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13128 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 13128 INSPECTION DIVISION JOB INSPECTION RECORD / 758-5 -WATER- FORD. DRIVE PERMIT EXPIRATION - JOB ADDRESS UNIT# LOT# • PERMIT EXPIRES IF WORK OWNER PAUL HOVLAND CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECO D 180 DAYS OF PERMIT ISSU- FOUNDATION " p , t�� CE OR 180 DAYS FROM ASTCALLED INSPECTION. LIFER PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING 7 ) ELECTRICAL ISS AN Ed T MECHANICAL BLQG.- ELECT. PLG. MFECH, DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED C,lt BUN INFORMATION PERMIT WOOD FLOOR VALUATION � CSIFT., PLUMBING MECHANICAL PERMIT TO ELECTRICAL FRAMING I K�fC-HES- �Mo.D INSULATION s*DRIES —TYPE CONSTR. OCC GROUP RES.UNITS I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED O.FT FLOOR AREA TOTAL ACREAGE ROOF DIAPHRAGM BUILDING LITE + HES MD CON PB OVu.r APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ID 1:1 ❑ F-1 ASSESSORS PARCEL NO. ROUGtj PLUMBING GAS TEST TRACT NO. PARCEL NO. MECHANICAL ACC.OATE ACC FILE NO, ELECTRICAL FINALS DATE INSP. FRAMING .-3o SAN ZONING ENG.SITE NO. INSULATION PLUMBING 0_ + GAS MECHANICAL FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "❑ [:] "o FLOOD ZONE A.L.0 c. LATH-INTERIOR ELECTRICAL LATH-EXTERIOR FIRE DEPT. - - v "� v "F SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING11-do-AX- 1BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, 'ELECTRIC FIN- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL - CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. w �. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY B I LD1 NG PROJECT IDENTIFICATION PERMIT NUMBER 90ILDING APPLICATION & PERMIT 1312 8 � DRE ss `CI c- I1 ATF,yf J2 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S l W 1` CJPG I PLAN CHECK VALIDATION y E v�L ' -I�7 OTY. ELECTRIC PERMIT FEE k 3 /"1- -- n �\ HONE (7��V CONTRACTORSUTLETS-SWITCHES-RECEP 10.00/1.0070 -:7 s�7 ?0 NAME LIC.NO. LIGHTING FIXTURES 10.00/1,00 CONTR ACTORS ADDRESS PPLIANCES-RESIDENTIAL 4.00 ADDRESS PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECTPANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER uc.ND. SIGNS TRANS. 3.00 ADR. ENG. PERMIT VALIDATION ADDDRESSSS SPECIAL CIRCUIT 5.00 ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'SADDRESS �A, MOTORS SEE FEE SCH, - SERVICE CHANGE 20.00 s� ^7 w O o LICENSED CON TRACTORS DECLARATION AID s I / r.r a u w I hereby affrm that I am licensed under provisions of Chapter 9 s ,' I's DATEI �- N < (commencing with Section 7000)of Division 3 of the Business and 1 qC ! BLDG. ELECT. sVj,G' -M CH. r o i Professions Code,and my license is in full force and effect. o 0 R Zw D License ClassLie.Number Date Contractor Y f ifir 0 .IIO 0 BUILDING'PERMIT ¢ S, ¢ OWNER-BUILDER DECLARATION INFORMATION tt wO a D MISC.- AMER ORD ; H 1 hereby affirm that 1 am exempt from the Contractor's License VALUATION SIFT. a. Law Law for the following reason.(Sec.7031.5,Business Professions PERMIT ISSUANCE 10.00 U v .y /-`�,f�, Sw0J Code:Any city or county which requires a permit to construct,alter, oC,U t/V V ¢ 0 improve,demolish,or repair any structure,pRor to its issuance,also ELEC.CONTR. LIG.N0. ELEC. o LL requires the applicant for such permit to file a signed statement that TOTAL ✓i PERMITj w$ be is licensed pursuant to the provisions of the Comrnctor's License �J��{.x� Hii Law(Chapter 9(commencing with Section 7000)ofDivision3ofthe /TG3N�A �'Af' ¢ Business and Professions Code)or that Ise is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ $ the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant ma civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($5001.): ❑ 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 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 builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 0 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that Ise did not build or im- pr forpurpuss ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licen contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Pro scions Code:The Contractor's License Law does not apply to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER -STORM EP,200ft 0.00 the Contractor's License Law. TRACT NO. PARCEL N0. ❑ I am exempl ander Sec. .114P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 1 16.00 X\ I{ � 1 ( ACC.DATE ACC.FILE NO, WOR KE.RS'COMPF.NSATIO DF.CLA RATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, Inn Ill r or a certificate of Workers'Compensation Insurance,or a certified )t6vQi `r ZONING ENG.SITE N0. copy thereof(Sec.3800,Lab.C.L Policy No. Company ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 ZZ ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. O Applicant Y❑ N❑ Y C] N[]p: m PERMIT ISSUANCE 10.00 Lu CERTIFICATE PE SATION ION FROM WORKERS' FLOOD ZONE A.L.U.C. W � COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. 1 0 (This section need not be completed if the permit is for one TOTAL p?O C Y❑ N❑ Y❑ N 1 0 2 hundred dollars($100)or less.) U 0 I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mil is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. Q w BUILDING L� y NO Applicant ALTER OR ADD TO MECH. 5.00 �� } N NOTICE TO APPLICANT: If,after making this Certificate sa ion F 2 emotion,you the L become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you muss l ocso lh comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10,00011F.M.) 4.00 CONSTRUCTION L17NDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 7[- 1 hereby effort that tlsere is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Cw.C.L Lender's Name Lender's Address HEATING UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC 30W I certify that l have read this application and slate that 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.T.U.) 6.00 0< d hereby authorize representatives o1' this city to enter upon the BOI LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-m utuared property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may ' any way accmc fgainst said City in consequence of the PERMIT ISSUANCE 10.00 gra ti of this pe sit. MECH.CONT. LIC.NO. MECH. -/o TOTAL TOTAL ao2D2 S' tura ofAllplicarrIfUcantractor Date OFFICE COPY