16534 u
POST THIS CAR•D NEAR FRONT OF BUILDING PERMIT NUMBER {
CITY OF .CUPERTINO, 1
INSPECTION DIVISION 1653;4
JOB INSPECTION RECORD
\` \_ PERMIT EEyX�PI CR/ATIgN
EDB ADDRESS ste v` �'U UNIT# }r LOT# � RERMI EXPIR I WORK
' OWNER Vy D� -km � CONTRACTOR -1a, / �L.p l(P IS ,NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT'ISSU-
FOUNDATIONANCE OR 180 DAYS FROM
NOTE:
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PREGUNITE- - TO COMPLY WITH THE APPROVED PLANS AND CITY OF r PERMIT VALIDATION
CUPERTINO" UPERTINO STANDARDS. .i
GARAGESLASS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ..� , �_ ,�;�c, u��'�Ai 07
UNDERGROUND /SLAB f.G+1.ZG'61.fCLC.G '
PLUMBING -
ELECTRICAL
ISSUANCE DATE
MECHANICAL - - HU)G. I.I.CCT Pia. MECH
❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT -
WOOD FLOOR INFORMATION
PLUMBINGVALUATION
- -_
MECHANICAL
ELECTRICAL - M PE+MIrOTO
FRAMING - PAID l `�c-
INSULATION ', STOILRES TYPE CONSTR. t
Nov
DCC.GROUP , RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED —CYY Of
CUPPrtinn SO FT FI,O(]H AHFA TOTALACREAGE I
.;O _ ROOF NOTE: FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONINSTRUCTION TAX IS PAID
BUILDING USE
' ROOF SHEATHING � REs IrvD CON Pe oln.• I
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
ASSESSORS PARCEL NO
ROUGH SAN.#
' PLUMBING ELECT.ENERGY
TRACT NO 'PARCEL NO
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL - MECK ENERGY
ELECTRICAL BUILDING ENERGY ACC.DATE ACC FILE NO
FRAMING � - -
I -ELECT.FINAL TEST - -
ZONING ENG.SITE NO,
INSULATION' PLUMBING
GAS TEST - GAS
'- MECHANICALtryL FIRE SPRINK ENERGY T.za
. ❑
' .COVER NO.WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y E] NE] Y ❑ N
PL00020NE ALEI Ci
EXTERIOR SHEAR ELECTRICAL RELEASE I
'INTERIOR SHEAR FIRE DEPT. Y❑ N❑ ° ❑ N❑
SHEETROCK GRADE ' FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH, TEMPORARY APPROVALS BUILDING
SCRATCH COAT . ELECTRIC PLAN CHECK
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDMG FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
o� 'ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
= SEE PERMIT FOR EXPIRATION DATE -' MECHANICAL
IMPORTANT! CONST,TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING.FOR FINAL INSPECTION. 7;
OFFICE COPY.
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
'BU I LDMG PROJECT I DENTIFICATI ON .PERMIT NUMBER,
- m,ILDING APPLICATION & PERMIT . q
A45MESS
BUILDING - ELECTRICAL-PLUMBING-MECHANICAL -
6534
eo l7ss sre E EE
OWrvEH'S - PLAN CHECK VALIDATION
NAME QTY. ELECTRIC PERMIT FEE
Wbermirir,roi4 G11EUkET
CONTRACTOR'S
NAME OUTLETS-SWITCH 10.00/1.00
LIGHTING FIXTURES 10.00/1,00
ADDRESS APPLIANCES . 4.00
CONTRA $Zc� �AAAmoNA �I6�
Zv 1Q{J�ii. 94/ ' PHONE 32 -6W�3 rPANELS , '!I 10.00 DATE OF APPLICATION ,
AflcwrecTTNF /jJ;G 1I1'TE`-rtA(2s>L PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P4C.,NO.
OR
ENGINEERA LIC.No. a SIGNS TRANS. 3.00
ARCH ESSENG,�O 1•I)aIUE1s I\-YAiB SPECIAL CIRCUIT- 5.00 PERMIT VALIDATION
P CA, xIP Iq J4I FrEMP.METER OR POLE-INS. 20.00
APPLICANTS CL.f/'h ATE EhU-I NE EL'I Na
ADDRESS rING• MOTORS SEE FEE SCH.
