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13010 (2) O POST THIS CARD NEAR FRONT OF BU I LDING RN,ITN MBER CITY OF CUPERTINO INSPECTION DIVISION 13010 JOB INSPECTION RECORD P- PERMIT EXPIRATION JOB ADDR ES511082 Fi rP thnrne UNIT# LOT# PERMIT EXPIRES IF WORK . OWNER Chih-leu Peng CONTRACTOR Franz Termite IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 160 DAYS FROM UFER LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ` PLUMBING - PQ` LJ�����• ELECTRICAL ISSJANCE DATE MECHANICAL - LDO, ELECT. PLG. MECH, '00 D ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED- BUILDING PERMIT WOOD FLOOR - (r\�Y INFORMATION VALUAl10N S/FT. PLUMBING {Q MECHANICAL /eCc„ ' ELECTRICAL PERMIT TOt FRAMING �' t' • ,I'1' ` k INSULATION - STORIES TYPE CONSTR. OCGGPULP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - 1 ROOF 50 FT.FLOORAREA TOTALACREAGE DIAPHRAGM BUILDING USE 1 RES IND , CON PB OM,, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ A55 SSORS PARCEL NO. ROUGH PLUMBING GAS TEST TRACT NO. PARCEL NO. MECHANICAL .DATE ELECTRICAL FINALS DATE INSP. A ACG FILE NO. FRAMING SAN # INSULATION PLUMBING ZONING ENG.SITE NO. GAS MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N[:] I V ❑ N� FLOOD ZONE A.L.U.C. LATH-INTERIOR -- 2- ELECTRICAL LATH-EXTERIOR FIRE DEPT. Y❑ N❑ Y ❑ N❑ SHEETROCK ADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING t O FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY - SEISMIC FEE hi OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL JCJ ,J CALLING FOR FINAL INSPECTION. OFFICE COPY jre>PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY y^ "BUILDING PROJECT I DENTE FICATION PERMIT uuMeER BUILDING APPLICATION & PERMIT ADDflQg 3- x�,�F,N BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 13010 OWNER'S/ / 11 C lti N �L�N {NII al PLAN CHECK VALIDATION NAME DTV. ELECTRIC PERMIT FEE PHONE rvANine AcroRs UTLETS-SWITCHES-RECEP 10.00/1.00 ' Z- fR/LM/ TIE LIGHTING FIXTURES 10.00/1.00 CONTRACTOR os EA�OrOrs Yts APPLIANCES-RESIDENTIAL 4.00 0 cc S A 0r•-1� PHONE -p PANELS 10.00 DATE APPLICATION on oARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.c.No. ENGINEER LIC.No. SIGNS TRANS. 3.00 ADDRESS Ems' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 APPLICANT S ADDRESS MOTORS SEE FEE SCH.SERVICE CHANGE 20.00 14 ``���o o LICENSED CONTRACTORS DECLARATION "W < i w I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE <T (commencing with Section 7000)of Division 3 of the Business and ELECT. PLG. MECH. H w i Professions Cmkpin my license is in full fora a feet. 31 is i`�o License IT ss Lic.Number _ 1 ,A H w Datc Contractor a r M s fB U,D1NG PERMIT M OWNER-BUILDER UECIARAT p U IfNFORMATION K 3 d I_ I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD RF( LL o Law for the following reason.(Sec.7031.5,Business and Profe inns _ PERMIT ISSUANCE 10.00 yALag S/FT. Code:Any city or county whichrequiresa permmit toconstruct.alter, Q 1YloB6,l,�1'- improve,deolish,or repair any structure, to i6 issuance,also ELEC.CONTR. LIC.NO. ELEC. D u rNuires the applicant for such pernit to file a signed statement that TOTAL n w m he is licensed pursuant to the provisions of the Contractor s License PERMIT TO FiQ Law(Chapter 9(commencing with Section 7000)of Division 3 oflhe vv T E i o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE V60/Q �K R r the basis for the alleged cxempion.Any violation of Section 7031.5 STORIES TYPE CONSTR. n by any applicant for a Permit subjects the applicant W a civil penally of not mom than five hundred dollars($500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS sole compensation,will do the work.and the#ruct ore is not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractors License Law doa not apply to an owner of property who builds or improves themon,and who does such work FIXTURES-PER TRAP 5.00 SET FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such Improvc- mentsarenotintendedorofferedforvle.IL however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA) 200 BUILDING USE builder wW have the burden of proving that he did not build or im- . . . RES IND CON PB Omar Prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to eonwei the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.DO ASSESSORS PARCEL NO. and Psofcssions 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 IEA.) 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SAN EA.200ft/10.00 the Contractors License Law. TRACT NO. PARCEL NO. 0 I am exempt under Sec ,BAP.C.for the WATER HEATER WNENT 6.00 reason Owner Due WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affims that 1 have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.l. ) Policy No. Company O 0 Certified copy is heKby funis a PC 7 FIRE SPRINK ENERGY TQ4 z Z � Certifrcd o y is filed wit t c sly n pcmlon von. ❑ ❑ ❑ ❑ F- 0 A�Spl;cant � �___�r MISC.- REFER TO ORD. Y N V N oj CC N CERTIFICATE OF EXEMPTION PROM WORKERS'Fy PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.c. LL > COMPENSATION INSURANCE. PLG.CONTR. LIC.NO. PLG. d O (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ Z hundred dollar,(5100)or less) V O I certify that in the performance of the work for which this per. QTY MECHANICAL PERMIT FEE FEE SUMMARY LL V mit u issued,I shall not employ any person in any manner m as to O ul become subject to the Workeri Compensation Laws of Califomia. Date APPllcant ALTER OR ADD TO MECH. 5.00 BUILDING .Sa } % NOTICE TO APPLICANT': If,after making this Certificate of Ifx- F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the tabor Code, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT ITO 10=C.F.MU 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10p00C.EM16.00 SEISMICFEE S,© I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the..,it I'or which this permit is issued(Sc, MICROFILM 3097,Civ.C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender',AddR, _ _ HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Icernly that l have reed t his application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and 801LER-COW(3H.P.or100,000B.T.U.) 6.00 hereby m authorize rcpresemalives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. ' above- entioned-property for inspection purposes. MECHANICAL (We) agree to save, indemnif nd keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,ju nb, -and expenses which PERMIT ISSUANCE 10.00 CONST.TAX May i way accrue agar H in consequence of the t is permit MECH.CONT. LIC.NO. MECH. -L- TOTAL TOTAL Q Signature Appli nt/ ortr ter Date OFFICE COPY