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18763 POST.THIS CARD NEAR FRONT OF'BUILDING - 1 .. PERMIT NUMBER t( CITY OF CUPERTINO 1863` .INSPECTION DIVISIONi JOB INSPECTION RECORD `` PERMIT EXPIRATION JOB ADDRESS ' J t SIJhl „' �UNT LOT# PERMIT EXPIRES EXPIRES IF WORK owmeR � . ,coNTaAcroR G `a•• "1_ 'IS NOT- STARTED`WITHIN INSPECTION - DATE INSPECTOR -INSPECTION RECORD 180 DAYS OF PERMIT fsSU- _ ANCE OR 180 DAYS FROM. • FOUNDATION NOTE: LAST CALLED INSPECTION. LIFER ALL GRADING AND'DRAINAGE SHALL BE INSTALLED . - = PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF -PERMIT-VALIDATION T CUPERTINO SYAI�RDS2.' GARAGE SLABS: - - -' "'' - - J A h 11 a✓��eC: POUR NO CONCRETE UNTIL ABOVE HAS BEEN.SIGNED - UNDERGROUND /SLAB .' PLUMBING ), citv rf (`II^`'T �: rt;"D ELECTRICAL'., .? ” ' ISSUANCE UATR: MECHANICAL* .. - 9Lu' - ELECT. PLG mecR. . ❑' .© ❑. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED . - - BUILDING PERMIT ,WOOD FLOOR' INFORMATION PLUMBING I'!A ION 'SIFT. I (/IBJ MECHANICAL'.., `� ELECTRICAL �j P`TNmI1 To FRAMING• INSULATION STORIES TYPE CONSTR. .00C.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO,f T.FLOOR AREA `'TOTALnCREACE ' ._ ROOFS NOTE:.NOFINAL•1NSP.SHALLBEMADEBEFORE wt+- CONSTRUCTION TAX IS PAID .0,� THE DIAPHRAGM ' ROOF SHEATHING. �' ' ' •RES • INuuaO`ON USEPB0,11- . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. L 0 L L ASSESSORS PARCEL NO. . ROUGH., SAN.#.., PLUMBING" , . . - ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACTNO, PARCEL NO.. MECHANICAL - l MECH.ENERGY. ELECTRICAL BUILDING ENERGY' - ACC.DATE nca EILe HO `FRAMING ELECT.FINAL TEST. ZONING INSULATION ['NG,SITE N0. .. PLUMBING .. - GAS TEST GAS ' _ ~ FIRE SPRINK ENERGY T.24 . MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING -. Y ED Cl Y ❑ N❑ ' EXTERIOR SHEAR ELECTRICAL FLOOD ZONE A.I.U C,RELEASE - � - INTERIOR SHEARFIRE DEPT. v NL v L NET SHEETROCK. * GRADE FEE SUMMARY EXTERIOR LATH, -- BUILDING. " BUILDING • '- .INTERIOR,LATH `- .TEMPORARY. APPROVALS 019.1 SCRATCH COAT , -' ELECTRIC - - PLAN CHECK . C ;(} GAS .. FEE 'NO,TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING.IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM • � ARRANGE FOR'INSPECTION BY P,HO,NING 252-4505' ELECTRIC w. �9 ' F� ''ONE WORKING DAY BEFORE REQUIRED' INSPECTION. " PLUMBING 0 PLEASE GIVE J0 ADDRESS WHEN PHONING. Z - —.,SEE PERMIT FOR EXPIRATION''DATE 1—` MECNANICA� CONST.TAX IMPORTANTI PLEASE READ REVERSE SIDE BEFORE "I CAL'LING'FOR FINAL INSPECTION.., TOTAL I`$ OFFICE COPY: rL ' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT.PE, ONLY + '. BUILDING PROJECT IDENTIFICATION " Y PERMIT NUMBERaUiLOING '- APPLICATION & PERMIT ,Q 1] L+� • ADDRESS1JSZ I NWst C�'WN(� 1g.1. BUILDING-ELECTRICAL-PLUMBING-MECHANICAL ' .18 ( 6 OWNER'S , ?' +II'{PLAN CHECK VALIDATION NAME - OTY. ' 'ELECTRIC PERMIT` FEE t rF ' Rv%_ T W I PHONE 446• ✓,16� - d.:.'