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17989 (2) POST THIS CARD NEAR FRONT-OF BUILDING • - PERMIT NUMBER CITY OF CUPERTINO , , � 17989 n ! INSPECTION'DIVISION r'i':•'t.A. JOB INSPECTION RECORD � ' . ki � :.I� ,. 9p�� ZZPERMIT EXPIRATION JOB-ADDRESS Ol i3 -�� W DtA2 UNIT# c • " /I -- " "• '.^' J 3 PERMIT EXPIRES'IF-WORK OWNER, um� CONTRACTOR IS NOT'STARTED WITHIN ' APIECrIoNo DATE INSPECTOR LINSPECTibN RECORD 180 DAYS GF PERMIT ISSU FOUNDATION - ANCE OR 180 DAYS FROM NOTE:,' - LAST CALLED INSPECTION. UFER ALL GRADINWAND DRAINAGE SHALL BE INSTALLED >," PREGUNITETO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION - I'll- - CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PADJD M� ' UNDERGROUND /SLAB N 5 1989 PLUMBING • ELECTRICAL CitV os y; - f Cu el Yno ISSUANCE DATE - MECHANICAL' - - eE EL r PLO. MECR. El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FCOOR INFORMATION ' PLUMBING VALUATION $/FT. - MECHANICAL ELECTRICALPPERRMIT TO FRAMING - r"(' �-�-�� LtzkL INSULATION - - STORIES TYPE CONSTR, OCG GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED i• - 50.Fr.FLOOR AREA TOTAL ACREAGE . ROOF,. NOTE:NO FINAL INSPSHALL BE MADE BEFORE' DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING HES IND CON PB omr, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ` ❑ ❑ ❑ ❑ ASSESSORS PAR CEL NO. ROUGH SANA PLUMBING , _ - ELECT.ENERGY TRACT N0. :PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICALBUILDING ENERGY ACC..DATE -ACC.FILE No. • - FRAMING - ELECT.FINAL TEST INSULATION PLUMBING zONING ENG SITE N.O. GAS TEST GAS .+. MECHANICAL - FIRE SPRINK ENERGY T.7q COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' �Y.❑ N❑ Y ❑ " NE], ,EXTERIOR SHEAR , ELECTRIC RELEASEFLOOD zoNE ,A.L.uc INTERIOR SHEAR _ - FIRE DEPT. Y"[] No Y L7 NE] SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING ,INTERIOR LATH - - TEMPORARY-APPROVALS euILDING SCRATCH COAT ELECTRIC' 'PLAN CHECK GAS ' FEE • NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ''SEISMIC FEE ". OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED,BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ,' o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUM6ING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT'! . CONST PLEASE READ REVERSE SIDE,BEFORE CALLING FOR FINAL'INSPECTION TOTAL . OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDE IFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT. 17/y� Q gpOREss z-3'O^ O�QC��A BUILDING-ELECTRICAL-PLUMBING , 1 1 V S V -;MECH'ANICAL +�'r O N NAME � - PLAN CHECK VALIDATION . DTV. ELECTRIC PERMIT, :FEE �•� PRONE � CONTRgL Na E - OUTLETS-SWITCHES-RECEP 10.00/1.00 gD19 , 4•� OR'S LIGHTING FIXTURES 10.00/1.00 CONTRACTOR • APPLIANCES-RESIDENTIAL � 4.00 IQI XONE- PANELS IO.00 /VI) DATE OF APPLICATION ci o��5/I•eA� �' PANELS(OVER 200 AMP) 20.00 PLAN CHECK FEE P.L.NO. LIC.No. ISIGNS TRANS. Q-Kf 3.00 j0ov noo ess ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zlv TEMP.METER OR POLE INS. 20.00 _ L eek APPLICANTS _ MOTORS SEE FEE SCH. QJ ADDR Ess - n ¢ i SERVICE CHANGE 20.00 o (i F O O LICENSED CONTRACTORS DECLARATION - I G •0 b .... Fi w 1=affirm Ihut I nm licensed under provisions Of Chapter 9 S �' NQ Y O p ISSUANCE DATE _ a e (commencing with Section 7000)of Division 3 of itle Business and SLOG. ELECT. PLG. MECH. r w i Professions Cnyl license is in full foFFcc�}•��appQQeffect. ❑ ❑ ❑ zO i w o License Class // Lic.Number.7�..,y_/�-Z_ H Date ,-I Contractor a x BUILDING PERMIT OWNER-BUILDER DECLARATION O INFORMATION wN 1 hereby affirm that 1 am exempt from the Coulomb 's License MISC.- IL O< Law for the following reason.