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17866 POST THIS CARD NEAR FRONT OF BUILDING ' PF.Rh9 T,NUh1BER CITY OF:, CUPERTINO' 17966 a, INSPECTION DIVISION JOB INSPECTION.RECORD MM��T EX y_�y, Z' R( IRATION JOB ADDRESS � c>t5l LE NOI Vf .. ✓• U�N/ITA I# _LOT# 4orDAiS IT (pLRrS'IFjWORK OWNER VA H' CONTRACTOR L r'V—�L - T. 9STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD OFPERMIT ISSU- "alANCE OR 180 DAYS FROM . FOUNDATION NOTE: - LAST CA L LED I NSPECTI ON. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITETO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATTGN CUPERTINO STANDARDS. ' GARAGE SLABS POUR NOCONCRETEUNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB e� PLUMBIN.G.: ELECTRICAL _ ISSUANCE DATE. MECHANICAL . Pu:. MECR DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT 1j 2B% aRzEC INFORMATION WOODFLOOR SIFT. PLUMBING MECHANICAL ELECTRICAL - PERMIT TO .r FRAMING - - - ... - "" ' •"� INSULATION STORIES 1 VPE CONSTR. OCC GROUP TIES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED G - _ 50.f i.FLOOR Ai EA TOTAL ACREAGE ROOF - NOTE:NO FINAL INSP.SHALL BEVADE BEFORE, I j DIAPHRAGM THE CONSTRUCTION TAX IS PAID �) BUILDING USE ROOF SHEATHING,-.�• � ' " � REs IND CON Pa ow., ❑ ❑ v ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS- DATE INSP: ASSESSORSPAFI CELNO. ROUGH SAN.# ` PLUMBING- ELECT.ENERGY '- l.(;• Ct TRACT N0. PARCELNO TUBS 8 SHOWER PAN. PLUMBING ENERGY. - MECHANICAL - MECH.ENERGY ACC DATE ACL FILE NO. ELECTRICAL . - - BUILDING ENERGY FRAMING` _g ELECT.FINALTEST ZONING ENG.SITE NO. •INSULATION ✓ PLUMBING GAS TEST - - — GAS - FIRESPRINK ENERGY T 2 c MECHANICAL - } ❑ N❑ 'r ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEARQ ELECTRICAL`RELEASE FLOOR ZONE A.L.0 c. _lq ❑ ❑ .N❑ ❑ N _ INTERIOR SHEAR ` FIRE DEPT. SHEETROCK 1/ GRADE FEE SUMMARY EXTERIOR LATH BUILDING 'Z INTERIOR LATH, ' ' . TEMPORARY APPROVALS BUILDING I - . SCRATCHCOAT ELECTRIC - - PLAN CHECK GAS FEE NO TAPE, OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE- OCCUPANCY OF BUILDING IS NOT-PERMITTED UNTIL BUILDING FINAL ISSIGN ED BY BUILDING INSPECTOR. )MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING I f ® Z PLEASE GIVE JOB ADDRESS WHEN PHONING:- - SEE PERMIT FOR EXPIRATION,DATE - MECHANICAL IMPORTANT! CONST rnx PLEASE READ'REVERSE'.SIDE BEFORE _ TOTAL CALLING FOR FINAL INSPECTION. 1J_ OFFICE COPY APPLICANT.TO FILL IN INFORMATION WITHIN RED LINES = USE BALL POINT PEN ONLY"r, BUI LDI NG PROJECT I DENT]FICATION - PERMIT NUMBER BUILDING APPLICATION-& PEQMIT ' ^ AOm7Ess BUILDING-ELECTRICAL-PLUMBING-MECHANICAL _ b LE64AVM LMtGt= OWNER'S Ig I,�f�. �ui�� ,PLAN CHECK VAL ATION NAME �E/'R- I plsF CMCJ OTY. ELECTRIC PERMIT FEE �^ Dew DN�aS fLf J 19 I �3 v.Inc) . CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 NAME /�y ""� uc.NO. 4z Q�r LIGHTING FIXTURES 10.00/1.00 CONTRACTORS C�. Js(///yf/j�C PPLIANCES-RESIDENTIAL 4.00 ADDREss PHONE PANELS 10.00 onTE OF APPLICATION ARCHITECT PLAN CHECK FEE' P.C.NO. OR _ PANELS,(OVER200 AMP) 20.00 ENGINEER uc.NO SIGNS TRANS. 3.00 ' ARCH.OR ENG. PERMIT VALIDATION ADDRESS ; - SPECIAL CIRCUIT 5.00 'ZIP TEMP.METER OR POLE INS:, 20.00 ADORESS - MOTORS 'SEE.FEE SCH. i. ADORE SS , SERVICE CHANGE 20.00. _ / (2 woo LICENSED CONTRACTORS DECLARATION CY - a U LHi I herehy aflmn that I am licensed under provisions of Chapter 9 - r ISSUANCE DATE _ z (commencing with Section 7000)of Division 3 of the Business and BLDG: ELECT. PLG. ECH. yi Professions O wr w C�odeld�m C(lcense is in full force;,- cA's' z LicenseC sscambe , Date Cortracmrr �Ixyl 1r' a Y f IT .¢ ¢ OWNER-BUILDER DECLARATION BUILDING PERM INFORMATION w 3 w d y I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD $/FT. uoa Law for the following reason.