH - SAN.p - PLUMBING ELECT.ENERGY TRACT No. PARCEL NO TUBS&'SHOWERPAN. PLUMBING ENERGY . MECHANICAL MECH.ENERGY ACC.DATE' ACC.FILE NO, ELECTRICAL � ' BUILDING ENERGY FRAMING ELECT,FINAL TEST.. - INSULATION ZONING ENG.SITE NO. - PLUMBING73 GAS TEST . GAS '• MECHANICAL FIRE SPRINK ENERGY T-24 - , ❑ r ❑ ❑ - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING I- � • V ❑ NN EXTERIOR SHEARFLOOD ZONE AL,Uc ' ELECTRICAL'RELEASE - INTERIOR SHEARFIRE DEPT. - Y❑ "❑ V ❑ NO 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 OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. . MICROFILM ARRANGE FOR INSPECTION BY PHONING,252-4505, ELECTRIC o� ONEWORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING �,IJ S� Z PLEASE-GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANiCAL IMPORTANT! CONST.rnx 'PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL LO`I OFFICE COPY l APPLICANT TO FILL IN INFORMATION WITHIN RED LINES USE BALL POINT PEN ONLY BUILOI NG PROJECT IDENTIFICATION - PERMITNUMBER _ BUILDINGAPPLICATION &'PERMIT 17317 AODREss BUILDING — ELECTRICAL—PLUMBING—MECHANICAL 1 1 1 OWN 's (O ( C_ PLAN CHECK VALIDATION NAM QTY. ELECTRIC PERMIT FEE •� _ -zel-i / v `PHONE C ACTORS v/ / l _/ UTLETS-SWITCHES;RECEP 10.00/1.00 (�•r ¢.No �/Y � LIGHTING FIXTURES 10.00/1.00 co ACT Rs PPLIANCES-RESIDENTIAL 4.00 4 PMONE 6GD PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS'IOVER 200 AMP) 20,DO PLAN CHECK FEE .C.NO. ENGINEER ' Lid,No. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zIP EMP.METER OR POLE INS. 20.00 APPLICANTS AnDPES$ MOTORS SEE FEE SCH. '/�/pCV�C//�/. SERVICE CHANGE � 20.00 0 0 o LICENSED CONTRACTOR$DECLARATION a <i W I hereby affirm that I am licensed Pride,ptovkim,,of Chapy.r 9 - ISSUANCE DATE (co Con cin S 7000)of Division 3 of BI my16 add L G. ELECT: PLG. MECH. H y i profess s nsc 19 1 full { ❑ ❑ 0 o Licen I� hit.Numbe - F m r J Datc Cnntrncmr , ¢ m ¢ OW'NIi R-BUILDI°R DECLARATION BUILDING PERMIT — o e- U INFORMATION I hereby affirm that 1 mn exempt from tie Contractor's License MISC.— EFER O ORD LLOa Law for the following reason.(Scc.7031.5,Businessand ProfnuonsPERMIT ISSUANCE VALUATION S/FT. � — Code:Any city or county which retimmse(conit tucomlrt¢Luller. - ¢m or to its ksuanev,also ELEC.CONTR. LIC.NO. a improve,demolish,or repair any structure, ELEC. 0 i ¢ requires the applicant for such pcmsit in filee a a signed statement TOTAL wD he is licensed puN PE ST TO $ nuunl to the provisions of the Contractor's License _ N H z i Lt.(Chapter 9(commencing with Section 7000)of Division 3 ofthe I/yk, a Boa mcsss and Professions Code)or thin he is excinpl therefrom and QTY. PLUMBING PERMIT FEE ¢ r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES PE CONSTR. by any applicant for a Permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(S500)J: ❑ I,an,owner of the property,or my employees with wages as BACK FLOW PROTECT..DEV ICE 4.00 ACC.GROUP RES.UNITS their sole compensalion,will do the work,and the sfineture N 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 inyiroves thereon,and who does such work FIXTURES-PER TRAP 5.00 - SQ.IT.FLOOR AREA TOTAL ACREAGE himself or through his own employees.provided that such improve- Crentsarenotintended or offered for sale if,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 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 nl salol. INDUSTRIAL WASTE INTER. 30.00 RES IND - CON PB . Omar ❑ 1,as owner of the property,am exclusivoy contracting with 1:1 ❑ ❑ ,El ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Profession COde:'The Contractors License Law does not apply - to an owner of properly who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5 IEA.) ' 1.00 contracts for Such projects with a coutraclous)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sea ,BAP.C.for this WATER HEATER W/VENT ' 6.00 ,deans owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, N'ORKERS'COAIPENSATION DECIARA'f1ON WATER TREATING EQUIP. I 5.00 I hereby affirm that I have a certificate of consent to self-Ins re, ZONING ENG SITE N0. . or a certificate of Workers'Conlpensoliun Insurance;or er^ld/{Ld copy mereof(See+3800,Lab.C.). e•sle s Policy No, Company - 0 ❑ Ce,fI d yls he u ishdJ. - FIRE SPRINK ENERGY T"24 Z Z Certf pd t the oily inspection division. MISC.- - REFER TO ORD. F c) rpt LitI is - Y N V ,� PERMIT ISSUANCE' .10.00 L) FLOOD ZONE A.L.uc. LU CE 'I'I FIC OM OP I Al ION INS FROM WORKIiRS' A CLO need not , co N INSURANCE PLG.CONTE. LIC.No. TOTAL I O Y N❑ Y ❑ N� Z) Z Ed re dollars need not he completed if the permit in for o hundred dollars lS 1 the or less.) one U I- 1 certify that h the r re,l ly an of Ilea work for which this Per, QTY. MECHANICAL PERMIT- FEE FEE SUMMARY LL U mit is issued, I shall not rkers' any pawn in any Ina Calx so as In U w become subject to the Wocant Compenwtion laws of Calilomia. r Ca. Date—Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } m NOl'ICf. '1'0 APPLICANT: IC alter making this Certificate of lis: F Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Usher Code, you most forthwith comply with FEE U such provisions or this pemsil shall be demned revoked. AIR HANDLING UNIT(TO 10=C.F.NL) 4.00 CONSTRUCTION LENDINGAGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction knding agency for EXHAUST HOOD (WITH DUCT) 5.00 the pedummnce 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 Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC 1certify that l havercad t his application and staid l leaf t he above VENTILATION FAN (SINGLE) 4,00 ® infuredtion is cored. 1 agree to comply with all city and county BOILER-CONP(3 H.P.or 100,0008.T.U.) 6.00 PLUMBING r oQ ordinances and state laws relating to building construction, and hereby authorme representatives of this city to enter Lunn the BOILER-COMP(Oser 100,000 BTU)SEE FEE SCH. MECHANICAL abovcanenlioned property for inspection purposes. (we) agreeto save, indemnify and,ke,p harrinh s the City of MISC.- REFER TO ORD. uperti o against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX nay "n any ay Bins, said City in consequence of the an n o(1 pa 1 it. MECH.CONT, LIC.NO. MECH. �. TOTAL TOTAL pD Sign to of Applin t/Contractor Date OFFICE COPY