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17353 POST THIS CARD NEAR FRONT OF BUILDING JT s' PFRMIT"NUMBER CITY OF CUPERTINO 17353 INSPECTION DIVISION JOB INSPECTION RECORD �// �J 7� PERM IT.EXPI RATION JOB ADDRESS � 0 - ^' � p' O'b?4 ' UNIT# _LOT# PERMIT.EXPIRES IF WORK OWNER' - CONTRACTOR IS NOT STARTED WITHIN . INSPECTION 'DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE'OR180 DAYS.FROM .FOUNDATION NOTE: - LASTCALLED INSPECTION. . LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED' PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF - PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - r POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED , 'UNDERGROUND /SLAB . �3 I.. PLUMBING _ ELECTRICAL - I ISSUANCE DATE'. . MECHANICAL 403. [LECT.I 'vLG. . MECR, ❑ ❑ ii ❑ .. „ . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT • INFORMATION•- WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL - ELECTRICAL" - PERM T TO FRAMING - - IIIA INSULATION," STORIES TYPE CoNSTH. � � _ , ., UCC.GROUP- RES,UNITS PLACENOSUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' ROOF _ NOTE:NO FINAL INS P.SHALL BE MADE BEFORE SO.FT.FLOOR AREA .TOTAL ACREAGE DIAPHRAGM : THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING' - - Res IND _ CON Pe om., . .APPLY-NO ROOFING UNTIL ABOVE HASBEEN SIGNED FINALS DATE INSP. ❑' ❑ Q. - ❑ D ASSESSORS PARCEL GO,- HOUGH SAN.H - PLUMBING - ELECT.ENERGY n+ACT No. PARCEL.No., TUBS&SHOWER PAN - PLUMBING ENERGY MECHANICAL MECW ENERGY'. 'ELECTRICAL BUILDING ENERGY ACCDATE ACC.FRE NO._ � , FRAMING ELECT.FINAL TEST zoNlNc FNc.SITE NO. INSULATION - PLUMBING GAS TEST GAS i MECHANICAL FIRE SPRINK ENERGY T-74 ❑ N❑ L] N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A.Luc. Y N❑ L N❑. INTERIOR'SHEAR' FIRE DEPT. ' SHEETROCK - GRADE FEE SUMMARY 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 OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTORS MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC , �� ' ONE WORKING DAY BEFORE REQUIRED INSPECTION PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - MECHANICAL - SEE PERMIT FOR EXPIRATION DATE=- � '71 1;17 IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING.FOR FINAL INSPECTION'. OFFICE COPY APPLICANT4TO FILL IN INFORMATION WITHIN RED LINES— USE BALL POINT PEN ONLY BU I LDING PROJECT.I DENTI FICATI ON PERMIT NUMBER. •BUILDING - APPLICATION & PERMIT .`. 1,73J3 ADDRESS I 5 QQ BUILDING-ELECTRICAL—PLUMBING—MECHANICAL OWNER's PLAN CHECK VALIDATION NAME �1 ,�.�1 //1y�11�_ QTY. ELECTRIC PERMIT FEE 5'1 PHDNEa�} 74� CONTRACTOR'S uAME '1 UTLETS'-SWITCHES-.RECEP 10.00/1.00 Ai IuS t{�I uC,No. g10�'b� GHTING FIXTURES 10.00/1.00 CONTRACTORS P IANCES-RESIDENTIAL 4.00 ADOREss/� -- ' ♦,(y!r/j�e(L•�+r U(,• S-V.PRONE '�"'"� PAN S 10,00 DATE OF APPLICATION ARCHITECT - PANELS VER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGI FER- � LIC NO SIGNS TRANS. - 3.00 AR H7 ADORE$$ P ENG. SPECIAL CIR IT 5,00 PERMIT VALIDATION EMP:METER POLE INS. 20.00 J, ANTONIX� I ADDRESS MOTORS - SEE FEE SCH. AS 1,66L� SERVICE CHANGE 20.00 0 0 o LICENSIi I)CONTRACTORS DECLARATION }} _ Ie o u I hereby affirm that am licensed under provisions of Chapter 9 J �� ISSUANCE DATE azw (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. mz Professions Cody,a 1I'J�ty license is in lull 1'or" ❑ru ❑ n—li z o m — License, 1 ss 5==�Li c:Number �� P (U/ 2 , Dale j� Gommatsr Ci of Cu a s - BUILDING PERMIT w ¢ OWNFR.BUILOER DECLARATION _ _ ` .INFORMATION wo d D MISC.- ' REFER TO ORD - 3 LL m I hereby affirm that I um exempt from tire Contractors License _ VALUATION LL o sr Law for the following reason.(See 7031.5,Business and Professions PERMIT ISSUANCE . 