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18367POST THIS CARD NEAR FRONT OF BUILDING ...• CITY OF CUPERTINO INSPECTION DIVISION JOB. INSPECTION RECORD JOB ADDRESS 6L 6 l �'e/U D �'p Q -' ' UNIT# _�LOT# 1 - - OWNER�V�A CONTRACTOR llll ltl�l PERMIT NUMBER 18367. PERMIT EXPIRATION ' ' PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. - INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED COMPLY WITH THE APPROV6q AND CITY OF CUPERTINO STANDARDS`I UFER - PREGUNITETO - PEI+MI I VA LIMA i ION [}.� li3!n-`�\T" ' 7 ISSUANCE UA TEa . GARAGE SLABS •. ., .POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED L%iy t, ��r�� C' `� - UNDERGROUND/SLAB PLUMBING ELECTRICAL - .. MECHANICAL - BLDG. I ELECT I PLG. OLD. ❑ ❑ /i6L ' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION _ WOOD FLOOR AwAnoN ! srPT. PLUMBING MECHANICAL - ELECTRICAL - �1t �eEHMIT TO( //1/A. lfff(/ `�666� v FRAMING INSULATION sroRlEs TYPE .CONSTR. - OCC. GROUP 'RES. UNITS PLACE'NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP.'SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID ' 5O IT rLooR AREn rorAL ncRPAce DIAPHRAGM ROOFSHEATHING. BUILDING USE RES No .CON . PB 00— ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS' DATE - INSP. ' .ROUGH ..SAN.# ASSESSORS PARCEL NO PLUMBING- - SELECT. ENERGY TUBS & SHOWER PAN - PLUMBING ENERGY TRACT NO PARCEL No MECHANICAL - MECH.ENERGY - ELECTRICAL BUILDING ENERGY ACC. DATE ACC. FILE. NO. FRAMING'. . ELECT. FINAL TEST INSULATION PLUMBING - LUMBINGGASTEST' TO ,ENG SITE NO. GAS TEST.'GAS FIRE SPRINK v0 NL] ENERGY T.T< r N� - ' MECHANICAL, - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING _ EXTERIOR SHEAR -. - ELECTRICAL RELEASE FLooD roNE v NQ n.L u.c. v ❑ N❑ INTERIOR SHEAR* .. - FIRE DEPT. SHEETROCK -. - GRADE -FEE SUMMARY EXTERIOR LATH BUILDING BUILDING .INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC - - PLAN CHECK FEE ' - GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY OCCUPANCYOF BUILDINGIS NOT PERMITTED UNTIL BUILDMISFINAL IS SIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING. 252-4505, H ONE WORKING DAY BEFORE REQUIRED INSPECTION. O� - PLEASE GIVE JOB ADDRESS WHEN PHONING. z —SEE PERMIT FOR EXPIRATION DATE = ELECTRIC PLUMBING ,O G ..' MECHANICAL GG TAX IMPORTANT!-coNsr. PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL3S. OFFICE COPY m ,1t. O Z P O X. LU.� CL o U O LL - Q U a z APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY rj BU LDI NG PROJECT I DENTI FICATI ON APPLICATION & PERMIT PERMIT NUMBER BUILDING ADDRESS 0/6i L o BUILDING—ELECTRICAL—PLUMBING='MECHANICAL 18367 OWNER'S PLAN CHECK VALIDATION NAME 7 -in, PHONE 2 s5---3063 OTY. ELECTRIC PERMIT FEE , - CONTRACTOR'S NAME 0" of i' LIC. NO. UTLETS-SWITCHES -RECEP 10.00/1.00 _ CONTRACTOR'S ADDRESS PANELS 10.00 PHONE DATE OF APPLICATION w ARCHITECT OR O PANELS (OVER 200 AMM 20.00 PLAN CHECK FEE x P.C. No, ENGINEER uc, No. SIGNS TRANS. 3.00 AARCH. OR DDRESS ENG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 - ZIP '�] ( �' A ADDRESS ORE Sa,mIf MOTORS SEE FEE SCH. SERVICE CHANGE 1RA100 LICENSED CONTRACTORS DECLARATION t 1989 ill 2, 6ISSUANCE 1 hereby affirm that I um licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full form and effect License Class'- Lia Numher Dale Contractor DATE BLDG. ELECT. PLG. I� . MECH. BUIL INFORMATION OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Professions Law forthe citywhichTires a permit to Code: -Any city or county which requires a permit to constrict alter, improve, demolish, or repair any structure, prior to its issuance, ulsu requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and MISC.REFER TO ORD - VALUATION §/FT. - ' pERMIT ISSUANCE 10. ELEC. CONTR LIC. NO. ELEC. TO PERMIT TO/ - OTY. PLUMBING PERMIT FEE STORIES" TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of no morethan five hundred dollars(S500).): s -. -` - • ALTER -DRAIN &VENT -WATER (EA.) 5.00 k us 1. ars owner of the property, or my employees with wage their sole compensation, will do the work, and the structure is not. BACK FLOW PROTECT. DEVICE. 