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15357 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF 'CUPERTINO 15357 INSPECTION DIVISION JOB INSPECTION RECORD III• PERMIT EXPIRATION JOBADDRESS 868 South Stelling UNIT AI:__LOT PERMIT EXPIRES IF WORK OWNER Blais CONTRACTOR ' IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE.OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION.` LIFER ALL GRADING AND DRAINAGE SHALL BEINSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVEHASBEEN SIGNED ,,` UNDERGROUND /.SLAB ! PLUMBING ELECTRICAL IssunNCE DATE MECHANICAL BLDG ELECT...,PLG. MCCH. ❑ ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOORINFORMATION ' ' 'A �� VALUATION s1ET. PLUMBING - .�OUJ$ ra v ' MECHANICAL - QII, .� '• ELECTRICAL PERMIT TO I � �- \t'" e,�Q IQ FRAMING INSULATION t sroRlEs \rvpE co"sTH. , t OCC.GHOUP RES.UNITS I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa•FT n.00H nncA TOTAL ncREAce IAPHRAGM - - .THE CONSTRUCTION TAX IS PAID F70F SHEATHING HESINu ILDCON INNG USE PB DIH.I koON NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - FINALS - DATE INSP. ❑' ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO, ROUGH SAN.q G —//_ ELECT.ENERGY TRACT NO PARCEL NO OWERPAN PLUMBING ENERGY ICAL - MECH.ENERGY ACC.DATE ACC FILE NO CAL BUILDING ENERGY ELECT.FINAL TEST INSULA' ZONING , ENG.SITE NO. PLUMBING �?6 ,�'8' GAS TEST .- GAS MECHANICAL FIRE SPRINK' ENERGY 12 COVER NO YORK UNTIL ABOVE HAS BEEN SIGNED HEATING . ❑ "❑ ` "11 C L U. . EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A. ,i INTERIOR SHEAR FIRE DEPT. Y❑ N❑ Y,Q N❑ $HEETROCK GRADE FEE SUMMARY EXTERIOR LA BUILDING ,INTERIOR LATH _ TEMPORARY APPROVALS BUILDING [SCRATCHCOAT ELECTRIC PLAN CHECK GAS FEEE O TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ;ELECTRIC FEECCUPANCYOF BUILDINGISNOTPERMITTED UNTILBUILDING FINALISSIGNED'BY BUILDING INSPECTOR. LMARRANGE FOR INSPECTION BY PHONING 252-4505;� ONE WORKING DAY BEFORE REQUIRED INSPECTION. cZ -PLEASE GIVE JOB ADDRESS WHEN PHONING.SEE PERMIT FOR EXPIRATION DATE — ICALIMPORTANT! AXPLEASE REiAD REVERSE SIDE BEFOREAL CALLING FOR FINAL INSPECTION. FE OFFICE COPY i APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER \ / B�ILOINGiL �/ (` ( fy 1 N APPLICATION & PERMIT � [�� Y AU. sW \ a d V cal, 5 BUILDING—ELECTRICAL—PLUMBING—MECHANICAL OWNER'S PLAN CHECK VALIDATION •� ' Z.Sl-060 OTY. ELECTRIC PERMIT FEE N B � PRONE CONTRACTOR'S �,�y_ OUTLETS-SWITCHES-'RECEP 10.00/1.00 C- 1^�e rLIC.No.476 L2 3 LIGHTING FIXTURES 10.00/1.00 Rac CorvTroR's lVaQc APPLIANCES-RESIDENTIAL 4.00 OOo CONTRACTORS O� �0.rA ✓F� PHONE 7 `L.(!i PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE .C.NO. OR PANELS (OVER 200 AMP) 20.00 . ENGINEER 1 � uc.No. SIGNSTRANS. 3.00 nooA'E°ss ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. -' aooRE SI p SERVICE CHANGE 20.00 I 02 LICENSED CONTRACTORS DECLARATION •' a U U 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE H Q vwwi (commencing with Section 7000)of Division 3 of the Business and BL ELECT. PLG. MECH. r w a Professions COde, 1 my license is in full forc,, Jd�i-j.,— ❑ � ❑ O0 A - Licenys'e Class � �/ Lie N inber__ .--/-t 4L Date J" 1_T n Contractor a Y J f, �U ILDING PERMIT ¢ ¢ w u OWNER-BUILDER DECLARATION -r$. INFORMATION X ;LL y I hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO ORD A u 04 Law for the following mason.