(Sec.7031.5.BusinessanJ Professions PERMIT ISSUANCE i880 V�J � - Code:Any city or county which requiresa permit to construct,alter, ELEC.CONTE. LIC.NO. improve,demolish,air repair any structuru:prior m its issuance,also ' ELEC. 2 E, requires tire applicant for such permit to file a'signed statement that - TOTAL I\ - PERMIT TO a w m he is licensed pursuant to the provisions of the Contractor's License a, Law(Chapter 9(<ummencingwith Section 7000)of Division3 ofthe �f Ylr�l-�'IQ . a Business and Professions Code)or that he is exemptiherefrom and DTV. PLUMBING PERMIT FEE ,-s Vii' F p the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. dam by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 -of not lnore than five hundred dollars(S500)J: ❑ I,as owner of the properly,or my employees with wages as BACK F LOW PROTECT.DEVICE 4.00 their sole compensation,will do the work,and the structure isnot OCC.GROUP [ RES.UNITS _ intended or offcmd.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 property who builds or improves thereon,and who docs such work FIXTURES-PER,TRAP 5.00 SO,FT FLOOR ALACHEAGE himn,are net hrough ownemployees,for sale, If,ed howeat ver,the impmvng GAS-EA.SYSTEM-11NC.40UTLETS 6.00 t rents are not intended or offered for sale Ic completion,tire building or improvement is sold within one year of the did rot the owner- GAS-EA.SYSTEM-OVER 4 IEA:) 2.00 builder will have the burden ail'proving that he did not buil)or ice- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES nrvD CON PB Omer ❑ I,as owner of tie 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 Cade:The Contractor's License Law does not apply in an owner of property who builds or improves thereon,and who LAWN SPR IN KLERS-OVER 5(EA.) ' 1.00 contracts for such projects with a contractors)licensed pursuant to - theContractor'sLicenseLaw. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL No. ❑ I am exempt under Sec.-,BARC.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE No. WORK ERS'COMPENSA'DON DECLARATION WATER TREATING EQUIP. 5.00 I hereby of no that 1 have x certificate of consent to sell-insure. or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thu�(1$}g eco LrhC p,uy � - Policy N ..�($$--•SSf��Compuny- f ❑ Certified copy is hereby furnished. FIRE SPRINK "ENERGY T-24 Z Z wCertified copy is tiled with the city inspection division. MISC.- REFER TO ORD. O AOphc:ml Y ❑ N❑ Y ❑ N❑ CC N C 1.R 111'I CA'ILE OF EXEMPTION FROM WORKERS', PERMIT ISSUANCETO:OU I FLOOD ZONE A.L.U. ,- LLI > COMPENSATION INSURANCE PLG.CONTR. - -. LIC.NO." PLG. CL C3 (This section Iced not be completed if Om permit is for one Y❑ N❑ Y ❑ N❑ D Z hundred dollars(8100)or In,,.) '- U O 1 certify that in the performance of the work for which this per- OTY• MECHANICAL PERMIT FEE FEE SUMMARY U_ E- mit is issued, I shall not employ any persim in any umammer so as to U become subject to the Workers'Compensation Laws of California, w' DAm - BUILDING CL ate Applicant ALTER OR ADD TO MECH. 5.00 , i86 } to NOTICE: TO APPLICANT: If,after making this Certificate of Ex- - . Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO'10)000OF.NL) 4.00 CONSTRUCTION LENDING AGENCY- ., AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE X19 I hereby.affirm that there is a Con Duction 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(OV ER 100,000 B.T.U.)9.50 Lcndcrfs Address ELECTRIC d5.0,1 -I c n'ly that I have rad 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 stair. l w- relating H g to building onstfu tion, and BOILER-COMEi .P.or 100,000 B.T.U.) 6.00 hereby m thou t representatives of this City to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL I abov n rationed property torinspection purposes. _ ` nu (We) agree In Naive, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,a judgments, costs and expenses which _ PERM_ IT ISSUANCE `Z' 't&BO CONST.TAX may in any way ucena ruins[ sa'd City in consequence'of the rlin,l'1'1 's 'nniL �� MECH.CONT. LIC.NO. MECH. , \vJl TOTtL8 h TOTAL Sig Oeol' pp unl/Con actor Date �/� OFFICE COPY-