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17957 .+r POST THIS CARD NEAR FRONT OF BUILDING PENN„TNHM9ER CITY OF CUPERTINO 17957 INSPECTION DIVISION JOB INSPECTION RECORD -�n1 /, PERMIT EXPIRATION JOB ADDRESS /y/`' V / UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- 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 PLHN+n VALIDATION CUPERTINO STANDARDS. _ GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL, pitV of CI nPl11110 ISSUANCE Un I F. SLUG ELECT PLG. b1ECR. MECHANICAL ❑ 1:1121/ El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOORvnLun nory SIFT. PLUMBING N F, MECHANICAL PEHMIT TO ELECTRICAL FRAMING O STORIES ES TYPE CONSTH INSULATION ' OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SU FT (LOOM ANE.A TOTAL ACH(.nGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID R W LDI ON USL Hes IND ROOF SHEATHING - El 11 0 PH O LL 1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. nS5E550R5 PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION PLUMBING GAS TEST GAS y' • FIRE SPH INK ENERGY T.]< MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ! ° ❑. N'❑ 1:1 N� EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE A.Luc INTERIOR SHEAR FIRE DEPT. `'❑ NE) NL N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK F - GAS EE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ' I' SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F- ONE WORKING DAY BEFORE REQUIRED 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 BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT I61 7957 BUILDING-ELECTRICAL-PLUMBING -MECHANICAL 1, OWNER'S PLAN CHECK VALIDATION NAME TY. ELECTRIC PERMIT FEE P0PHON co FACTOR s UTLETS-SWITCHES-RECEP 10.00/1.00 NA z4o LIC.N LIGHTING FIXTURES 10.00/1.00 CONTRACTORS ! APPLIANCES-RESIDENTIAL 4.00 ADDRESS 7T PHONE D PANELS 10.00 DATE OF APPLICATION ORCHITET PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER uc.No. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS - cl, EMP. METER OR POLE INS. 20.00 ADDRESS {/^�1 AMOTORS SEE FEE SCH. DRESS E55 SERVICE CHANGE 20.00 w o o LICENSED CON'T'RACTORS DF.CLARA'fION C Q v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE N Q w( commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. o P'.fesslona Clicense is in full for n t. Nu ❑ z 41 a o w License Clout 'X/J Lic. mbei��� 0 11 ❑ 9 z r Dale Coractor CDPEp[1N a Y� 3 nt1SY 04 DEPS' BUILDING PERMIT OWNI:R-BUILDER DECLARATION INFORMATION Ce o a O MISC.-r REFER TO ORD w 3 u m I hcrehy affirm That 1 am exempt from lbe Contractor's License VALUATION S/FT. FU04 Law for Dte following reason.(Sec.70JL5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requiresa permit to construct,alter, tt Q 0 re Improve,demoi h,nr¢pair any st octon,,prior to its issuance,ala. ELEC.CONTR. LIG N0. ELEC. C u requires the applicant for such pemtit to file a signed statement that TOTAL PERMIT TO u w m he is licensed pursuant to the provisions of the Contractor's License r z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe Fb IKk NC - a Business and Professions Code)or that he is exempt therefrom unA CITY. PLUMBING PERMIT FEE , Nl M F o the basis]or the alleged exemption.Any violation of Secliun 7031.5 STORIES TYPE CONSTR. cL by any applicant lot a permit subjects the applicant boa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars{$500).): "❑ 1,as owner of the property.or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 Oce GROUP RES.UNITS their sole compenmtion,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 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- mentsare not intendedoroffered lot sale,If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 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- proveforpurposeofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND eOry PB Omn ❑ I,as owner of the property,am exclusively contracting with El El 13 11IiccnscJ contranors to construct the project ISec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 Ass ESSORS PARCEL NO. and 1'rofcssions 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 c.ntractons)licensed pursuant to the Contractors License Law. SEWER-SANITARY-STORM EA.200ft110.00 TRACT No. PARCEL NO. ❑ l mn exempt under Sec.-.B&P.C.for this WATER HEATER W/VENT rr�0 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPENSA1'ION D[CLARA'f ION WATER TREATING EQUIP. '5.00 1 hereby affirm that I have a certificate ofconsent to self-insure, - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurane• a certified �,pyB • p fi, '. . s yyllIC.).qq [)Oil Ginnany O ❑ Certifmdc.py is here yfurnished. FIRE SPRINK ENERGY T.24 _Z Z ertifi cop h h• c' MISC.- REFER TO ORD. y ❑ IN C] y ❑ N❑ p A li ;ud n Fw11§CATI501 ([ IiXF h1 P1'10 KI?RS' PERMIT ISSUANCE 10.00 N FLOOD ZONE A.L.U.G. , R Lid COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLO. d ❑ ('flus sectilin need nut be completed if the permit is for one TOTAL /1 Y❑ NNE] Y ❑ No Z hundred dollar,($100)or Icss.) U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY IL I- mit is issued,I shall not employ any person in any manner so as to 0U become subject to the Workers''Compenset ion Laws of Carfornw. BUILDING Date ApplicantALTER OR ADD TO MECH. 5.00 } rail NOTICE TO APPLICANT': 11,after making This Certificate of lA F ? emption,you should th"muesubjcet 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(TO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AG17NCy AIR HANDLING UNIT(OVER 10=C.F.M.16.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the pertormance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). IHEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address 1 certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter,upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upetlino against liabilities,judgments, costs and expenses which CONST.TAX in any way accrue against said City in consequence f the PERMIT ISSUANCE 10.00 ling Of this pe nit. MECH. LIC.NO. MECH. ` TOTAL TOTAL b re Applicant/Contramor Date OFFICE COPY ..