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17852 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 17852 INSPECTION DIVISION ' JOB INSPECTION RECORD [� /� �r� a PERMIT EXP R TION JOB ADDRESS ��TIVILJI� VGI 1 'L` UNIT# '�`� LOT#'' r� - ') b. `� � _ i PERMIT EXPIRES IF WORK IowN �ER G coNTRAc.oR IS NOT STARTED WITHIN ' INSPECTION DATE INSPECTOR INSPECTION RECORD• IOU DAYS DF PERMIT ISSU ANCE OR 180 DAYS FROM FOUNDATION NOTE: - LAST CALLED INSPECTION. . UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED • PREGUNITE - - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PI RMI I VALIDATION CUPERTINO STANDARDS. ,t GARAGE SLABS , /"�"lXt'T'CJ1�UC.LI��UF1 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB I' ' 11 Ila ' PLUMBING ELECTRICALr ISSUANCE DATE MECHANICAL - - BL G. ELECT v c. NIECR 9 V El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDINGPERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION /" sIPT, �. Go0 • MECHANICAL PERMIT t0 ELECTRICAL FRAMING., ' 'INSULATION - STORIES .TYPE CONSTR. • CCJlr/S�I•(_�GiG - ,� /� OCC GROUP RES UNITS ,.PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF ' - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.Fr.FLoo1+ARIA TOTAL ACPLATE DIAPHRAGM THE CONSTRUCTION TAX IS PAID 9uILOIUSE ROOF SHEATHING Res IND CON PB on.•, -'APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 El El 1:1 ID ASSESSORS PARCEL NO. ROUGH SAN.N G PLUMBIN31 ELECT,EN ERGY TRACT NO. PARCEL NO. TUBS 8 SHOWER PAN - PLUMBING ENERGY MECHANICAL, - MECH.ENERGY / ,� ' ELECTRICAL BUILDING ENERGY ACCDATE -ACC.FILE NO FRAMING _�I- `-V-AA ELECT, FINAL TEST —A�/`k�( zoNiNc ENG,SITE No. INSULATION PLUMBING '7-/zX '� GAS TEST GAS MECHANICAL 7- C/- FIRE SPRINK ENERGY i.]C I COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 7/ 'EXTERIOR SHEAR ELECTRICAL:RELEASE ,FL000 zoNE aL.u.c. INTERIOR SHEAR FIRE DEPT. Y-Ej NEI ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING /y J� }• INTERIOR CATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE D OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM ---- ARRANGE FOR INSPECTION BY PHONING 252-4505,• ELECTRIC Iy• F ' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING zo 00 z PLEASE GIVE'JOB ADDRESS WHEN PHONING:' - SEE PERMIT FOR EXPIRATION DATE - rN CHANICAL . IMPORTANT! ST,TAXPLEASE READ REVERSE SIDE BEFORE OTAL CALLING FOR FINAL INSPECTION. OFFICE COPY . APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I DENTI FICATI ON - PERMIT NUMBER[ BUD,OusG u.1 levo APPLICATION & PERMIT 17552 ADORESS BUILDING-ELECTRICAL-PLUMBING-MECHANICAL Zd is �I1 .ht+ OWNERS PLAN CHECK VALIDATION N /ICvRDrl �6 y QTY. ELECTRIC PERMIT FEE 1 CONTRACTOR'$' �J NAME r UTLETS-SWITCHES-RECEP 10.0011-00 .S � _ LI ��p sp LIGHTING FIXTURES 10.00/1.00 1 AD RAcroRs PPLIANCES-RESIDENTIAL 4.00 AD RES, "ail 9SW 8 PANELS 10.00 DATE OF APPLICATION ARCNITET PANELS (OVER 200 AMP)' 20,00 PLAN CHECK FEE . .NO. OR ENG, RA LIC.NO. SIGNS TRANS. 3.00 ARCHE REND SPECIAL CIRCUIT 5,00 PERMIT VALIDATION APPLICANTS ZIP, EMP-METER OR POLE INS. - 20.00 \ AN,to�� AODFE!lSJ Tc REss MOTORS SEE FEE SCH, 11% nwj Y . SERVICE CHANGE 10 20.00 1FJ`l ` - 0 m zI., - - r 00, 1 ICENS iD CONTRACTORS ECLARATION - mo u I hereby affnn that I am licensed under provisions of Chapter 9 ISSUANCE DATE Nw (commencing with Section 7000)of Division 3 of the Business and BLDG ELECT. PLG. MECH. Professions Code,' my license is in full to c((gdry b ❑ io i'u, In License Lic.Number_ D �a M F m r J Dulc� Cunt mcion _ _cot ,r W a x 1 BU DING PERMIT M a w u OWNIi R-BUILDER DECLACumbw RA' ION I FORMATION w3 a ,- I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD Fero J Law for the following reasoa(Sec.703.5,Businwsand ProlessiOms PERMIT ISSUANCE I - TBAO VALUATION / 5/FT. o Code:Any city or county which retp,ioS a pcmnit to constnmt alter, ar ¢0 inlprovc,demolish.or repair any stn¢Tum,prior to its issuance-ulso.'ELEC.CONTE. LIC.N0. ELEC. Cf 000 . o u I requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO Iq A w he is licensed pursuant to the provisions of the Contractor's License ` F a ¢ Law(Chapter 9(commencing with Section 