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15641 (2) EI POST THIS CARD NEAR.FRONT OF. BUILDING t ., PERMIT NUMBER CITY O,F GUPERTINO 156�tk1 INSPECTION DIIVISION ; ! JOB,INSPECTION RECORD PERMIT EXPIRATION I � JOB ADDRESS l.6 �a3 -IN 'T, ' _LOT# '•� 1 - L, PERMIT EXPIRES IF WORK OWNER Q 'r a 6-- p-� ~ '.'coNrancroR�•• �HL671�- c'7J`, , - ISNOT STARTED WITHIN INSPECTION . ' -DATEINSP CTOR INSPECTION RECORD. AS0 DAYS OF PERMIT"ISSU FOUNDATION'S NOTE. y' ANCE.OR 180,DAYS FROM��' - - LAST CALLED INSPECTION UFER .. ALL GRADING AND DRAINAGE SHALLL'BE'INSTALLED .w- PREGUNITE , TO COMPLY WITH THE APPROVED PLANS AND CITY OF .PERMIT VALIDATION r ° f CUPERTINO STANDARDS: - '•b1 GARAGE SLABS ayµ, r _( , . t POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED { / ' `' UNDERGROUND /SLAB. }A ry a PLUMBING . ?+ rf ELECTRICAL „ r }'ISSUANCE DA;E MECHANICAL P.o- - BLDG. - .ELECT•. PLc. .Mec R.l :IVEl D . ❑- ®~ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT W00D,FL00R INFORMATION ' t' VALUATION - $IFT. PLUMBING I'.. MECHANICAL - ELECTRICAL 7 • IEy PERMIT TO FRAMING a - , ,-'' :1fSI z ! { INSULATION STORIES- TYPE CONSTR._ . ,e , ,'.' •y'. {„ . . AV, ` s`. OCC.GROUP: RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED V, - SOFT •T ,FLOOR AREA OTAL ACREAGE c, ROOF ' NOTE NO FINAL INSP.SHALL BE MA�g DIAPHRAGM " v THE CONSTRUCTION�TAX;IS PAID' ROOF'SHEATHING - ` - , fk• BUILDING USE � -BEs IND corv' 'PB o ' .'APPLYAO'ROOFING UNTIL ABOVE,HAS BEEN SIGNED,, ,FINALS " ❑¢- ❑ ' ❑ ❑ > ❑ DATE INSP.r 'ASSESSORS PARCEL NO U ROUGH SAN.p "t> IV PLUMBING1. <',,. ,ELECT.ENERGY _ Y i I n , ✓ .TRACT NO. y TARCEL NO y TUBS 8 SHOWER PAN � � PLUMBING ENERGY � MECHANICAL - MECH.ENERGY ELECTRICAL ,' ACC DATE , Acc.FILE NO, 'BUILDING ENERGY . I FaAMING- '`, ELECT.FINALTEST : - - ••INSULATION _ <• PLUMBING' +:• •- , zow NG ENO SITE.No 'GAS TEST - GAS - I » '' G - i., MECHANICAL ,FIRE SPgI^K- ENERGY T}G.. I I COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED ,» HEATING' u❑ -'"❑, `' ❑ '"�" ,I r{ - ,EXTERIOR SHEAR - •:, .,-� ELECTRICALRELEASE ,. FLooD zorvE A.L u.c - INTERIOR SHEAR- i FIRE DEPT.` "+Y ❑ N❑ Y ❑, tN❑; SHEETROCK' ' " GRADE, . . - FEE SUMMARY EXTERIOR LATH `T _ .,- BUILDING ,•'r INTERIORLATH ',,-TEMPORARY APPROVALS :E eulLOwc SCRATCH COAT . ELECTRIC '` PLAN CHECKPrtq ' GAS . .. :FEE'Po r NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED• OCCUPANCY,, w SEISMIC FEE OCCUPANCY OF,BU I LDING IS NbT PERMITTED UNTI L BUI LDING F INAL IS SIGNED BV BUI'LDING.INSPECTOR .+ MICRO FILM + AR`RANGE'F,OR'INS'PECTI,O,N BY PHONING 252:4505; " ELECTRIC T �A. o�. ONE.WORKLNG'OAX BEFORE,REQUIRED ''INSPECT.ION PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING —,SEE PERMIT:FOR.EXPIRATION DATE MEcGANICALs ''> L i .IMPORTANT! CONST"TAX PLEASE READ REVERSE SIDE BEFORE "-CALLING:FOR FINAL`.INSPECTION: TO AL.,+h OFFICECOPY — -- Y --/ r APPLICANT TO{-FI,LL IN INFORMATION WITHIN RED LINES:--1' USE BALL POINT PEN ONLY a n v PERMIT NUMBER r.