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18637 (2) POST THIS CARD NEAR FRONT OF BUILDING , PERMIT NUMBER CITY OF CUPERTINO 18637 INSPECTION DIVISION JOB INSPECTION RECORD` 6 // // ,PERMIT EXPIRATION " JOB ADDRESS /U! 2- N Wd . Q UNI LOT#' PERMIT EXPIRES IF WORK OWNER 91 tom CONTRACTORS - IS' NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION 'ANCE OR 180 DAYS FROM NOTE: •LASTCALLED INSPECTION.P LIFER ' ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EG UNITE TO COMPLY'WITH THE APPROVED PLANS AND CITY OF PERMIT VALmA TION CUPERTINO STANDARDS. ��® GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED SEPI •� ' UNDERGROUND /SLAB SEP 21 1989 (� PLUMBING . /yq,� 4! .HW jvn 'J C:- ELECTRICAL - flay o�1 Vtl !1 ISSUANCE RATE MECHANICAL - BLOC ELECT. PLc. MECR. ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE.HAq BEEN SIGNED -- - BUILDING PERMIT WOOD FLOOR 1 INFORMATION ' PLUMBING VALUATION SIFT. j MECHANICAL PERMIT TO ELECTRICAL , FRAMING INSULATION - STORIES TYPE c NSTR, OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO FT FLOOR AREA TOTAL ACREAGE ROOF, ' NOTE:NO FINAL INSP.SHALL BE MADE BEFORE ' •, DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING I I RES IND CON Pe O'n- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.N ASSESSORS PARCEL NO PLUMBING. ELECT.ENERGY ' TUBS 8 SHOWER PAN PLUMBING ENERGY .TRACT NOPARCEL NO MECHANICAL' ,. MECH.ENERGY ELECTRICAL BUILDING ENERGY - ACC DATE ACC.FILE NO FRAMING ELECT,FINALTEST INSULATION - PLUMBING T zowrvc .ENG.SITE NO, GAS TEST - - GAS MECHANICAL -FIRE SPRINK ENERGY T-24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v ❑ N�] v ❑ N❑ 1 EXTERIOR SHEAR - ELECTRICAL RELEASE (JAZ FLOOD ZONE A.L UC. INTERIOR SHEAR FIRE DEPT: - Y❑ No v ❑ • r;❑ SHEETROCK GRADE FEE SUMMARY I6 EXTERIOR LATH BUILDING INTERIOR LATH ' TEMPORARY APPROVALS - BUILDING SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING F INAL.IS SIGNED BY BUILDING INSPECTOR'. 'MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 83<VD UJ ONE WORKING DAY BEFORE REQUIRED INSPECTION. . PLUMBING00� PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL- CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL • 0b CALLING FOR FINAL INSPECTION., '� OFFICE COPY _. - -- rAPPeLICANT.-TO FILL,IN INFORMATION WITHIN RED LINES=USE BALL POINT PEN ONLY Bill LDI NG PROJIII I DENT[FICATION - - PERMIT NUMBER BUILDING. I'If n APPLICATION & PERMIT 0 RRESS EDS , WVL # la`Z. .� ek' 1 8637 BUILDING — ELECTRICAL—PLUMBING—MECHANICAL O sm - • PLAN CHECK VALIDATION NAmE � �YL 4 QTY. - ELECTRIC PERMIT FEE , l`�O"•�wHONE CONT TORS No" C e - UTLETS-SWITCHES-RECEP 10.00/1.00 Q, � C �.rva C•/O CO TRACTORS 4 7V/4 LIGHTING FIXTURES '10.00/1.00 D ' a REs.sGT p� APPLIANCES-'RESIDENTIAL . '4.00 1HONF0193l /01?— aPANELS 10,00 DATE OF APPLICATION 7 ' ARCHITECT t I PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMPI,. 20.00 ENGINEER _ AENGLIC.NO. SIGNSTRANS. 3.00 .- ADDRESS oREssSPECIAL CIRCUIT. " 5.00 PERMIT VALIDATION ZIP ITEMP.METER OR POLE INS. " 20,00 _ AADDRESSPPLICA TS� MOTORS" . SEE FEE SCH. `2f 0P aI A!Q5ec,4 SERVICECHANGE - 20.00 „ - .Woo- LICENSED CONTRACTORS DECLARATIO C/71" u�L f, n.oD v� l a u - I hereby affirm that I am licensed under provisions of Chapter 9 '' - y a a " (commencing with Section 7000)of Division 3 of the Business and t ISSUANCE DATE r: i Professions Code,and my license is in full force and effect. BLOG:, ELECT. PLG. MECH. o Z w W License Class Lic.Number SEP 2119 fPX '(P El y H Date Contractor. ow u OWNER-BUILDER DECLARATION BUILDING PERMIT X ; I hereby affirm that I am exempt from tire Contractor's License MISC.— `RiLyF L R T ORD INFORMATION u O ¢ Caw for the following reason.