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18096 POST THIS CARD NEAR FRONT OF BUILDING .. • PERMIT NUMBER CITY OF CUPERTINO 18096 " INSPECTION DIVISION . JOB INSPECTION RECORD P.EMIi12PIRATION ��L Lz64�i/oN _ JOB ADDRESS " - UNIT# LOT# "�.. s ! r� PERMIT'-EXPIRESjI F(WORK, OWNERCONTRACTOR. --. . < ISI NbT�STA TEDJ,VYITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD - - tao oars oFIRERMI,T�Issu- ANCE OR 180 DAYS FROM FOUNDATION • - NOTE: UFERALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. TO COMPLY WITH THE APPROVED PLANS AND CITY OF EEMIT VALIDATION PREGUNITE CUPERTINO STANDARDS. GARAGE SLABS itA ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB •//� PLUMBING ELECTRICAL ;� '— .ISSUANCE LATE MECHANICAL IT ELEECCjT, P+.G. . Mi:cr+. El DO NOT,POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INF RMATION .PLUMBING WOOD FLOOR - - VALUATI SIFT. 7(�]� r MECHANICAL ELECTRICAL P�ERRM�7 rTD.��(,!��l]/ FRAMING 'STORIES, -TYPE CONSTR. INSULATION - OCC.GHOUP, RF:S.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINALJNSP.SHALL BE MADE BEFORE 5O IT FLoow AREA rornL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE " _ROOF SHEATHING.. > RES_ IND CON Pa 00", ,APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El ❑ ASSESSORS VAHCEL NO. ROUGH ! - - SAN.a PLUMBING • ELECT.ENERGY iHACS ND. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL - MECH.ENERGY ncc.DATE ACC.FIT.F.No. ELECTRICAL - �, BUILDING ENERGY FRAMING ELECTFINALTEST l ZONING ENG.SITE NO. INSULATION �' PLUMBING GAS TEST GAS '. FIRE SPRINK ENERGY Uta MECHANICAL ❑ N❑ ❑ N❑ .COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASET FLooD zorvE n.-1 C. INTERIOR SHEAR. - � .. � 'FIRE DEP Y❑ I's ❑ N❑ SHEETROCK GRADE _ FEE SUMMARY EXTERIOR LATH BUILDINGloi - INTERIOR LATH,` TEMPORAR APPROVALS BUILDING SCRATCH COAT ELECTRIC• ' PLAN CHECK .+ ..." GAS i +•,` FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE •(� OCCUPANCY OF,BUILDING IS NOT PERMITTED,UNTIL BUILDING FINAL ISSIGNED BY BU ILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O� PLEASE-GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! coNsr.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL L CALLING FOR-FINAL INSPECTION. .. OFFICE COPY �I APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY f' BE I LDING PROJECT IDENTIFICATION ,PERMIT NUMBER L" BUILDING APPLICATION & PERMIT 89 Ay9RESS - - b lo`3/'O Leboon ( BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 6 0 NER'S ` D PLAN CHECK VALIDATION ME - , QTY. ELECTRIC PERMIT FEE - � 5zPHory NAME5 - RAc R - OUTLETS-SWITCHES-RECEP 10.00/1.00 7a©. � JC,NO. LIGHTING FIXTURES 10.00/1.00 1/ cDNTRACTORS APPLIANCES-RESIDENTIAL 4.00 Q ADDRESS "� 1 -J�/1�� PHONE PANELS 10.00 DATE OF L1lICAAA OR RGNfTecr PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE C.NO. ENGINEER r , LIC,No' SIGNS TRANS. 3.00 ADDR.SS ENG. - - PERtVALIDAT1,11ON ADDRESS � SPECIAL CIRCUIT 5.00 / _ zlv EMP.METER OR POLE INS. 20.00 APPLICANT'5 - MOTORS SEE FEE SCH.ADDRESS SERVICE CHANGE 20.00 o O / LICIiNSEU CONTRACTORS UCCLARATION .. v -I hereby afiinn that I ate lieelised under provisions of Chapter q r 0 ISSUANCE GATE y a w (commencing with Section 7000)of Division 3 of the Business and - BLDG LECT PLG. MECH. F w 2 Professions Code,and my license is in full force and effect ❑ ,❑ z Ls -o License Class Lic.Number, o z to r,0 Dam Contactor JUL.2 b 14Q9 m 2 wit BUILDING PERMIT In 2 w OWNER-BUILDGR DECLARATION MISC.