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14317 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER Y CITY OF CUPERTINO 1 INSPECTION DIVISION �� / JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 22654 OAR CREST COURT UNITtk LOT PERMIT EXPIRES IF WORK OWNER STAN TENOLD CONTRACTOR RIEHARD ARECHIGA IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD. 180 DAYS OF PERMIT ISSU" ANCE OR 180 DAYS FROM FOUNDATION NOTE: LASTCALLED INSPECTION. LEER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLRMIT VALIDATION' CUPERTINO STANDARDS. C�4fA6E SLP.BS � _ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -Ty,$$ 1^OCK- 5 it W-ctl .� .r UNDERGROUND /SLAB PLUMBING !� d ELECTRICAL s< ISSUANCE DAIC BL MECHANICAL rU 4 ELECT PLG. MEnI O E DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED r.rSBU ILDING PERMIT INFORMATION WOOD FLOOR - VALUn TION SIFT. PLUMBING i .. MECHANICAL PERMIT TO ELECTRICAL . FRAMING STORIES TYPE CONSTR INSULATION UCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa FT FLoow AREA RETAIL ACRLACL T•' DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING RES IND ILUCON USE APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS - DATE INSP. ❑ El El El 11ASSESSORYAHC EL NO ROUGH SAN,# PLUMBING - ELECT.ENERGY ' TRACTNO PARCEL NO TUBS&SHOWER N PLUMBING ENERGY MECHANICAL MECH.ENERGY " ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING 1 ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING -( GAS TEST GAS , _ FIRE SPB_INK ENERGY T.74 MECHANICAL Y ❑ N❑ Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING aoou ZONE ALUc EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR � FIRE DEPT. ❑ N❑ L N❑ SHEETROC q, GRADE FEE SUMMARY EXTERIOR LATH BUILDING R— BUILDING f:'(J INTERIOR LATH TEMPORARY APPROVALS .. SCRATCH COAT ELECTRIC PLAN CHECK FEE ....I. GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTEO UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM' ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC / r F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 00 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST,TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. r OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY e BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 14 317 ADDRESS 5 CNefCN BUILDING -ELECTRICAL-PLUMBING-MECHANICAL(0 OWNER'S PLAN CHECK VALIDATION N"MEn 7-<,-,,1d OTY. ELECTRIC PERMIT FEE " DN corvrRAcroRs OUTLETS-SWITCHES-RECEP 10.00/1.00 13 /� AQ All OC.No120 4 IGHTING FIXTURES 10.00/1.00 C) CONTRAOrOR'V 766 14 b4 q-E/ PPLIANCES-RESIDENTIAL 4.00 ADDRESS L O ��1 �jLbldn�. - /- PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.No. SIGNS TRANS. 3.00 ARCH,OR ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ADDRESS zu, TEMP.METER OR POLE INS. 20.00 cap; APPLICANT'S MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 0.00ipplo FG` 1 w o o LICENSED CON TRACTORS DECLARATION ' � a u I hereby affirm Ihat I am licensed under provisions of Chapter 9 ATE zw (commencing with Section 7000)of Division 3 of the kusiness and G. ELECT. PLG. MECH. ri Professions Cody.�rµI my license is in full R e,ln l - z z g o License Class Lic.Number l'2 7 1 ax j Date.-z-a- ��Dntmetn _ N� �uper� ¢ ¢w< OWNIiR-BUILDER DECLARA'T'ION BUILDING PERMIT A o A U MISC.- REFER TO ORD INFORMATION w 3 LL N I hereby affirm that 1 am exempt from the Contractor's License VALUATION $/FT. F LL o j Law for the following reason.(Sec.7031.5.Business and I'I,fessiors PERMIT ISSUANCE 10.00 Q Code:Any city or county which requires a permit to construct,Mter. ¢a Q 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. y t� DLL requires IIIe applicant for such permit to IIIe a signed statement that TOTAL 0 PERMIT T� A w m he is licensed pursuant to the provisions of the Contractors License /' )�T� F z a Law.