7000)of Division 3ofthe /I,` Business and Professions Code)0r that be is exempt therefrom and QTY. PLUMBING PERMIT FEE W ¢ r o the basis for the alleged exemption.Any violation of Section 7031.5 _ STORIES TYPE CONSTIN. a ;m by any applicant for a permit subjects the applicant Tu a civil penalty ALTER-DRAIN&VENT- WATER (EA.) 5190 of not more than five hundred dollars 15500),) ❑ 1,as owner of the property,or my employees with wxFes as BACK F LOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure Is net intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:'rhe Com tractor'sLiceue Law docs not apply to an owner of e•N A property who builds or improves thereon,and who dos such work _ FIXTURES-PER TRAP - Q. OU SQ FT,FLOOR AREA TOTAL ACREAGE himself or through hi sow^...ploycce,provided That such inlprovc- mentsarenOTlntendedorofferedforsale.If.however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 Of improvement is sold within one year of completion,the Owner- GAS-EA.SYSTEM-OVER 4 (EA) 2.00 builder will have the burden Of proving that he did not build or im- BUILDING USE -ow prove for purpose ofsale.). - INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB other ❑ 1,as owner of the property,con exclusively contracting with ❑ ❑ , ❑ , ❑ ❑ liccnsud contractors to construct the project (Sac.7044.Businar LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Co^tmemr's License Law do¢not apply to an owner of property who builds or imprrvts Thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with o contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Cont ❑ I um exempt tinder Sea ,R&P.C.lin this WATER HEATER W/VENT 6.00 Owner Owner Dale WATER SYSTEM Z04U13 2,00 ACC.DATE ACC.FILE NO. WORK FRS'CONIPENSATION DECLARATION WATER TREATING EQUIP, 5.00 I hereby affmn that I have a certificae of consent to all-insure. ZONING or a certificate of Workers Compensation Insuranncc�e,,or u certified ENG.SITE NO- copy PolicyNOC.Cof(SC Pany�,gAg U ❑ Certified copy is herebyfurnished.- f= C•`- FIRE SPRINK ENERGY T-N Z 2 ❑ Cof p4, s tiled rill the city ins��reellion,�.a1I(vision. MISC. REFER TO ORD. ❑ ❑ ❑ ❑ p APPlimnt _ /JU'-�_ v N V N ~ w ��-'s`"`�� PERMIT ISSUANCE `?CBB FLOOD ZONE A,L.0 C. CC CCRTD'ICA i OF EXEMI'1'ION I7RONI WORKERS. W COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG. Y❑ - N❑ Y❑ N❑ CL Z (This section need not he completed if the permit is for One TOTAL /1V t hundred dollars IS 100)or ke..) U O I certify that in the performance Of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY W F mil is issued, I shall not employ any perssm in any manner .as to O w Ixcon a soloed to the Workers'ConpcnsuGon laws of California. y Dec Applicnnl ALTER OR ADD TO MECH. 5.00 BUILDING Job } ro NOI Chi TO APPLICANT: If,after making this Certificmc of Ex- F ? emnlion,you should become subject to the Workers Compenvlion APPLIANCE 5.00 PLAN CHECK provisions of the labor Code, you most forthwith comply with FEE .0 sssoh provisions Or this permit shall be desnned revoked AIR HANDLING UNIT(TO 10MC.F.M,) 4.00 CONST RUCTION LENDING XCENCY AIRHANDLING UNIT(DVER I0)000QF.M.) 6.00 SEISMIC FEE a I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is Tolled(Sec, MICROFILM _-.. 3097,Civ C,L HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lendeh Name H EATI NG UNIT(OVER 100,000 B.T.U.)9.50 Lender's Name x ELECTRIC I Certify that I have read this application and slate that the above VENTILATION FAN'(SINGLE) 4.00 �7r� information is correct. I agree to comply with all city and county PLUMBING �•A.111 00 ordinances and state laws relating t0 building construction, and BOILER-IX 13,H.P.or100,000B.T.U,) 6.00 hereby authorim representatives of this city to enter upon the BOILER-0OMP OU.,1100,000 BTU(SEE FEE SCH. MECHANICAL above mentioned property for ins�ction purposes. _ - (We) agree to save, indemnify and keep h"Didess the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10,00 CONST.TAX ey in an way accrue against said City in c queue of the I ranting his Permit - MECTLCONT. LIC.NO. MECH, TOTAL TOTAL Slgr tare Applicant/Contractor Dat - 11(0-'40 OFFICE COPY