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14539 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER' ITY OF CUPERTINO 1 $539 INSPECTION DIVISION JOB INSPECTION RECORD - •. PERMEXPIRATION JOBADDRESS /� •� > '�HVT�-,fi"I-c', UNIT# t _LOT# PERMIT EXPIRES IF WORK OWNER _(s �rJ-� (�- �_/,q-,C',J� CONTRACTOR IS NOT STARTED WITHIN'. INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION NOTE: ANCE OR 180 DAYS FROM. IASTCAILED INSPECTION. ,.' UFER - ALL: GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGESLABS _ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB P/�ID ' PLUMBING 4 ELECTRICAL "' AR 3 . U'J' '1 SSUANCE DATE MECHANICAL - BLDG ELECT, , PLG. MF.CH City Of Cu rti® Q 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - BUILDING PERMIT v INFORMATION _ WOOD FLOORVALUATION _ S/FT. PLUMBING �� ') q� ECHANICAL tot M ELECTRICAL - vERMrt To _ FRAMING INSULATION - STORIES . TYPE CONSTR. A/-y Pd > s OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE'NO FINAL INSP.SHALL BE MADE BEFORE so.ET ELoaR AReA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID - C?Zn BUILDING USE ROOF SHEATHING RES IND CON PB om—IV 0 [1 - 0 El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. • ROUGH AssessoRS PARCEL No. ti+� SAN.q L PLUMBING S./] ELECT.ENERGY '•�/6- 3 ,TRACT NO. PAHCEL NO TUBSBSHOWER N }. PLUMBINGENERGY .//.� Ild MECHANICAL' MECH.ENERGY /_OPF 14 ELECTRICAL - ACC DATE ACC.FILE NO. _ BUILDING ENERGY FRAMING Co` ELECT.FINAL TEST ZONING ENG.SITE NO. ' INSULATION � �-2 PLUMBING - / .� GAS TEST GAS 7Yee MECHANICAL D FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FL..GZONE A.L U.C. EXTERIOR SHEAR ' ELECTRICAL RELEASE ' INTERIOR SHEAR- FIRE DEPT. YE] N[] YL N❑ SHEETROCK _ -`L- GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARYAPPROVALS a Sa SCRATCH COAT ELECTRIC PLAN CHECK GAS _ FEE. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED loccuPANCY SEISMIC FEE' OCCUPANCY OF BUILDING IS NOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ' Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC -fl . H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING o PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL 1,41 - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAXA PLEASE READ REVERSE SIDE BEFORE OTAL,. CALLING FOR FINAL INSPECTION. OFFICE COPY ,APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATION ' PERMITNUMBER APPLICATION & PERMIT- - • �F A [ �[] ,, eu' tsc ^ a nas5_ BUILDING-ELECTRICAL-PLUMBING-MECHANICAL c J \7 OWNERS L� PLAN CHECK VALIDATION NAME" ' L PHONE�� QTY. ELECTRIC PERMIT FEE �3 (.rL:PJ CONTRACTORS V /, 7 0, NAME)! Q OUTLETS-SWITCHES-RECEP 10.0011.001,4V LIC.NO.3743 LIGHTING FIXTURES 10.00/1.00 ' f,ONTR/CTOR'a X ao�GEs APPLIANCES-RESIDENTIAL 4.00 -� PHRNEZ '�' ( PANELS 10.00 DATE OF APPLICATION OR RCHITECi PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER Jd�J<M �`/r GI . ua NO SIGNS TRANS. .3.00 ARCHES.E.G. SPECIAL CIRCUIT - S,OO PERMIT VALIDATION 47 ZIP EMP.METER OR POLE INS. 20.00CA ap �/I� DDRESrvr. 3 , AMOTORS SEE FEE SCH. , = AW((d7-11114 APPLI SERVICE CHANGE 20.00 (� O o 9 LICENSED CONTRACTORS DECLARATION J ^ is a cmi u I hereby affirm that 1 am licensed under provisions of Chapter 9 ISS E DATE - y z i (commencing with Section 7000)of Division 3 of the It i S ad _ 6 Ea YB PLG. MECH. o z Professions Codi{{��d pm, license is in full for f z o 1 License Class_1r 1_Lic.Num In m F w Uate_�_,(_j�j_�CoOhutlor LC Y f 1��((I/✓ BUILDING PERMIT ¢ w OWNER-BUILDER UL'ChA AMONK-"-- w0 ' w - 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD uoj Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. � - Code:Anycityorcounty which requires a permit to construct,alter, d ) a ¢ ¢ 0 improve,demolish,or repair any slructare,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. �j_r / !