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15388 r a- POST THIS CARD NEAR FRONT OF BUILDING .1 PERMIT NUMBER CITY OF CUPERTINO 1538 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION TOB ADDRESS �� O ''�/ �i�'''✓ ^T'✓� UNIT# LOT# - F� PERMIT EXPIRES IF WORK OWNER /n/F /—f}- CONTRACTOR U G-��- �� L.L. IS NOT STARTEO,WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU FOUNDATION - - ANCE OR,E1BO DAYS FROM NOTE: LASTCALLED INSPECTION,' UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF - PEHMIr VALIDATION CUPERTINO STANDARDS. ' GARAGE SLABS - '- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING - - 1 ELECTRICALIssuANCF.DATE MECHANICAL _ ALDG. ELECT,I PLG., MEC., DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED, - - , BUILDING PERMIT y �;, INFORMATION WOOD FLOOR - r�'' VALUATION ..I $TFT. PLUMBING •/ / . MECHANICAL - - - ELECTRICAL - - - PLHMIT 7TO. FRAMING _ .. - /'/T.i,',-C , ,t 7` _iL SI ORIES TYPE•CONSTR. INSULATION OCC.RHODE RES.UNITS i PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - -' ROOF NOTENO FINAL INSP.SHALL BE MADE BEFORE sn.Fr.FLooH AREA rout ACREAGE Vw DIAPHRAGM THE CONSTRUCTION TAX IS PAID - BUILDING USE:V�) ROOFSHEATHING - RES IND CON PB• 0"", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS - DATE INSP. �'_ "1-1 ❑ 1:1 ASSESSOHS PAHCEL NO ROUGH SAN.# _ T• PLUMBING' ELECT:ENERGY - - P , TUBS BSHOWER PAN PLUMBING ENERGY � �� TRACT No, ARCELINO ' MECHANICALMECH.ENERGY _ ACC..DArE ACC'FILE NO ELECTRICAL BUILDING ENERGY FRAMING - ELECT.FINAL TEST' ZONING ENG.SITE NO, ' INSULATION � � PLUMBING . GAS TEST - GAS ' - FIRE SPRINK ENERGY T.2C ' MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HE Y ❑ re❑ ` ❑ NO L UC. ' EXTERIOR SHEAR � � ELECTRICALRELEASE FLOOD/UNE A. ' INTERIOR SHEAR - FIRE DEPT. Y El ElY ❑ N❑_ _ SHEETROCK' GRADE FEE SUMMARY EXTERIOR LATH '• BUILDING INTERIOR LATH. TEMPORARY A PROVAL BDILDmG ;'/ SCRATCH COAT ELECTRIC PLAN CHECK . GAS _ FEE GAS TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM uT ARRANGE FOR INSPECTION BY PHONING 252;4505, ELECTRIC ~o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING." - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! . ' CONST.TAX PLEASE READ REVERSE SIDE BEFORE r� 4;1 CALLING FOR FINAL INSPECTION. TOTAL' �. OFFICE.COPY PP,.LICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY - / BU LDI NG PROJECT IDENTIFICATION - PERMITINUMBER BrILr,NG APPLICATION & PERMIT 1 C� O nooREss I J U I BUILDING -ELECTRICAL-PLUMBING-MECHANICAL (�A OWNER'S PLAN CHECK VALIDATION �-1,_ "AME [[�� OTY. ELECTRIC PERMIT ,FEE N ivotil $Rz -LSa1 Y 1 . PHONE -6 t . COMER TORS UTLETS-SWITCHES-RECEP 10.00/1.00 r� ?, 51msec.NO S LIGHTING FIXTURES 10.00/1.00 r,ONTR TORS ADDREPPLIANCES-RESIDENTIAL 4.002. , ' �� 2� S P.E.t/ - PANELS � 10.00 DATE OF APPLICATION . ARRCHITECT PANELS (OVER 200 AMP) 20,00 - PLAN CHECK FEE .C.NO. ENGINEER - sec.NO ISIGNS TRANS. 3.00 - AD�RRess E"G' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP _ EMP.METER OR POLE INS. 20.00 ' APPucnrr$ MOTORS SEE FEE SCH. ADDRESS S - SERVICE CHANGE 20.00 _w o O LICENSED CONTRACTORS DECLARATION5`7�s7�� o v 1 hereby affirm that I am licensed under provisions of Chaph.r 9 J a . . _ v.kL ISSUANCE DATE w G N Professions g with Section 700e i of D,v,smn 3 of the Busmcss and - ,BLDG. ELECT. PLG. MECH. H D i• Professions Codc.�yd y license is in full for w ftL ❑ ❑ a; o`�' ittnse C Lic.Numbc� 4A r •"� z v_ ]alc � _(,),.F�_Conl ructus - +i• ❑ BUILDING PERMIT ¢ ¢w ¢ O NIi K-BUILDER DIiCLARA ON h O d u :?.� INFORMATION X ; LL r 1 hereby allirm that 1 am exempt from the Contractor's Licase MISC.- REFER TO ORD',sM ( •: LL O ¢ ' Law for the following reason.