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17860 (2) POST THIS CARD NEAR FRONT OF BUILDING A , _ - PERMIT NUMBER " CITY OF CUPERTINO 17$ 0 INSPECTION DIVISION" f' -" JOB INSPECTION RECORD '�• - Q - - , _ , PERMIT EXPIRATION JOB ADDRESS ° ST• UNIT# _LOT# - ��y - - PERMIT EXPIRES IF WORK, OWNER - �Q[. CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD' 180 DAYS'OF PERMIT,ISSU: FOUNDATION ANCE OR, 180 DAYS FROM 'NOTE: LAST CALLED INSPECTION. UFER - ALL GRADING AND DRAINAGE SHALL BE.INSTALLED, TO COMPLY WITH THE APPROVED PLANS AND CITY OF •,PLRNIIT VALIDATION./ PREGUNITE'. CUPERTINO STANDARDS. GARAGE SLABS F' - :r ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING • . �, ELECTRICAL ISSUANCE DATE MECHANICAL -, !' `• RLDG -ELECT,r. PLG, MecR . ^ PAID• CV 'C�]! C�' C�' DO NOT,POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED MAY INFORMATION BUILDING PERMIT WOOD FLOOR 11 VALUATIO sIFT. PLUMBING, "- � - •� -- ' MECHANICAL . City Of Cll .e ;r..; ELECTRICAL " yy r;PERraIr tlo - •. FRAMING P t 11L.'Iti 'I 11�.5. �'• r INSULATION - - - 'STORIES TYPE CONSTR. '�✓� �JG' -, /�ONa' , DEC.GROUP, TIES UNITS P ACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED OK 7 /cr-gc ,y ' 50.IT.FLOOR AREA TOTAL ACREAGE ' 'ROOF NOTE:NO FINAL-INSP.SHALLBE MADE BEFORE ' THE CONSTRUCTION TAX IS PAID� _- DIAPHRAGM. - .. :fl ,- auaolNc use ROOF SHEATHING - Res IND CON Pe Om,,, APPLY NO ROOFING UNTILABOVEHASBEENISIGNED- FINALS':' DATE - INSP. ❑ -0 ' '❑ '❑ ' ❑ ROUGH SAN.N'". A$$E$$ORS PARSE LNO. PLUMBING ELECT.ENERGY TRACT N0. • PARCEL NO. TUBS B SHOWER PAN• - PLUMBING ENERGY - , MECHANICAL - - .MECH.ENERGY- ELECTRICAL BUILDING ENERGY - ACC DATE ncc,wLE NO FRAMING ELECT.FINAL TEST - - PLUMBING ZONING ' ENG.SITE NO. r INSULATION- - - GAS TEST - GASlof� _ ' • MECHANICAL EIRESPRINK -ENERGY T24 4 COVER NO WORK ONTIL ABOVE HAS BEEN SIGNEDHEATING. , Y ❑ NEI ` ❑ NE] EXTERIOR.SHEAR I ELECTRICAL RELEASE ' LOZONE A.L.u,c. INTERIOR SHEAR - FIRE DEPT. Yo` ,N❑ Y ❑ NEI SHEETROCK GRADE- FEE SUMMARY EXTERIOR LATH. - BUILDING �- - INTERIOR LATH 1 TEMPORARY APPROVALS ' - BUILDING INTERIOR I 4. _!D SCRATCH COAT - ELECTRIC+ T' PLAN CHECK t GAS .. t FEE I ` NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. SEISMIC FEE j `= OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR' "MICROFILM -ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC "le ONE'WORKING DAY BE FORE'REQUIRED INSPECTION It^y"? • ' 0� ''PLEASE GIVE.JOB ADDRESS WHEN,PHONING. PwMewc,: Z - MECHANICAL l.J ,, • — SEE PERMIT FOR EXPIRATION DATE �. It 1 IMPORTANTI• CONST.TAX PLEASE READ REVERE SIDE BEFORE I Y f ,.+ . CALLING FOR F-INAL'INSPECTION. TOTAL Ut I't OFFICE COPY l.1 L APPLICANT TO FILL IN INFORMATION WITHIN RED,LINES - USE BALL POINT PEN ONLY UI DING PROJECT I DENTI FICATION ,PERMIT NUMBER _ G,NG APPLICATION & PERMIT-S 1 ^h BUILDING = ELECTRICAL'- 7O V PLUMBING'-MECHANICAL 11 O � OWNER'S - „ _ PLAN CHECK VALIDATION ,. NAME ` - CITY. ELECTRIC PERMIT FEE 1; - - PHONE CONTRACTOR'S NAME KI ,/- OUTLETS-SWITCHES-RECEP 10.00/1.00 10), . uC.ry 47 I LIGHTING FIXTURES 10.00/1.00 (D, CONTRACTOR s ADPPLIANCES-RESIDENTIAL 4.00 HONEa PANELS 10.00 DATEOF APPLICATION '♦• ARCHITECT . PLAN CHECK FEE P.C.NO. OR ' PANELS (OVER 200 AMP) 20.00 ENGINEER . UC.NQ: SIGNS TRANS. 3.00 ARCH.OR ENG, PERMIT VALIDATION ADDRESS -__ ' SPECIAL CIRCUIT 5.00 ZIP ITEMP.METER OR POLE INS. 20.00 A �\.Ty`A.,�.li�-rte` ADDRESS MOTORS " - SEE FEE SCH. .L\ 1 IV'�2 . ADDRESS '. I `M - SERVICE CHANGE:`- 20.00 5111 /89 o O LICENSED CONTRACTORS DECLARATION a U U Chereby affirm that I am licenser)under provisions Of Clsapter 9 - 'ISSUANCE DATE n 4 w (commencing with Section 7000)of Division 3 of the Business and ¢ a g BLDG. ELECT. PLG. MECH. H w Z Professions CosJ16 lind my license is in full fort a z 0 w- License Class Lic.Number /�f( L-L��- - m r ea Date •Contractor , - H ' MAY 11 1989 a r f ., ._ BUILDING PERMIT ¢ ¢ a OWN:R-BUILDER DECLARATION - - INFORMATION I.1.erehy uIfinI tlml I am exempt 1'rmn the Cmumelor's License MISC.r I„ REEE T nn u 0¢ Law for the following reason.(Sec.7031.5,Business and Professionx PERMIT ISSUANCE,- - VALUATION w>i Code:Any city or county which requiresa permit to construct,alter, - ¢ ¢ ¢0 improve,demolish,oLiepalf any structure,prior to its issuadce,also ELEC:CONTR. LIC.NO. ELEC. Q� '-'e�r.