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13070 POST THIS CARD NEAR FRONT OF BUILDING PERNITNUMBER CITY OF CUPERTINO 13070 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 11490 CHARSAN LANE uNlr# LOT# 2 PERMIT EXPIRES IF WORK OWNER CHUCK"MASTERSCONTRACTOR STEVE ,ZANKICH IS NOT'STARTED WITHIN INSPECTIONDATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM ' LASTCALLED INSPECTION. LIFER r PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL A OVE HAS BEE SIGNED PAdD UNDERGROUND /SLAB II ryry PLUMBING - - JUL14 OL19v ,r ELECTRICAL I�UNCED TE BL MECH. MECHANICAL '❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $/FT: PLUMBING /0 - - _ MECHANICAL -;L/-f7 ` PERMIT TO ELECTRICAL FRAMING p- - - STORIES y TYPE CONSTR. INSULATION o•L ' OCC,GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE,HAS BEEN SIGNED I ROOF (C..Q. SO.FT FLODH AREA TOTAL ACREAGE DIAPHRAGM Yom• BUILDING USE :RES IND CON PB Olner APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El El 0 E ASSESSORS PARCEL NO, ROUGH PLUMBING ' TRACT NO, PARCEL NO, GAS TEST MECHANICAL ELECTRICAL . S'$Y' ' FINALS DATE INSP. ACC,DATE ACC.FILE NO. FRAMING - ,i SAN # ZONING ENG.SITE NO. ' INSULATION PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY TZa COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED i;"I HEATING - "� ❑ N❑ FLOODZONE A.LUC. `MFIR,EWALLS OR 3' ELECTRICAL -�'d OR FIRE DEPT. v "� v �] "� - GRADE FEE SUMMARY OR BUILDING i IOR TEMPORARY APPROVALS BUILDING , - ELECTRIC -� PLAN CHECK 9- 9 GAS FEE NMPIEV04 P ASTER UNTIL ABOVE HAS BEENAMNED OCCUPANCY SEISMIC FEE M OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O� PLEASE GIVE JOB ADDRESS WHEN PHONING. , Z -'FMECHANICAL — SEE PERMITOR EXPIRATION DATE — IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. • OFFICECOPY - T \- -PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER IJSI IIII ..� z APPLICATION & PERMIT 13070 ADDRESS 4 r ' BUILDING-ELECTRICAL-PLUMBING-MECHANICAL : 4 ._SHA , AAT J'IT ' LO PLAN CHECK VALIDATION OWNER'a • NAME OTY. ELECTRIC PERMIT FEE s G V C, �S PHON coNTRACTOR's UTLETS-SWITCHES-RECEP 10.00/1.00 NOMTE Llc."O. 2..Z LIGHTING FIXTURES 10.00/1.00 CONTR ACTOWs PPLIANCES-RESIDENTIAL 4.00 ADDRESS PNONE 5- PANELS 10.00 DATE OF APPLICATION Rcrsrracr PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR ENGINEE LIC.No. SIGNS TRANS, 3.00 IC7 1 ADDRESS ENG. SPECIALCIRCUIT 5.00 PER ATION ADDRESS ZIP TEMP.METER OR POLE INS. 20.00 L't qL APPLICANT'S JulU J s ADDRESS MOTORS SEE FEE SDH. 'L L-, 1 SERVICE CHANGE 20.00 CLtf eF%�l 0 Woo LICENSED CONTRACTORS DECLARATION ( �� ¢ u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE G y (commencing with Section 7000)of Division 3 Of the Business and BLDG. ELECT. PLG. MECH. H h i Professions Code, d my Ilcenee is in full force and elle t. - ❑ ❑ ❑ z o w- License CI s Lia Number Z 9 L L Date�Conlmctar P y fBUILDING PERMIT ¢ ¢w a OWNER-BUILDER DECLARATIO4�11 INFORMATION onto MISC.- REFER TO ORD X ; r 1 hereby affirm that 1 am exempt from the Contractor's License ww0 Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION S/FT. ~ yr0 J Code:Any City Or County which requires a permit InconstNCt,alter, a 2¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO.- ELEC. W CLL requires the applicant for such pennant to file a signed statement that TOTAL PERMIT TO a E $w he is licensed pursuant en the provisions of the Contractor's License ��k./� F Z> Law.(est and 9(commencing Code)or Section is exem t Division o of the a the and he alleged eCode)or that he is exempt therefrom and STY. PLUMBING PERMIT FEE s t$ [he basin for the alleged exemption.Any violation of Section 7031.5 I STORIES TYPE'CO/NSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 s/V of not more than five hundred dollars(8500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 their sole compensation,will do the work,and the structure is notOCC.GROUP RES.UNITS intended or offered for Sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 5.6-0-- 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 SO,FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedor offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.40UTLETS8.00 3176 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Osner prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-I 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 contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 -7p reason Owner Date WATER SYSTEM 5.00 ACC.DA E ACC.FILE N0, WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof No. -f. 3800,Lab.C.). t ( 13-Evil C�,B HI �a-,� /e' Policy Company T' Y Q ❑ Certified copy lshereby furnished. FIRE SPRINK ENERGY T-24 Z Z O'Certifild cop is filed with tIt c' inspection division. MISC.- REFER TO ORD. O APPlicant Y❑ N❑ Y❑ No Fy CERTIFICATED IFROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE AL.U.C. LU W >_ COMPENSAATIONTION INSURANCE URANCE . PLG.CONTR. LIC.NO. PLG. y❑ N❑ Y❑ N❑ 0. 0 (This section need not be completed if the permit is for one TOTAL D Z hundred dollars IS 100)or less.) U O I certify that in the performance of the work for which this ver- OTY. MECHANICAL PERMIT FEE FEE SUMMARY ly I- mit is issued,I shall not employ any person in any manner a0 as to p Q W become subject to the Workers'compensation Laws of California. BUILDING 6�CrS.D Date Applicant ALTER OR ADD TO MECH. 5.00 } N NOTICE TO APPLICANT: If,after making this Certificate of Ex. F 2 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 U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT ITO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10PMC.F.M.) 6.00 SEISMIC FEE ILI 07 1 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,Civ.C.). 5 HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address • 1 certify that I have read this application andstate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all City and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTUI SEE FEE SCH. MECHANICAL above-mentioned property for inspection purpoxs. (We) agree to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities;judgments,costs and expenses which CONST.TAX may in any way accrue against said City inconsequence of the PERMIT ISSUANCE 10,00 ,JP0 granting th' permit. ntractor MECH.CONT. LIC.NO. MECH. Ik TOTAL TOTAL �7�6"7 igna reof cant/Coto ' OFFICE COPY