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15917 (2) POSTTHISCARD NEAR FRONF_BUILDING PERMITNUMBER CITY OF CUPERTINO 15917 INSPECTION DIVISION r JOB INSPECTION RECORD C) PERMIT EXPIRATION JOB ADDR ESS �`"/ '� Mai✓/�� GT UNITJ# _LOT V9_NPERMIT EXPIRES IF WORK OWNER . %_�J34< / vC,(g. . ,ZZ CONTRACTOR 4/N.T Lam= �� IS NOT STARTED WITHIN .INSPECTION DATE INSPECTOR INSPE ION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 7'"4Z F Sak— -- UNDERGROUND /SLAB —' _ o6c) c PLUMBING �j.E[,F Q'aG(JZ� n ELECTRICAL L2ANSE UA I E MECHANICAL L L % ELECT� I PLO, MEC. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED LL i BUILDING PERMIT INFORMATION WOOD FLOOR ^ VALUATION - $/ET. ' PLUMBING000 ELECTRICAL MECHANICAL _Z�yy- /` 000 ELECTRICAL PERMIT T/o/� 'FRAMING Seo w "- INSULATION - MES. TYPE o ST R kA4 S��- OCCC . , GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.TqT prLo R AREA TOTAL ACREAGE DIAPHRAGM _ THE CONSTRUCTION TAX IS PAID 6(//.� k.' y/ BUILDING USE ROOF SHEATHING Ir' IND CON PB on,•., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. "-^ 0 ❑ 0 0 ASSESSORSPARCELNO ROUGH SAN.11 a-- ` _ �g p PLUMBING y/ �-? ELECT.ENERGY 3 Nol—� -Wa ! TH ACI NO PARCEL NO TUBS&SHOWE PAN PLUMBING ENERG MECHANICAL MECH.ENERGY ACC DATE ACC PILE NO ELECTRICAL BUILDING ENERGY FRAMING 2 -ITI, ELECT,FINAL TEST ZONING ENG,SIZE NO. INSULATION PLUMBING GAS TEST GAS ' • FIRE SPRINK ENERGY T.7G • MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING [:] NQ, ❑ N� EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE ALuc 7 INTERIOR SHEAR FIRE DEPT. C] Nf L No 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 ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC i F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBINGLU Z PLEASE GIVE JOB ADDRESS WHEN PHONING. ' _ — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX 11/1 PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. 0 OFFICE COPY PPLICANT TO FILL IN INFORMATION WITHIN RAIIIIIIIIINiWIES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER ✓Q <ooAla APPLICATION & PERMIT 1 5917 p MAN ( c/U-fG� C BUILDING-ELECTRICAL-PLUMBING -MECHANICAL 0 I J I I OWNER 5 PLAN CHECK VALIDATION -Q "AME QTY. ELECTRIC PERMIT FEE CONTJ 'JK VGN,µ PNDNE SS9- / c*ons NAME UTLETS-SWITCHES-RECEP 10.00/1.00 / NAME 1 AI 0EC No,Jr LIGHTING FIXTURES 10.00/1.00 CONTRACADDRESSTOR C4W�O`vJ`1.e- PPLIANCES-RESIDENTIAL 4.00 119,15- NA3VI tJ !` EvHONE ��/ PANELS 10.00 DATE OF APPLICATION FnLnITECT ° PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGn INEEn PK LIC,ND. SIGNS TRANS. 3.00 ARCR.DR Erv4 PERMIT VALIDATION �Q ADDREss n_ �, q[�. SPECIALCIRCUIT 5.00 7 W iQ zlP/S/ EMP.METER OR POLE INS. 20.00 APPLICANT SMOTORS SEE FEE SCH. ADDRESS -, SERVICE CHANGE 20.00 / v w o o LICE SCD CON'TRACI ORS DECLARATIONal a 1 hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE H a H (Commencing with Section 7000)of Division 3 of the Business and , fi LDG. ')ELECT. I PLG. MECH. r m z Professions Cod toy license is in lull for. pffzci. �1„ z o H - 1-,eche C's C -nn Lie Numher L b �� rR o ¢ H,�i pate�.-.� Contractor NG PERMIT �z 2 ¢ ¢ w ¢ OWNER-BUILDER DECL R ON _ o A G MISC.- REFER TO ORD RMATION F. 3 LL w I hereby affirm that I am exempt from the Contractors License LL04 Law for the billowing reason.(Sec.703 I.S.Business and Professions PERMIT ISSUANCE P`/ApLunnoN S/FT. � - Cade:Any city orcounty whichreyuiresapermit to construct.alter, /� U�tiu.y8(tIRQ _ ¢ ¢ Qa improve, or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. 