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17336 r POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 17336 INSPECTION DIVISION JOB INSPECTION RECORD • 'PERMIT EXPIRATION JOB ADDRESS Vim In��J1� a U N I T# - _LOT# � PERMIT EXPIRES IF WORK OWNER rv"� CONTRACTOR . (�(.9.5� - IS NOT STARTED WITHIN INSPECTION .DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION IN- ANCE OR 180 DAYS FROM OTE: LASTCALLED INSPECTION. UFER ALL GRADING.AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION• CUPERTINO STANDARDS. GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED c'L Ft to P- UNDERGROUND /SLAB ��„ _ % '�bF_ PLUMBING ELECTRICAL " ISSUANCE DATE MECHANICAL 31_06, I ELECT, I PLO. NEC. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION 5/F T. � r7 MECHANICAL G ELECTRICAL PERMIT TO FRAMING I "&' 'KdvEj;(_ INSULATION STORIES TYPE CONSTR, UCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.FT.1I.00H AHla TOTAL ACIIeACE ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE L• DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING - BUILDING USE HE IND CON FB Om", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El El '❑ ASSESSO115 PARCEL NO. ROUGH SAN.p PLUMBING ELECT.ENERGY ' TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO MECHANICAL - MECH.ENERGY t . C IAT ELECTRICAL BUILDING ENERGY L ncDE Acc.FILE mO FRAMING Q - ELECT.FINALTESTl INSULATIONPLUMBING WEzoNiNc ENG.SITE NO. GAS TEST - GAS. MECHANICAL FIRE SPRINK ENERGY T.]a COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - _ Y ❑ N❑ ` ❑ N EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A,LUC. INTERIOR SHEARFIRE DEPT. 40 N❑ ° ❑ N❑ SHEETROCK- - GRADE - ' I FEE SUMMARY EXTERIOR LATH BUILDING ib INTERIOR LATH TEMPORARY APPROVALS BUILDING S'T�O SCRATCH COAT MIAELECTRIC PLAN CHECK p� ' GAS - FEE �ZJ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE O OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRICI ISO ONE WORKING DAY BEFORE REQLu UIRED INSPECTION. PLUMBING �� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR'FINAL: INSPECTION. ) OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LOI NG PROJECT I DENTI FICATION .PERMIT NUMBER BDDRES . APPLICATION & PERMIT 1 WDRE55 ;Z.21,ZOf.UmESTF+9D �7J BUILDING-ELECTRICAL-PLUMBING -MECHANICAL 7336 OWNER'S PLAN CHECK VALIDATION NAME CITY. ELECTRIC PERMIT FEE A PRONE 7&_7-6771 NAMERAcrons 2 OUTLETS-SWITCHES-RECEP 10.00/1.00 L OO LC.NO. LIGHTING FIXTURES 10.00/1.00 ADDRESS TORS APPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION+ ARCHHECT PLAN CHECK FEE P.C.NO. on - PANELS (OVER 200 AMP) 20.00 ENGINEER LIC.NO. SIGNS TRANS. 3.00 ARCH eOR ENG SPECIAL CIRCUIT 5.00 PERMIT^VALIDATION .zlp TEMP.METER OR POLE INS. 20.00 noxa SSTs MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 o 0 ' r 0 o LICENSED CON'T'RACTORS DECLARATION a u, u 1 hereby affirm that 1 am licensed under provisions of Chapter 9 i ISSUANCE DATE (commencing with Section 7000)of Division 3 Hf the Business and BLDG. ELECT. PLG. MECH. H w z Professions Code,and my license is in full force and e(1cet. ❑ ❑ Z 0 m - License Clac Lic.Nom bet @ r a Date Contractor a IS M BUILDING PERMIT O w a OWNER-BUILDER DECLARATION - a o> " INFORMATION m g LL y I hereby a illo that I o n exempt from tile Contractor's License REFER TO ORD u O j Law for the lollnwing reason.(Sec 703 L5,Business and Professions VALUATION $/FT. 1.- PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to construct,alter,R < p improve,demolish,or repair any sln¢toie,prior to its issuoncc,also ELEC.CONTR. LIB-NO. ELEC. ^ � le 0¢ requires the applicant for such permit to file a signed statement that TOTAL o. w ea u he is licensed pursuant to the provisions of the Contractor's License • PERMIT TO FZa, , Law(Chapter 9 fcommencing with Section 7000)of Division 3 oftlo, rOCC. Business and Professions Code)or that he is exempt therefrom and CITYPLUMBING PERMIT FEEIS F m the basis fill the alleged exemption.Any violation of Section 7031.5 TYPE CONSTR. ec Laby any'applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 ofn tmore than five hundred dollars(S5001.): 1z 1,as owner oPtle property,or my employees with wages as ggCK FLOW PROTECT. DEVICE 4.00their sole compensation,will do the work,and the structure is not P RES.UNITS intended or offered for sale (Sec. 7044, Business and Poifirsslons DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of . properlywhothrough buildsor improves p maid who does such int Work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE himself or through his Own roves t employees.provided that such such ove- mentsarenotintended or offend for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 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 h -e did not build or im- BUILDING USE prove for purpose of sale.). E IND CON PB Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 El ❑ El El contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 600 and Professions Code:'I'lie Contractor's License Law does not apply . ASSESSORS PARCEL NO, to an owner of papery who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contmetons)licensed pursohntto the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. teaser PARCELND. Ellam exempt under Sec.� B.&I'.C.for this WATER HEATER W/VENT 6.00 _��/ Owner flat WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. woasE:RS'ctinlPl'.,NSA'noN DECLARATION � WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate mcconsenl Insert..ure. or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(See.3800,Lab.C.). Policy NO. Company I O Cl Certified copy is hereby fuminhed. Z Z ❑ Certified copy is filed with the city inspection division. FIRE SPRINK ENERGY T 24 O Applicant MISC.- ,REF TO fiD. YEI NO Y � N� ~ � y CIiRTl PIG1TIi OP F:%IiMPT[ON FROM wORKf:RS' PERMIT ISSUANCE Will LU COMPENSATION INSURANCE PLG.CONTR IC.NO. FLOOD ZONE A.L.U.C. Z hundred Kdidm need mol be completed if the permit is for one TOTAL Y❑ N❑ Y [] N hundmtl section IS eed or less.( U O I certify that in the performance of the work for which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued,l�shall not employ any person in any Gamna so as to U U become subject to the Workers'Compensation Laws of California. DatW NO1 IC N1l1 1 ALTER OR ADD TO MECH. 5 00 BUILDING 4S va } w NOTICIi TO shoo)ICAN'I': U',after making this ,,'C.m,,v of fix- ? emption,you shoWA become subject to lhv Workerz'Compensation APPLIANCE 5.00 PLAN CHECK rte` provisions of the Labor Code, You must forthwith comply with 2('�•Zl. U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 FEE CONSTRUCT ION LENDING AGENCY AIRHANDLINGUNIT(OVER10=C.F.M.) 6.00 SEISMIC FEE 1Ctir. 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 Jv the performance of the work for which this permit is issued(Sec. 3097,Civ m Lender's Name HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Address - HEATING UNIT(OVER 100,000 B.T.U.)g.SO ELECTRIC 13t� I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 immmoltlon is correct I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMPO H.P.Or 100,0008.T.U.) 6.00 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOI LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which - CONST.TAX may in any w' accrue against said icy in consequence of the PERMIT ISSUANCE 10.00 ranting chi' cl iL MECH.CONT. LIC.NO, MECH. Date TOTAL TOTAL Slgna[u�reoCAppllcant/Contactor Dam OFFICE COPY