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14231 (2) . - . POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14231 INSPECTION DIVISION y JOB INSPECTION RECORD PERMIT EXPIRATION I' JOB ADDRESS 10620 MERRIMAN ROAD UNIT# LOT# PERMIT EXPIRES IF WORK OWNER JEFFREY MCEWEN CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- C� p FOUNDATION -1^�1`W8 IN�'L' r y�m' LM'ne ''h° tNCE OR 180 DAYS FRONTNASTCALLED INSPECTION. UFER PERMIT VALIDATION+ PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PAD l/ UNDERGROUND /SLAB 'I q PLUMBING '�ANJI,€J907 ELECTRICAL BLDG. ELECT. -PLG._ MECH. MECHANICAL '❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOORvA LUATtor� $/FT. .PLUMBING C MECHANICAL ' ELECTRICAL Bq y.)�/"ro//� FRAMING vYJ STORIES TYPE CONSTR. INSULATION - OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 5O F,,FLO.G AREA TOTAL ACREAGE . ROOF DIAPHRAGM -BUILDINGUSE HES IND CON PB Olney APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH F PLUMBING a,,.f s• , TRACT NO. PARCEL NO. GAS TEST MECHANICAL „S_ ACC.DATE ACG FILE No, ELECTRICAL FINALS DATE INSP. FRAMING SAN # zorvlrvc ENc.SITE No. INSULATION 6 PLUMBING GAS url FIRE SPRINK ENERGY T-]a �.. MECHANICAL �]'�d� v ❑ N❑ Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH-INTERIOR �7 ELECTRICAL Z „ _ FLOOD ZONE aL.u.c. LATH-EXTERIOR �7- FIRE DEPT. v❑ rv❑ v ❑ N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING _ SHEAR EXTERIOR TEMPORARYAPPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK 6cr '� (7� -t?PS C GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 4 OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F_ ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL -SEE PERMIT FOR EXPIRATION DATE CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY i APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I BENTI FYCATI ON -- PERMIT NUMBER BDIIDING APPLICATION & PERMIT A ^ AOOgEs� I G till , 111BUILDING -ELECTRICAL-PLUMBING -MECHANICAL OWNER'S TYI�JOZD �_ PLAN CHECK VALIDATION *4 [i QTY. ELECTRIC PERMIT« FEE AA >Xk CONT CTORS OUTLETS 10.00/1.00 NAME ,IC,No. LIGHTING FIXTURES 10.00/1.00 DREScroR's ADAPPLIANCES-RESIDENTIAL 4.00 Z' CONTRA PHONE Z, PANELS 10.00 o DATE OF APPLICATION N r ARCHITECTr� �:w1 ��-J, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.N0. n ENGINEER No. ISIGNS TRANS. 3.00 ARCH.oR END' SPECIAL CIRCUIT 5.00 E LIDATION ADDRESS 11, pp 36 r� fG Jr ZIP TEMP.METER OR POLE INS. 20.00 JAN ^Ff 1N8� APPLICANT'S MOTORS SEE FEE SCH. JJ ADOREss q� � C O f'Kr 'rV4q✓� SERVICE CHANGE 20.00 - L�.r..EdiwBl� woo LICENSED CONTRACTORS DECLARATION L�BW� ¢U�y 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE N ,N (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. M H H z i Professions Code,and my license is in full force and effect. z o= License Class Lia Number - 9 z H o Date Contractor P y M � BUILDING PERMIT ¢ ¢ wOWNER-BUILDER DECLARATION INFORMATION I w ;u w I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD .. o j Law for the following reason.(See.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION 3/FT. � - Code:Anycity crcounly which requiress permit to construct,alter, R ¢ Q 2O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. G _ 7 -G ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO ' w$ he is licensed pursuant to the provisions of the Contractor's License HiQ Law(Chapter 9(commencing with Section 7000)of Division 3 of the ' f 4 a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ H o the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TVP CONSTR. m by any applicant for a permit subjects the applicant tort civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five Imlid red dollars($500).): ❑ 1,as owner of the property,or limy employees with wages as BACK F LOW PROTECT. DEVICE 4.00 ocC.GROUP RES.UNITS their sole Compensation,will do the work,and the structure is not intended car Offered for sale (Sea 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 Pr.FLUOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- rGAS-EA.SYSTEM-1INC.4OUTLETS 6.00 rents me not intended or offered far sale.If,however,lite building or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 / builder will have the burden of proving that he did not build or int- BUILDING USE proimpose,,I've for pose ofsale.). INDUSTRIAL WASTE INTER. 30.00 RE5 INo CON PB omer ❑ I,as owner of the property,can exclusively contracting with ❑ ❑ ❑ ❑ ❑ 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 not apply to an owner of properly who builds or improves(hereon.and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 contrac or such projects with a Conlrxctots)licensed pursuant to NO tractor's License Law. SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. I am exempt under Sue. ,B.&P.C.I'..tli5WATER HEATER W/VENT 6.00 on Owner Uate� WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. KERS'COIAPENSATION DECLARATIO WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate of consent to self-insure. ZONING ENG.SITE NO. ora Certificate of Workers'Compensation Insurance,or a certified COPY thereof(See.3800,Lab.C.). Policy No. Con.pray Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z z ❑ Certified copy is Bled with the city inspection division. MISC.- REFER TO ORD. 0 Applicant Y❑ N❑ Y ❑ N CC CERTIFICATE OF EXEMPTION I7ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COMPFNSAT'ION INSURANCE PLG.CONTE. LIC.NO. PLC. eo O_ 0 1'1'his section need not be completed if tilePemilt is lir one TOTAL - V E] NE] V El N❑ Z) Z hundred dollars IS 100)or less.) L) O I certify that in the performance of the work for which"his per- DTV MECHANICAL PERMIT FEE FEE SUMMARY LL H mi"is issued,I shall not employ any person in any manner so as to Ow become subject to the Workers'Compensation Laws of California. BUILDING Date Applicant ALTER OR ADD TO MECH. 5.00 slv >_ 0 NOTICE "f0 APPLICANT: If,after nuking this Certificate of Ex- F Z eruption,you should bill,olne subject m 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 1000011F.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 of the work for which this permit is issued(Sec. HEATING UNIT IT 100,000 B.T.U.) 8.00 /- MICROFILM 3097,Cie C.). Lender's Name HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address . I certify(hat I have read this application and state that the above JBOI VENTILATION FAN (SINGLE) 4.00 x i information is correct. I agree to comply with all city and county PLUMBING ordinances and stale laws relating to building construction, andBOILER-COMP(3H.Ror100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon theLER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property 1or inspection purposes.(We) agree to save, indemnify and keep harniless the City ofMISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE10.00 CONST.TAX may in any w y accrue against said City in consequence of the granting of lhi r I MECH. LIC.NO. MECH. f IOTA` TOTAL X33 Signa plicant/Conlmctor Ua OFFICE COPY �� y ' — _ CITY OF CUPERTINO OFFICECOPY J GAS.AAME NOTICE 1 q `sYf i ,To I You are hereby authorized to connect the-GAS service for . ` Owner or Tenant - �r� /_2e S� �'7:�e' rw i.•s. At (I No.of Meters Reconnect No.of Add. Meters' .. Move Service t • ' _, Move Meter _ PLUMBING INSPECTOR ✓r>.w�.s}u �'�' Q�+� OT