(Chapter 9(commencing with Section 7000)of Division 3ofthe A f z o Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE ¢ I_ o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. ac;m by any applicant for a permit subjects ilia applicant too civil penally � p ALTER-DRAINSt VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).1: V �'s^ ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEV ICE 4.00 occ.GROUP RES.UNITS unit Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, tlusiness Cade:'rite Contractor's License Law docs not apply to an owner of / property who builds or improves thereon,and who does such work FIXTURES.PER TRAP 5.00 f 50.IT,FLOOR AREA TOTAL ACREAGE himlf seor through his own employees,provided that such Improve- mentsarenotintendedorofferedforsale.It,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within mile year of conlpleion, lite owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden o1'proving that he did not build or im prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omar ❑ I,as owner of the property,ant exclusively contracting with 1:11:1 ❑ ❑ 11licensed contractors to construct the proiect(See 7044,Basin... LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code The Contractor's License Law docs not apply to au owner of property who builds or improves thcrlon,and who ILAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects will,a contructoos)licensed pursuant to the Contracmra License Law. SEWER-SANITARY- LT OR "2OOR/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.tie ads WATER HEATER WIV 6.00 reason Owner Dale WATER SYSTEM 5.00 ACC.DATE ACG FILE N0. WORK Ii RS'COMPENSA I ION DECLARATION WATER TREATIN O P) 5.00 I hereby affirm that I have a certit Teale mf convent to x111-insure'• � ZONING ENG.SITE NO. oro certificate of Workers'Cnnlpunsalion Insurance,or a certified copy thereol'(Sea 3800,Lab.C.). Policy No. Company O ❑ Certified copy is hereby furnished. FIRESPRINK ENERGY T-24 Z Z ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. Applicant Y ❑ N❑ Y [:] N❑ F- m," PERMIT ISSUANCE 10.00 O - FLOOD ZONE A.L.U.C. cr 5 CHkTIIICATIi OP EXEMPTION PROM WORKERS' IL _ COMPENSA PION INSURANCIi PLG.CONTR. LIC.NO. PLG. C O (This action need not he completed it the permit is for one TOTAL Q - V❑ N❑ V❑ N❑ Z) Z hundred dollar,S 100)or let ,) U O 1 eerily that in the performance of the work lou which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY O_ H mit is issued,I shall not employ any person in any manner so as to _ Qw become subject m the Workes Con I tion aw}o ulil'or 'u. � [ELECTRIC UILDING 80 42, DaIJ2=3r177_Applicum�`�j' ALTER OR ADD TO MECH } w NO'(ICI!TO APPLICA] I ,ul tar making this Cerl1 mute ix F Z emption,You should become subject to the Workers'ColmpansalION APPLIANCE 5.00 LAN CHECK SD 3 2 provisions of the Labor Code, you nmst forthwith comply with moo! U such provisions or thus permit shall be dimmed revoked. AIR HANDLING UNIT(TO 10 IF NY) 1 4.00 EE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT IOVE GEM.1 Q EISMIC FEE. 72 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH D .QO lite performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,0 .T.U.) 6.00 ICROFILM 3097,Civ-CJ. Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address I artily that I have read this application and state that III,above VENTILATION FAN (SINGLE) 4.00 • information is correct.1 agree to comply with all city and county PLUMBING = ordinances and state laws relating to building construction, and BOILER-OOMP(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 STU)SEE FEE SCH. MECHANICAL above-mentioned properly for inspection purposes. �S (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses whichCONST.TAX may in any way accrue against Said City in consequence of the PERMIT ISSUANCE 10.00 p� mnlin lis p MECH.CONT. UC.NO. MECH. �2-�-8� TOTAL /S -- TOTAL /fZ \ Signature of Applicant/Cmntr r Dare - ' j OFFICE COPY