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16825 POST THIS CARD NEAR.FRONT OF BUILDING . PERMIT NUMBER. CITY OF CUPERTINO 16825 INSPECTION DIVISION i JOB INSPECTION RECORD // E+ 7 PERMIT EXPIRATION JOB ADDRESS 1,,, �� -/I J � C UNIT# - LOT#Y`��i PERMIT EXPIRES IF WORK .I OWNER 6k, pj CONTRACTOR E'—'Z— � C.7i(i L IS NOT STARTED WITHIN INSPECTION DATE JINSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT'ISSU' FOUNDATION - ANCE OR 180 DAYS FROM NOTE: ' LASTCALLED INSPECTION. UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAIJOATION CUPERTINO STANDARDS. GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - 'u "" • ' UNDERGROUND /SLAB / PLUMBING ELECTRICAL �� ISSUANCE DATE MECHANICAL - ELECT PLG. MECR. 9 o o 1:1 , DO NOT POUR FLOOR UNTIL ABGVE HAS BEEN SIGNED 0 ILDING PERMIT WOOD FLOOR t 0� INFORMATION VALUAiI PLUMBING MECHANICAL PERAtII i0 ELECTRICAL - T FRAMING 'INSULATION N STOR ES TYPE CONST OUP ES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO.FT.FLOOR AREA TOTAL nCHLnGE „ DIAPHRAGM THE CONSTRUCTION TAX IS PAID RUILomG USE ROOF SHEATHING RES IND CON PR APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS - DATE , INSP- ❑ ASSESSORS PARCEL NO.❑' El 0' El- ROUGH �� SAN.q - ' ' PLUMBING ELECT.ENERGY - ' TRACT NO. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY ' MECHANICAL MECH.ENERGY ELECTRICAL- BUILDING ENERGY ACL.DATE ACC.FILE NO FRAMING ELECT. FINAL TESL' ZONING ENG,SITE N0. INSULATION PLUMBING GAS TEST GAS FIRE SPRINK' ENERGY T.24 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING �� EXTERIOR SHEAR ELECTRICAL RELEASE - FLOOD ZONE ALU C, INTERIOR SHEAR FIRE DEPT. - Y [ IN Y I] N�. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR' LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS , FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPER MITTEDU NTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC G F� 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 BEFOREs CALLING FOR FINAL INSPECTION. TOTAL , 1 OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LD1 NG PROJECT I DENT]FICATI ON ,PERMIT NUMBER 41.61-DING APPLICATION & PERMIT & 16825 AODR A ^ ��Q 9 �• T� IiUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S v PLAN CHECK VALIDATION NAME � qOTY. ELECTRIC PERMIT FEE PHONE NA.0 UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 , GADDORESSRESS Dofla APPLIANCES-RESIDENTIAL 4.00 J 7i PHONE 7r3 PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS'(OVER 200 AMP) 20:00 PLAN CHECK FEE . : O. OR ' ENGINEER LICNO. SIGNS TRANS. 3.00 ADDRESS ENG' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION nP TEMP.METER Oq POLE INS.• 20.00 Q ' APPLICANT'S - / tea ADDRESS MOTORS SEE FEE SCH. JG IY� Y. yl1 i/ SERVICE CHANGE 20.00 0 - LICENSED COMRACTORS DECLARATION ¢u U I hereby affirm that I am licensed under provisions of Chapler 9 SSUANCE DATE ww (conttnce,ing with Section 7000)of Division 3 of the Business and O G. ELECT. PLG. MECH. F m i Professions C nd vJicense is in lull force ❑ ❑ ❑ Z o m - License Cla a !J Lie.Number 9 Z F G Daic_-fLContrudor < u, E BUILDING PERMIT ¢ C w ¢ OWNER-BUILDER,DECLARATION INFORMATION O MISC. REFER TO ORD - K ;odLL H m 1'hercby-affirm that 1 am exempt frothe Contrudnr's License VALUATION SIFT. H LL o j Law for tie following reason.