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18816 POST THIS.CARD NEAR FRONT OF BU LDIING FERMI NUMBER CITY OF CUPERTINO 18816 INSPECTION DIVISION JOB INSPECTION RECORD I PERMIT EXPIRATION JOB ADDRESS / O /(/ IT LOT# PERMIT EXPIRES IF WORK OWNER �✓1��(/ CONTRAc1S NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM FOUNDATION NOTE: LASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNI TE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PIT VALIDATION CUPERTINO STANDARDS: , GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED A 'UNDERGROUND /SLAB PLUMBING. - Lr�Llj i ELECTRICAL PAID J SSUANCE DATE MECHANICALBLD ELECT. PLC. MSCI+ oc i s CT 1981. ❑. ❑ ❑ DO NOT"POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDp - BUILDING PERMIT •' Cl Qf COOP"rIIRO - INFORM_ATION WOOD FLOOR VALUATION- SIFT. PLUMBING, MECHANICAL ' PER&t.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' SO F..FLOOR n'+cn TOTAL�c"FACE �• DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDINGUSE ROOF SHEATHING RES IND CON PB O'l,, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El ❑ ❑ E ASSESSORS PARCEL NO. ROUGH SAN.# . PLUMBING ELECT.ENERGY TUBS 85HOWER PAN - PLUMBING ENERGY - "TRACT NO. PARCEL NO. MECHANICAL MECH.ENERGY 'ELECTRICAL ' - BUILDING ENERGY Acc:DATE ACC,PILE Na. FRAMING - ELECT.FINAL TEST Z.0NING ENG.SITE NO. INSULATION PLUMBING . GAS'TEST GAS FIRE SPRINK ENERGY TQC _ MECHANICAL ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y N❑ . ❑ NE] FLOOD ZONE PLUG: EXTERIOR SHEAR ELECTRICAL RELEASE Y 0N 1 ❑ N❑ -INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH IBUILDING BUILDING INTERIOR 'LATH I TEMPORARY APPROVAL O'D SCRATCH COAT . ELECTRIC- PLAN CHECK GAS FEE' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL'ISSIGNED BYBUIEDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252=4505, ELECTRIC H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL'INSPECTION. TOTAL 1g,S�. OFFICE COPY APPLICANT TO'FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT-PEN ONLY BUILDING PROJECT IDENTIFICATION ,PERMIT NUMBER BUILDING - ..q APPLICATION & PERMIT ADDRESS 1 }n{/}�( 1 I^� + D rAU BUILDING - ELECTRICAL-PLUMBING-MECHANICAL O; 188 1 V OYJI Ell 5PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE 20.6 CONTRACTOR NAIVEOUTLETS-SWITCHES-RECEP 10.00/1.00 V l/ • " LIc.NO. 2 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 ADDRESS - K' SPHONO r/ PANELS -10.00 DATE OF APPLICATION ` ADRRCHITECTcA n q. PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGINEER G�'^ sec,NO,Ci J IR 6 SIGNS TRANS. 3.00 ARCH.OR ENG. fl P IT VALIDATION • ADOREsS . SPECIAL CIRCUIT 5.00 EMP.METER OR POLE INS. 20.00 APPLICANTS ADDRESS MOTORS E FEE SCH. SERVICE CHANGE aims� 20.00 woo LICGNSIiU ONTRACI'ORS DECLARATION n nor n W V 0VO u I hereby affirm that 1 in.licensed under provisions of Chapter 9 v DANCE DATE y a y (Commencing with Section 7000)of Division 3 of the Business and BLDG ELECT. PLG. MECH. F y a Professions Code,and my license V in full foorc d (kct,�� / ❑ ❑ ❑ Z 0,v, - License Class Lia Nta, bLr_LL((��'"'�L.__JJ.. Lit 91 ARM. 0 . 1- aa Date Conlydctor� ..-� a m f " I �K/'7 BUILDING PERMIT IS a u o NER-BUILDER DECLARATION OWContractLicenseMISC.- REFER TO ORD INFORMATION wN I hereby affirm that I am exempt from the Contractor's License VALUATION SIFT. ca Law for the following reason.