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17233 -POST THIS CARD NEAR FRONT OF BUILDING � •u PERMIT NUMBER CITY -OF CUPERTINO 723: INSPECTION DIVISION JOB INSPECTION RECORD { r� .: •, n / .. 1 ::1 ' PiRMfT EX�RATION JOB ADDRESS' 'I - � N (c� �l�;/ - UNIT# _LOT-# (". I ,, 1(,tll~y-) PERMIT EXPIRES IF WORK' OWNER e CONTRACTOR IS NOT STARTED WITHIN INSPECTION DA4-E INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - Qrt - - ANCE OR'180 DAYS FROM . NOTE:. LAST CALLED INSPECTION. UFER Q ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE'APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. - PAIDGARAGE SLABS - ! POUR NOCONCRETE UNTIL ABOVE HAS BEEN SIGNED qq ff �� t — ✓ UNDERGROUND /SLAB - AF 1 198J ' PLUMBING - - - p� I J,� -Aj; .. Yt tsLt.J ELECTRICAL ISSUANCE DATE MECHANICAL BLDG - ELECT PLG. MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT ' - INFORMATION WOOD FLOOR VALUATION s/FT. PLUMBING , ; 3 N MECHANICAL � � - � 'WQ PER M11IT TO ELECTRICAL FRAMING I�' I ��• ' INSULATION TORIES TYPE CONSTR. ,. - � ,� OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS.BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 50 FT`Loon AFT TOTAL ACBeare DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND 'CON PB Om,•, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El 0 0 0 ASSESSORS PAHCELNO.' ROUGH SANA PLUMBING - ELECT.ENERGY TRACT NO. PARCELNO .. TUBS&SHOWER PAN. PLUMBING ENERGY MECHANICAL - MECH.ENERGY . ELECTRICAL' BUILDING ENERGY ACC DATE ACCFILE NO• FRAMING -' - - ELECT.FINAL TEST _ ZONING ENG,SITE NO. INSULATION PLUMBING GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [D N❑ Y.Q IN FLOOD ZONE EXTERIOR SHEAR ELECTRICAL RELEASE A.L UX INTERIOR SHEAR FIRE DEPT. Y o N Y ❑ No, SHEETROCK ^�,r GRADE FEESUMMARY EXTERIOR LATH _ BUILDING 8�,1,�LDING INTERIORLATHTEMPORARY APPROVAL4 ' SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE /D OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNEOBY BUILDING INSPECTOR. MICROFILM , ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED.INSPECTION. PLUMBING bePLEASE GIVE JOB ADDRESS WHEN PHONING. V Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL CONST.TAX IMPORTANT!' ' PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE CO" .APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY : BUILDING " � BUILDINGBUILDING PROJECT lDENTI FICATION PERMIT NUMBER - APPLICATION & PERMIT 4' AOjF6J O L BUILDING -ELECTRICAL-PLUMBING-MECHANICAL +c' � �� 33 OWNER'S NA E PLAN CHECK VALIDATION t 0 7 PHONE 8OTY. ELECTRIC'PERMIT FEE N Y -III C 3 NAME CONTRACTORS NAME OUTLETS-SWITCHES-,RECEP 10.00/1.00 \1 LIC,NO. LIGHTING FIXTURES 10.00/1.00 C �c$N�x.) C,ONTRACTOR'S ADDR Ess PPLIANCES-.RESIDENTIAL 4.00 PHONE PANELS - 10.00 DATE OF APPLICATION ARCHITECT PANELS 200 AMP) 20.00 PLAN CHECK FEE 'P.C.NO. ENGINEER uc.NC. SIGNS TRANS. - 3.00 ARCH.OR EN6igl PERMIT VALIDATION ADD Esso A � SPECIAL CIRCUIT 5.00 t N iIP EMP.METER OR POLE INS. 20.00 APP CANT'S - MOTORS SEE FEE SCH. ADD ESs SERVICE CHANGE _ 20.00 F o o LICENSED CONTRACTORSDECLARATION _ x J Q� ( •',1 'Q z U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE w G w (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT.' PLG. MECH. O 1 91989 H H z Professions Code,and my license is In full forco and effect. � ❑ ❑ ❑ z o rn - License Class Lic.Number 1{r.-�{ - 9 w r Date Contractor C'V W cup"00 ¢ y NI Y BUILDING PERMIT ¢ IF st OWNER-BUILDER DECLARATION - INFORMATION X ;LL w 1 hereby affirm that I am exempt from the Contractor's License MISC.- - REFER TO ORD u O¢ Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT. F - PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to construct,alter, ¢ ¢¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. 1 ia u requires the applicant for such permit to file a signed statement that ^ TOTAL K m he is licensed pursuant to the provisions of the Contractor's License PERMIT TO Fzi Law(Chapter 9(commencing with Section 7000)ofDlvision 3 ofthe 4 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE I N1E I2 �I_lo L ¢ H m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a3� by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) '5.00 of not more than five hundred dollars($S00)): ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structum is not intended or offered 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 does such work FIXTURES-PER TRAP - 5.00 SQ.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such mimprove- GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 improve- ments are not Intended or offered far Bale.If,however,the building or 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 prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Hiner ❑ I,as owner of the property,oto'exclusively contracting with - ❑ ❑ licensed contractors to construm 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 o builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such proje' a contractors)licensed pursuant to the Contractor' tens L' SEWER-SANITARY-STORMEA.200ft/10.00 TRACT NO. PARCELNO. ❑ tum ext on r ,B.&P.0 treashl on WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. OR'ERS' OMP ENSATION DECLARATION WATER TREATING EQUIP, 5.00 1 hereby affirm that 1 have u certificate of consent to s If-insure, or B certificate OC Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO, copy thehereofof(Sec.3800,Lpb. _ Policy No, Coo - 0 ❑ Certified Copy ishereb Company hereby furnished. FIRE SPRINK ENERGY T-24 Z Z Certified copy is filed with the city inspection division. - . ❑ ❑ F O App ant MISC.- REFER TO OR D. Y C] IN Y ❑ N = N . CERTIFICATE OF 1 iXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR, LIC.NO, PLG. CL 0 (This section need not be completed if the permit is for one TOTAL YE] N Y❑ N Z hundred delta..S 100)or less V O I certify that in the performance of the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY UL mit is issued,I shell not employ any person in any mmnner so as to O Or - become subject to the Workers'Compensation Laws of California. Q. Date Applicant ALTER OR ADD TO MECH. 5.00 r 3 B } m NOTICE TO APPLICANT: If,after making this Certificate of Ex- H 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 �- V such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 111, CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10000C.P.M.) 6.00 SEISMIC FEE 510 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 issued(Sec, --- MICROFILM 3097,CivCA - HEATING UNIT(TO 100,000 B, - ) 8.00 Lender's Name Lender's Address H EATING UN IT(OVER 100,009"4)9. ELECTRIC 'I Certify that l have read this application and state that the above VENTILATION FAN (SINGLE 4.00 information is correct.I r comply with all city and County PLUMBING ordinances and state s elating to building construction, and BOILER-COMP13 H.P.or 100,000 B.T.U.) 6.00 hereby an re iines hi olives of this city to enter upon the above-me in i pr a fo spepurp BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL yoses. (We) gre to s v i nify and keep hannlcas t Ci of MISC.- REFER TO ORD. uperti o a at t i1' s it menu, costs and ex sas h CONST.TAX may any y a cr ins f said City in const nce f t e PERMIT ISSUANCE 10.0011 ran Of i r i. MECH.CONT. LIC.NO. - MECH. y TOTAL TOTAL Si f at a lT OFFICE COPY