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17338 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER -CITY 01 " CUPERTINO 1733$ INSPECTION DIVISION JOB INSPECTION RECORD E / , � ..6 "4 +fJ , #lPERMIT EXPIRATION JOB ADDRESS `—r 1/=�lL— ` UNIT _LOT# PERMIT EXPIRES IF WORK OWNER Davie- G ♦^ CONTRACTOR ( IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECOR6 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 CIN OF 7 PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS ' , Y POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED `_3" - PLUMBING UNDERGROUND'/SLAB AR U3 1kj �(A�, f1�C ELECTRICALat/y�pv 1 City W y � ISSUANCE DATE MECHANICAL VLDG ELECT. PLG, MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT" WOOD FLOOR INFORMATION PLUMBING VALUATION • SIFT. -- .. MECHANICAL ELECTRICAL FRAMING 1 INSULATION 5 RIES TVP ONSTR. • � , OCC.GHOUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 FT.FLOOR AREA TOTAL ACREAGE - ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOFSHEATHING HES IND CON PB' om„ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.N ASSESSORS PARCEL NO. • PLUMBING ELECT.ENERGY ' . TUBS 8 SHOWER PAN PLUMBING ENERGY - TRACT NOPARCEL NO.. MECHANICAL MECH•ENERGY ACC.DATE ACC.FILE NO, ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST INSULATION ZONING ENG.SITE NO. PLUMBING GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T 2< COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ° ❑ N❑ ` ❑ "❑ _ - FLOOD ZONE A L U C. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT, W [] N❑ Y ❑ N❑. 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 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM w ARRANGE FOR INSPECTION BY PHONING 252-4505, gg1 ELECTRIC I-' - ONE WORKING DAY BEFORE REQUIRED-INSPECTION. {'J-q PLUMBING dD z PLEASE GIVE JOB ADDRESS WHEN PHONING. ]] a° 1 /.;' MECHANICAL -"SEE PERMIT FOR EXPIRATION DATE'- ye. r IMPORTANT! CONST-TAX PLEASE READ REVERSE SIDE BEFORE { TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT-TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY . BUILDING PROJECT IDENTIFICATION PERMIT NUMBER APPLICATION & PERMIT aDh17338 '��i BUILDING—ELECTRICAL—PLUMBING—MECHANICAL OWNERlj# Z6'S - PLAN CHECK VALIDATION NAME ��11� /� &5N �1 TY. ELECTRIC PERMIT FEE PA I/ 1. eE 142 CONTRACTORS [[ UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 ADDRESSTo s f4ve PP LI ANCES-RESIDENTIAL 4.00 U r NemoV1 PHONE p PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR PANELS(OVER 200 AMP). .20.00 ENGINEER uc.No. SIGNS TRANS. .3.00 ADDRESS etc. SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. .20.00 ADDRESSTs MOTORS SEE FEE SEH, SERVICE CHANGE moo woo LICENSED CONTRACTORS DECLARATION 9:ke - _<0 Lt1 hereby affirm that 1 am licensed under provisions of Chapter 9 N,a w (commencing with Section 7000)of Division 3 of the Business and ISSUANCE DATE H H z Professions Code,and my license is in full force end effect. MAR9th'I DG. ELECT. PLG. MECH. a; o m - License Class Lic.Number r❑ S � 9 w H w Dale Contractor , 4 u BUILDING PERMIT a ¢w OWNER-BuaOER Dec LA RATTON - INFORMATION X;LL v 1 hereby affirm that I em exempt from the Contractor's License MISC.— REFER TO ORD u. 04 Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT. i m i Code:Any city or county which structure permit o its issuance, ager, PERMIT ISSUANCE 70.00 ¢ ¢ 4 O improve,demolish,of repair any structure,prior to its issuance,also .ELEC.CONTR. 'LIC.NO. ELEC. i O¢ requires the applicant for such permit to file a signed stat...hunt that TOTAL PERMIT TO w $ he is licensed pursuant to the provisions of the Contractor's License ' H z i Law(Chapter 9(commencing with Section 7000)of Division 3 oftbe r` 4 Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE sro IF m the basis for the alleged exemption.Any violation of Section en L5 STORIES TYPE ONSTR. A, ; _ by.any applicant fore subjecathe ubjectt($500plicanl tuucivil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than flue ImndreJ Dollars($500).): ❑ I,as owner of the propertyor my employees with wages as BACK F LOW PROTECT. DEVICE -4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR;ROOF,AREA,COND. 5,00 7 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who do0a6gch work FIXTURES-PER TRAP '5.00 , SO.FT.FLOORAREA TOTALACR EAGE himself or through his own employees,provided that such improve- memsarenotintended 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 tact ac did not build or im- BUILDING USE prove for purpose of sale.). - RES IND CON. PB " Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ❑ El ❑ D 13licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 600 ASSESSORS PARCEL NO. CX nd Professions Code:The Convector'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 contraclons)licensed pursuant to - the Contrnetor'sLicense Law. SEWER-SANITARY-STORM EA.2000/10.00 TRACT NO, PARCEL NO. ❑ I am exempt under Sec..,BAP.C.for this reason WATER HEATER W/VENT t 6.00 Owner - Date rWATER SYSTEM 5.00O Z Z,1 h ACC.GATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm lhatl have acerl ificate of consent loself-mare, ZONING or a certificate of Workers'Compensation Insurance,or II certified _ ENG.SITE NO. V copy thereof(Sec.3800,Lab.CJ -' J Policy No. Company JJJ ❑ Certified co is hereby to is Z Z ❑ Corti f Py ItIt a city inspectlou division. FIRE SPRINK ENERGY T-Z4 FO Applicion MISC.- REFER TO ORD. y [:) N❑, yC-] NE iy CERTIFICATE oh FxLmPTION PROM WORKERS' PERMIT ISSUANCE 1000 1.2-0 FLOOD ZONE A.L.U.C. h LU COMPENSATION INSURANCE: PLG.CON R. LIC.NO. PLG. d O (This section need not he completed if the permit is for one if TOTAL y❑ NF] y[] NE) Z) Z hundred dollars IS IOD)or less.) U O 1 certify that in the performance of the work foi which this par- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mil is issued,1 shall not employ any person in any mm�ner to as to O w become subject to the Workers'Compensation Lawsof California. IS. Dale Applicam ALTER OR ADD TO MECH. 5.00 BUILDING } b NOTICE TO APPLICANT: If,after making this Certificate 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 U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.EM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for _ EXHAUST HOOD(WITH DUCT)' 5.00 the pert'......nuc of the work for which thispermit is issued(Sec. MICROFILM 3097,CivC.). HEATING UNIT(TO 100,000 B.T.U.) 6.00 Lender's Name Address Lender's Address - HEATI NG UNIT(OVER 100,000 B.T.U.N.50 ELECTRIC I cenily that l have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 d0 ® information is correct I agree to comply with all city and county PLUMBING ordinances and stale laws relating to building construction, and BOILER-COMP(3 H.P.or100,000B.T.U.) 6.00 e hereby authorize representatives of this city to enter upon the BOILER-COMP (over 100,000 BTU)SEE FEE SCH. MECHANICAL abovcmhentioned.properly for inspection purposes. (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 10.00 CONST.TAX may in any way accrue against said City in consequence of the ran of S permit MECH.CONT. CIC.NO. MECH. —ZL �� % 3-�— / TOTAL TOTAL / Od Sag ar o p hcafi ` o Dat _ OFFICE COPY