� O u requires the applicant for such permit to file a signed statement that " 39A0 TOTAL i PERMIT TO w $m he is licensed pursuant to the provisions of the Contractor's License ' I,'y , 1 ���,{fy�[�` F z < Law(Chapter 9lcommencing with Section 7000)of Division 3 ofthe. WTCI-1E,ti-1 ('Z.\'IWL,) q i 0 Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE at the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. e , by any applicant for a permit subjects theapplicont to a civil penalty ALTER-DRAIN -WATERIER.) 5.00 - of not more thin rive bandied dollars l 55001.1: ❑ I,as owner of the,property,or my,ermloyees with wages as BACK FLOW PROTECT. DEVICE 4,00 OCC.GROUP' RES.UNITS their sole compensation,will do the work,:rad^the struc Rue is not n intended or offered lb, sale(Sec. 7044, Busine"ss and Professions +pRAINS-FLOOR,ROOF,AREA,COND. 5.00 - Code:The Contractor's Lii'en,c Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SQ.FT.FLOOR AREA TOTALACREAGE • himself or through his own employees,provided that such.improve- ments are not intended proffered for sale.11,however.the budding GAS-EA.SYSTEM-I 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 im- .- BUILDING USE prove for pummic of sale). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other ❑ '1,as owner of the property,am exclusively contracling with ',Q 11.110 1-1 , licensed conlraclprs to construct the project)Sec. 7044,business LAWN SPRINKLERS'-1 INC 5 V.B. j 6,00 . ASSESSORS PARCEL NO. and Professions Code:The Contract,),',License Law does not apply to an owner oIproperty who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a controctod,)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. - TRACT NO: PARCEL NO. ❑ I am exempt under Sec. B.b.P.C.for this WATER HEATER W/VENT 6.00 reason Owner _ Date WATER SYSTEM -5.00 - ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION . WATER TREATING EQUIP. 5.00 I herby affirm that I hn've a certificate ol'Icimwnt[o sclGinaurc, or.a certificate of Workers'Compensation Insurance,or cLrtific L 1, ZONING, ENG.SITE NO. copy thereof(See.3800,Lab.C�'..]]ppr.q� Policy No, Cmnpanyl�&F__ _r - 0 Certified copy is hereby furnished. f FIRE SPRINK ENERGY T-24 _Z Z Certi ie copy is Fl i I Ie city inspection division.. MISC.- REFER TO ORD. O Applicant - - - Y ry Y [] N� Hy PERMIT ISSUANCE .10:f)0 FLOOD ZONE A.L.U.C. CERTI FICATI:OF IiXF. 'PION FROM WORKERS' I q.W ' LU COMPENSATION INSURANCE PLG.CONTR. L PLG. ' CL ❑ (This section decd not he completed if Ilm permit is for one TOTAL �� �' V N Y C] N E] Z hundred dollars IS 100)or less) I - - U 0 1 certify that in the performance or the work for which this per- DTV.• MECHANICAL PERMIT FEE FEE SUMMARY, LL 1- mit is.issued,I shall not employ any person in any nlarinerso as to O W become suhject to the Workers'Compensation Laws of California. 0- Date ApplicantALTER OR ADD TO MECH ' 5.00 BUILDING 225q- } N NOTICE TO APPLICANT: If,after making this Certificate of lix . I. 2 einption,you should become subject to the Workers'Compensalion APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwifh<comply with h �7 U such provisions or this permit shall.be deemed revoked. AIR HANDLING UNIT(TO 10=r-F.M.) 4.00 FEE - L) CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.FM.) 6.00 SEISMIC FEE ' I I I hereby affirm that there is a,constructinn lending agency for EXHAUST HOOD(WITH DUCT) 5.00 (p, the performance of the work for which this permit-is issued(Sec. MICROFILM 3097,CiVe.). - HEATING UNIT(TO 100,000 B.T.U.) 8.00 ' Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 r] 4O Lender's Address - ELECTRIC _' I "rtify that)have read this application and%(ote that the above VENTILATION FAN (SINGLE)' 4.00 information n correct 1 agree tog to b with all city and county _ BOILER-CUMP,(3 H.P.of 100,000 B.T.U.) 6.00 PLUMBING f 8 _ ordinances and stole lows relating m building,construction, and - hereby,authorize representatives of this city"to enter upon the BOILER-COMP IOver 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property lot inspection purposes. I S 5 (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE - 49:80 Iaz GLS CONST.TAX may in any way ac-rue ag 'est Said City in consequence of the Hing of this pe,tit MECH.CONT. LIC.NO. MECH. V TOTAL Sign IMF Ap ant ontmctor „ D'ate' �sl�t � . TOTAL STI „OFFICE COPY ,