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12489 (2) POST THIS DNEARTRONTOFBUILDING • PERMITNDMBER CITr.OF CUPERTINO ` 9 ,INSPECTION DIVISION 0 24 9 JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 22883 LOnQddwn Road' UNIT# LOT# PERMIT ,EXPIRES IF WORK OWNER Harold E.' Kannarr CONTRACTOR IS NOT STARTED WITHIN ' INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSUE, ANCE OR 180 DAYS FROM ; FOUNDATION LASTCALLED INSPECTION. LIFER - PREGUNITE ' PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING � � ELECTRICAL IssuA cE ATE MECHANICAL BLDG. ELE PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED B11ILDING PERMIT • WOOD FLOOR INFORMATION VALUATION $/FT. PLUMBING' - MECHANICAL 'g + ELECTRICAL " - c. �„aPERMITT FRAMING •fes`" - STORIES TYPE CONSTR. INSULATION - - OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50,FT,FLOOR AREA TOTAL ACREAGE ROOF- " DIAPHRAGM BUILDING USE RES IND CON PB -OE. APPLY,NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ C3 . ❑ ❑ ❑ ASSESSORS PARCEL.NO. ROUGH - PLUMBING - TRACT NO. PARCEL NO. GAS TEST - MECHANICAL - ELECTRICAL � _ FINALS DATE INSP. ACC.DATEACC.FILE NO. FRAMING ,� SAN # ZONING ENa.SITE No. INSULATION PLUMBING - GAS MECHANICAL FIRE SPRINK ENERGY T 24 Y'[-] RE]COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ N❑ ' FLOOD ZONE A.L.U.C. LATH—INTERIOR - ELECTRICAL LATH—EXTERIOR v E:]. NE] v ❑ N❑ FIRE DEPT. SHEETROCK• GRADE FEE SUMMARY SHEAR INTERIOR a: BUILDING - - . SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING - FIREWALLS " ELECTRIC PLAN CHECK I GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGN EF1 OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM , ARRANGE FOR INSPECTION BY,PHONING 252-4505, ELECTRIC F ONE WORKING;DAY BEFORE REQUIRED INSPECTION. vLuMewc ." z PLEASE GIVE-JOB ADDRESS WHEN PHONING — SEE PERMIT FOR EXPIRATION DATE MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION, OFFICE COPY. ' - APPLICANT TO FILL IN INFOAWNATION WITHIN ,RED LINES - USE IILLL POINT PEN ONLY . : BUI LDI NG PROJECT I DENTI FIC PERMIT NUMBER So APPLICATION & PE T ADDRESS,pp� 1 2 AAA ;9_8_6 J DA/Fi ONJ D BUILDING - ELECTRICAL-PLUMBING-MECHANICAL I G 4 vn x9.1 OWNER'S y ,A PLAN CHECK VALIDATION NAME , AROLO 'E -4F .SJl�/�[[- Y /r/ , GY.., ELECTRIC PERMIT FEE - _ PHONE✓x5T -L , CONTRACTORS' NAME. - �Q UTLETS-SWITCHES-RECEP 10.00/1,00 0, LiC,NO. LIGHTING FIXTURES - 10.00/1.00 - CONTRACTOR'S ADDRESS APPLIANCES-RESIDENTIAL 4.00 - PHONE- PANELS 10.00 DATE OF APPLICATION ARCHITECT - _ - ' PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.N0. ENGINEER - LIC.NO. ISIGNS TRANSr 3.00 ADOFESS ENG' ., SPECIAL CIRCUIT .5.00 PERMIT VALIDATION -. ZIP TEMP.METER OR'POLE INS. 20.00 ADDRESSrs - MOTORS SEE FEE SCH. -�-�-yam.--•� SERVICE CHANGE 20.00 f^ ��/ Woo LICENSED CONTRACTORS DECLARATION �'i (.0 l/ a v I hereby affirm that I am licensed.under provisions of Chapter 9 ISSUANCE DATE y Qli (commencing with Section 7000)ofDivision3 of the Business and r y i Professions Code,and my license is in full force and effect. ^ /- BLDG., ELECT. PLG. MECH. Z o m- License Class Lic.Number /s fir' , 4 -D Date Contractor Cl`J' Of CU a El L s w DBff1p0 BUILDING PERMIT rc o OWNER-BUILDER DECLARATION - INFORMATION X g y 1 hereby affirm that I am exempt from the Contractor's License MISC.- . REFER TO ORD H _O J Law for the following reason.(Sec.7031.5;Businessarid Professions PERMIT ISSUANCE 10.00 ,Q VALUATION $/FT. Code:Any city or county which requiresa permit to construct,alter, re a¢O improve,demolish,or repair any structure,prior to its issuance;also ELEC.CONTR. LIC.NO. ELEC. O u requires the applicant for such permit to file a signed stalement.that - - TOTAL 7�V'� PERMIT TO a w m he is licensed pursuant to the provisions of the Contractor's License _ H z Q Law(Chapter 9(commencing with Section 7000)of Division 3 of the EL ,. E D 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 Section 7031.5 STORIES - TYPE CONSTIF a3 _ by any applicant for a permit subjects the applicant to a civil penalty - ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(S500)J: 1,as owner of(lie property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES.urvlTs Utah 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,CON D. 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 5.00 SQ.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended 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- builder wner GAS-EA.SYSTEM OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or i - . m- BUILDING USE prove for purpose of sale.). RES IND CON - PB Orh¢r ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 1:1 11 ❑ ❑ 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 Got 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 uontractoos)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 , the Contractor's 'cense Law. TRACT NO. PARCEL NO. ❑ lam pt under Sec. ,B.&P.C.for this WATER HEATER W/VENT - . 6.00 reason - J�t Cason Date WATER SYSTEM - 5.00 - - ,,ACC.DATE ACC.FILE N0. WORKERS OMPE TION DECLARATION , WATER TREATING EQUIP. - 5.00 1 hereby affirm that I have a certificate of consenttoself-insure, ZONING ENG.SITE NO. or a certificate oh Workers'Compensation Insurance,or v certified - copy thereof(See.3800,Lab.C.).' , - Policy No. Company - O ❑ Certified copy is hereby furnished. Z Z ❑ Certified copy is filed with the city.inspection division. FIRE SPRINK ENERGY T-24 FO Applicant a _ MISC.- REFER TO ORD. Y [-] N[ Y ❑ NQ r' Cry'.' CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTR.-, LIC.NO. • PLG. n' O (This section need not be completed if,the permit is for one - TOTAL. ' Y N v N Z hundred dollars IS 100)or,Iess.) 00 . 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL t mil 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. Q. Date ApplicantALTER OR ADD TO MECH. 500 BUILDING >_ N NOTICE TO APPLICANT: If,after making this Certificate of Ex- . . _ Z_ 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 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER,t0i"C.EM.) 6.00 SEISMIC FEE ' 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 HEATING UNIT 100,000 B.T.U.)9.50 q Lender's Address ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN,(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-COMP(3 H:P.Dr.100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposesBOILER-COMP(Over 100,000 BTU)SEE FEE$CH. 'MECHANICAL . - - - (We) agree [o save, indemnify and keep hamnless,the City of MISC:- . REFER TO ORD. Cupertinomst Babilities,judgme ts, costs and expenses which CONST.TAX may In `0 way accrue against siall City in consequence of the PERMIT ISSUANCE 10.00 gra I f[his•p Y MECH.DONT. . LIC.N0. MECH. S rorAL TOTAL 1 nt acro Date I OFFICE,COPY