0 ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO wm" he is licensed pursuant to the provisions of the Contractor's License r� / La As i L..(Chapter 1)(commencing with Section 7000)of Division 3 of lire 4 Business and Professions Code)or that he is exempt thcn4mm and QTY. PLUMBING PERMIT FEE ¢ o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. n ; m by any applicant fora permit subjects the applicant penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 �Vr�/(.� 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 RES.urvrtS their sole compensation,will do the work,and the structure is not tended or offered for sale (Sea 7044, Business and Pmfessioas 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 5.00 SG.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve menti are not intended or ol'Ibred for sale:If,however,the building 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 (EA.) 2.00 BUILDING USE Q builder will have the burden of proving that he did not build or im- prove for purpou ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ 1,as owner of the properly,am exclusively contracting with ❑ ❑ ❑ ❑ licensed Contractors to construct the project(Sec. 7044,Business LAWN SPR IN KLERS- 1 INC 5 V.B. 6.00 ASSESSOHS PARCEL NO. and Professions Code:'I'lie 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 3 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT N0. PARCEL NO. O lam cxemptunder Sec. .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 1 hereby:Himn that I have a certificate ofconsent to sell-insure. ZONING or a certificate of Worker.v Comp.}ytun IasumIICC.or a certified ENG.SITE NO. copy thereof(Sec.3800.I-ab.0.). Policy No. Company O Cl Ceailied copy' ..4Y folmilled. FIRE SPRINK ENERGY T-24 Z Z untt�.d L y / d w' yhc�espn division. O� p /.r MISC.- REFER TO ORD, -y v ❑ N❑ v ❑ N❑ rn CIi R'I' 1C file OF:1?h EMPTION FROMWWBKERS' PERMIT ISSUANCE FLOODZONE A.L.u.c. LU COMPENSATION INSURANCE PLG.CONTE, u1..NO. PLG. IL O This section recd not be completed it' the permit is for one TOTAL 4 Y❑ N❑ Y❑ N❑ Z hundred dollms($100)or less.) U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued, 1 shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. BUILDING I i� Date pplicunt ALTER OR ADD TO MECH. 5.00 W } ti NO110E '10 APPLICANT': If,after making this Certificate of Ex- j.- ? enption,you should becnnic subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of tire 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 10DWC.F.M.) 6.00 SEISMIC FEE tz I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 Ole performance of the work for which this permit is issued(Sec MICROFILM 3097,Civ.C.L HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender a Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address e�- 1 certify that 1 have read this application and state that tiro above VENTILATION FAN (SINGLE) 4.00 U information is correct. 1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMPI3 H.P.or 100,0008.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000BTUISEE FEESCH. 44J MECHANICAL above-mentioned property for inspection PUTPIWS beg. ndemnify and keep harmless the City of MISC.- REFER TO ORD. es,judgments, sts and expenses which PERMIT ISSUANCE CONST.TAXagai t sr ty i consequence of the MECH.CONT. LIC.NO. MOTAL 7-Ir- q�G/ TOTAL a0 3 /� ign Lure of Applicant/Contractor Date OFFICE COPY