(Sec.703 1.5,Business and Professions VALUATION I- - PERMIT ISSUANCE 10.00 L 0 O Code:Any city or county which requircsa permit to construct,alter, - 2 rc¢0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. l e 0 LL requires the applicant for such permit to file a signed statement that TOTAL 5 PERMIT TD e. w m he is licensed pursuant to the provisions of the Contractor's License i Law.(Chapter 9(cmmnemcingwUll Section 7000)of Division 3 of the �I �-�`� ic Business and Professions Code)or that he is exempt therefrom unit QTV. PLUMBING PERMIT FEE 44 eGt{-'V� the basis for the alleged exemption.Any violation of Section 7031.5STORIES TYPE CONSTR. i;- by any applicant for a permit subjects the applicant toa civil penalty gLTER-DRAIN$ VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner ol'tile property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS sale compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,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 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such impow- mentsarenotintendedorofferedforsale.If,however,the budding GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the dm owner- GAS-EA.SYSTEM-OVER 4(EA) 200 builder will have burden of proving that h . . e did not build or int- BUILDING USE Prove for purpose of ide,). RES IND CON PB Other ❑ I,as owner at the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ El ❑ E] licensed contractors to construct the project(See.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 Conor tractor's h License with a CODIIJCInr(s)licensed pursuant t0 SEWER-SAN ITARV-STORM EA.200ft/10.00 the Contractor's h proje Law. TRACT NO. PARCEL N0. ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner - Date WATER SYSTEM 5.00 ACC.DATE ACG FILE N0. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 baso a Corlificirc of Consent 1.self-insure, ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified ropy thereS y�(q]J��b.C.) Policy No ' 307 Q frYCettiliedc ¢hereby fumltls L FIRE SPRINK ENERGY T-24 Z Z ❑ Cefii ied is GI i t c cityi s •inion division. MISC.- REFER TO ORD. Q APPlicant _ V[] N� V E] NE M m CERTIFICATF OF EXIiMPnON FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COMPENSATION INSURANCE. PLG.CONTR. LIC.NO. PLG. M Z m (This section need not be completed it the permit Is Gtr on ❑e TOTAL Y N Y N❑ hundred dollars($100)or less) L) O I certify that in elle performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued.I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. .n a Dae ApplicantALTER OR ADD TO MECH. 5.00 BUILDING } W NOTICE 1'0 APPLICANT: If,after making this Certificate of 17x- F 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 provisiomor this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 - SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of tile work for which this permil is issued(Sec. MICROFILM - 3097,Cw.C.). HEATING NIT T(TO 100,000 B.T.U.) 8.00 Leader's N. HEATING UNIT(OVER 100,000 B.T.U.)9.50 - ,3 Lender's Address ELECTRIC - a I certify that I have read this application and stale 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, unit BOILER-W MPI3H.P.Or100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon (lie g01LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agre to ve, indemnify and keep harmless the City or MISC.- REFER TO ORD. Cupertino a inst H ilities,judgments, casts and expenses which PERMIT ISSUANCE 10.00 CONST.TAX a I any way a rue again id City in consequence the rant oft is per MECH.CONT. LIC.NO. MECH. A-A-11C. TOTAL TOTAL Signature of Applies tu racDate OFFICE COPY