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8910 (2) . POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO9� INSPECTION DIVISION JOB INSPECTION RECORD �/J 'PERMIT EXPIRATION ,OBADDAESS `+'0 _ UNIT# LOT# PERMIT EXPIRES IF WORK OWNER / CONTRACTOR G IS NOT STARTED WITHIN INSPECTION TE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSu- FOUNDATION - SACO TReex -2--F/'44,4f9 ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UPER PREGUNITE yy PERMIT VALIDATION t POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB A' PLUMBING - - -� '. ✓ ELECTRICAL - ISSUANCE DATE MECHANICAL BLDG, ELIENT. PLG. MBCH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT - I FORMATION WOOD FLOOR VALU TION $AT.. 'PLUMBING � ' MECHANICAL - ELECTRICAL - y ERMIT TO FRAMING ogles vP N TR. INSULATION - OCC,GROUP ARES Ury TS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO,FT-FLOOR AREA TOTALACREAGE DIAPHRAGM - - BUILDING USE. ' HES IND CON-,� PB Omer APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El O ❑`T ❑ ❑ ROUGH ASSESSORSPAR.CE L NO. PLUMBING • - GAS TEST TRACT NO, PARCEL NO.' F MECHANICAL L U ACC;DATE ACO.FILE NO. ELECTRICAL _ } FINALS DATE INSP. , FRAMING C SAN # - ZONING "ENG,S GAS NO. INSULATION PLUMBING ' FIRE SPRINK ENERGY T.24 MECHANICAL - - v ❑ NEJ -VE) N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ELECTRICAL FLOOD ZONE A.L.U,C. LATH-INTERIOR � _ _ LATH-EXTERIOR FIRE DEPT. ,row Y0. N .Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING `arms SHEAR EXTERIOR TEMPORARY-APPROVALS BUILDING - 1' FIREWALLS ELECTRIC PLAN CHECK •• FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. - T - MICROFILM oARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC � 'ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE -. MECHANICAL IMPORTANT!, coNsr.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. • -�r.(.#yi'ti; ,. OFFICE COPY ' J FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY#7t6 30 d PROJECT IDENTIFICATION APPLICATION SI PERMIT PERMITNUMBER lairr.x V 6 i p,ta A BUILDING -ELECTRICAL-PLUMBING -MECHANICAL 8910 e-0,14- 1 _7 t/ OTY. ELECTRIC PERMIT FEE PLAN CHECK v\1quogn//o�1ry Q1(^ CONP I' PRONE / 7- O]OO )7�/ O/ / NAME UTLETS-SWITCHES-RECEP 10.00/1.00 0 3 LIE No. LIGHTING FIXTURES 10.00/1.00 DONP/ ADDRESS APPLIANCES RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION onncHITECT PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P.C.NO. NGINEER LIC.No. ISIGNS TRANS. 3.00 ARCH ESS OR ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 pD�/,r'(� oo LICENSED CONTRACTORS DECLARATION TEMP,POLE 30.00 111py U J( c an u I hereby affirm that I am licensed under provisions of Chapter 9 I•IA l , i ISSUAN E tlATE (commencing with Section 7000)bf Division 3 of th Business and BL G. ELECT. PLG. MECH. H z Professions Cp�,.�nd my license is in full for Ci y ©CI pePLG ❑ z o,mr, - License Class_],,,J!�_Lic.Number 4 L,t- Dale Contractor Q y E a m w a OWNER-BUILDER DIiCLARATION � BUILDING PERMIT A. ;LL w I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION H LL O¢ Law for the following reason.(Sec.7071.5,Business and Professions VALUATION S/FT. Code:Any city or county whichrequiresspermittoconstrucr,alter, PERMIT ISSUANCE 10.00 QX¢ 0 improve,dL`mnhf'h,or repair any SIIIIC(nre`,pO0!to 11515SllanCe,also ELEC.CO NTR LIC.NO. ELEC. d'ri LD e a requires the applicant for such permit to file a signed statement that TOTAL PERMI A. he is licensed pursuant to the provisions of the Contractor's License O H 2 aLaw(Chapter 9(commencing with Section 7000)of Division 3 ofthe g 4 O Business and Professions Code).or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE X 1- $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE TR. n ;� by any applicant fora permit subjects(he0).): am loucivilpenulty ALTER-DRAIN 5.00 of not more than five hundred dollars(my employe ' ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP REY,UNITS intended or offered 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 al' property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5,00 so.Pr.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-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE Prove fors owner of soled. INDUSTRIAL WASTE INTER. 30.00 ,❑ I❑ N ❑ 0❑r O I,as owner of the property,am exclusively contracting with licensed contractors to constracl,the project(Sec.7044,Business LAWN SPRINKLERS•1 INC 5 V.B. 6.00 g55EBS SPARCEL NO. anti 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 contracoms)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT 0 PARCEL NO. ❑ 1 am exempt under Sec..,B.&P.C.for this reasonWATER HEATER W/VENT 6.00 Owner Oso. Dal '_ WATER SYSTEM 5.00 ACC.DATE ACC.FILE N0. WORK ERS'COMPE ATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers Compensation Insurance,or a certified ZONING ENG.SITE NO, copy thereof(Sec.3800,Lah.CJ. Policy No. Company ^ O ❑ Certified copy is hereby furnished. FIRE BPRINK ENERGY TY4 Z Z ❑ Certified copy is filed with the city inspection division. F O Applicant MISC.- REFER TO ORD. y N� v 0 N� CL rn CERTI PICATF.OIr EXEMPTION IrROM WOR KIiRS' PERMIT ISSUANCE 10.00 FLOOD Z4FEE LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O 1'fhis section need not be completed if the permit is for one TOTAL V❑ � Z hundred dollars IS 100)or less.) U O I certify that in the performance of the work for which this per. OTY. MECHANICAL PERMIT FEE F LL U mit is issued, I shall not eroploy any person in any turner so as to become subject to the Workers'Compensal ion Lawsol'California, O iDate Applicant ALTER OR ADD TO MECH. 5.00BUI LOIN} NOTICE; TO APPLICANT: If,after making this Certificate of Ex- Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHprovisions of the Labor Code, you must forthwith comply with FEE such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10MC.FM.) 6.00 SEISMIC y P I hereby affirm that there is a construction lending agency for i EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is Issued(Sec. MICROFILM 3097,Civ CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC • I certify that 1 have read ibis application and slate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all City and coumy PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authored represen forivesins of this city to enter upon the BOILER-COMP (Ove!100,000 BTU)SEE FEE SCH. MECHANICAL hereby mentioned property farinsp ofth i purposes. IWO agree to save, indemnify and keep harmless rhe City of MISC.- REFER TO ORD. hbjgpa�11"u�reol erino against liabilities,judgments, costs and expenses which CONST.TAX n any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 ling of this per . MECH.CONT. LIC.NO. MECH. TOTAL TOTAL pplican[/Conlrx r Date OFFICE COPY / /