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14424 (2) POSTTHISCARD NEAR FRONTOF BUILDING PERMIT NUMBER CITY� OF CUPERTINO 14424 INSPECTION DIVISION 'rel JOB INSPEC•iION RECORD `,•� '']] PERMIT EXPIRATION JOB ADDRESS //`1'0 S=i-70 2 ,(J,Q UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER E2.D CONTRACTOR . A 7LA r 76- IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD "^180.DAVS'OF PERMIT ISSU f -'..s...-. FOUNDATION . gANQE;OR 180DAVS'FROM". NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE CU CUCOMPLY WITH THE APPROVED PLANS AND CITY OF - -•-PEMn VAuunnoN PERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCENATE MECHANICAL - BLDG ELECT PLG. I MECH ❑ ❑ ❑ ❑a' 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING _r VALUATTONW, SIFT. MECHANICAL ELECTRICAL PERMITT/Fo FRAMING INSULATION - STORIES TYPE CONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSPSHALL BE MADE BEFORE so,rT 71.00RARF.A TOTAF ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID N ' ROOF SHEATHING .ves . BDILDNNUSE ,i NIOPo oindf APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. i �� ❑ ❑ ❑ ❑ ROUGHSAN.N u, AssESSORSPARCECNO PLUMBING ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT No PARCEL No MECHANICAL MECH,ENERGY ELECTRICAL BUILDING ENERGY ACC.DATE ACC FILE No FRAMING - ELECT.FINAL TEST INSULATION PLUMBING zoN+NG ENG sire NO. GAS TEST GAS MECHANICAL _ FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING _ . Y ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FOOD ZONE Ai.UC INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE EXTERIOR LATHBUILDING FEE SUMMARY INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAMN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCYSEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTEO UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING - SEE PERMIT FOR EXPIRATION DATE - MECF NICAL �,. IMPORTANT! CONST. TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY ,APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY K-CMZ 8 BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDINGAPPLICATION & PERMIT ADDRESS - 14424 ADDRESS 1140 TUkttCJ�d l BUILDING —ELECTRICAL—PLUMBING—MECHANICAL OWNER NAMEPLAN CHECK VALIDATION NAME ,}QTY. ELECTRIC PERMIT FEE vHorvE NOM>fERncroR's ,\ r � UTLETS-SWITCHES-RECEP 10.00/1.00 TJQ,� N a IIC.No. 10 LIGHTING FIXTURES 10.00/1.00 ACONTRACTOR DDRESS ro H's rr�� PPLIANCES-RESIDENTIAL 4.00 LSSPANELS 10.00 DATE OF APPLICATION RCRITFCT - PLAN CHECK FEE P.C.N0. O DR PANELS (OVER 200 AMP) 20.00 ENGINEER uc.No. SIGNS TRANS. 3,00 ARCH. DD ESS EOR NG' SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANTS ADOREss L' t MOTORS SEE FEE SCH. ISS MMGf S1YCC4- S06rkI SERVICE CHANGE 20.00 Foo LICENSED CONTRACTORS DECLARATION Q a u U 1 hereby infirm Wal 1 at, licensed under pro,isim:s of Chapter 9 H G w (commencing with Section 7000)of Division 3 of the Business and ISSUANCE DATE F y z Professions zF Code.. rise is in full fore BLDG. ELECT. PLG. MECH. LicenseC o.— nd _ c.Numbero 77 O yzFw -111 Canloom, CliI wa OWNER-BUILDER DECLARA'T'ION BUILDING PERMIT ° to INFORMATION X g w I hereby affirm that 1 am exempt from tlm Contractor's License MISC.— REFER TO ORD u0j law for the following mason.(Sec.7031.5,Business and Professions VALUATION $/FT. — PERMIT ISSUANCE 10.00 m Code:Any city or county which requiresu permit To construct,alter, QQ <� improve, or repair any structure,prior to its issuance,also ELEC.CONTR. LIG NO. ELEC. o w ro rt requires the applicant for such permit to file a signet)statement that TOTAL pERO he is licensed pursuant to the provisions of the Contractor's License F z a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe �. i o Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE ¢ F m the basis for the alleged exemption.Any violation of Sect ion 703 L$ STORIES TYPE CONSTR. a ; ,- by any applicant fora permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of nre ot mothan five hundred dollars(S5OOL): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 their sole compeneation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,CON D. 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 t himself or through his own employees,provided that suds improve- mentsare not intended or offered]or sale.If,howevee the building GAS-EA.SYSTEM-I1NC.40UTLETS 6.00 or improvement is Sold within ono year of Completion,the owner- builder will have the burden of proving that he did not build or Ire- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose off theJ. INDUSTRIAL WASTE INTER. 30.00 O IN❑D CON 0 other ❑ Las owner of the propcDY,run exclusively Contracting with licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. Slid Professions Code:The Contractor',License Law does not apply to an owner of property who it or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contTacror(S)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. O Inn exempt under Sec..,EI for thisreason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. woRKERS•COMPe NSertifiNe of consent ION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a EFCOSdicaw of consent or setGrtilie, or a certificate of Workers'Cnmpenmuon Insurance,or a cetlifial ZONING PSrISMICFEE NG.SITE NO. copy thereof(S�•c�-3 E. ,, p� - Policy No.1r1L�? a Y_ O CI Certified copy is hereby furnished. Z 2 K Certified��o�X its fled with the City inspection division. ENERGY T-24 FO Applic:lnt_(,t-C1� MISC.- REFER TO ORD. � Y � N� LO CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 E A.L.U.C.W COMPIiN$A'1'ION INSUkANCIi PLG.CONTR. LIC-NO. PLG.0 ❑ ('('his section ted not be completed if the permit is for one TOTAL v ❑ NU O hundred dollars l$100)or less.) I certify that m the performance of the work for which(his per- OTV MECHANICAL P SUMMARYLL — mit is ssued,I ain t not employ any person in any mannerso as r- FEEO W becomesubject to the Workers'Compensation Laws of California. aDow ICANI;ntALTER OR ADD TO MECH. < , p N NOIICfi '1O APPLICANT: If,alter making this Certificate of lix- emption,YOU should become subject to The Workers'Compcomtion APPLIANCE 50 Kprovisions of slit Labor Codc, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO QOODC.F r4,CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER1 . .M.16.00 E I hereby affirm that There is a construction Iendiog agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of tiler work for which this permit is issued(Sec. 3097.Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 g,(0 MICROFILM Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T,U.)9.50 ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE). 4.00 information is correct.1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP H.P.Dr 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter Upon the BOILER-COMP above-mentioned property for inspection purposes. (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree In save, indemnify and keep harmless Ole City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX my in any way accrue against Said City in consequence of the PERMIT ISSUANCE 10.00 IO.CX7 ran//Yng of Onis per`,m�/L'� n MECH.CONT. LIC.NO. MECH. Id�la/iQ plh� 5 �(�I fffS TOTAL 0* TOTAL Signature of Apphcan T/Contractor IJate ..F-�sS /t N-f I$.Ov OFFICE COPY O O