/" ¢ requires the applicant for such permit to file a signed statement that r TOTAL p PE/R�MCs u- IT w w he is licensed pursuant to the provisions of the Contractor's License S�L Fz> Law(Chapter 9(commenciagwith Section 7000)of Division 3 ofthe - 4 o Business and Professions Code)or that he is exempt.therefrom and OTY. PLUMBING PERMIT FEE ¢ H $ the basis for the alleged exemption.Any violation of'S� nn 7031.5 STORIES TYPE CONSTR. i3 by any appli...tfar a pemtit subjects the applicant too civil penalty ALTER-DRAIN IEA.) 5.00 (( of not more than five hundred dollars($500).): V /u'/p'!ua ❑ 1,as owner of the property,or my employees with wagcsas r BACK FLOW PROTECT. DEVICE 4.00 their Side compensation,will do the work,and the structure is not Tib' OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR;ROOF,AREA,COND. 5.00 •n Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who docs such work O FIXTURES-PER TRAP 5.00 166 SO.FF FLOOR AREA TOTAL ACREAGE himself re through his own employees,provided that such improve- ments mprove- himself. thronot ng his or offered emor ployees, provided that such building 1 GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or hnprovement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA.) 200 BUILDING USE builder will have the burden of proving that he did not build or im . . . - RES IND CON PB OtM1er prove F.,purpow al'sale.)' INDUSTRIAL WASTE•INTER. 30.00 El El❑ 1,as owner of the property,am exclusively contracting with EJ 13 licensed contractors to construct the project(Sec.70449 Business LAWN SPRINKLERS-I 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 ,3 S�-�6 -3 contracts for such projects with a coneactorfs)licensed pursuant to' Q 7 I the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ tum exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT -6.00 reason Owner Date WATER SYSTEM 5.00 �`-� J ACC.DATE ACC.FILE NO. WORK FRS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified 74 copy thercof(Sce.3800,Lab.C.). Policy No. Company .0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is filed with Hte city inspection division. MISC.- REFER TO ORD. Q Applicant Y ❑ N� Y [3 NE] I= y CERTI14CA1'I7OF IAIiMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLoop ZONE A.L.U.C. Lu >_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL o (This section need not be completed if the pemtit is for one TOTAL Y❑ N Y N Z hundred do$[...(S 100)or less.) U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F- mit is issued, I shall not employ ny perso m i •6ny o are so as to Q W berotlle 9t�jyelOLNte Workors' oat s { jawj�f California. - y Dat-1- QApplicant ---�4. ALTER OR ADD TO MECH. 5.00 BUILDING 'Q l5a } 0 NOTICE TO APPLICANT: If,at er I taking this CerNlicate of Ex- emption,you Should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE 6.1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=r_F.NL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a Construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 Is- the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000.B.T.U.) 8.00 - MICROFILM 3097,Civ.C.). - Lender's Na H EATI NG UN IT IOV ER 100,000 B.T.U.)9.50 'ELECTRIC g Lender's Address 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 will,all city and county BOILER-COMP(3 H.P. r 100,0008.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and -� hereby aufhorim representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL /- /}0 above-mentioned property for inspection se purpos. i (We) agree to save, indemnify and keep harmless the City of MISC.- :REFER TO ORD. up timo against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 Q--� CONST.TAX S_7 may n any ay accrue against said City in consequence of the ran mg of seer IL �f.. MECH.CONT. LIC.NO. MECH. TOTAL j��' TOTAL /�f/lyf Signal a of Apphca ontRC, OFFICE COPY