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14803 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14803 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 10110 Westminister Ct. UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER - Stan Filip CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: UFER'. ALL GRADING•AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PREGUNITE �'T' CUPERTINO STANDARDS. GARAGESLABS ' a POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ ; Tt UNDERGROUND /SLAB PLUMBING AFIRl 1�• I ELECTRICAL. m ISSUANCE DATE MECHANICAL oul 1PIRBIHIIIILLEGI. 1 PLY. MEC., . _ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION $/FT. MECHANICAL .r •.�.n ELECTRICAL PERMIT TO FRAMING 4 LfJi 7 4 ,g G.•.:., INSULATION - STORIES TYPE CONSTR. ; OCCGROUP - RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SOFT FLOOR AREA .TOTAL ACREAGE • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND CON PB - oor, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ 0 0 1:1 ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO MECHANICAL 'MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE ACC.FRE NO FRAMING ELECT.FINAL TEST _ 1� 20NING ENG.SITE NO. INSULATION - PLUMBING � �,� GAS TEST - GAS MECHANICAL FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING pL g1, Y (]• IN[D ° NQ EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE ALUC INTERIOR SHEAR - FIRE DEPT. Y Q' -❑ yo No SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING L - 1• INTERIORLATH - TEMPORARY APPROVALS BUILDING , .r -^ SCRATCH COAT . ELECTRIC jPLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE /' OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC FRG ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING -- .' o� PLEASE GIVE JOB ADDRESS WHEN PHOWNG. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL u - CONST.ONST.TAX PLEASE READ REVERSE SIDE BEFORE, TOTAL CALLING FOR FINAL INSPECTION. - OFFICE COPY Y1y;�PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUitDI NG PROJECT I DENTI FICATION - PERMIT NUMBER �� ' LDING � APPLICATION & PERMIT q A n o �, s OREss 14 sr � BUILDING— ELECTRICAL—PLUMBING—MECHANICAL 8 OWNER'S N;:r �f vHorvE7pa9`0 0 CITY ELECTRIC PERMIT FEE P N CHECK �/.VlA�LloN ` corvrRncroRs - ` CAME c_5 OUTLETS'-SWITCHES-RECEP 10.00/1.00 I 6 1M 00 S LIC.NO. 3 Z LIGHTING FIXTURES 10.00/1.00 CONTRACTOR', ADOREssPALO Af.T'O Lgls� .. 'APPLIANCES-RESIDENTIAL 91D 'S/)n14,vk*i RHONE` g —7a7t7 PANELS 10.00 DATE OF APPLICATION .' ARCHITECTPLAN (OVER 200 AMP), . 20.00 PLAN CHECK FEE P.C.N0. ENGINEER UC.No. SIGNS TRANS. 3.00 ' ADDRESS ENG. - SPECIAL CIRCUIT. 5.00 'PERMIT VALIDATION zIP EMP.METER OR POLE INS. 20.00 . AS - MOTORS' - SEE FEE SCH. ADDREDDRESSS ' SERVICE CHANGE 20.00 .w 00 LICENSED CONT RACTORS DECLARATION /.�� a l/ IS v I hereby affirm that I am licensed under provisions of Chapter 9 sCy ANCE ATE ¢ y (commencing with Section 7000)Of Division 3 of tlse Business and BLDG. ELECT. PLG. MECH. H 7 Professions Cod anit license is in 1411 torcc' effect z o License C ss S.] Lia um actor y O Dale — Contractor ,4 ' Q y f J ¢ IS ¢ OWNER-BUILDER DECLARATION BUILDING PERMIT 0 a 0 INFORMATION X 3 u H 1 hereby affirm that ham exempt from the Contractor's License - MISC.— REFER TO ORD • w VALUATION $/FT. u0¢ Law for the following reason,(See,7031.5,.Business and Pro fessions /0— -r Code:An cit or count q I - PERMIT ISSUANCE 10.00 � M 4 y y county requires permit to construct,alter, ELEC.GONTR. LIC.NO. ¢ ¢ ¢ p improve,demolish,or repair any structure,prior to its issuance,also ELEC. �'�� '(. ` a 0 ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO w m w he Is licensed pursuant to the provisions of lite Contractor's License r z a Law(Chang Professions ode)with Section 7s 00)exempt ion the IS 4 0 Business and Professions Code)or that he is exempt therefrom and QTY. - PLUMBING PERMIT FEE V ¢ H p� 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 notmore than five hundred dollars($500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00 N2,-rC ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS a, their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Brumess'and Professions DRAINS-FLOOR,ROOF;AREA,COND. 5.00 I, Code:The Contractor's License Law does not apply to an owner of _ protect', who builds or improves thereon,and who does such work FIXTURES,PER TRAP - 5,00 SQ.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve mre mems anot intended or offered for,sale.If,however,Ole building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner - GAS-EA:SYSTEM-OVER 4(EA.) . 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES '. ' CON PR Other prove for purpose ole.). INDINDUSTRIALWASTE INTER. 30.00 1:1 El F-1 El ❑ - ❑ I,as owner off the property,am exclusively 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(,)licensed pursuant to. SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner _ Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WORKERS'COMPENSA'fION DECLARATION WATER TREATING EQUIP." 5.00 �nI I hereby affirm that I have a certificate of consent m self-insure, - or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy the, of Sec 38 ,Lab.C.L Lg Policy N mpany ❑ Certified copy is hereby furnished. ' FIRE SPRINK ENERGY T24 z Z)\ ❑ Claart-.e cagy �s-Jtled with hwcity ion division. MISC.- REFER TO ORD. ❑ ❑ ❑ O F Applicant C l Y N V N CERTIFICATIi OF EXEMPTION FROM WORKERS' . PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU COMPENSATION INSURANCE PLG.CONTE. LIC.NO. TOTAL N V N CLZ (This section need not be completed if the permit is for one _ _ V❑ ❑ ❑ ❑e UlJ hundred dollars IS 100)or less.)- - - 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL.U mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws o(California.It. Date Applicant ALTER OR ADDTO MECH, 5.00 BUILDING 9� ' } to NOTICE TO APPLICANT: If,after making this Certificate of Ex- F Z' emption,you should become subject to the Workers'Compensation APPLIANCE - 5.00 PLAN CHECK proPermit of the Labor Code, you must forthwith comply with FEE V such provisions or this shall be deemed revoked' AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 pp CONSTRUCTION LENDING AGENCY - 'AIR HANDLING UNIT(OVER 10=C.FM.) 6.00 SEISM IC FEE 0 7 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.0.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name H EATING'UN IT 100,000 B.T.U,)B.50 3 Gender's Address ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply witlt 811 city and county PLUMBING � ordinances and state laws relating to building constran on, and BOILER•COMPI3H.P,Or.t00,000B.T.U.I.`6.00 hereby authorize representatives ec this city es enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE BCH. MECHANICAL above-mentioned propertyforinsp of this purposes. (We) agree to save, indemnify and keep harmless the City Of MISC.- REFER TO ORD. vT 1 Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in consequence of the — rantin (this permit. MECH.CONT. LIC.NO. 'MECH. rorALar /*- TOTAL Signature OfA plican 1/Contractor Date - OFFICE COPY