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18570 POST THIS CARD NEAR FRONT OF BUILDING - PERMIT NUMBER CITY OF -CUPERTINO INSPECTIONDIVISION. 16570 JOB INSPECTION RECORD PERMIT EXPIRATION 2 • JOB ADDRESS 1V^ �-• a� .�� - UNIT# _LOT# '^ ^ + � PERMIT EXPIRES IF WORK owrvER v✓ r LY' CONTRACTOR - 'IS NOT STARTED WITHIN ' K INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - - - ANCE OR 180 DAYS FROM. NOTE: - LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE _ TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION _ CUPERTINO STANDARDS;. . - GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB •••�� w"`� PLUMBING .. ELECTRICAL - - • issuarvcE uniE MECHANICAL - BLDG ELECT. PLT MECO PAN DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION SER IM9 VALUATION $LFT, PLUMBING7 U ' MECHANICAL PERMIT To ELECTRICAL FRAMING STORIES TYPE CONSTR. INSULATION - - OCC.GROUP RES UNITS , PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' • ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE s0.Fr FLOOR AREA TOTALACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILOI USE ROOF SHEATHING - ,Res •ANO cONory Pe om APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑' ❑ ❑ ❑ ASSESSORS PARCEL NO,, ROUGH SAN.N - PLUMBING ELECT.ENERGY TRACT NO PARCEL NO. .. TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL - MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC.DATE ACC 4P LE No FRAMING ELECT.FINALTEST INSULATION ZONING ENG.SITE NO. PLUMBING GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T-34 ❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ .NY [D N❑ FLOOD ZONE .A.L U.C. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FI RE DEPT. Y❑ N❑ Y ❑ N❑ SHEETROCK, GRADE FEE SUMMARY EXTERIOR LATH - BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING r^- .'._`' SCRATCH COAT- ELECTRIC PLAN CHECK U a GAS 7FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 5U OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSI GNED BY BUILDING INSPECTOR. MICROFILM ELECTRIC LU ARRANGE FOR INSPECTION BY PHONING 252-4505,•. 5 H- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL r — SEE PERMIT FOR EXPIRATION DATE — ' IMPORTANT! CONST.TAX . PLEASE READ REVERSE SIDE BEFORE - CALLING FOR FINAL INSPECTION. TOTAL ! rY OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT.PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING 10 z3 N• Ir-� w23�.�vr� APPLICATION & PERMIT. IT ADDRESS 1,8570 iQG�E Z.3 �/�LOO BUILDING - ELECTRICAL-PLUMBING-MECHANICAL }„ OWNER'S PLAN CHECK VALIDATION NAME DTV. ELECTRIC PERMIT FEE • Vim/ Ii�/�, PHONE CONTRACTORS NAME rvaAME / UTLETS-SWITCHES-RECEP 10.00/1.00 LIC.NO. 0fZZ LIGHTING FIXTURES 10.00/1.00, CONTRACTORS APPLIANCES-RESIDENTIAL 4.00 ADDRESS �/�� /J-� /'('��.-,�pp D / G�G4��ii♦ PHOJTJ!{J ' - PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE OR PANELS (OVER 200 AMP) 20.00 ENGINEER LIG.No, 1.1SIGNSTRANS. - 3.00 7 BD ADDDDRESS ENGSPECIAL CIRCUIT ' 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 avvucarvrs/Q.7,,57J L MOTORS SEE FEE SCH. f ADDRESS" /v�jeQ 7/jp SERVICE CHANGE 20.00 - M o LICENSED CONTRACTORS DECLARATION t ///. ., <u 1 hereby affirm that I um licensed under provisions of Chapter 9 / 'I SSUANCE ' ¢ u (commencing will)Section 7000)of Division 3 of the Business and - - BLDG. ELECT. PLG, MECH.. H N i Professions Codc, nit my license is in full for d Effect. G0 m o License Class�uc!-Lic.NumM1erLp ❑ ❑ F L H j Datep/.��//,oyy�_�Can�gay/qr M m aa 6WNIiR ItUILDER DECLARATION BUILDING PERMIT INFORMATION w ; LL y 1 hereby affirm Il)al 1 am exempt from fire Contractor's License MISC.- D VALUATION $/FT. u O¢ Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 3x,00BUJ /,20,00 �+ m Code:Any city or county whichrequiresa permit to construct,alter, ¢ G Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO: ELEC. ca O u requires the applicant for such permit to file a signed Statement that TOTAL / r PERMIT TO w8 w he is licensed pursuant to the provisions of the Contractor's License 1 r z a Low(Chapter 9(commencing with Section 7000)of Division 3 of the f 4 D Business and Professions Code)or that he IS exempt therefrom andOTV. PLUMBING PERMIT FEE tc H $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. n ; _ by any applicant for a permit subjects the applicant to a civil penally ' ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500.): ❑ 1,as owner of the properly,or my employees with wages as BACK F LOW 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(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 properly who builds or onloOves 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 improve- ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Omer prove for purpose of sale.) INDUSTRIAL WASTE INTER. 30.00 ❑ 1,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 PARCEL NO. and Professions Code:The Contractor's License Law does not apply to on owner of property who builds or improves thereon,snit who LAWN SPRINKLERS-OV ER 5(EA.) 1.00 contracts for License Law.hnjeewith acantmmrl es)licensed pursuant to the Contractor's for such SEWER-SANITARY-STORM EA.200fl/10.00 TRACT NO. PARCEL NO. ❑ Iamexemplunder Sec. ,BAIC. ,it this WATER HEATER W/VENT 6.00 .son Owner Date WATER SYSTEM 5.00 - ACC.DATE ACC.FILE NO, WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insvue• ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(See.3800,Lxb.C.). Policy No. Company Q Certified cop is IT c yfurnished. FIRE SPRINK ENERGY T 24 Z Z CaNifie I ,/tl��y��.it.y,��ins_�pect�i_o�n division. p ddPPhcunt MISC.- REFER TO ORD. v ❑ N❑ v ❑ N❑ � yCPERMIT ISSUANCE � 10.00 FLOOD ZONE' A.L.u.c. LU CERTIFICATE OP EXEMPTION FROM WORKERS' LUOMPIiNSATION INSURANCE: PLG.CONTR. LIC.NO. PLG. ' CL 0 (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ D Z hundred dollars($100)or less.) ' U 0 I certify that in-the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY U. I- mit is issued,I shall not employ any person in any manner So as to U become subject to the Workers'Compeasat ion'Laws of California. G6. D. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING ' } W NOTIC17 TO APPLICANT: If,after making this Certificate of Fx- F Z emotion,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK / 057 provisions of the Labor Cade, you must forthwith comply with FEE ' U such provisions or this permit shall be deemed revoked.. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.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 the work for which this permit is issued(Sec. - MICROFILM 3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NO UN IT(6V ER 100,000 B.T.U.)9.50 ELECTRIC Lender's AdJrc I I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all city and county PLUMBING ordinances and state laws refuting to building construction,and BOILER-COMP I3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representativesofthis city to enter upon the BOILER-COMP(Over 100.000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Caper line ago' st liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in a*fPP accrue ago sl said City in consequence of lire -^ ra hg /�//' TECH.CONT. LIC.N0. TOTALq 7 TOTAL ,Signature ant/Contractor Date OFFICE COPY