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15343 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO ' 15343. INSPECTION DIVISION JOB.INSPECTION RECORD D PERMIT EXPIRATION JOB ADDRESS "? 9/J5 `-5"4c_e'�7 �C' ,Z�Ly`dL N IT# _LOT# PERMIT EXPIRES IF WORK OWNERCONTRACTOR OC/C Lp- IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSP TION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM NOTE: LAST CALLEP INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EG UNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT v LIDATiON CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED IyIY� tV(lill/`',t--` • UNDERGROUND /SLAB MAP x ' PLUMBING � p 198 y Q, tlD RFtinaUANCE DATE ELECTRICAL i MECHANICAL civ Wrbet t1IF6T P❑ MEC 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED u RUILDINOOPEaMl7 INFORMATION WOOD FLOOR VALUATION PLUMBING MECHANICAL PERMIT ro ELECTRICAL FRAMING INSULATION STORIES TYPE CONSTH. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE EO.IT,FLDOH AREA TOTAL ACIE.TGE� DIAPHRAGM THE CONSTRUCTION TAX IS PAID HES IUILU(;ON NUSEPB �UU�e� ROOF SHEATHING - NU APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO. ROUGH SAN.N PLUMBING. - ELECT','ENERGY TRACT NO PARCEL NO. TUBS&SHOWER PAN PLUMBING ENERGY - MECHANICAL MECH.ENERGY - ELECTRICAL BUILDING ENERGY ACC.DATE AGL.FILE NO FRAMING - - ELECT.FINAL TEST - • ZONING ENG.SITE NO, INSULATION PLUMBING GAS TEST GAS FIRE SPRINK ENERGY T-74 MECHANICAL Y 0 NNC] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING " EXTERIOR SHEAR - ELECTRICAL RELEASE FLDDD ZONE AL QC. ,Y ❑. NQ , INTERIOR SHEAR FIRE DEPT. .Y L• NE - SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING - INTERIOR LATH TEMPORARY'APPROVALS BUILDING SCRATCH COAT - v ELECTRIC- -_PLAN CHECK . . GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMICFEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC NO �' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z�. PLEASE GIVE JOB ADDRESS WHEN PHONING. .-- = SEE PERMIT. FOR EXPIRATION DATE — rNSTHANICAL.TAXIMPORTANT! ••..PLEASE READ REVERSE SIDE 13EFORE CALLING FOR FINAL INPECTION. OTAL OFFICE COPY APPLICANT TO FILL IN-INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU IOING PROJECT I DENTI FICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT 15.343 4DDRESs !I ✓( cPZI III 111 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OwNE S f I PLAN CHECK VALIDATION NaMF I46 OTV. ELECTRIC PERMIT I FEE '1 �CY �� ONE Ir�p Z7 CONTRACTORS rvaM s OUTLETS-SWITCHES-RECEP 10,00/1.00 C `rA LIGHTING FIXTURES 10.00/1.00 cox RACE APPLIANCES PHONE 4.00 AooPEss PHONE PANELS - 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.N0. DR PANELS (OVER 200 AMPI 20,00 ENGINEER _ ffI SIGNS TRANS. 3.00 ADDRESS ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 ' - APPLICANT ADDRESS MOTORS SEE FEE SCH. �A 0� �• �' � � ' ' SERVICE CHANGE ,20.00 woo LICENSED CONTRACTORS DFCLARA'r10N ^- 1 ^, �✓ I()(J a U b 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE m a N (commencing whh Section 7000)of Division 3 of the Business and r D z Professions Code,and my license is in full force and effect. C• of dh9Gt�I ,FLECT. PLG. MECH. I'm o License Clans Lia Nomhce l V m r j Datc Ccetnctor aY s iL 0 w OWNER-BUILDER DIiCLA RATION BUILDING PERMIT INFORMATION wn m I hereby affirm that I am exempt from the Contractor's License MISC. REFER TO ORD u O¢ Law for the following reason.(Sec.7031.5,Business and Professions VALUATION -w< PERMIT ISSUANCE 10.00 3w> Code:Any city or county which requiresu permit to construct,alter, Q a ¢ o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIQ N0. ELEC. wO requires the applicvnt for such perruCto file a signed statement that TOTAL PERMIT TO 2 - he Is licensed pursuant to the provisions of the Contractor's License y ` a. Late(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe �I ic Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE IS the basis for the alleged exemption.Any violation of-Section 703 LS STORIES TYPE CONSTR. n3 � by any applicant for a permit subjects the applicant On civil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(8500).1: ❑ I,as owner of the property,or my employees with wages as -BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS sole compensation,will do the work,and the structure is not intended ar offered for all (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License Law does not apply to an owner of - ' properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself re through his own employees,provided time such improve memprovemnnot tis old or offend within year lcompleveq the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 or improvement is sold within ane year of completion,the owner- builderri - will have the harden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE prove for purpose of tire INDUSTRIAL WASTE INTER. 30.00 RES IND CON Pe Omar ❑ d as owner of the property,ons exclusively contracting with 0 ❑ ❑ 0 0 licensed contractors to construct the pricer Bee 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:III,Contractor's License Law does not apply to all owner of property who ballon tr bnprovice rased pt,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracthe Cotsfor ctor',hcenects Lwilhacontractol(sl licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law, TRACT N0. PARCEL NO. ❑ I an,exempt under Sec.-,B.&F.C.for this reason WATER HEATER W/VENT 6.00 Owner - Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPFNSAIION DECLARATION WATER TREATING EQUIP, 5.00 1 hereby affirm that I have a certificate ol'consent to schr-onure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(See.3800,Lab.C.L Policy,No. Company 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z Cl Certified copy is filed with the city inspection division. O Applicant MISC.- REFER TO ORD. Y ❑ N Y ❑ NC y CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.OQ FLOOD ZONE A.L.U.C. W > COMI'I!NSWION INSURANCE PLG.CONTR. LIC.NO. PLG. CL 0 (This section need it be completed it the permit is for one TOTAL Y[] N Y [:] No Z hundred dollars l$100) ales.) U O I certify that in the performance of the work for which(IRS per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL H 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. Q. Dam Applicant W NOTICE TO APPLICANT: If,after making this Certificate of nix- ALTER OR ADD TO MECH. 5.00 f" Z eruption,you Should become subject to 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 rev)ked. AIR HANDLING UNIT(TO 10MOC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.FM.)-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 MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC •.I certify that I lL,,c read fill,appliemion and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county -BOILER-COMP(3 H.P.of 100,000 B.T.U.) 6.00 PLUMBING ordinances and stale laws relaling to building construction, and r heme- authorize repertyfor ins inspection it, city es enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL abovomentioned properly forinsp of it,i purposes. - (We) agree to save, indemnify-and keep,h5i •ss the City of MISC.- REFER TO ORD. uper.ino against liabilities,judgments, costs and penses hilt I CONST.TAX may in any %accru agai Ls i Hy in con quence f the PERMIT ISSUANCE 10.00 ranting of unit. ECH.CONT. LIC.NO. MECH. - TOTAL (� TOTAL Signa ur p Lo Bur Uu( OFFICE COPY