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16373 (2) POST THIS CARD,NEAR FRONT- BUILDING.' ,.,�. PERMIT NUMBER CIT.Y`OF -CUPERTINO, 16373 �. INSPECTION.DIVISION JOB•INSPECTION RECORD [ ' PERMIT EXPIRATION JOB ADDR ES57y�-� �5,.�7�ZLJ!VQ• lj UNIT#_ _LOT# ' PERMIT EXPIRES IF WORK OWNER ' `• teT' �ti/ �gC.%� ` CONTRACTOR - IS NOT STARTED.WITHIN ' INSPECTION DATE' I INSPECTOR INSPECTION RECORD 180 DAYS of PERMIT Issu FOUNDATION - ANCE OR 160 DAYS FROM Sy NOTE: ' UFER � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. •TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PREGUNITE _ CUPERTINO STANDARDS. GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB - " PLUMBING . P y ' ELECTRICAL -, ISSUANCE DATE ' MECHANICAL•. FLOG ELECT 1. PLG. MECR,� El El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR INFORMATkQN VALVATI ON $/FT, PLUMBING - - H - MECHANICAL-, - � ° " •A ELECTRICAL' '" S PERMIT - FRAMING INSULATION _ - R S,' TYPE CONSTR. i C1tY' j, • " - OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED So Fb FLOOR AREA TOTAL ACREAGE I 'ROOF . NOTE:NO FINAL INSP.SHALL BE MADEBEFORE DIAPHRAGM - THE CONSTRUCTION-TAX IS PAID BUILDING USE ROOFSHEATHING - RES IND CON PF o,I, APPLY NO ROOFING UNTIL ABOVE HAS.BEEN SIGNED _,'-,,. FINALS �a. "DATES:,< n INSP..' ❑ ❑ ❑ El ❑ ROUGH, - SAN.N ' nsscssORS PARCEL Na PLUMBING T ' • ELECT.ENERGY ' ' TUBS&SHOWER,PAN `� - PLUMBING ENERGY TRACT NO. PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC,DATE ACCFILE NO. FRAMING - �• - - - ELECT:FINAL TEST,_- ZONING ENG SITE No. INSULATION _ PLUMBING ' GAS TEST - GAS . . FIRE SPRINK ENERGY T-2a MECHANICAL . COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ID "� �' "❑. EXTERIOR SHEAR ELECTRICAL RELEASE ' - FLOOD ZONEALU.C. INTERIOR SHEAR; FIRE DEPT. - - Y El , -[IY L " .N❑I SHEETROCK - GRADE FEE SUMMARY EXTERIOR,LATH - BUILDING •r _ •• - INTERIOR LATH TEMPORARY.�APPROVALS ' BuiLDIruG ` SCRATCH COAT JELECTRIC - ../ PLAN CHECK GAS',,•. n ' FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING'IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING 11 OR. ARRANGE FOR INSPECTION BY PHONING.252-4505,' ELECTRIC 0.6 1-- _ ONE WORKING'DAY'BEFORE REQUI'.RED INSPECTION. '' • PLUM.BING z PLEASE GIVE JOB ADDRESS'WHEN'PHONING - SEE PERMIT FOR:EXPIRAT,ION,DATE `' ` MECHANICAL IMPORTANT! CONST.TAX ..", PLEASE READ REVERSE SIDE BEFORE, TOTAL . CALLING-FOR FINAL INSPECTION. 'OFFICE COPY ' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENTIFICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT �� Aoo��EEss A• � - BUILDING —ELECTRICAL-PLUMBING -MECHANICAL OWNER'S PLAN CHECK VALIDATION N E ,� - QTY- ELECTRIC PERMIT FEE PHONE CONTRACTOR'S �. rvA OUTLETS-SWITCHES-RECEP " 10,00/1.00 1r LIC.NO.�_/I//Q LIGHTING FIXTURES 10.00/1.00 CONTRACTORS PPLIANCES-RESIDENTIAL 4,00 i§J U eM C NE PANELS 10.00 DATE OF APPLICATION ^ ORRCHITECT PANELS (OVER 200 AMP) ' 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.No.' SIGNS TRANS, 3.00 - ADDRESS ENG. SPECIAL CIRCUIT-. 5.00 - PERMIT VALIDATION ZIP EMP. METER OR POLE INS. p .." APPLICANTS ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 O¢i ) / r O O LICENSED CONTRACTORS DECLARATION LANCE a- a u I hereby affirm that 1 um licensed under provisions of Chapter 9 %" ISS ANCE DATE l . N a N (Commencing will ection 70001 of Division 3 of the Business and BLDG. ,ELECT. PLG. MECH. H y z Professions Cod d my liwnse is bu full fo .E e t "'1 µ ❑ O 0 O m - Licens as Lic.Number o w_ � Date Contractor - f :t ¢ a OWNER-BUILDER DECLARATION - µ� ING PERMIT F 0 LL N I hereby affirm that Ion exempt from the Contractor's License MISC.- - REFER TO ORD .t V(1e'1+N>`ORMATION IL O j Law for the following reason.