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15719 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15719 INSPECTION DIVISION " JOB INSPECTION RECORD 1 PERMIT EXPIRATION JOB ADDRESS-L( �/< UNIT# _LOT#_ PERMIT EXPIRES IF WORK OWNER /LQ�.�/4-TON CONTRACTOR ,Ay[ T Ni C,14^,I.0 IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATIONANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. _ UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PR EGUNITE CUPERTINO STANDARDS. ' GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB 7 PLUMBING ELECTRICAL •ISSUANCE DATE MECHANICAL PLUG ELECT PLG. MECR DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED \ ` BUILDING PERMIT INFORMATION WOOD FLOOR - a�F PLUMBING vnwAnoN sIPT, MECHANICAL ' PERMIT ro ELECTRICAL id 4 FRAMING STORIES 1VPE CONSTR INSULATION OCC GROUP RES UNITS it•� ., PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED \ ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa.Fr FLOORAREA TOTAL ACREAGE JJ DIAPHRAGM THE CONSTRUCTION TAX IS PAID CON BUIL use ROOF SHEATHING TIES IND ory Pe olPD El •• APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ L–] 11 ASSESSORS PARCEL NO ROUGH SAN.4 PLUMBING ELECT,ENERGY TRACT NO PARCEL NO TUBS B SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY , Acc onrE ACE FILE No ELECTRICAL –/ BUILDING ENERGY FRAMING ELECT.FINAL TEST zoNlNc ENG.sire No. INSULATION PLUMBING D _�� GAS TEST GAS FIRE SPRINK ENERGY T�?4 MECHANICAL - -yam v ❑ No v [:] N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE P-/D- FL000 zorvE A,ulc ❑ N❑ INTERIOR SHEAR FIRE DEPT. y L-1 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 _ ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING �T 0-0 PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! ENALXPLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ~ BU I LDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 15719 ADDRESS BUILDING-ELECTRICAL-PLUMBING -MECHANICAL 0'//Q N /� WNE 's PLAN CHECK VALIDATION AME /fn /� / c -x OTV. ELECTRIC PERMIT FEE t4r fJ/l 1`rC g.�GT6� PRONE J- J '. CONTRACTOR S3-SWITCHES-RECEP 10.0011.00 -i NAME 1-IOh� TCC NICE NdNO7f� 0 J J LIGHTING FIXTURES 10.00/1.00 -_ CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 DOR Ess QJS �', jL(Tn-f'qJ PRONE -�� PANELS 10,00 DATE OF APPLICATION - AF CRITwT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P,C,NO, OR ENGINEER ' LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS ZIP EMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADOR E Ss SERVICE CHANGE 20.00 - o ¢ z en O o LICENSED CONTRACTORS DECLARATION log/7 a u U I hereby affirm that I am licensed under provisions of Chapter 9 w \Hk7155UAN CE DATE Z w (commencing with SaKtiob 7008)of Division 3 of the Business and BLDG. I ELECT. I PLG. MECH. 0-. w z professions Code and ny license ism full force and effect._ z o m - Liccn sc Clms�� Lic.Nut In *61 - a z w Date L Contract P, Y E -1�a BUILDING PERMIT E ¢ w a OWNIi R-BUILDI!R DECLARAX(0 INFORMATION wS A N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD " o 4 Law for the following reason(Sec.7031,5,Busines'sanciProfessions PERMIT ISSUANCE 4v.W / _ `/ALUAnoN SIFT. Code:Any city Or county which requires permit to construct.alter, /K� ¢ ca 4 O unpnwe,demolish,can' any structure,prior hr its issuance,also ELEC.CONTR. LIC.NO. ELEC. -O , requires ilia ul'plicanl lin such permit to lila a signed statement that TOTAL PERMIT TO u w C, he is licensed pursuant to the provisions of the Contractors License t. 7 ��' �` HAi Law(Chapter 9(commencing with Section 7000)ofDivisRm3ofilm 4 Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ =$ the basis for the alleged ascription.Any violation of Section 7031.5 STORIES TYPE CONSTR. u , by any aPpliam,for a Permit subjects ilia applicant to a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than five hundred dollars(5500)): 01,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for ole(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 5.00 SD.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 ments are not intended or offared for sale.IC however,the building ��_ or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Other .-e prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project ISec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner or property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contruetods)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft110.00 TRACT NO. PARCEL NO. ❑ luno exempt under Scc. .Bt&P.C.tin this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 - ACC.OATE ACG FILE NO. wORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of.....sant to sclfvia,cm. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified /. copy thercof(See.3800,Lab.C.). 1" r..hcy No. Cohnp:my O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z y(I Cert copy hs file n the city inspection division. MISC- REFER TO ORD. 0 ,{pplicanL - Y❑ N❑ Y ❑ N❑ F w PERMIT ISSUANCE ,10,90/,I�- FLOOD ZONE A.L.U,C. LU Cf:R'I'IIICCO IPE EXEMPTION TION PROM WORKERS' Ill need not be Com INSURANCE PLG.CONTR. LIG NO. PLG. 3/ �� Y❑ N❑ Y ❑ N❑ d ❑ 1'I'his sectiuin nee) not be completed it' the Permit is Ito one TOTAL bb D Z h undyed dollars IS 100)or lues) U O I certify that in to performance of the work I'(ir which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- 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 d Date M+plicunt - ALTER OR ADD TO MECH. - 5.00 �- } In NOTICE '10 APPLICANT: If,after making this Certificate of fix- F-. ? emption,you should become subject to the Workers'Compemation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deenhed revised. AIR HANDLING UNIT(TO 10)000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance or the work for which this permit is issued(Sec. MICROFILM HEATING UNIT(TO 100,000 B.T.U.) 8.00 ender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address -- I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 3 6 (0 infornmtion is correct. I agree to comply with all city and county PLUMBING ordinances and nate laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon ilia BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL O� above-mentioned property far inspection purposes. (we) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judg anis, is and expenses which � CONST.TAX may in any way accrue Sian said City in consequence of the PERMIT ISSUANCE _1866 cL ranting of this permit. MECH.CONT. LIC.NO. MECH. TOTAL a/� TOTAL 73 - S re ofA ;cant Clint or Date / OFFICE COPY