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17908 (2) - POST THIS CARD NEAR FRONT OF'BUILDING PERMIT NUMBER ' CITY OF.. CUPERTINO . 17808 INSPECTION DIVISION 'JOB INSPECTION RECORD I'� rr ,,11 SP 10 PERMIT EXPIRATION y JOB ADDRESS Q�3 N- 'LD l �CL UNIT# - LOT# PERMIT EXPIRES IF WORK OWNER \ CONTRACTOR Ve ip e,�L 1S NOT STARTED WITHIN - INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS.OF PERMIT ISSU-,y FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION.'*,!e LIFER, . ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED P`US AND CITY OF PERMIT VALIOArION CUPERTINO STANDARDS. pp, n GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING OLYunplai � I1 V. 1loC�. /�1 ELECTRICAL ISSUANCE DATE V MECHANICAL BLDGELECT [ PLG. MCR. ❑ ❑ El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION VALUATION SIFT. PLUMBING MECHANICAL - ' PE fIT TO ELECTRICAL , J� FRAMING INSULATION' - STORIES TYPE CONSTR. OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn.7T ELoory AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING U E ROOF SHEATHING I RES IND CON PS O L , APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ 0 ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SANA PLUMBING ELECT,ENERGY TUBS 8 SHOWER PAN " PLUMBING ENERGY - TRACT NO PARCEL NO MECHANICAL MECH.ENERGY ACC.OATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO, INSULATION PLUMBING GAS TEST GAS _ MECHANICAL FIRE SPRINK ENERGY T.24 ` "� FLooD zorvE COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING NE A.Luc. ` Ir EXTERIOR SHEAR ELECTRICAL RELEASE I INTERIOR SHEAR FIRE DEPT. v❑ NQ Y ❑ N❑: • SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING I SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ' F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING _ O PLEASE GIVE JOB ADDRESS WHEN PHONING. ZI � . = SEE PER FOR EXPIRATION -MECHANICAL IMP - • IMPORTANT! CONST.TAX PLEASE.READ REVERSE SIDE BEFORE TOTAL , V CALLING FOR FINAL INSPECTION. OFFICE COPY i.APPLICANT TO FILL.IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT I DENT' IC O PERMIT NUMBER BDILDING APPLICATION & PERMIT Aoo BUILDING - ELECTRICAL-PLUMBING-MECHANICAL - 17908 NAMEn a - S K PLAN CHECK VALIDATION PHONE OTV. ELECTRIC PERMIT FEE CONTRACTOR'$ UTLETS-SWITCHES-RECEP 10.00/1.00 uC.No. 1J.�ilI LIGHTING FIXTURES 10.00/1.00 noto�/A`.eJs=s/'oRs ((�'�Q PPLIANCES-RESIDENTIAL 4.00 / /�+rx L,t�• 11�♦ PHO IVa 70 PANELS 10.00 DATE OF APPLICATION `• ARCHITECT PLAN CHECK FEE P.C.NO. OR �^ PANELS (OVER 200 AMP) 20.00 _ ENGINEER M U��t I, y� I r`l.. �1\Y N SIGNS TRANS, 3.00 ARCH.OR ENG. PERMIT VALIDATION AIOI EW64, �•� SPECIAL CIRCUIT 5.00 ZIP EMP.METER OR POLE INS. 20.00 Zy APDRESSTs MOTORS SEE FEE SCH. "( SERVICE CHANGE 20.00 .p w o o LICENSED CONTRACTORS DECLARATION < u I hereby affirm that I am licensed under provisions of Chapter 9 y a n (Commencing with Section 7000)of Division 3 of the Business and ISSUANCE DATE H O i PrG fessions CrAg�pR I' Is in full forc��l' �/ t� BLDG. ELECT. PLG. M CH. rG-L apse 7l zo z w o License C -laic.Number H = r J Date Centractor _ pp��as�� s//�s��./, ❑ ❑ ❑ E o IS st IS U' OWNFR-BUILDER DECLARATION YIy ut VYpono BUILDING PERMIT E: 3. u_y I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION O j Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT. M Code:An cit or count PERMIT ISSUANCE 10.00 P y y y county requiresa permit t oconstr gahnr, ¢ Q 4 Improve,demolish,or repair any St NOture,prlUr IO IIS Is once,also ELEO CONTR. LIC.NO, ELEG o M requires the applicant for such permit to file a signed s lenient that TOTAL , PER IT TO E `� he is licensed pursuant to the provisions or the Con .ctor's License Hzi Law(Chapter 9(eommencingwith Section 7000) Division3ofthe )ry/t� 3 i c Business and Professions Code)or that he is a pl