- ORD INFORMATION w3 LL I- I hereby affirm that I am exempt from the Contractor's Licenec VALUATIONM 8/FT. r u o j Law for the following reason.IStt.7031.5.Business and Professions PERMIT ISSUANCE .00 W Code:Any city or county which requires a permit to construct,alter. L�/`�/ ne aa Q 2 improve,demolish,or repair any structure,poor to its issuance,also ELEC.CONTR. - LIC.NO. ELEC. ' - O p requires the applicant for such permit to file a Signet)Vatcntent that - - TOTAL PERMIT TO - A w m he is licensed pursuant to the provisions of the Contractor's License - Hzi Law(Chapter 9(commencing with Section 7000)of Division3 ofthe � Qx• -"l - A Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE K/I �l F o the lad,for the alleged exemption.Any violation of Section 703 L5 STORIES TYPE CONSTR. dam by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(S500LL - I ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES,UNITS their .It compensation,will do the work,and the structure is not - intended or offered lir 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 improves thereon,and who docs Such work FIXTURES-PER TRAP 5.00 . sO.FT.FLODR AREA 'TOTAL ACREAGE himself or through his own employees,provided that such improve- - - ,�, f ments are not intended or offered for sale.If.however.the building GAS-EA.SYSTEM-I INC.46UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA.) 200 BUILDING USE builder will have the burden of proving that h . . . e did not build or am. RES IND CON PB Other ' prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 In I,as owner of the properly,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensee contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:T'he Contractor's License Law does not apply to a"owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 cont racts'for such projects with a conrmctor(s)licensed pursuant to ' the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00TRACT NO. PARCEL NO. am exempt under Sec.-,H.&P.C.for this WATER HEATER W/VENT 6.00 d ' Owner set ,WATER SYSTEM 5.00 ACGDATE ACC.FILE NO. wORKt:RS`COMPF:NSA['ION DLCLARA'I'[ON WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent toself-insum. ZONING or a certificate.of Workers'Compensation Insurance,or a certified ' ENG.SITE NO. copy thereoffScG 3800,Lab.C.L - - - Policy No. - Company - 0 ❑ Certified copy ishereby furnished. FIRESPRINK ENERGY T-24 Z z ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. O ApplicantY ❑ N❑ Y ❑ .N❑ ,ir rn CERTIFICATE OF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > CO,\IPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y❑ N❑ Y ❑ N❑ d O 1'I-his Section need not be c repleted if' the permit is for one TOTAL Z) Z hundred dollars 151001 or less.) U O I certify that in the performance of the work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY 0} mit is issued,I shall not employ any person in any manner so as to _ �� L, becmne subject to Wlicaut QrmpensutiomLaws of Culifornie. 0 a Date APPlicant - ALTER OR ADD TO MECH. 5.00 BUILDING } to N011CIS TO APPLICANT: If,after making this Certificate of Ex- H � emption,.you should become subject to the Workcri Compensation APPLIANCE 5.00 PLAN CHECK _ provisions of the Labor Code, you aural 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 UNITIOVER I0=C.F.M.) 6.00 SEISMIC FEE- ' O I hereby ufl'inm that[here is a construction leading agency for EXHAUST HOOD(WITH DUCT) - 5.00 the performance of the work for which fit,permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name HEATING UNIT(OVER 100,000 B.T.U.19.50ELECTR IC Lender'SA ddresx I certify that l 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 ' ordlni refs a d late laws relating to building ,instruction, and BOILER-CDNIP(3 H.P.or 100,000 B.T.U.) 6.00 hereby'authors.e rep ental of this 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 hamdess the City o1' Misc.- REFER TO ORD. - Copertino against liabilities,judgments, costs and expenses which - CONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 acting of this permit.' MECH,CONT, LIC.NO. MECH. -;A 4 TOTAL TOTAL- N Signa OFFICE COPY