(Sec,703 L5,Business and Professions VALUATION $/FT. - PERMIT ISSUANCE Code:Any city or County which requires a permit to construct,alter, 0 improve,demolish,or repair any structure,prier to its issuance,Ce,also ELEC.CONTR. LIC.NO. ELEC. CUdv u O LL requires the applicant for such permit to file a signed statement that TOTAL X m Itc is licensed pursuant to the provlsionsof the Contractors License PERMIT TO " FZQ Lov(Chapter 9(commencing with Section 70000af Division 3 ofthe E i O Business and Professions Code)or that he iscxempt therefrom and Ie J- the basis for the alleged exemption.Any violation of Section 7031.5 QTY. PLUMBING PERMIT FEE aTORIE TYPE CONSTR. w, by any applicant for a permit subjects the applicant m a civil penalty of trot more than five hundred dolkus(S500f) ALTER-DRAIN&VENT-WATER (EA.) 5,00 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 Oce.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code'rhe Contractor's License Law does not apply to an owner of • properly who builds or improves thereon,and who does such work F IXTURES-PER TRAP5.00 50.FT.FLOOR AREA TOTAL ACREAGE Himself or through his own employees,provided that such improve- memsurenotintendedorofferedforsale,If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold.within one year oIcompletion, the owner- GAS EASYSTEM OVER 4(EA) 200 builder will have the burden of proving that h - . - . . e did not build or im- BUILDING USE prove for purpose ofsale.). RES IND CON Pa Other ❑ I,as owner of the property,um exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 11 ❑ 1-1 ❑ ❑ 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 property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1,00 contracts for such projects with a contmco mo licaniad pursuant to the Contractor's license Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt coder Sec.—,HAP.C.for this reason WATER HEATER W/VENT 6.00 OwnerDate WATER SYSTEM 5.00 ACC:DATE ACC.FILE NO, WORK ERS'COMPENSA1 1ON DECLARATION- WATER TREATING EQUIP, 5.00 I hereby affirm that I have a cert it icute of consent b sell- sure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). /sl �i Policy No. Compan �,- ❑ Certlftedcopyisherchyfumishcd FIRE BPRINK ENERGYT-24 Z Z ❑ Certif�Bpd c9py_is ed with the city inspection division. 2--Z Applicant 1�1C1 MISC.- REFER TO ORD. y N v ❑ N[3 y CERTIFICA'I'EOF E%EMP'I'ION FROM WORKERS' PERMIT ISSUANCE- 10.00 FLOOD ZONE A.L.u.C. lL COMPFNSATION INSURANCE PLG.CONTR. LIC.NO. _ PLG. CL O (This rection need not be completed if the permit is for One TOTAL Y❑ N[] Y ❑ No ::) Z hundred dollars($100)or tris) U O 1 certify that in,the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- not is issued,I shall not employ any person in any mmmBr so as to O U become subject to the WorkcDf Compensmion Luwx of Calif y Date nppbcam ALTER OR ADD TO MECH. 500 BUILDING >_ to NOTICE TO APP'LICAN'T: If,after making this Certificate of Ex- . Z emption,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 revoked. AIR HANDLING UNIT(TO 10=C.F.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. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Nome -HEATING UNIT(OV ER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC (N I certily thal.l have read this application and ,are that Do above VENTILATION FAN (SINGLE)' 4,00 intormation is correct. I agree to comply with all city my county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMPI3 H.Ror100,000B.T.U.) 6.00 hereby authorize representatives of this City to enter upon the BOILER -COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree t0 save, indenmlfy and keep hormlcsa the City of MISC.- 'REFER TO ORD. - upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX ay in any way accrue,against said City in consequence of the hug of tltisver' n MECH.CONT. LIC.NO. TMECH OTAL TOTAL non Itre Lu Applicant/Cnmr toDate OFFICE'COPY.