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15195 (2) POST THIS CARD NEARFRONT OF BUILDING PERMITNUMBER CITY ,0F Z@gRTING 15195 INSPECTION DIVISION JOB INSPECTION RECORD .PERMIT EXPIRATION 14 wi 1 ADDRESS.. iCl'rlsa`� JOB -="✓ — PERMIT EXPIRES IF WORK 6W \yItbo- OWNER �1/^ '1 CONTRACTOR NIT#1 1I�\ e LOT# + IS NOT STARTED WITHIN INSPECTION' DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION `a7,— 6 C Z ( ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER Z_1 6-g$ C.` ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE � - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGES - 9 . POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED t. UNDERGROUND /SLAB PLUMBING - I_ ELECTRICAL - ISSUANCE DATE I MECHANICAL BLOC ELECT PLO. MEc,, A a ©> Q . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - 01INFORMATION LNG PERMIT T WOOD FLOOR VALUATION $/FT. PLUMBING MECHANICAL - ELECTRICAL EHMIT TO_ _ FRAMING 'I INSULATION STORIES TYPE CONST!I, 1 OCC,GHDUP RES UNITS PLACE NO SU BFLOOR UNTIL ABOVE HAS BEEN SIGNED SO,FT:PLODHAFI:A TOTAL ACHLALE r - ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE , , THE CONSTRUCTION TAX IS PAID Oz DIAPHRAGM BUILDINGuSe \' ROOF SHEATHING �i.•(%. jy W RES IND CONPu 011— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. © ❑ 0 El ASSESSORS PARCEL NO '- ROUGH SAN.p PLUMBING 2,4r, ELECT.ENERGY • TRACT NO. PARCEL NO Tues 8 OWER P p (o-_ -� wig PLUMBING ENERGY MECHANICAL CF>yteq PWS ECH.ENERGY ALC. ELECTRICAL - ACC.DATE FILE NO BUILDING ENERGY - FRAMING ELECT.FINAL TEST INSULATION PLUMBING - ZONING ENG.SITE No. GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T@A COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING El "El ` 0 NF] EXTERIOR SHEAR �'], (V' ELECTRICAL RELEASE FLOOD ZONE ,A.L UC. INTERIOR SHEAR ! (*'+_-4�• . IRE DEPT. `"❑ N❑ v 01 N❑ SHEETROCKGRADE FEE SUMMARY EXTERIOR LATH - BUILDING BUILDING .'-j• : :.: .INTERIOR LATH 0 'TEMPORARY APPROVALS - ' SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING r, .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. OFFICE COPY A'OPLICAN,T TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION % PERMIT NUMBER, BUIIL DING APPLICATION& PERMIT 15195 Q �- �Wlf I 0 LottBUILDING —ELECTRICAL—PLUMBING—MECHANICAL OWNE 'S PLAN CHECK VALIDATION PHONE ' OTY. ELECTRIC PERMIT FEE NACONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 LC:NO, LIGHTING FIXTURES 10.00/1.00 ADORESs ions PPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION: ' ARCHITECT ` . PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGI LIC,NO SIGNS TRANS. 3.00 ACRE 5 ENG. SPECIAL CIRCUIT 5.00 i PERMIT VALIDATION /f IV IP EMP.METER OR POLE INS. 20.00 D0 ADDRESrvr'S MOTORS SEE FEE SCH. roo ADDRESS �� r(xl( SERVICE CHANGE .20.00 LICENSED CON' ACTORS DECLARATIONa i Ef I hereby affirm that I am licensed under provisions of Chapter 9 UANCE DATE y 4 i (commencing with Section 7000)of Division 3 of the Business andBLDG. ELECT. PLG. MECH. r 7 Z Wit Professigns Code, my license is in full force and effect. \ z O� - License Lic.Number - 4 m r w Dete Contractor st m S � BUILDING PERMIT IS , 4 OWNER-BUILDER DECLARATION m v INFORMATION X °'w I hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO ORD F W o Q Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 164 VALUATION�- $/FT. W Code:Any city or county which requires a permit to construct,alter. r[ Q p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTH. LIC.NO. ELEC. u wD ¢ requires the applicant for such permit t0 file a signed statement that TOTAL PERMIT TO $ he is licensed pursuant to the provisions of the Contractor's License Fri Law(Chapter 9(commencingwith Section 70000o(Division 3 of life 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE c, I-$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a ; any •. byetmorfloofor. ivehundreddollars $500licumwacivilPenalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars the applicant p li ❑ I,as owner of the property,or my 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,CONIC. 5.00 Q_3 Code:The Contractor's License Law docs not apply to an owner of r properly will,builds or Improves thereon,2nd who does such work F IXTUR ES,PER TRAP 5.00 SO.Fr.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- _K1 roents are not intended or offered for sale.If,however.the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 CZO of improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE Prove purpose of sato.).' RES IND CON PB Oruer as owner of the property,he project(See. contracting with INDUSTRIAL WASTE INTER. 30.00 licensedPro contractors to construct the project La 7044,Business LAWN SPR INKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to antr owner of h projects builds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractorlsl licensed pursuant to the Contractor's License Law. SEWER-SAN V-STORM EA.200h/10.00 TRACT No. PARCEL NO. ❑ 1 um xempt under Se - ,B.&P.C.for 1 is - �// Yy reason -� � WATER HEATER W/VENT 6.00 Q Owner Date v WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO. WORKf:RS'COMPIiNSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby nffirm,tlmt I have acerfificutc of consent msel M1insure. or a certificate of Workers'COm) �,ri Uon Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.l.Lll\ Policy ere Company �I// /— b ❑ fife opyishereby fu sed. 'FIRESPRINK ENERGYT-24 Z Z CertilI led t tl+e w division. _ Y N v N� � O Applicant_ � MISC.- -• REFER TO.ORD. _ N CERTIFICATE 01'EXEMPTION FROM WORKERS' PERMIT.ISSUANCEU 1Q6@ l�-f FLOOD ZONE A.LU.C. LU l.l ' (This section need f sT noNn comINSURANCE lc ed PLG.CONTR. LIED permit is for anLIC.NO. TOTAL JAa V N Y N al, Z hundred dollors(8100)or less.) U O 1 certify that in Ore performance of the work for which this per. OTY , MECHANICAL PERMIT FEE FEE SUMMARY ELF mit is issued, I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. y • Date Applicant BUILDING Q Sa } W NOTICE TO APPLICANT: If,after making this Certificate of 11 ALTER OR ADD TO MECH. 5.00 J (_ 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 CONS'fRUCfION LENDING AGENCY AIR HANDLING UNIT(OVER l0,000QFM.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,Civ.C.). 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 I Lenity that I have read Ibis application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING gg7 _ ordinances and state laws relating to building construction, and BOILER-C0MP(3H.P.or100,000B.T.U.) 6.00 �z R�Y hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL J t1 above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE CONST.TAX Ir ay in any way accrue agar at lad City in cone,uence of lite ang of this permit MECH.CONT. , LIC.N0. MEC .natureofApplicant/Contractor IaTOTAL ' d3 TOTAL .(oG(ige OFFICE COPY