`736 6"aair SERVICE CHANGE 20.00
o o LICENSED CONTRACTORS DECLARAf ION
a ci u 1 hereby affirm that I am licensed under provisions of Chapter 9 PAID
ISSUANCE DATE '
yam (commencing with Section]000)of Division 3 of the Business and SLOG. ELECT. PLG. MECH.
r w z I'rofessiuns Code and my license is in fall forctSa t. ❑ ❑ ❑
z Licenu Cln �-80...-Lie.Nunrber�J NOVg
O w r w Date Q�• Contractor U
< m BUILDING PERMIT
¢ ¢ w a OWNlilt-BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License
MISC.- I O TO ORD INFORMATION
a. oat j Law for the following reason. 7031.5,Business and Professions VALUATION $/FT.
- g PERMIT.ISSUANCE 10.00
Code:Any city or county which requires a permit to construct,altuq
a2co improve, or repair any structure,prior to its issuance,also ELEC.CONTR. - LIC.NO. ELEC.
a ¢ requires the applicant for such permit to file it signed statement that TOTAL w PERMIT TO he Is licensed pursuant to the provisions of the Contractor's License
Z ¢ Law(Chapter 9(commencing with Section 7000)of Division 3 oft lie p
4 c Business and Professions Codd or that he is exempt therefrom and OTV. PLUMBING PERMIT . FEE l-
IF r m the basis for the alleged'exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
n ; _ by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN -WATER IEA.15.00
of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE " 4:00 OCG GROUP RES.UNITS
their•sole compensalion,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions GRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of
property who nnlhls Or trip.OVes turn nn,and who does SUC t work FIXTURES-PER TRAP 5.00• SQ FT.FLOOR Afl EA .TOTAL ACREAGE himself or through his own employees,provided that such Improve-
ments are not intended or offered for Sale.If,however,the thudding GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00
or,tmprovemenl is within one year of completion,'the.owner. GAS EASYSTEM OVER 4 (EA) 2.00
builder will have the burden of proving that h - . - .
e did not build or im- BUILDING USE
prove for purpose ofsele.). INDUSTRIAL WASTE INTER. - 30.00 RES IND CON PS Other
❑ I,as owner of the propam exclusively aexclusively contracting with •❑ ❑ ❑. ❑. ❑
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 contractor(s)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ Into exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT _6.00
reason
Owner Data WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO,
WORK Ii RS'COMPIiNSA'I]ON DECLARATION • WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate(it consent to self-insure,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.).
Policy No. Company '
O ❑ Certifiedcopyis hereby furnished FIRE SPRINK ENERGY T24
Z_ Z Certil iurl}.opy�isrl yiif I the city inspection division. MISC.- REFER TO ORD. ❑ ❑ [:] ❑
p Ap^plicanl _ed or, _ �[� V ' N VN
irto -A1 / PERMIT ISSUANCE 10.00
LU - CIiRT114CCOMOFEAIIOT ION NSUR N WORKERS' r FLOOD ZONE A.L.U.C.
LU � COMPENSATION INSURANCE � ' PLG.CONTR. LIC.NO. PLG.
d O (This section need not he completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑
Z hundred dollar,(5 100)or lass.l
U O I certify that to Ne performance of the work I'or which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued, I shall not employ any person in any manner so as to
O become subject to the Workers'Compensut ion laws of California.
W Date Applicant ALTER OR ADD TO MECH. 5.001BUILDING
} to NOTICE TO APPLICANT: If,after making Ibis Certificate of Ex.
