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14214 (2) POST THIS CARD NEAR FRONT OF BUILDING rERnvr rvuMREH CITY OF CUPERTINO 1421 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 21851 HERMOSA AVE - UNIT# LOT# PERMIT EXPIRES IF WORK OWNER CRAIG CLARK CONTRACTOR CRAIG. CLARK IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION LAST CALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE • POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING - ELECTRICAL - ISSUANCE DATE MECHANICAL BLDG. ELECT, I PLG. MECH. El 1:1 E 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT ,_WOOD FLOOR INFORMATION VALUATION $/FT. PLUMBING 1 , MECHANICAL '-l� ,;; - PERMIT TO ELECTRICAL FRAMING -� $t0RIES TYPE CONSTR. INSULATION ' 9Q OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - 50,FT.FLOOR AREA TOTAL ACREAGE r ROOF DIAPHRAGM BUILDING USE RES IND CON PB Omer El ED Eil El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El ASSESSORS PARCEL NO. ' ROUGH - PLUMBING mL4•/. .8 - GAS TEST TRACT No. PARCEL No, MECHANICAL Bud - ELECTRICAL - FINALS DATE INSP. ACC.DATE ACG FILE NO. FRAMING - -2 SAN # INSULATION PLUMBING ZONING ENG.SITE NO. GAS MECHANICAL FIRE SPRINK "ENERGY T"N COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING El COVER LATH—INTERIOR ELECTRICAL FLOOD ZONE A.L.U.C. LATH_EXTERIOR FIRE DEPT. Y[D N� Y I] -N❑ SHEETROCK - GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS _ BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE ' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE _ OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM T ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL - SEE PERMIT FOR .EXPIRATION'DATE -� IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY ' ,_,pPPi;.ICANT,TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDING PROJECT I DENTI FICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT �� ADDRESSO /.,85I _ SA ,L ''rC,Y�'� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION E � I20-2374 QTY. ELECTRIC PERMIT FEE ClaiePHONE N°N>ERAcr(R Lh.1'V LIC.NO. UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'I PPLIANCES-RESIDENTIAL 4.00 ADDRE S ZIiZ Oa PHONE (J��f {�7O PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 7`7 LAN CHECK FEE P.C.NO. EIN[ER NO /� LIC.ND. SIGNS TRANS. 3.00 ADDRESS ENG. SPECIALCIRCUIT 5.0Q PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESS /�- SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION < u I hereby affirm that I am licensed under provisions of Chaplet 9 ISSUANCE DATE G a (commencing with Section 7000)of Division 3 of tiro Business and BLDG. ELECT. PLG. MECH. H D i Professions Code,and my license is in full force and effect. O ❑ ❑ ❑ 2 o rv3 - License Class Lic.Number 9 z H D Dale Contractor ¢ y 5 J BUILDING PERMIT ¢ ¢ w sat OWNER-BUILDER DECLARATION INFORMATION wo MISC.- REFER TO ORD ;e N I hereby affirm that 1 am exempt from the Contractor's License VALUATION S/FT. ar a- Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 /!� Code:Any city or county which requires permit to construct,alter, V Q la¢ Improve,demolish,or repair any structure,prior to its Issuance,also ELEC.CONTR. LIC.NO. ELEC. c o u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO wm m he is licensed pursuant to the provisions of the Contractor's License H z r Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthc a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE I C STORIES TYPE CONSTR. ¢ R the basis for the alleged exemption.Any violation of Sec tion malty i ; � by any applicant fora permit subjects $500).licammacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(8500)J: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS (heir sole compensation,will do the work,and lire structure 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 improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- GAS-EA.SYSTEM-1 INC.4 OUTLETS 6,00 . mems are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 O 1,as owner of the property,am exclusively contracting with licensed 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 con(ract°r(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200tt/10.00 TRACT NO. PARCEL NO. ❑ I um exempt under Sec.-,B.&P.C.for this WATER HEATER WIVENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 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 copy themof(Sec.3800,Lub.CJ, Policy No. Company 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is riled with the city inspection division. MISC.- REFER TO ORD. O Applicant Y ❑ N Y ❑ N❑ PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. Lu CIiRTIFICCOMOF COMPENSATION FROM WORKERS' W � COMPENSATION INSURANCE PLG,CONTR. LIC.NO. PLG. CL D (This section nc d not be completed if the permit is for one TOTAL YE] N❑ I Y❑ N Z) Z hundred dollars 18100)or less.) ' V O 1 certify that in the performan of the w0r o hie this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY U.. 1- mit is I sued,1.`sSIBOJJI of employ nY Pe n i um r sD as to U bccor��f s r h Workers' ompe oa s f nia. 0. exv Datc y plicate- ALTER OR ADD TO MECH. ,5.00 BUILDING S } N NOTICE TO APPLICCCCCC'ANT: If,aft, ak ng this Certificate of Ex- F Z emprom,you should become sobjcc to the Workers'C0nlPBRSatiOo APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MOCF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE �ZJ I hereby affirm that there is a construction lending 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 Name Lender's AddHEAT[NG U N IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC ress .� 1 certify (hal 1 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 relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 Hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU(SEE FEE SCH. MECHANICAL ubove-mentioned property for inspection purposes. (We) agree to save, i emni fy and keep harmless the City of MISC.- REFER TO ORD. Cupert' o against dveil' s,j. much costs and expenses which CONST.TAX may i anfye b ago st said City in consequence of thePERMIT ISSUANCE 10.00gmn[ gof .. CH.CONT. LIC.NO. MECH. TOTALTOTALore, t/Contmctor Date OFFICE COPY