10.00 $/FT. � — Code:Any city or county which recuirc.iapennit to construct,alter, - tt ¢p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC." w —0¢ recono the applicant for such p null to filea age (I -tat stent that TOTAL PERMIT TO w he Is licensed parijant to the provisions of tire Contractor's License _ z a Law(Chapter 9 ficorrinencingwithSection 7000) fDI Ision 3 ofthe Business and Professions Codes or that he's exempt therefrom and QTY. PLUMBING PERMIT _ FEE rl rc I o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. dam tire by any applicant for a permit subjects e applicant to a civil penalty :ALTER-DRAIN&.VENT-WATER (EA.) 5.00 of not more limn five hundred dollars(8500).): O I,as owner of the properly,or my employees with wages as BAC LOW PROTECT.DEVICE 4.00 . OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is nut intended or offered for sale (Sec..7044, Business and Professions DRAINS- LOOR,ROOF,AREA,CONO. 5.00 - Code:The Contractor's License Law does not apply to an owner," property who builds or improves themon,and who does such work FIXTURES ER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended ornffcredfor sole.IL however,the building GAS-EA.SYS M-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYST -OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or int BUILDING USE - RES IND CON PR Other prove 1,aso nee of talc.). INDUSTRIAL WAS INTER. 30.00 ❑ . ❑ ' El 1] El ❑ L as owner of the properly',no exclusively contracting with licensed colons on to construct the project La 7044,Business LAWN SPRINKLERS- INC 5 V.B. 6.00 -- ASSESSORS PARCEL No. and Professions Co petty Contractor's License Law Joos not apply •. to in owner of property who builds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for Such projects licensed pursuant to SEWER-SANITARY-STORNA 200ft/10.00 ' the Contractor's License law. TRACT NO, PARCEL NO. I] lam exempt under Sec. .B.&P.C.for this WATER HEATER W/VEN6.00 reason Owner -.Date WATER SYSTEM - 5.00 ACC;DATE ACG FILE NO, WORKERS'COMPI:NSA1ION DECLARATION WATER TREATING EQUIP. 5.00 hereby affirm that I have a certificate of consent to self-insurc. - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified . copy IhzzeQ[�g 3800.Lab.CJ. ��yy,�� ar Policy Na✓IFSS/" Company^ - O Certified copy is hereby furnished, FIRE SPRINK ENERGY T-24 Z z Cerlificy py s Filed wish tiro city inspection division, p Applicant—L� r�RS MISC.- REFER TO ORD. - Y ❑ N[J Y ❑ NQ_ F— y PERMIT ISSUANCE 10.00 FLOOD ZONE 'A.L.u�c. f1 CER1'II ICAI I OF I XEMP110N FROM WORKERS' CL COMP I NSAI ION INSURANCE PLG.CONTR. LIC.NO. PLG. . 1 CL a2 Clink section need not be stimpletul it lire permit is for one TOTAL Y N� Y N� Clink dollars(S I00)or less.) U O ' 1 rOdy that in the Pcrfonnancc or tire work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is iss"Imd.1 shall not cnmloy nny person in any none,so as Io - U become subject to she Worker;Corapensalioi Lows of Calilornia. a Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING ' } W NOTICE TO APPLICANT: IL sutler making this Certificate of Ex+ _ 'F Z emotion,you should hocome suhject to the Workers'Compensation APPLIANCE 5.00 . PLAN CHECK pr visions of the Labor Code, you must forthwith eumply wit FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 ' CONS'1'RUCHON LENDING AGENCY AIR HANDLING UNIT(OVER 10DWC.F.M.) 6.00 SEISMIC FEE 1 hereby affirm that there is It construction lending agency for EXHAUST HOOD(WITH DUCT). - 5.00 the performance of the work for which this permit is Issued(See MICROFILM 3097,Ci,.C.). HEATING UNIT(TO 100,000 B.T.U.) UO 1,0d • Lender;Na LelldmAddress me HEATI NG UN IT(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 and countyPLUMBING ordinances and state laws relating to building construction, and 601 LER-713(H.P.Or100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon she 201 LER-COMPIOver 100,000 STU)SEE FEE SCH. MECHANICAL •;�I l�i above-mentioned property for inspection purposes. - . (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. . Cup vino against liabilities,judgments,costs and expenses which 'a CONST.TAX f In any way accrue against said City in consequence of the PERMIT ISSUANCE �TB[BO M-Ymg of this S pen 1 MECH.CONT. LIQ N0. MECH. ' IIy, �u> L4&sa�c0 TOTAL / TOTAL 0o ant Sig azure of Applic /Comra ,Lctor Date O7 vO OFFICE COPY