H ? emption,you should become subject m the Worked Compensation APPLIANCE 5,00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or Ibis permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)MDCF.M.) 4.00 qo
. CONSTRUCTION LENDING AGENCY HANDLING UNIT 10=C.EM.16.00 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,Cw C.).r- 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
1 certify that 1 have read this application and state Mat the above VENTILATION FAN (SINGLE) 4.00
• information is Correct. I 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.LU.1 6.00
hereby authorize representatives of on rposes outer upon Ih° BOILER-COMP fOvar 100,000 BTU)SEE FEE SCH. MECHANICAL ''�0
lereb
above-mentioned property forimsp tit this
purposes.
(We) agree to save, indemnify and keep harmless'lhe City or MISC.- REFER TO ORD..
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 QO CONST.TAX
may in any way accr against Said City in consequence the _
tomtit OLthis n 't MECH.CONT. LIC.NOi MECH. -
Cd.
ImATE
ENGfNErr.*k-r 1h4c. T TALL. A(,, TOTAL l
rat cant/Contractor' at !Jt t.3 99 /
OFFICE COPY '
POST THIS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO 16534
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESSQ - v—�'- -+-�-'—UNIT L/OT tt DERMPffEXI"RES IF WORK
U0—t. W D CUNTHIICIUN ac-t c[L` ? IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION NOTE: LAST CALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED II
TO COMPLY WITH THE APPROVED PLANS AND CITY OF MII w^I IUnrN.N
PREGUNITE CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDv��, -k- w rr 1)e+%'i
UNDERGROUND/SLAB * �` Q
PLUMBING
ELECTRICAL ' IssuwNrl uwn
tlll•Ir fl[CI Yll: MIr•
MECHANICAL
OD NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOODFLOOR alua nl,N snl
PLUMBING
MECHANICAL A. of N"ul
ELECTRICAL Mia C
FRAMING IJA. I l; l.vf un.;l••
INSULATION
J 1
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED CRY Of ClipPrtinn
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
`. tlUll MINI".u'+fYlf
ROOF SHEATHING III r. INI. I UN r
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ n b El ❑
n]'.L SSI x115 V wlN:l L NU
ROUGH SAN.#
PLUMBING ELECT.ENERGY Y
U,al:l NU nNl:l I I.
TUBS&SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
al.c uarf ncc inf•.,
ELECTRICAL BUILDING ENERGY
FRAMING I _ ELECT.FINAL TEST roNINN fnl,vrf r...
INSULATION IPLUMBING
GAS TEST GAS
fINf SVillh,t fNFNLv I,a
MECHANICAL .❑ NC •❑ '❑
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING w l„l
i IIIUU fUNf
EXTERIOR SHEAR ELECTRICAL RELEASE r
INTERIOR SHEAR FIRE DEPT. h�
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING
BUILDING
INTERIOR LATH TEMPORARY APPROVALS
ELECTRIC PLAN CHECK
SCRATCH COAT FEE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM
y
ARRANGE FOR INSPECTION BY PHONING 252.4505, lir ELECTRIC
FW- ONE WORKING DAY BEFORE REQUIRED INSPECTION. �I•t PLUMBING
00 PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z MECHANICAL
—SEE PERMIT FOR EXPIRATION DATE— ;f
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE t' +.
TOTAL
CALLING FOR FINAL INSPEC'T'ION.
OFFICE COPY
APPLICANT TO FILL IN INFORMAI ION WI-IIIIN ICED LINES Ub1. ,TALL. a'OINI-I'Llw .•111'!
