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8838 (2) POST THIS CARD NEAR FRONT OF B•UI,LID ING ' PERMIT NUMBER CITY OF -CUPERTINO , ' "$• .. � INSPECTION DIVISION " . '. "JOB INSPECTION.RECORD PERMIT EXPIRATION, JOB ADDRESS' II % (P {L�,1 � .: UNIT# 'LOT# ' PERMIT. EXPIRES IF WORK. OWNER - - - GO CEDE , IS NOT, STARTED WITHIN INSPECTION DATE INSPECTOR IN TION RECORD 18abAYSOFPERMIT ISSU- FOUNDATION a Com;, G-r F, ANCE'OR.;180 DAYS FROM - y� `LAST CALLED INSPECTION. LIFER wn Lal -1 ' u PREGUNITE - Q\E6"S 6 .V PERMIT VALIDATION, POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB I "` PLUMBING ELECTRICAL' ' F �"ISSUANCE NATE.' + - MECHANICAL - ,E eLoc. ELECT. PLG. .MECH.- ' 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING ^XALUATION- V, $/Fr. MECHANICAL ELECTRICAL PERMIT TO' _ FRAMING v j' INSULATION ' „ ,TO AI TVPFj , - , OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SD.FL FLOOR AREA TOTAL ACREAGE„ DIAPHRAGM c Y - BUILDING USE a' „RES." IND CON PB ,-Other APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED • ❑ El ❑ ASSESSORS PARCELNO. ROUGH ' PLUMBING GAS TEST - TRACT.NC. +�PARCELNO., MECHANICAL' - J`• ACC.DATE ACC.FILE NO. ELECTRICAL ' FINALS DATE INSP. FRAMING - 'SAN INSULATION ZONING .,ENG.SITE NO. - - - PLUMBING • - GAS MECHANICAL FIRE'SPRINK ENERGY T.}4,. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [_] *NE], "Y ❑` ,No LATH—INTERIOR ELECTRICAL - FLOODZONE - AXCU.c.-. LATH—,,EXTERIOR - FIRE DEPT. - C❑ N❑ ..v Ej N❑ . SHEETROCK - - GRADE - FEE SUMMARY SHEAR INTERIOR - BUILDING+ SHEAR EXTERIOR TEMPORARY APPROVALS . ' BUILDING; i ` FIREWALLS ELECTRIC • PLAN CHECK ,! GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC_F.EE m}-777 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM . .,ARRANGE FOR INSPECTION BY PHONING 252-4505, ; ` ELECTRIC LU ONE WORKING DAY BEFORE REOUIRED.INSPECTI0N.• O PLUMBING' Z PLEASE GIVE JOB ADDRESS WHEN'PHONING. - SEE PERMIT FOR'EXPIRATION DATE'- ' MECHANICAL IMPORTANTI "coNs 'TAx 4 - .J ) 4 PLEASE READ REVE RSE'SIDE:BEFORE CALLING FOR FINAL'INSPECTION'., , TOTAL - - - "- OFFICECOPV APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDINGP OJECT IDENTIFICATION - , PERMITNUMBER BDILpING APPLICATION & PERMIT ADD E s 8838 8 3 8 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL o OW ER's PLAN CH K VALIDATI NA j OTV. ELECTRIC PERMIT FEE 6 PHONE r // I CONTRACTOR'5 1 OUTLETS-SWITCHES 10.00/1.00 i3�� VMELIC.NO. 8G5 LIGHTING FIXTURES 10.00/ . 0 �./JlVVV CONTFACTVW ADDRESS s PPLIANCES-RESIDENTIAL 4.00 kodiiVAIIHONE 34s-vlao PANELS 10,00 OAell PPLICATION OpRCRTCr ` �pt IV1 PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEEP.C.NO. ENGINEER R C!a LIc.No. SIGNSTRANS. , 3.00 AOon'OR F55 "O. SPECIALCIRCUIT 5,00 PERMIT VALIDATION aa. ZIP -W(, EMP.METER OR LE INS. 20.00 ADDRESS MOTORS SEE FEE SCH. q ) ADDRESS /^ SERVICE CH GE 20.00 W woo LICENSED CONTRACTORS DECLARATION TEMP.PO 30.00 <is v 1 hereby affirm that I am licensed under provisions of Chapter 9 IBSUAN E DATE N C N (commencing with Section 7000)of Division 3 of the Business and BL G. ELECT. PLG. MECH. Professions Cod• unpmy}I se is in full farce' (f ❑ El Elpo License n-�-C�d Lic.NumbeC i Date `��,rJ��_'OQ6 Contractor < x Ic x w OWNER-BUILDER DECLARATION BUILDING PERMITINFORMATION X ;u 1- 1 hereby affirm that I am exempt from the Contractor's License ISG:- REFER TO ORD v. 0 Law for the following reason.