- 1 .. HAme ncTORs OUTLETS-SWITCHES-.RECEP'' 16.00/100 �� . M,.T(P_1JU .NO. S1cG1 LIGHTING FIXTURES -' - 10.00_/1.00 CONTRACTOR r�•4 SSQ•$311, APPLIANCES-'RESIDENTIAL 400 ' AOOq[ss r ,^y All O'C t.1Q6e u PHONE W PANELS 1000 ; ./PATE OF APP LICATIONfY. ARCHITECT P ANEL$ (OVER 266AMP 26,00 _ PLAN CHECK FEE P.C.N0. ENGINEER L145@' uc.No. r .SIGNSTRANS. T7. J). 'i.jF"y-y-` . 300 ' ADDRESS ENG. - - PERMIT VALIDATION ADDRESS OR SPECIACCIRCUIT '_•) _ 5.00 .-al + / ziPEMP.,METERO, FPILE/I 20.00 ' APPLICANT'S' - ` MOTORS •' - "SEE'FEE-SCH. ADDRESS - �•''`' SERVICE CHANGE 2000 o¢ 7, / 0 0 LICCNSI>IJ CON'T'RACTORS DECLARATION . a ami w I hereby affirm that I am licensed under provisions of Chapter 9 ,Y ISSUANCE DATE (Lommencmg with Section 0000)of Division 3 of the Business and a A - BLDG ELECT. PLG. MECH. F w i Professions Cody.and my license Is in full( e.f1n{1 e c p ❑ z O u,- License Class-I'j Lm NuOulurl Jp.1 - f- lEr o N r Date-to.�Gp. �'9 Coal...O -.,17 x r BUILDING PERMIT Q o a o OWNER-BUILDER DECLARATION - INFORMATION X g N I hereby affirm that I a in ex ml t from the Contractor's Liccese MISC.- REFER TO ORD LL o j Law for the follo mg rtason.(Sec 7091 5,Business and Professions pERM1T ISSUANCE 10 OD ALLUUATTIIOry •' H Code'Any city or county which requires a pemnt to construct,alter, ,l�l !•IP 1 ¢ ¢ ¢ Improve,demolish,or repair any structure,prior to Its issuance also ELEC.CONTR. LIC NO ELEC. D ¢ requires the applicant for such permit to file a signed statement that . , TOTAL ' V awmLL {;"` PFLRMITdO he is Ch.ptc pursuant to the with provisions of the Contractor's 3 of the. i BuW(L'ha nd Professions with Section is exempt Division O *•- 'At." U��.( ` S te i o Rosiness for Professions Cole)or that vi is therefrote coon 70 and STV.' '.PLUMBING PERMIT ¢ H Q the basis for the alleged exemption.Any violation'nl Section 7031.5 ., r '"�� '•_ ^.. �- � ,- c STORIES TYPE CONSTR. - T ; by any applicant(ora permit subjects the applicant to a civil penalty' - - ofnot mom than five hundred dollars(5500).): ' ALTER-DRAIN&.VENT-WATER•(EA.)'5.00 'r''*� ' ❑ 1,as owner of the property,or myemployees with wages as BACK FLOW PROTECT. DEVICE 4.00 -'OCC.GROUP - RES,UNITB- their sole compensation,will do the work,and the structure is not intended,or offered Cor role (Sec. 7044, Business and Professions. DRAINS-FLOOR,ROOF;AR EA,CON D. 5.00 Cade:The Contractors License Law does not apply loan owner off - property who builds or improves thereon,and who does such work. F I TUR ES-PER TRAP 5.00 50.FT,FLOOR AREA 'TOTAL ACREAGE 1 himself or through his own employees provided that such improve- mems are not intended or offered for sale If,however,the building A$-EA.SYSTEM-1 INCA LETS w or improvement is sold wilh'm one year of completion,the owner- GAS-EA.SYSTEM-'OVER-4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- - - RESP" IND CON PB - Om., for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,nor exclusively contracting with - ED ❑ ' El ❑ _ licensed contractors to construct the project(See. 7044,'Business / '• LAWN SPR INKLERS-1INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Profuasions Code:Tho Contractor'sLicense Law docs nal apply - ,. 