(Scc.7031.5,Business and Prr fcssiuns _ VALUATION $/FT. I- - PERMIT ISSUANCE 10.00' 0 - Code.Any city or county which requires a pemr a to construct,alter, - ¢ Q ¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. - LIC.NO. ELEC. 36 ¢ requires the applicant for such permit to Glc a signed statement that TOTAL w9 he is licensed pursuant to the provisions of PERMIT TO the Contractor's License HZQ Law(Chapter 9(commencing with Section 7000)of Division 3 of the INTEaG U� ?e7_11 L 4 o Business and Professions Cudo or tirflic is exempt therefrom and DTV- - PLUMBING PERMIT FEE ¢ F the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR, a ; _ by any applicant for u permit subjects the applicant toe.civil penalty - -ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not mom than Ove hundred dollars($51X1).1: - ❑ I,as owner of the properly,ser my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCs.GROUP RES.UNITS their.tole cnmpensatiun,will do the work,and the structure 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 doe not apply to an owner of - - ' property who builds or improve thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mmHtsare net intended oroffered for dale.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 EASYSTEM ,OVER 4 IEA) 200 builder will have the burden of proving that he did not build or ire - . - . . - BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RFS IND CON PB ones ❑ I,as owner of the property,em culusivcly.contructing with El E:1 ❑ ❑ ❑ licensed contractors to construct the project ISec. 7044.Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 -ASSESSORS PARCEL NO. and Profesions Code:The Contractor i License Law does our apply to an owner of property who builds or hnpmve thereon.and wlio - LAWN SPRINKLERS-OVER 5(EA.). 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200tt/10.00 the Contractor s License Law. TRACT NO, PARCEL NO. ❑ [am exempt under Sec. ',B.&P.C.for this WATER HEATER W/VENT' 6.00 awn (hv"ef Da1e WATER SYSTEM- - 5.00 ACC.DATE ACC.FILE N0. WORK F-RS'CO.MPIINSA'IION DECLARATION - WATER TREATING EQUIP. 5.00 'I hereby affirm that I have a en,fic,Ite of consent to self-insure. . or a certificate of Workers Compunwlin Insumnc'c,or a certifiedZONING 'ENG.SITE NO. copy thereof(Sec.3800,mLa1hC.). -- Policy No. Cmpair, a 0A O ❑. Certified copy is hereby furnished. CC�� - - FIRE SPRINK ENERGY LN Z Z ❑ Ccrlific 'opy is fw'led r t e city inspection tr� on. Applicant_ MISC.- REFER TO ORD. v❑ N❑ Y ❑ rv❑ ~UJ CFRTI PICOr I IOION FROM WORKERS' PERMIT ISSUANCE - 10.00 FLOOD ZONE AL.U.C. W COMIIiN$ATIN INSURANCE PLG.CONTR. LIC.N0. PLG. CL 0 - f[his section need not be completed if the permit is for one TOTAL - Y❑, - N❑ Y ❑ N❑. ::) Z hundred dollars IS 100)or lea.) U O 1 certify that in the performance of the.work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued, 1 Shull nor employ uny,pcaon in any ronnerwr as to become subject to the Workers'Conrpemstition Laws of California. 111 a Dmc - Applicant ALTER OR ADD TO MECH. 5.00 BUILDING ��sa } h NOl'ICE TO APPLICANT: If,after making this Certificate of Iix- 2 m tion,you should become subject to We Workers'Com I- _ c r i pelywit APPLIANCE 5.00 - PLAN CHECK provisions io the his pe Code, you most forthwith comply with FEE U such provisions or this permit shall be deemed revoked. • ' AIR HANDLING UNIT(TO 10,000GF.M.) 4.00 CONSTRUCFION LENDING AGENCY AIR HANDLING UNIT(OVER 10p00C.F.M.) 6.00 SEISMIC FEE 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,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 6.00 Lender's somn Add HEATING UN IT 100,000 B.T.U.)9.50 - r 300-0 Lender's Address ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 ;L information is correct. I agree to comply with all city and county _ PLUMBING 5' ordinance and stale laws relating to building construction, and BOILER-COMP(3,H.P.or 100,000 B.T.U.) 6.00 hereby authorise representatives of this-city to enter upon the g01 LER-COMP Over 100,000 BTU)BEE FEE SCH. s above-mentioned property for inspection purposes. . MECHANICAL (We) agree m save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs umd caseoses which PERMIT ISSUANCE lobo CONST.TAX ray in } way accrue against Spid-City in consequence of the anon f d permlf MEC H.CONT. LIC,NO. MECH. q \/ ' TOTAL TOTAL P/ 0-0 Signature of A DIme OFFICE COPY \