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
APPLICATION&PERMIT 16534
A„Nlss
Z SS S•1•-E BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
pvNER1 PLAN CHECK VALIDATION
OTY. ELECTRIC PERMIT FEE
HI lb C1iEU
IN_: we yERAeroR. OUTLETS•SWITCHES-RECEP 10.00/1.00
InIC LIGHTING FIXTURES 10.00!1.00
fOi1NACOX�� PPLIANCES-RESIDENTIAL 4.00
IZq(rypNA 1
AtwRess U /S)
h1G cA. y PnoNE,3 PANELS 10.00 DATE OF APPLICATION
`rorEaTNE/�L'LHITE-C c(A(2a�L
PANELS(OVER 200 AMP) 20,00 PLANCHECK FEE
NO
ING,NIER
lits No SIGNS TRANS. 3.00
:.,concis E"0 T2o �+fsalV�R=.1'y A(/E PECIAL CIRCUIT 5.00
SPERMIT YALIpATION
Z,P' EMP.METER OR POLE INS. 20.00
ADDRE. ''CMZ►yr4�E 6hIL-IHEIeL'1 P(C-a IIJG. MOTORS SEE FEE SCH. ////��•�--,-//yy,,--,.,�-
936 6eirrAA-�Atli SERVICE CHANGE' 20.00 ��-
u o O LICENSLO CONTRACTORS DUTARATION
1 hereby.rfsmr that 1.N. kcenaed cmdc,pr,viuum or Chapter Y PAID ISSUANCE DATE
Icommex w,b Season 700)of D.-unt! f the loos. and
,n. L.G. I ELECT. PLG. MEC"
„ Profrw (,.it, 1 my INrnw ti in Intl tun U .ea 1�
L,ow C I e" Lic.Nwnlwr L J •U ❑ ❑ ❑
12 L J Date�Jj_y'/Jet+ Conlraclnl.frL.•`„(i�.L� F. Ll 8 --
rt BUILDING PERMIT
OWNER-BUILDER DHCLARAI ION
pMISC.- I O TO ORD INFORMATION
I hereby affum+hall am Hemp,frons the l'unpacl,r'+4anae a vALuw noN SYF r.
o J Law Nur the fo°owing re.wn.(Sec.70d 1.5.Ilwmeu and Yroleavons PERMIT ISSUANCE 10.00
Code Any city or county whichrequ,rea,parnut lnconstrwCAl",
Q"'f G costive,Jelnolish,,r rcPalr y RraK'lue.pour Iu Ila p>uanae.alwi ELEC.CONTR. LIC.NU. 'LEC
O Hg.ues the applicant fur sochhpermit lu jilt.Rjocd Malco-I Thal TOTAL PERMIT TO
•$ he n Ircenaed purawnl m the pronaiom ul the('nnlrx'tor'+Luenat
i Law(('haper Ylcommex.ngwtlh Section 7UWlof th, luNJ I,the li
q O to IN nal Professaom CnJO or that
he i+<.ampl mereh..m aria CITY. PLUMBING PERMIT FEE e
the ba,s for the alkgcJ eacn,ptiun.Any viola!uln or 5ecl,am 7Ud I.5 B ORI 5 TYPE CONST"
$ byany•pphcam ror.pemdt.ubl.0.0..pPlan❑,aarval liana NY ALTER•DRAIN&VENT-WATER(EA.) 5.00
of vial more than hvc hunJrcdd.Itc (S5WI.1'
❑ I,,+owner,f me pIu""Y, al
or my empb,yaea with wH... BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES UNITS
Iheu wk c,=son,will do the work,and the rualnn n mol
!ended or olfercd fur Life IS-7044,9ua-andYrole+Jun. DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Co.....Iur s License Law does no.apply loan,of
properly who build,Lir cmprorn th.....and who duo Ricca wick FIXTURES-PER TRAP 5.00 60-F1.11.0014-1. TOTAL ACREAee
hJn+eIf or through IN.own riployeea,proHJud Thal Rath u III—-
n
"ms n
Lie ut imlendd or,Rend for Mk If,h.-er,the buckling GAS•EA.SYSTEM-1 INC.40UTLETS 6.00
p-Hm ent i,wildo.mw year of-uplelum.the owner- GAS-EA.SYSTEM•OVER 4(EA.) 2.00 BUILDING USE
budder wJl have the burden of proving t1UI he did vial build or on- RES IND CON PB oro.,
pone for purpose of Mk.E INDUSTRIAL WASTE INTER. 30.00
❑ I,.a owner of the property,am exclusively eonlr+,h,g with ❑ ❑ ❑ ❑ ❑
hcenred cootrxtoR to c.n,Ducl the pruien(Sac.7044.B..-. LAWN SPRINKLERS•1 INC 5 V.B. 6.00 ASSESSARSPAHCELNO.
and Prufecoum Code.The Contractors,LlcenR•Law it-,cwt apply
10 an owner of property who build,or unpmrr,Ihrre,n..nd who LAWN SPRINKLERS•OVER 51EA1 1.00
mmracl.for wch project,wcth a rontncromM I-med pu-I m SEWER-SANITARY-STORM EA.2001,/10.00
the Contractors Littre Law. TRACT NO. FARCE L NO
re?