10 an owner of property who builds or improves thereon.and who 15 LAWN SPRINKLERS'-OV ER.5(EA.) 1.00 Zs - contracts for such projects with a contractods)licensed puramnt m SEWER-$ANITAR V-STORM EA.200ft/10.00 ilia Contractor's License Law. TRACT NO. PARCEL NO Cl taco exengrrundor Sec • ',B.&PEC.for this WATER HEATER W/VENT. 6.00 reason Owner - Date WATER SYSTEM '- 5.00r a ACC-DATE .ACC.FILE NO. WORKERS'COMPENSAT1ON DECLARATION _ WATER TREATING EQUIP. 5.00„y -I hereby affirm that I hove a ccrttfi ale of co lent or a certificate of Workers'Compeasal ion Insurance,ora certified ','ZONING "ENG.SITE NO. PocylNoe neD o so� n.y.)�.�.�N1C �N�._BRCH • •x('�',_ ' - 0 ❑' Cutlilietl copy is hereby famished. '" ,t .. " FIRE$PgINK ENERGYTgO Z 2 ❑ Certified copY s filed I Ne city inspection division. -. p Applicant l l._ 111. � '. MISC.- REFER TO ORD. " Y ❑ ' N❑ Y Q No F- y PERMIT ISSUANCE /,�.� "'1'QCC Cr CIiRTIFICA TE FXIFION NSURAMWORK ISRg• FLOOD ZONE A.L.U.C. W COh1PIiNSAT10N INSURANCE PLG.CONTq. '• _ LIC.N0. PLG. ' .? Z (This Section need not be completed if the permit is for one . _ TOTAL- Y❑ N❑ Y ❑ N❑ '- hundred dollars(S 100)or less) _• V 0 1 cerlify that in the pert'ormanee of the work for which"R'per' OTY, MECHANICAL PERMIT. - - ,.,FEE -. FEE SUMMARY LL I- mil is Issued,I shall not employ any Person in any manner so as to - , Ow become subject to the Workers'Compensation Laws of California. BUILDING y Datc Applicant ALTER OR ADD TO MECH. 5.00 } m NO'T'ICE TO APPLICANT: If,after making this Certificate oC nix- - F 2 coalition,You should become subjeet to the Workers'Compensation APPLIANCE '."- " 5.00 PLAN CHECK-" d� provisions of the Labor Code, You must forlhwith comply with FEE - U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10OMCF.M.) 4.00 CONSTRUCTION LENDING AGENCY F* AIR HANDLING UNIT(OVER 10=C.F.M.),6.00 SEISMIC FEE ,63 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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 - MICROFILM 3097,Civ.C.), A . Lender's Name H EATI N G U N IT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC• 'I certify that l havemud thusapplication an,, ,are that the'above VENTILATION FAN (SINGLE) 4,01) inlonnution is correct:I agree to comply with all city and county PLUMBING ordinances enA state lows relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorwe representatives of this city to ender. upon the BOILER-COMP Over 100,000 BTU)SEE FEE SCM. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- - REFER TO ORD. Cupertinoagainst liabilities,judgnnents costs and expenses which CONST.TAX may in any w y e rue ugum t said City in cyucme of the ' ,PERMIT ISSUANCE ranting of`A[hisp 1{yint MECR CONT. LIC.NO.' MECH l - V.L. TOTAL TOTAL. Signature of Applicant/ nnlraclor Dade ' OFFICE COPY