+ b BUILDINGPROJECT IDENTIFICATION 1 +c 1 ! aDILDINc x B" qrG� ,APPLICATION'& PERMIT , . , s Au e ,7 CLg „ r BUILDING ' ELECTRICAL'PLUMBING'—MECHANICAL 1• OWNER'S 1 1 PLAN CHECK VALIDATION NAME QTV. a ELECTRIC PERMIT -' FEE + :ter D 0AjA5ri NONE CONTRACTOR'S - - NAMFOUTLETS-SWITCHES'-RECEP,.10.00/100 ua NoLIGHTING FIXTURES /7: " 10.00/1.00 ` CONTRACTOR'S , 4 •, {' \ APPLIANCES RESIDENTIAL 4.00 PANELS 1, '„ 10,00 'J' .b .DATE OF APPLICATION ` ARCHITECT - -YPLAN CHECK FEE'. . P C NO., OR ry PANELS (OVER"200•AMP) 'P •,2000 ` ENGINEER' _ LIC.NO, SIGNS TRANS.. ' - 300 ARCH,OR ENG.. . . . Y, ft'PEflMIT VALIDATION • L- I ADDRESS ,-' SPECIAL CIRCUIT' • t . '. 5.00 D , t•`? ZIP EMP.METER OR POLE INS ;2000 APPLICANT'S - ~ ADDRESS - wu. MOTORS.' SEE FEE SCH r SERVICE CHANGE ' 2000 M o LICENSED CONTRACTORS DECLARATION i aI ' a E,U I hereby affirm that I am licensed under provisions of Chapter 9 !ISSUANCE DATE r-.z w (commencu with Section 7000)of Division 3�ofthe Busin_essand - 'ME H� . g PLG. C y Q y ,r. BLDG. ELECT. o Professions C e nil li,ease is in full fort a d c. Our, I O w a.r ' Licens Cla Lie Number :� :�, A'�'❑•• ❑; _ � 9 Date' Contmdor ,A r a, —y/i i;JjO�—dam r l a m j y . ., . •..., { ', C...' .,• • . -." ...BUILDING PERMIT , OWNER-BUILDER DECLARATION �'�+'•' a hi o- • , . .s ' INFORMATION i o a MISC.— _ .,,REFER TO ORD X g; u.y. 1 hereby affirm that I am exempt from the Contractor's License - y VALUATION $/FT � LL0 La for the following rrason.(Sec.70315.Business and Professions p . PERMIT ISSUANCE �b5 `.1000 t 1 5 . Code:Any city or county which req hires a perm t to construct,alter, r R ce s, 0., improve,demolish,or.repair any structure,prior to Its issuance also ELEC.CONTR.NTR, LIC.NO: 1 ELEC. K m LL requires the appllcan Lfor such permit to file a signed statement that Hh. ^ITOTgL T -„p, PERMIT TO n w he is licensed pursuant to the provisions of the Contractor's License. y:�r• . I, care Law(Chapter 9(commencing with Section 7000)o'Division 3 ofthe. "" Q Business and Professions Code)or that he is exempt therefrom and QTV. PLUM BINGPERMI+ 11, FEE -� ! _,$-. the basis for the alleged exemption.Any violation of Section 703 L5 .: ]STORIES• TYPE CONSTR. a ; bypny applicant for a permit subjects the applicant ton civil penalty ,. I"d'..?{ + _k of not more than five hundred dollars lS500)J.a 1p A,LTER-DRAIN&VENT_WATER (EA.) 500 t:' ❑ 1,as owner of the property,or my employees with wages as i OCC.GROUP .. RES.UNITS their sole compensation,will do the work,and-the structure is not BACK FLOW PROTECT;_DEVICE 4.00 intended or offered,for sale (Sec. 7044, Business`und Professions DRAINS"'FLOOR ROOF"AREA,COND. 500 : ' Code:-The Contractor's License Law does not apply to un owner of - property who builds or improves thereon,and who does such work FIXTUR ES,F PER TRApU' ig t..5bo 1 90 FT'FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve' - r - memsare'Got intended or offered for sale.If,however,the buddig .GAS-EA.SYSTEM 11NC.40UTLET$ 600 - - r improvement is sold within one year of Complete me own - GAS=.EA.SYSTEM=OVER 4(EA.) 2.00 - .,BuaowG USE builder will have the burden of proving that liedid not build or Im- - - - qE5• IND• + CNG PB Other prove for purpose of sale J., I NDUSTR IAL WASTE I NTER.r3000 ❑, 1,as owner of the property,am exclusively contracting with - a❑'. ❑ �'❑ ❑ , " licensed contractors to'construcl the project(sec.7044,Business LAWN SPRINKLERS='1-INC5,V,B:' 6.00 - - ASSESSORS PARCEL