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18682 (3) POST THIS CARD NEAR FRONT OF BUILDING PERp,ITNDMBEd ��. CITY OF • CUPERTINO . 8682 INSPECTION DIVISION JOB INSPECTION RECORD ; • �� ' '�`( �p��,�Ir��I �) �Z 1P RI/VAI T. XPIpATION JOB ADDRESS_ SS y P_td_�UNIT# -_LOT# � /J PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 160.DAYS OFPERMITISSU- ' FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLEDINSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE - TO COMPLV WITH THE APPROVED PLANS AND CITY OF - PEHMIr VAuuA ,ION CUPERTINO STANDARDS. GARAGE SLABSPARD POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB NOV U9,198q f k• I +�. 1 PLUMBING 1 L� ELECTRICAL - - < n ' . C+I�" � ""?►110 �' ISSUANCE DATE MECHANICAL - BLDG ELEcr. PLT,. •MECH. ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION VALUATION $/FT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION ' STORIES.+ TYPE CONSTR. 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 - ROOFSHEATHING G RES IND CON PB O'l APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ AS5ESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO.. PARCEL NO. TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL - MECH.ENERGY • ELECTRICAL BUILDING ENERGY Acc,OnrE ACC FILE No FRAMING - ELECT.FINAL TEST ZONING ENO.SITE NO. INSULATION �� PLUMBING GAS TEST GAS . MECHANICAL FIRE SPRINK ENERGY T-24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑ //•�� • EXTERIOR SHEAR � ELECTRICAL RELEASE FLOOD ZONE A.L.0 C.r. INTERIOR SHEAR' FIRE DEPT. Y❑ N❑ r ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALSV BUILDING SCRATCH COAT ELECTRIC PLAN CHECK �<?? GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC'FEE . 6' OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. 'MICROFILM e . ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC' • o� ONE WORKING DAY BEFORE REQUIRED'INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. Z. = SEE PER FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX:. PLEASE READ REVERSE SIDE BEFORE TOTAL S-6 CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN 4NFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY BU I LDING PROJECT I IDENTIFICATION PERMIT NUMBER aDILDING APPLICATION & PERMIT, Q e� AppKSs ,� O G V -SASE 413y. BUILDING -ELECTRICAL-PLUMBING -MECHANICAL „- • OwNER'S - PLAN CHECK VALIDATION "" E QTY. ELECTRIC PERMIT FEE • �'wPHorvE pp n CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00 ^5 NAME rr qq,�, /�q - (�p ,A)e 4 ICUSS C.No.526q D LIGHTING FIXTURES 10.00/1.00 I(! r CONTRACTORS qy�3 APPLIANCES-RESIDENTIAL 4.00 ADDRESS (J ft�g Q' f D PHONl15 p Vy PANELS 10.00 DATE OF APPLICATION OR PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.N0. OR ENGINEER uc.No. SIGNS TRANS. 3.00 ARCH.oRNc.-ZI �. �IC70Ky '✓A 'SPECIAL CIRCUIT 5.00 PERMIT VALIDATION- ADDRESS C zIp 03 EMP.METER OR POLE INS. 20.00 APPucprvr's MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 ` o o LICENSED CONT FACTORS DECLARATION ' �� V G a v u I hereby affirm that I am licens<•d under provisions of Chapter 9 ( .Q ISSUANCE DATE w a N (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. H. r 89 z o LD Z Professions Code,and my license is in full force and effect. p ❑Lic.Number El '13pl`I � {, g w License Class H o Date ContractorContractory ' nS nllr,'.`Ino - - J Lc Q w a OWNER-BUILDER DECLARATION BUILDING PERMIT 0 rl O MISC.- REFER TO ORD INFORMATION w 3 u_I- 1 hereby affirm that 1 am exempt from the Contractor's License uoa Law for the followingreason:(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION S/ET. � - Code:Any city orcounly which requires a permit to construct,alter, ^� IC a, ¢ p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIG NO: ELEC. f/ LLrequires the applicant for Such permit to file a signet]statement that TOTAL - PERMIT TO K $ he Is licensed pursuant to the provisions of the Contractor's License x '�� r z i Law(Chapter9(emnmereingwith Section 7000)of Division 3 cflhe a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE �L- $ the basis for the alleged exemption.Any violation of Section 7031.$ STORIES TYPE CONSTR. t by any applicant for a permit subjects the applicant Ina civil penally gLTER-DRAIN& VENT-WATER IEA.) 5.00 of not more than five hundred dollars(S500)J: ❑ 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(See. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The,Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00SD,IT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedorofferedforsale.Il;however the building GAS-EA.SVS7EM-11NC.40UTLET$ 6.00 1 or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or fm- GAS-EA.SYSTEM-OVER 4 (EA.) 2,00 RES �IND BUILDING USE CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with - licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCE L 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 for such projects with a cornractotls)licensed pursuant to SEWER-SANITAR V-STORM EA.200ft/10.00 the Contractor's License Line. TRACT NO. PARCEL NO. - ❑ I not exempt under Sec. .B.&P.C.for this WATER HEATER W/VENT 6.00 reason' Owner Date WATER SYSTEM 5.00 ACC,GATE ACC.FILE N0. WORK Ii RS'COMPF.NSA1'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofconsent to self-ins re. ZONING ENG.SITE N0, or a certificate oPWorkers'Compensation Insurance,or u certified copy thereof(Sec.3800,Lab.C,4. - Policy No. Compa(DQ Q ❑ C tifie}�o y1Sl cry oy fu�hed, FIRE SPRINK ENERGY T-24 Z Z 1Q' Ce ifE y I Bled wi�I the city inspctioti division. MISC- REFER TO ORD. O p..Icanl Y N V N Hy ,/ r .>� PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. � % C.FTI FICA'fE °IiXEMI"PION FROM WORKERS' L � COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y N� Y ❑ NO d 0 ' (This section need not be completed if the Permit is for one TOTAL Z hundmd dollms IS I00)'m lass.) FEE SUMMARY 0.0 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE LL H mit is issued,I shall not employ any person in any manner so as m U become subject to the Workers Compemalion Laws of California. w Oat, Applicant BUILDING . n ALTER OR ADD TO MECH. 5.00 } y NOTICE TO APPLICANT: If,after making this Certificate sa Ex- emption, x- Z em vision you should become subject m the Workers'Compensation APPLIANCE - 5.00 PLAN CHECK provisions io the hisLabor permit sh you must forthwith comply with - FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,00012-F.M.) 4.00 • CONSTRUCTION LEDING AGENCY AIR HANDLING UNIT(OVER 10=C.FM.) 6.00 SEISMIC FEE 6 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. HEATING UNIT(TO 100,000 B.T.U.) 8.001MICROFILM 3097,Civ.CJ. , Lender's Name _ HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address 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 and county PLUMBING ordinances and State laws relating to building construction, and BOILER-CUMP(3 H.P.or 100,000 B.T.U.) 6.00 . hereby authorize representatives of this city to enter upon Om g01LER-COMP Inver 100,000 BTUI SEE FEE SCH. MECHANICAL above-mentioned properly for inspection purposes. (We) al�� 0"use, Indemnify and keep harmless the City of MISC.- REFER TO ORD. upertipb a most Iia hies,j Bgments, costs and expenses which CONST.TAX may yt w5 rue ag nst said City in conse<luence of the PERMIT ISSUANCE 10,00 Ian 'Ihise mit - I G 1 MECH.CONT. LIG NO. MECH. 7 TOTAL TOTAL '. Si sure of APP leant anlracto Date OFFICE COPY