I Am raempt under Sae_,B&P(*
,BAP(.North" WATER HEATER W/VENT 6.00
Owner Date WATER SYSTEM 5.00
ACC.DATE ACC.FILE NO
WORKE.RS'COMPFNSATION pt-.0 LARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I hair....fit..[,u(conwnl 1.Nelfmwire' ZONING ENG.SITE NO
or a certificate of Worker"CompenvNon Insurance•or a c i,f J
copy thereof ISec.3800,Lab.C.l.
Policy No. Company
0 C, Certafied copy IS hereby furnallied FIRE WRINK ENERGY T 2.
Z ZO _yLa� cerllf d p I
! the city m+pecticn dnisron.
Appbc+nl = a,S•aL
y._-� -^ MISC.• REFER TO ORD. Y❑ N❑ Y❑ NO
CC a CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE AL.0 C.
W COMPENSATION INSURANCI: PLG.CONTR. LIC.No. DLG, Y❑ N❑ Y❑ N❑
a-O (This section ed not be compkled it Ih,petmil n for one TOTAL
Z hacheddollanf111001-1 A
(JO I mHfy that in the pe,for-I l'(he work h,r which con N, QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL U I„1"oun,J,1 J+111,wt en,pIcY+nY perwn i ray manner w h In
o become wbkct to lis,Wwken'Cumpeo-"ors L+w+uf Calif.-
i Dale Apphcanl - ALTER OR ADD TO MEC". 5.00 BUILDING
}rn NOTICE TO APPLICANT.If,after making+hi,('ertifkate of Ea-
F-.? empt+on,you Ificuld be--cabled 1,the Worken'Co,nlwnulwm APPLIANCE 5.00 PLAN CHECK
pnNH-S of the Labor Code,you cowl lorlhwtlh comply..If, P� FEE
U -IN prorwona or this permtl shall be deemed rerokd. AIR HANDLING UNIT(TO 10.000CF.IVL) 4.00 jo-
CONSTRUCTIONLENDINGAGENCY AIR HANDLING UNIT(OVER 101100GEM.)6.00 SEISMIC FEE
1 hereby affirm ua.l mere i,a coHir-lio.kndtng.W,-y for EXHAUST HOOD(WITH DUCT) 5.00
tlw performann of the work for which 1hn Nano u mud ISec. MICROFILM
dWT,test.+. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender i Name HEATING UNIT(OVER 100,000 B.T.U.19.50
Lrmkrl Add-
ELECTRIC
I certify that lhaeread this application and talc that lhcabove VENTILATION FAN ISINGLE) 4.00
m(ormauarn n incl.I Per m comply w m all city and cmnly BOILER 13 H.P.or 100,000 O.T.U.) 6.00 PLUMBING
.rdmances andco%fair laws relating to budding conslrwNon.and
hereby
auxeire irpremnlatives of the,c,ly to enter upam the
�•-• BOILER-COMP Iom 100.000 B7UI SEE FEE SCH. MECHANICAL
,m.r,nemlinma properly for inspection purpox•,.
(We)gree to fare,Indemnify and keep harmlm the City of MISC.- REFER TO ORD.
,penin,against liabilities•lu lt-Ia,coni,and eapemea whichCO' NST•TAX
ay in any wry ash, ,Pima said city m ao sHtuenCe the PERMIT ISSUANCE 10.00 If?E,x30
lin Of lhk nit MECN.CONT, LIC.NO. MECII
C/.imA�T6 ENc-IHE6CItW-,rNc. r rAI} L'��6�� TOTAL /G• )G'
lam Cantrxtor t e� 1•(41'il-p1J