(Sec.703 1,5.Husinessand Profcaswus PERMIT ISSUANCE 10.00 - Code:Any city or county which requires a permit to construct,alter, res- 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.N0. ELEC. 1301iu ¢ requires the applicant for such permit to file a signed statement that TOTAL sept PERMIT TO K $ he is licensed pursuant to the provisions of the Contractor's Licmue � �sT� Fzi Law(Chapter 9beummencingwith Section 7000)of Division 3 of the T//k'� CLf�/iQ(C a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE the basis for the alleged exemplion.Any violation ofSect ion 7031.5 STORIES TYPE CONSTR. p3 _ by any applicant for a pemih subjects the applicant to IT civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not moor than Ove hundred dollars(S500).1: ❑ L as owner of the prupcny,or my employees with wagca as BACK F LOW PROTECT. DEV ICE 4.00 their sole compensation,will do tire work,and the structure is not OCG GROUP RES.UNITS intended or offered for sale (Sec 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License Law does not applyto an owner of property who builds or improves thereon,and who lows such work FIXTURES-PER TRAP 5.00 SD,FT,FLOOR AREA TOTAL ACTrEAGE himself or through his own rmploym,provided that such improve- ments are not intended or offered for sale.If.however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or imprmxmcnt Is sold within one year of completion, the owner- GAS-EA.-SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build Or ire- RES IND CON PB Omer Prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am eselusively contracting with El El El El 13 licensed contractors to construct the project(See. 7044,Boniness LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Profcsxions 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 ecnlracts for such projects with a conlrictoris)licensed pursuant to the Contractor's Liccna Law. SEWER-SANITARY-STORM EA.200tt/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. _,H.&BC.for this WATER HEATER W/VENT 6.00 reason Owner Datc WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPFNSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby aHirre that I have a certificate of consent to self-insert. ZONING ENG.SITE NO. v n - Hil,ate of W..kers'Conlpennatnnlnsuruncu,ur a ec,til copy thereof(See.3800,Lab.C.) T Policy No. Company /1�✓��.�1 S ❑ CertiGcJ copy is hcrch frpishc e FIRESPEINK ENERGYT24 � Ccrtificd t yw n�ey',yyy!it�Io io,. z 2O Applin In �a MISC.- REFER TO ORD. r E] . NE Y C] N❑ CC w CER1'IFIC E OF HXEMP1'ION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W a COMPENSATION INSURANCE. PLO.CONTE. LIC.NO. PLG. v N Y N CL O 'Ill his section need not be completed if the permits for one TOTAL D Z hundred dollars IS 100)or lr,J U O 1 certify that in the performance of the work for which this per- MECHANICAL PERMIT FEE FEE SUMMARY W F mit is issued. I shall not employ any person in any manner so as to U become subject to the W'orkeri Compensation Laws of California. wa Date-Applicant ALTER OR ADD TO MECH. - 5.00 BUILDING } rn NOTICE TO APPLICANTIf,after nicking this Certificate of lia- r mpr ion,you should become subject to the Workers'Compensationr.: APPLIANCE 5.00 PLAN CHECKrZ provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10MCF.M.) 4.00 CONSTRUCT ION LENDINGAGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby aftimr that then is a construction Irmfing agency for EXHAUST HOOD (WITH DUCT) 5.00 Lire CG.roance of the work for which this permit is issued(Sec: HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name HEATI NGUNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address nom' I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 '. Is information is correct. I agree to comply with all city and county PLUMBING t ordinances and state laws relating to building cu..ruction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 - �I hereby authorize representatives of this city to enter upon the BOILER-COMP 10v<r 100.00 BTUISEE FEE$CH. MECHANICAL above-mentioned property for inspection purpows. (We) agree to save, indemnify and keep Imrtiles' the City of MISC.- REFER TO ORD. Cupertino against [icy ics,judgments, costs and expenses which CONST.TAX - may in any way Ce against said C'y in c.o quence of the PERMIT ISSUANCE 10.00 ren ,It I. 8 MECEL DNT. LIC.NO. MECH. ?1 TOTAL TOTAL / SifroWt o Applicant Contractor ate OFFICE COPY