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C 8482 (2) POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PER",IrQNDh'BER. INSPECTION DIVISION ' (f x;482 JOB INSPECTION RECORD Di PERMIT EXPIRATION .J08 ADDRESS E G (J�C.i UNIT# _L•OT# ' .. / PERMIT EXPIRES IF WORK OWNER 1V CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180DAYS OFPERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LIFER . LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING f ELECTRICAL ' ISSU CE DATE MECHANICAL - BLDG.- ELECT, I PLG. MECH.: DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING P RMIT WOOD FLOOR INFORMATION PLUMBING - , r VALUATION $IFT, MECHANICAL' ELECTRICAL - - PEHMrtT FRAMING i INSULATION STORIES '—TYPE CONS T O C. ROU RES UNN�LjIS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED .. ...�-, ROOF SD.FT FL• F DIAPHRAGM BUILDING USE APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED RES IND CON PB Other i 0 E ❑ ROUGH ASSESSORS PARCEL NO. PLUMBING GAS TEST TRACT NO. PARCEL NO. MECHANICAL ELECTRICAL r-7-y FINALS DATE INSP. .ACC.DATE ACC.FILE No. FRAMING SAN # INSULATION - - PLUMBING ZONING ENG.SITE NO. ' GAS _ MECHANICAL FIRE SPRINK ENERGY TZE COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ ry❑ y N� LATH—INTERIORELECTRICAL _ _ FLooD zoNe A.L.u,c. LATH—EXTERIOR. FIRE DEPT. SHEETROCK _ GRADE SHEAR INTERIOR FEE SUMMARY BUILDING ..� _� SHEAR EXTERIOR TEMPORARY APPROVALS " BUILDING. ./ e'�. FIREWALLS ELECTRIC. PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC rH� ONE WORKING DAY BEFORE REQUIRED INSPECTION. - z PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING — SEE PERMIT FOR EXPIRATION DATE — MECHANICAC IMPORTANT! -CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL / J - OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION ERMIT NUMBER BDILDING APPLICATION & PERMIT ^ Put IN G O BUILDING -ELECTRICAL-PLUMBING-MECHANICAL Ow NE 'a N CHECK VALIDATION NAME p 25 Z- OTy- ELECTRIC PERMIT FEE i� 1flit, �[ CNA.E 3V ONTRACTORSOUTLETS-SWITCHES-RECEP ,�jl6pT{,00 V uc.ND.-'-� 0 LIGHTING FIXTURES 1AM11.00 AOaTRAT DDRESST % �1r APPLIANCES-RESIDENTIAL 4.00 / XPHONE�� �C� • PANELS 10.GO DATE OF APPLICATION ARCRRECT > PLAN CHECK FEE P.C.NO. on _�✓\rtoJL PANELS (OVER 200 AMP) 20.00 ENGINEER RLIC,NO. SIGNS TRANS. 3.00 ADDDDRESSSS SPECIAL CIRCUIT 500 A . ENG. . / PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S /J ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 w� R o O LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 Q U w �I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE GATE w a'w (commencing with Section 7000)of Division 3 of the Business and D S PLG R w z Professions Code,' d my license is in full f o z o m- License C11yy}}s_ Lia Number 8 w t- w Dale ///q� - Contractoru `DOWNER-BUILDER DECLARATION BU DING PERMI a, ; D INFORMATION a-y I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD F .. 0 4 Law for the following reason(Sec.7031.5.Business and Professions VALUATION S/FT. Code:An cit orcount PERMIT ISSUANCE � w 4� y y y it my structureg prior permit alter, 7000 W E 4 D requires,demolish,or for such any permit tore,pa signed lO its issuance,talsohat ELEC.CONTR. LIC.NO. 0 LL requires the dp pursuant for such permit to Ids a signed Statement that TOTAL 5� o. w m m he is licensed pursuant to the provisions of the Contractor's License .J PER T TO r z a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe 1 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE Ic r$ the basis for the alleged exemption.Any violation Of Section 7031.5 STORIES TYPE C NSTR. by any applicant for ve permit subjects theagplicanuoacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 �UGv of not more than five hundred Dollars(my em): l � ❑ I,as owner at the property,or my employees with wages as BACK FLOW PROTECT. DEV ICE 4.00 their sole compensation,will(S the work,and the nd Professions is not DpO,D�p ."C i TS intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 ��V✓6/L -1V91�1G]"/. Code:The Contractor's License Law does not apply to an owner of Property who builds or improves thereon,and who dons such work FIXTURES-PER TRAPhimse5.00 • mentsII're through did own employees.safe. If,however,that t h improve. he ilding SQ FT.F OOR AREA TOTAL ACRE'GE or imprvement hmdnd withinrone yearn l compltion ttheo nen- GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose of sale J' INDUSTRIAL WASTE INTER. 30.00 RE IND CON PS Omef ❑ 1,as owner of the properly,am exclusively contracting with E] C3 El ❑ licensed contractors to construct the project ISec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 600 and Professions Code:The Contractor's License Law does col apply . ASSESSORS PARCEL NO. to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contraalous)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.200tt/10.00 TRACT NO. PARCEL NO. ❑ [am exempt under Sec. ,B.&P.C.for this reason WATER HEATER W/VENT 6.00 Owner Uum WATER SYSTEM 5.00 ACC.­DATE ACC.FILE NO. WORT ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-nsurc, or a certificate of Workers Compensation Insurance,or a ce ified ZONING copy Iher�J l$ 33A!�(y]f11��1,36.Y.1. _ 1 ENG.SITE NO. Policy er �.:aE1U11 U 1'_`s�Z.Tn4T` O Certified copy is hereby lurnlshed. Z 2 ❑ Certifi d 'opy is file will the city in,, division. FIRE SPRINK ENERGY T-24 O Applicant MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑ PERMIT ISSUANCE CLQLU Cli IICAMPENEAIVDN INS PROM WORKGR$' 1 FLOOD ZONE A.L.UC. COMPotbe om INSURANCE PLG.LONTR. uC.No. PLG. ::I / fThhundred dolseclies need not he completed if the permit is for one TOTAL Y❑ N❑ Y❑ N 'hundred dollars(5100)or less) ❑ C.7 P I certify that in the performance of the work for which this per- OTY MECHANICAL PERMIT FEE SUMMARY LLmil is i Sued, shall not employ any person in ap y manner so as to FEEObeo1 Workcrs'Com et sal ion a ofCal fore'.- �ApPlicam ALTER OR ADD TO MECH. BUILDING ZNOT , 'f APP (CANT: If,a er m mg thls erhl'inte u ix- 5.00 emption,you should become subject to the Workers'Compensation APPLIANCE provisions of the Labor Code. You roust forthwith comply with 5.00 PLAN CHECK U such provisions or,this permit shall be deemed revoked AIR HANDLING UNIT(TO 10,000C.F.M.) 4,00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MCF.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 F the performance of the work for which this permit is issued(Sec. 3097,Civ C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Lenders Address - H EATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC 1 certify that I love read this application and state that the above VENTILATION FAN (SINGLE) 4.00 • information n correct. I agree to comply with all oily and County PLUMBING herindeby ces and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 - hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP G,,al 100,000BTU)S E mE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which may in any way accrue against said City in consequence of the PERMIT ISSUANCE CONST.TAX g ting lhis per ` MECH.CONT. LIC.NO. MECH. + TOTA Sgnat al ppluan nlractor TOTAL /y J � IOFFICE COPY (l