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18388 (2) RED APPLICANT TO FILL IN INFORMATION WITHIN RED ES -. USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDINGAPPLICATION & PERMIT ADDRESS 18388 8 3 8 ADDRESS l) I yU[-V(\yU(yU( l\J BUILDING-ELECTRICAL-PLUMBING-MECHANICAL y, Ow ER'$ PLAN CHECK VALIDATION ME QTY. ELECTRIC PERMIT FEE I� '� vH NE ///�� I) I},�v CONTRACTOR .�O / / `I CAME OUTLETS-SWITCHES-RECEP 10.00/1.00 11/Vsr/ LIC NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTORS ADDRESS APPLIANCES-RESIDENTIAL 4.W Q PHONE PANELS 10.00 DATE OF APPLICATION ORRCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.N0. ENGINEER uL.NO. SIGNS TRANS. 3.00 _ ARCH.OR ENG. PER MITy�LIOATION ARCH OR SPECIALCIRCUIT 5.00 /VVV'n!_ zIP EMP.METER OR POLE INS. 20.00 ,N, APPLICANTS d'QQ IY ADD MOTORS SEE FEE SCH, SERVICE CHANGE 20. 0 2 0 F O o LICENSED CONTRACTORS DCCLARA'I'[ON mazOki riao av 1 hereby affirm that I am licensed,mder,provisions of Chapter 9 z w ISSUANCE DATE w a H (commencing withSectiond... l lose)i of Division 3 of the Business and BLDG. ELECT PLG. MECH. F vi Professions Code,and my license is in full force and effect ❑ ❑ ❑ oz m W License Class Lic.Number rn F Dutc Contructnr a x ¢ ¢w a OWNER-BUILDER DECLARATION BUILDING PERMIT MISC.- REFER TO ORD INFORMATION w ;u y I hereby affirm that I am exempt from the Contractor's License u O j Law for the following reason.(Sec.7031.5,Businessandprofessions VALUATION $/FT. - PERMIT ISSUANCE Qu, Code:Any mulish couNy whiny structure pernd o its issuance,also a a Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. WI-c LL requires Ole applicant for such permit to file a signed statement that TOTAL 7. V �,w m he is licensed pursuant to the provisions of the Contractor's Licens PERMIT TO HiQ Law(Chapter 9(commencing with Seel ion 7000)of Division 3 of the i ¢ O Business and ]',of..ion,Code)or that he is exempt therefrom and V. PLUMBINGPERMIT FEE ¢ F $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. A. 3 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500).): LTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as B K F LOW PROTECT.DE V ICE 4.00 their sole compensation,will do Ilse work,and the structure is not OCC.GROUP RES.UNITS tended or littered for sale(Sec. 7044, Business and Professions DRA S-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law dues not apply to an owner of property who builds or improves thereon,and who does such work FIXTUR -PER TRAP - 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself re of rote his own employees,Provided that such improve- ments orimprsefeenmendedorofferoneyearoIf,huwelion the building GAS-EA.S EM-11NC.4OUTLETS 6.00 of builder will is sold within one proving of he dill coq the owner- builder will have the burden u(proving Ihm he did not build or im- GAS-EA.SYST -OVER 4(EA.) 2.00 BUILDING USE p[ovc I as owner purpose of the.l. INDUSTRIAL WAS INTER. 30.00 RES IND CON PB Other Hyl,as owner of the construct (lie am exclusively contracting with 0 El 11 E] El a ocontractorsto he project(Seo. 7044,Business LAWN SPRINKLERS- C5 V.B. 6.00 ASSESSORS PARCEL NO. and Profession Code:'I'ht Contractor's License Law does not apply to an own"u1'property who builds lir improves thereon,and who LAWN SPRINKLERS-OV 5 (EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORME 200ft/10.00 TRACT NO, PARCEL NO. ❑ lam exempt under Sec,-.B.&P.C.for this 6.00 reason WATER HEATER W/VENT Owner bYA1,LF - - _ I- WATER SYSTEM 5,00 WORK CRS'COhIPCNSATION DECLARATION WATER TREATING EQUIP, .00 ACC.DATE ACC.FILE N0. 1 hereby affirm that 1 have a certificate of eminent o self-insure. or a certifica le(See Workers'Compensation Insurance,or a certified ZONING ENG.SITE N0. copy thereof(Sec.3800.,an,.). Policy No.rt Company ❑ Certified copy is hereby furnished. z Z D Certified copy is IIIc) with the city inspection division. FIRE SPR INK ENERGY T-24 ~ Applicant MISC.