(Sec.7031.5,Husidmand Professions' PERMIT ISSUANCE 10.00 w O Code'.Any city or county which rwn luiresa permit toconstmt,alter, (� .Q le a o improve,demolish,or repair any structure,prior to its issuarnc,also ELEC,CONTR- LIC.NO. ELEC. 0 c, requires the applicant for such permit to file a signed statement that TOTAL X$ he is licensed pursuant to the provisions of the Contractor' License 1/ __ RMIO I . z i Law(Chapter 9(commencing with Section 7000)of Division 3 o flhe ZD5�0/U - ne a Business and Professions Codel Or that he is exempt therefrom and GTY. PLUMBING PERMIT _ FEE $ the basis for the alleged exemption.Any violation of Section 7031.5 r STORIES TYPE CONSTR. e- by any applicant Hire unfired dollarsthe00.)i mvioa cNilpedilly ALTER-DRAIN -WATER.IEA.) 5.00 of not more than live hundred dollars 15500)J: ❑ h as owner of the proNriy,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will du the work,and the structure is not intended or offered for sale (See 7044, Huninevs 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 AREA TOTAL ACREAGE • himself or through his own em ployecs.provided that such improve- mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 s or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder w91 have the burden of proving that he did not build or im- BUILDING USE Prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Om_ 131,asownerof 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 an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ Ialn cicmpt under sec. ,B.&P,C.for this WATER HEATER W/VENT 6.00 reaUltl Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. W'ORKERS'CONIPENS\TION DECLARATION WATER TREATING EQUIP: 5.00 I hereby affirm that I have d certificate of consent to sell-insum, - ZONING or a c,I,f c,Ic of Workers'Compensation Insurance,or a.cnitied ENG.SITE NO. copy�thcrcof(Scc.3800,1_1b C.). Policy No. Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 F" p AppplicanrUf J copy filed with (he city i/n�,jfp�entoJn,Jd}iyvisi . MISC.- REFER TO ORD. Y❑ N❑ Y ❑ rv❑ T r"-Y •- � ' PERMIT ISSUANCE 10.00 'CGR'I'I ICA'T;OFFXEM IONFkOM WORKLRS• FLOOD ZONE A.L.U.C, LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y❑ NF] YE] NEI 0 1'1'his section need not be completed if the permit is for one TOTAL hundred dollars IS 100)car I..) U O 1 certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL l- mit is issued,1 shall not employ any person in any manner ul us m 0w become mhject to the Workers re Conpnmtion Luwa of CBlifdnilw a DaeApplicant ALTER OR ADD TO MECH. 5.00 BUILDING } GO NOTICE TO APPLICANT: If,after making this Certificate of I'x- F Z emption,you should become subject to the Workers Compenution APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE (� such provisions or this permit shall be deemed revoked.' AIR HANDLING UNIT(TO 10=C.F.NL) 4.00 CONS'fRUCFION LENDING AGENCY AIR HANDLING UNIT(OVER 10pOD171EM.) 6.00 s SEISMIC FEE �O I hereby a01nn that their is a construction lending aciLncy for EXHAUST HOOD(WITH DUCT) 5.00 the 3097 Civ C.) nce of the work for which this permit is issued(Sec. MICROFILM HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UN IT(OVER 100,000 B.T.U.)9.50 Leodn Address ELECTRIC I certify that l haveroad this application and state that the above VENTILATION FAN (SINGLE) 4.00 information B correct. I agree tq comply with all city and county - PLUMBING ordinances and state laws relating to building construction, and BOILER-ODfvP 13 H.P.Or 1(X1,000 B.T.U.) 6.00 hereby authorise representatives of this city to enter upon the BOILER-COMP Over 100,000 BTU)SEE FEESCM. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep handless the City of MISC.- REFER TO ORD. 'Htertino against liabilities,j dgmrnts, costs and expenses which CONST.TAX By in any way ecree agglinst said City in consequence of the PERMIT ISSUANCE 10.00 n11 this pe 16 MECH.CONT. LIC.NO. MECH. _ I L � TOTAL TOTAL �0 SO S' p icanl/C roc for Date OFFICE COPY