(See,7031.5,Business and Professions VALUATI H - PERMIT ISSUANCE ,Q.QQ c�ORv S/Fr, Code:Any mulish county it any Structure permit riot o construct.c,also alter, 1_T� R ¢ G improve,demolish,of repair any etruclurt,prior to its issuance,x150 ELEC.CONTR. LIC.NO. ELEC. IP', �S Cs u Strains the upplic:utr for such permit to file a signed statement that TOTAL V PERMIT TO n w he is licensed pursuant to the provisions of the Contractor's License HiQ Law(Charter 9(commencing with Section 7000)of Division 3 ofthe E 4 c Business and Professions Code)or That 1,e is exempt therefrom and QTY. PLUMBING PERMIT FEE the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. all by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN -WATER (EA.) 5.00 , of not more than five hundred dollars(8500).): ❑ 1,as owner of the properly,or try employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.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,AR EA,COND. 5,00 Code:The Contractor's License Law does not apply to an owner of property who buih or improves[hereon,provided who does such work FIXTURES,PER TRAP S,OO 50,FT.FLOOR AREA TOTAL ACREAGE himself ptsare through his own employees,provided drat such ibuildi w mepts are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4OUTLETS 6,00 or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4 (EA) 200 builder will Ipthe burden of proving That hu did not build or int- - . - . . BUILDING USE prove forof sale.). RES IND CON PB other C30 1,ass purpose owner of the property,nm exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 0 0 El El 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 is contractor(s)licensed pursuant to - rheContractor'sLicenseLaw. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ 1 am exempt under Sec. ,ILmP.C.or this WATER HEATER W/VENT 6.00 reason " Owner Dale WATER SYSTEM 5.00 ACC.GATE ACC.FILE NO. WORKERS'COMPENSAI'ION UeCLARA1ION - - WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconwrit to self-insure, - or a celtificate of Workers Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(See.3800,Lab.0). ' Policy No. Company 0 ❑ Certified copy shereby furnished. FIRE SPRINK ENERGY T,-24 Z 2 ❑ Cerllfled' copy is filed with the city inspection division. FO . Applicant MISC.- REFER TO ORD. YE] N[D Y ❑ N[3 M N 6 CF.R'FIFICA'I'EOF EX]'.MI''I'ION FROM WORKIIRS' PERMIT ISSUANCE - 10.00 FLOOD ZONE A.L.U,C. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. = Z .(flus section need nor he completed if (lie permit i for one TOTAL Y❑ N Y ❑ N❑ hundred dollars(8100)or less.) U O I certify that in the performance of the work fors wF;h this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL U .it is issued,I shall not eam ploy any 'too ny Im er sn m In been uly�• t Woris r y nr Wore. 0'd Dat` /_Y 'Is 'c°"t - a ALTER OR ADD TO MECH. 5.00 BUILDING } NOT E'I'O API'.ICAN'f: II',attar making this Ccrt iricatc of Ex- f.. emption,you should become subject to the Workers'Cnmpensatiml APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, yon most forthwith comply with FEE U such provisions or this pennil shall be deemed revoked. AIR HANDLING UNIT(TO 10,000CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE SO 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.CJ, HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)8.50 Lender's Address ELECTRIC I certify that l have read this applical inn and state 11,41 Ihu above VENTILATION FAN (SINGLE) .4.00 information is correct.1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 above- authorize representatives for.ins ec This city to enter upon the BOILER-COMP (Over 10.000 BTU)SEE FEE SCH. 'MECHANICAL hereby authorize ned properly foninsp ofth i purposes. (We) agree 10 save, indemNfy ant keep hurmltas ilia City of MISC.- REFER TO ORD. uperfino against liabilities,judgmen costs and expenses which CONST.TAX ay in any w u Ie against Off/1--it, in consequence of(he PERMIT ISSUANCE 10.00 •ran of lK en i. MECH.CONT. LIC.NO. MECH. vA'(�- TOTAL TOTAL —/ Signature of Applican[Contractor Date OFFICE COPY