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14299 (2) I t POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14299 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 10535 MERRIMAN ROAD UNIT# LOT# PERMIT EXPIRES IF WORK OWNER J TOBY CONTRACTOR ANTHONY' S AM CONSTR CIS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD IUB DAYS OF PERMIT ISSU- ANCEORFOUNDATION LASTCAL 180 DAYS FROM ASTLED INSPECTION. LIFER PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB p PLUMBING S� ELECTRICAL IssunrvcE OnrE MECHANICAL BLDG. I ELECT. PLG. MECR. ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL FRAMING W STORIES TYPE CONSTR. INSULATION OCC.GRCUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $O.LT.FLOOR AREA TOTAL ACREAGE i • ROOF / DIAPHRAGM BU I LOI NGUSE RES INO CON PBEl El 11 11 1 D Uuuv APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO ROUGH PLUMBING a -�- TRACTNO. PARCEL NO, GAS TEST MECHANICAL ACC,DATE ACG FILE N0. ELECTRICAL FINALS DATE INSP. FRAMING SAN # ZONING ENG SITE NO. INSULATION .. "Ir-k-k PLUMBING - &' GAS FIRE SPRINK ENERGY L'1E MECHANICAL Y ❑ NE3 Y ❑ N[:] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH-INTERIOR ELECTRICAL _ FLOOD ZONE ALLY.U.C. NF]I/- ' LATH-EXTERIOR FIRE DEPT. Y N� YU SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING b /jM - - BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS gy _ FIREWALLS T, ELECTRIC PLAN CHECK UA� 6p (-ZQ- GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC I.- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING I.- PLEASE GIVE JOB ADDRESS WHEN PHONING. 2 MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY I t A" LICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT AD7aS_a/' M e. Z 12_J 14299 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION N EQTY. ELECTRIC PERMIT FEE `) PHONE CONTRACTORS IJ OUTLETS-SWITCHES-RECEP 10.00/1.00 NAME a CO ua.No. v LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S �//T,� o ,/F�F/-- C'TI APPLIANCES-RESIDENTIAL 4.00 DOR Fra$.. •)C/�J� (�' PHoNE� _ I+ / PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO, OR EN -` Llc.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. 5.00 PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT ZIP EMP.METER OR POLE INS. 20.00 APPucADDREnrvrs MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 IOFB ce o LICENSED CONTRACTORS DECLARATION to I hereby affirm that I am licensed Under provisionsof Chapter 9 ISSUANCE DATE N <$ (commencing with Section 7000)of Division 3 of the Business and H n BLDG. ELECT. PLG. MECH. z Professions Cod u ul my It ,se is in full fo ' J e to ❑ ❑ ❑ z i m - Liccn nus. Lia Numb S + 1 Q Dale Contracto `a y BUILDING PERMIT rc w < OWNER-BUILDER DECLARATION INFORMATION REFER TO ORD w ;LL H 1 hereby affirm that I am exempt Dom the Contractor's License MISC.- 3 VAwgn ON $/FT. H .. o a Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 q0 Code:Any city or county which requires a permit to construct,alter, pC ac Q Q improve,demolish,or repair nny structure,price tU Its ISsn:nce,also ELEC.CONTR. LIC.NO. ELEC. - o u requires the applicant for such permit to file a signed statement that TOTAL CdY PERMIT TO d m he is licensed pursuant to the provisions of the Contractor's License La La Law(Chapter 9(commencing with Section 7000)of Division 3 oftheC e Business and Professions Cole)or thus he is exempt therefrom and QTV. PLUMBING PERMIT FEE V� � �R re $ the basis fur the alleged exenmtion.Any violation of Section 7031.5 I STORIES TYPE CONSTR. ai by any applicant lin a permit subjects the applicant to a civil penalty gLTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($5000.): ❑ I,as owner of the property or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS theirsole compensation,will Jo the work,and the structure is not intended OroD'ered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,CON D. 5.00 Code:The Contractor's License Law does not apply to an owner at property who builds or improves lhenon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- man,,arc not intended oroffered forsale.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 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or m- GAS IND CON PB Other prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sac.7044,liminess 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 of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractods)licensed pursuant to SEWER-SANITAR V-STORM EA.200it/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ lanLsLrrpIurder Sec. ,B.&P.C.tin thixWgTER HEATER W/VENT 6.00 reason Owner Data WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKI!RS'COMPENSA'I ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of concent to self-insure. ZONING ENG,SITE NO. or a certificate of Workers'Compensation Insurance,or a Certified copy thercof(Sce.3800,Lab.C.). Policy No. Con...any O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. y❑ N Ln Applicant PERMIT ISSUANCE 10.00 FLOOD ZONLU CIiRTII%GATE F lA% I N INS FROM WORKIiRS'I1J > COMPENSATION INSURANCIi PLG.cOrvTR. LIC.rvO. PLGy❑ N CL Q (This section need not be completed if the permit is for one TOTAL 7� Z hundred dollxrs($100)or les,J U O 1 certify that in the performance ot'the work for which this per- QTV. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall nm em y any person in any��yyBB r so as to O w becol�m sgb�`ct to the Wor •or at oa Lawi`ofCeI rnia. D all` -Lig+Aplit t ALTER OR ADD TO MECH. 5.00 BUILDING �`S`� } rail NOT CE TO AI'I'LICAN'I': a(tc 1 aking This Cert it icons of nix r Z emption,you should hecmne subject o the Workers Conmpensation 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 I0)000QF.M.) 6.00 SEISMIC FEE NS� 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,Clv.(.'.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NO UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address 1 certify that I have read this application and state that the above VENTILATION AN (SINGLE) 4.00 information is correct I agree to comply with all City and countyBOILER-COMP(3H.P.Dr 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorise representatives of (his city to enter upon the BOILER-COMP(0.,100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. ertino against liabilities,judgments, costs and expenses which CONST.TAX PERMIT ISSUANCE 10.00 in any w .accrue ag ' 'id City in Consequence of the ing 1 i p rmil. MECH.CONT. LIC.NO. MECH, TOTAL TOTAL �� n reof plicunt/Contmetor Data OFFICE COPY