(Sec.7031.5,Business and Professions b VALUATION $/FT. � — J ' Code:Any city or county which requiresa Flermit toconstrum,alteq PERMIT ISSUANCE 10.00 Z_0 ' ia ¢ < 0O improve;demolish,or repair any structure,prior t0 its issuance, ISO ELEC.CONTE. LIC.NO. TEL J) m LL require' the applicant for such permit to life a signed statement 0tat TOTAL 3-�✓ PERMIT TO aw he is licensed pursuant to the provisions of the Contractor's License _ H z a Lew(Chapter 9(commencing with Section 70001 aC Division 3 of the - f 4 D Basiness and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ 1- o the basis for the alleged exemption.Any violation Of Section 7031.5 STORIES TYPE CONSTR. aim by any applicant for a permit subjects the applicant toacivilpenalty ALTER-DRAIN -WATER (EA.) 5.00 of a.'more 'hot'five It adred dollars($500).): ❑ I,as owner n the property,or my employees with wages as BACK FLOW PROTECT.-DEV ICE 4.00 OCC.GROUP RES.UNITS It sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 5,00 p Code:The Contractor's License To does not apply to on owner of _ - { it-'✓�lI property Who builds or Improves thereon,and who does such work F IXTUR ES-PER TRAP - himself or through his own employees,provi�dp�it that such improve- 5.00 50,FT.FLOOR AREA TOTALACREAGE mentsare not intended oroffered for sale.Iflowever,the building GAS-EA.SYSTEM-1'INC.4 OUTLETS 6.00 or improvement Is sold within one year of completion,the owner- . builder will have the burden of provmg that h dId not huild or ire- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE iI prove for purpose ofsale.). INDUSTRIAL WASTE INTER. - 30.00 RES IND CON. PB other ❑ 1,.as owner of the property,am exclusiv�i�iontracting withED 0 El D 11 licensed contractors to construct the project(Sec, 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 gSSE65OR5 PARCEL NO. and Professions Code:The Contractor's License Low 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 contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 . TRACT NO. PARCEL NO. ❑ tato exempt under Sec. ,B.&P.C.for this neteam WATER HEATER W/VENT_ " 6.00 o Owner - Date WATER SYSTEM 5.00 ACC.DATE ACG.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of Consent to self-insure,or a certificate of Workers'Compensation Insurance,Or a certified ZONING ENG.SITE N0, l copy thereof(Sec.3800,Lab.C.). Policy No. Company z,44 Certified copy is hereby ' lied. FIRE SPRINK ENERGY T-24 Z Z p�Cc tiff copy is fit wi the city in lion division. � 0 P`"can MISC.- .'. REFER TO ORD. Y'0 N� Y � W CERTIFIC 1 OI'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLODO ZONE A.L.U.o. W � C PENSATION INSURANCE. - PLG.CONTE. - - LIC.NO. DLG, ` CL 0 -(This section need not be completed if the permit is for one TOTAL Y N� ::).Z hundred dollars IS 100)or less.) U 0 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 become subject to the Workers'Compensation Laws of California. U i. Date Applicant ALTER OR ADD TO MECH. -' 500 BUILDING } Go - NOTICE TO APPLICANT: If,after making this Certificate of Ex- . f" ? emption,you should become subject to the Workers'Compensation APPLIANCE _ 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with - U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 1014.00 .FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0OOOQflM.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 100,000 B.T.U.19.50 �'.�•Q!) Lender's Address ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) - 4.00 s. information is correct. I agree to comply with all city and county - BOILER-COMPI3H.P.Or 100,000 B.T.U.1 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby' authorize representatives of this city to enter upon [he above-mentioned properly for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL ' above- (We) agree to Sit ' damnify and keep harmless the City of MISC.- REFER TO ORD. upertino against flit s,judgment osis and expenses which CONST.TAX ma i any wa a cru against said C'y in conceyu• ce of the PERMIT ISSUANCE 10.00 - - r g fthis iL MECH,CONT. - 41C.NO. MECH. - 2! �' TOTAL TOTAL bQ Sign eofA Contractor Date - I OFFICECOPY