- REFER TO ORD. Y ❑ No Y ❑ N[] '� PERMIT ISSUANCE LU - CI?RTIIlCAT1i OPCACION'INS FROM 10.00 FLOOD ZONE A.L.U.C. W � COMI'IiN$ATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL 0 (The, section need not be Completed if the permit is Ibr one TOTAL Y F-1N❑ Y IDN0 L) Z hundred do1Wrs(Sl OO)or IrssJ U O_ 1 certify Out in the performance of the work ILr which itis per- OTV MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any person in any manner so as to O 0become subject to the Workers'Compensation Laws of California. 0. Date Applicant ALTER ORADD TO MECH. BUILDING >_ to NOTICE:TO APPLICANT: If,after making this Certificate of fix- 5.00 F ? enption,you should become subject to the Worker,'CampenaatumPPLIANCE 5.00 PLAN CHECK provisions of Orn Labor Code, you e.et forthwith comply with U such provisions or this permit shall be deemed revoked. AI NING UNIT(TO 10ADC.FN-IMECH. M.) 4.00 FEE I - CONSTRUCTION LENDING AGENCY AIRING UNIT(OVER 10,000 CEM.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency forUST D(WITH DUCT) 5.00 the Performance of the work for which this permit is issued(Sec. MICROFILM 3097•Civ.C.). ING UNIT 100,000 B.T.U.) 8.00 Lender's Name Lender's Address ING UNIT 00,000 B.T.U.)9.50 ELECTRIC � Sd I certify that I have read this application and state that the shoveILATION FAN (SIN E) 4.00 information is correct Is agree to comply with all city and cos anydinPLUMBING hereby aces and state laws relating to is building! un ter upon and -COMP(3 H.P.or 100,00 .T.U.) 6.00 hereby authorize representatives forms of this city to enter upon the above-mentioned property for inspection purposes. R-COMP (Over t00,0008TU1S FEE SCM. MECHANICAL (We) agree to save, indemnify and keep harmless the City of - REFER T RD. Cupertino rest liabilities,judgments, assbs and expenses whichCONST.TAX may in way acerae against said City in consequence of theT ISSUANCE 10.00 mntl thi c slit LIC.NO. MECH. `ofApp'f 'j $ TOTAL TOTAL Ill Signature of Applicant/Contrac r Uate OFFICE COPY POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 18388 INSPECTION DIVISION r� JOB INSPECTION /RXJP ��E�LC�J(O')��R�D f JOB ADDRESS # #C(L/L' "' ( UNIT _LOTERMITLIRATION PEftMIT OWNER t;,J/�- CONTRACTOR S NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE COMPLY APPROVED PLANS AND CITY OF PER m nLluntlON CU , CUPERTINO STANDARDS.DS. f G��flyj`f)/► GARAGE SLABS , - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I " UNDERGROUND /SLAB 4 PLUMBING ELECTRICAL ISSUAN )ATE MECHANICAL BLDG ELE PLG. NIECH ❑ '4!11 ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION SIFT. - r, eep MECHANICAL 0�.; 1959 ELECTRICAL FRAMING �r1y dF,(�lp8�1110 �� INSULATION STORIES TYPE CONSTR OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa FT FLooR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID e ROOF SHEATHING BUILDING USE HES IND CON PB 001rr I APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ •❑ ❑ ROUGH ASSESSORS PARCEL NO SAN.p PLUMBING ELECT.ENERGY TUBS B SHOWER PAN PLUMBING ENERGY tRncT NO. PARCEL No MECHANICAL MECR ENERGY ELECTRICAL BUILDING ENERGY nCC DATE --A-CC FILE NO FRAMING ELECT.FINAL TEST INSULATIONPLUMBING zoNlNc ENG SITE No. GAS TEST GAS MECHANICAL FIHESPRiNK ENERGY T.za,_,Jy COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ N'❑ Y ❑ N EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A.L UC INTERIOR SHEAR FIRE DEPT. Y ❑ N❑ Y L No SHEETROCK GRADE ` EXTERIOR LATH FEE SUMMARY BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK T GAS I FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BLII LOING FINAL IS SIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, TOTAL ELECTRIC s� o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE v CALLING FOR FINAL INSPECTION. OFFICE COPY