4.00 occ. caouP - BEs. ururts' intended or offered for .In (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 does such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however. the building FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTALACREAGE GAS -EA. SYSTEM-11NC.40UTLET$6.00 �.•� or imp.cncmcntis sold within one year of c(mpletion, the owner- builder will have the burden of proving that he Aid not build or int- prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA) 2.00 - BUILDING USE RES IND CON Pa Other, • ❑ 11 El El 11 INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS -I INC 5 V.B. 6.00 ILAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. licensed contractors to construct the project (Sec 7144, Business amt Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon: and who contracts for such projects with a contractoni) licensed pursuant to the Cnntructor'z License Law. SEWER -SAN EA. 200ft/10.00 TRACT NO. PARCELING. '❑ I:on exempt uhAer Sec. ,B.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date — WATER SYSTEM - 5.00' ACG DATE ACF FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPINSATION DECLARATION I hereby affirm that I have a certificate of consent to sell -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. - copy Ihereuf (Sec 3800, LBb,C.L Policy No. Company - - FIRE SPRINK ENERGYT24 . ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with file city inspection division. Applicant Y ❑ N❑ V ❑ ' N❑ MISC.- REFER TO ORD. CERT IFICATIi OF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 LOODZONE A.L.uc. PLG. CONTR. LIC. NO. _ PLO. /�` TOTAL COMPENSATION INSURANCE T leis section' need not be completed if the pcnn it is for one Y [:] NJ[] v ❑ N ❑ , MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars (S 100) nr Ices.) I certify that in the performance of me work for which this per -DTV. mit is issued. I shall not employ any Pirxon in any manner so as to BUILDING become subject to the Workers Compensation Laws of California. Dane - Applicant NOTICE "f0•'APPLICAN'I': if, after ...akin, this Certificate of fix- ALTER OR ADD TO MECH. 5:00 _ 5.00 PLAN CHECK emption, you should 'heconro subject to the Workea'lompensat ion'APPLIANCE provisions -of the.Labor Code, you most ILrthwith comply with soeh .....visions car this nnrmit shall be deemed revoked. FEE ' AI ANDLING UNIT (TO 10=C.F.M.) JZ0 AIR LING UNIT (OVER 10= C. F. 6.00 .SEISMIC FEE - CONSTRUCTION LENDING AGENCY . I hereby affirm that there is a construction lending agency for the performance of the work Ior which this permit is issued fSec. 3097, Civ.C.). EXHAUST OD (WITH DUCT) 5.00 MICROFILM f HEATING UNI SATO 100,000 .U.1 8.00 HEATING UN IT ER 10 OO B.T.U.19.50 ELECTRIC Lender's Name •`'* Lender's Address I certify that I have read thisapplivution and state that the above information I, correct. 1 agree to comply with all city and county ordinances and state -laws relating to building construction, and VENTILATION FAN GLE) 4.00 PLUMBING O O gO1LER-ODMP13 H.P. 10 OO B.T.U.) 6.00 P4000BT BOILER -COMP ( SEEFEESCH, MECHANICAL hereby authorize representatives of this city to enter upon the above-nxnlioned. property for inspection purposes. (. , MISC. - REFE O ORD. '(We) agree to Save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the CONST. TAX PERMIT 1 ANCE 0.00 / MECH. CONT. UC. NO. , MECH. TOTAL TOTAL /1 ^O ranting of this per il. - 7 ZL-S7� Signature of licant/Contractor Date j OFFICE COPY