No. • and Professions Code:The Contractor's License Law does not apply " to,au"owner of property who builds or improves thereon;and who ^ _ LAWNaSPRINKLERS-�OVER_61EA_.1 � 1.00 . - - ] contracts for such projects with a contmetoKs)licensed pursuant to TRACT ' - theContractor'sLicenseLaw., ,j" SEWER-SANITARYSTORM EA:200ft/1000 I .TRACT NO : PARCEL NO_ ❑t lam exemptunder Site ,B:&P.C.for this ' 1NATER+HEATER W/VENT x 600 t '. ]i' + reason - ,; Owner - I Date WATER SYSTEM ;•. ` 500 f' ACC DATE -.Ace FILE NO. WORKERS'COMPLNSATION DECLARATION WATER TREATING EQUIP, 500 ' - 1 hereby affirm that I have a certificate of consent to self-insure,'—, q - i- r� n r• : ys ZONING ENG.SITE:NO. T i 'cola ctirtifioate'of Workers'Compenyltiop Ins anw,o a cetll(led �' copy[her We 3 fes,bab'.C.I. -zL ' Policy N /KC'' O ❑ Certified copy ishereby furnished. IF ra' i FIRE SPRINK '" _—ENERGY T24' z 2 `.Certified copy,is filed with the city inspection.division MISC. :';REFER TO ORD �y. r,N y ❑ sry❑ APp marti..❑ cc - ' - PERMITISSUANCE ., i1 a+ +, 1000 a+ ', FtooD zorvO "ALuc, lr CERTIFICATE OF EXEMPTION FROM WORKERS' - LU : COMPENSATION INSURANCE, "• PLG.CONTR- S,uC'N0. PLG +`y i4 N y❑ ,t N O C O ' (This section need not be completed if the permit Is for ane - y "a TOTAL Q ❑ Z h indred dollars($100)or 11SO t - U O,: I •rtify that in the performance of the work for which this Per- QTY. - ,MECHANICAL PERMIT ' FEE. FEE SUMMARY r.x LL {-' mit is issued,1 shallnotemploy any person in any manner so as to U become subject to tire Workers'Compensation Laws of California., Q'IL , Date - Applmant - ALTER OR ADD,TO MECH BUILDING } N ` NOTICE TO APPLICANT: If,alter making this Certificate of Ex- � Z empticn,you should become subject to the Workers'Compensation APP-LfANCE .-6.00 PLAN CHECKS provisions of the Labor Code, you must forthwith comply with r - FEE'�� 3 "^ U such provisions or,this permit shall be.deenied revoked AIR HANDLING'UNIT IT '10,000, • .1 4 0 - CONSTRUCTIONLENDINGAGENCY FAIR HANDLING IO .F.M.1600 '- .SEI SM IC FEE ' ' - Thereby affirm that there iss.construction lending agency for ,EXHAUST HOOD (WITH DUCT) 'Q -- the performance of the work for which this permit Is Issued(Sec. MICROFILM 3097,Civ.C.1. . HEATINGUNITITO 100000BT:U.) 800 " t Lender's Name HEATING UNIT.IOVER 100000 B:T.0 19.50 e Lender's Address - ELECTRIC.ik H ' I certify that l have read this applieahoii and state tlmt the above VENTILATION FAN.(SINGLE) - 4.00 r information Is Correct. I agree to comply with.all city and county PLUMBING' r� ordinances and,state laws relating to building construction and . 'BOILER-,COMPI3H P.or�1000008T.U.) 600 t r hereby authorize representatives oftms city to enter,upon the BOILER-COMP ]Ova'100,000 BTU]SE E FEE SCH I+ ,MECHANICAL 'VV atiove-mentioned property for Inspection purposes - - " ] S (We) agree to Save,"indemnify and keep,harmless.the City of MISC.' EFER TO ORD upertino against liabilities,judgments, costs and ex enses which O CONST TAX - 1 .. may in-anyway`accrue against said City in consequence of the +PERMIT ISSUANCE`'1 11. 100012-0 I - ranting of t 's permit MECH.CONT uI - LIC NO. MECH - .d• ^n ' ' TOTAL aIh1 TOTAL - ). Signature of pplicant Centrae ,r :"Date o3 OFFICE COPY` "