therefrom and DTV. PLUMBING PERMIT FEE e C,yam. ¢ H the basis for ilia allege)exemption.Any viol ton of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects"hr plicannoacivilpenally gLTER-DRAIN -WATER IEA.) 5.00 .fuel more than five hundred dollars( 0).): ❑ I,as owner at the property,o y employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP RES.UNITS their sole compensation,ion,will dot work,and ilia structure is not intended or offered for sole (S 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND.. 5.00 Code:'The Contractor's Licen Law does not apply on an owner of properly who builds or int ves"hereon,and who does such work FIXTURES-PER TRAP 5.00 so.PT.PLDOR AREA TOTAL ACREAGE himself or through his me employees,provided that such improve- mentsarenotintended offered for sale If,however,the building GAS-EA.SYSTEM-11NC.4 OUTLETS' 6.00 or int preventer,is so within one year of completion,the owner- builder will have t burden of proving that he did not build or im. GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE Proveforturpose fsale.). INDUSTRIAL WASTE INTER. 30.00 RES .IND CON PB other ❑ I,as ew of the property,Sin exclusively contracting with ❑ licensed cont eters to construct the project(Sec 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professi s Code:The Cnntraclor's License Law docs not ripply to an ow r of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) - 1.00 contract for such projects with a contmclor(s)licensed pursuant to the Co ractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ am exempt under Sec. ,BARC.for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 - ACC.DATE ACC.FILE NO, WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a Certificate ofconsenl to selbinsure. or a certificate of Workers Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). Policy No. Company - r r 0 4 Certified copy is hereby furnished. FIRE$PRINK ENERGY T�24 Z Z Cerli' epy is fled with the city inspecion division. y ❑ N❑ V ❑ N❑ p A pant_ E .a-t.ta•� al�ywr-g u, MISC- REFER TO ORD. CERTIFICATE OP EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. R o (This section need not be completed if tl in is !or one TOTAL Y❑ -N❑ Y ❑ N❑ � Z hundred dollars IS 100)or 1 ., U O 1 certify that in the perlormunc' la work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not empl ny person in any manner so as to U become subject m the We 'Compensation Laws of Calilorniu. UJ Dale kart ALTER OR ADD TO MECH. 5.00 BUILDING } m NOTICIi To CAN"f: If,aper making this Certificate of lix- F 2 emption,y lentil become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK' provost of the Labor Code, you must forthwith comply with FEE U 1.0revisions'or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,OD0GF.M.) 4.00 CONSTRUCTIONLENDI GENCY AIR HANDLING UNIT(OV IO,000C.EM.16.00 - SEISMIC FEE I hereby affirm that there ons ruction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of Ila-511 for which this permit is issued(Sec. r� MICROFILM 3097,Civ.C. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lend dme Lelfdcri Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city cti county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and slate laws relating to building construction, and hereby authorize representatives of This city to enterr uup upon the BOILER-COMP(Over 100,000 BTUI SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes, 1 • agree to save, indemnify ; J keep harmless the City of MISC.- REFER TO ORD. Cu rtl against Iihbili'c jud s, costs and ezpcnses which CONST.TAX TV in a way seeru g ins City in consequence of the PERMIT ISSUANCE 10.00 ming f is pe L MECH.CONT. LIC.NO. MECH. yr- (% �•/�� ?rTOTALL�� „()c7 TOTAL t SD Signet e o lie nt o rotor Date Mori LL4 19.J�` / I �- OFFICE COPY