(Sec.7031.5,Business and Professions / V L $/FT. - PERMIT ISSUANCE 10.00 Cade:Any city or county which requires apermit tocons.. ',alteralso' Q Q Q 0 Improve,demolish,or repair any Structure,prlo!10 IIS ISallaace,aI30 EL CONTfl. LIC.NO. ELEC. i w m LL requires the applicant for such permit to file a signed statement that TOTAL MIT TO he is licensed pursuant to the provisions of the Contractor's License TOTAL ` / F z < Law(Chapter 9(commencingwilh Section 7000)of Division 3 ofthe f 4 0 Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE M H $ the basis for the alleged exemption.Any violation of Section 7031.5 ST PIES TYII C15NITR. n3 � by any applicant for a permit subjects the applicant to'a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP- REB.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 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES,PER TRAP .00 SO,FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-l1NC.40UTLE 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IE 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE IN TE 30.00 IND Cory PB Oher ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sea 7044,Business LAWN SPRINKLERS-1 1,Nt 5 V.B. 6.00ASSESSORS PARCEL N O. and Professions Cade:The Contractor's LicenseLaw does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS- VER 5(EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY TORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sea ,B.&P.C.for this WATER HEATE /VENT 6.00 - reason Owner Date WATER SVST,LM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TR ATING 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 thereof(Sec.3800,Lab.C.l.� � � � / Policy No. Company / A Ltfs•fa a 4yA. O )f Certified copy is hereby f�mished�/// FIRE SPRINK ENERGY T@4 Z Z ❑ CertiN ed with the city inspection division. F prj• Applicant r MI C.- REFER TO ORD. Y ❑ N Y ❑ N❑ W v-7 CERTIFICATE OF EXEMPTION FROM WORKERS' RMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. SU CL > (This section need not be completed Rif heANCfpermit is for one vLG.CONTR. C.NO. TOTAL Y[:] N❑ Y ❑ NE]aD D Z hundred dollars IS 100)or less) U O I certify that in the performance of the work for which this per, QTY. MECHANICAL PERMIT FEE FEE SUMMARY IL - mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. BUILDING CL Date Applicant ALTER OR ADD TO MECH. 5,0 >- N NOTICE TO APPLICANT: If,after making this Certificate of Ex- F 2 emplion,you should become subject to the Workers'Compensation APPLIANCE0 PLAN CHECK provisions of the Labor Code, you must forthwith comply with U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F. 4,00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10 EM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH D T) 5.00 issued the performance of the work for which this permit is (Sec. MICROFILM 3097,Civ.CJ. I HEATING UNIT(TO 19,1K000 BT-U.180 Lender's Name HEATING UNIT(O R100,000 B.T.U.)9.50 Lender's Address ELECTRIC - I certify that I have read this application and state that the above VENTILATION AN (SINGLE) 4.00 information is correct.1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-CO (3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the g01 LER- MP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify unit keep harmless the City of MIS - REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which p MIT ISSUANCE 10.00 CONST.TAX may in a w' accrue agar aid City in consequence of the gmntin t penniL _ MEC ONT. LIQ NO. MECH. \�\/ TGTAL TOTAL Signature of Applicant Con or Dat OFFICE COPY