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17574 (2) POST THIS CARD NEAR FRONT OF BUILDING " PFR%I IT NUMBER CITY OF CUPERTINO 97574 INSPECTION DIVISION JOB INSP C ION CORD, 1 yQ�,��/ PERMIT EXPIRATION JOB ADDRESS L NIT# LOT U)X PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATIONANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIOATI CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ,-,T,; `t D I3�9 !u � PLUMBING ••V ELECTRICALlrun n ISSUANCE DATE !T•hT n - ' MECHANICAL - i•BUDG II.ECTrLc. mECa1 El El ❑ 2'' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SCT. PLUMBING MECHANICAL PEHh11T TO' ELECTRICAL FRAMING 1 V STORIES TYPE CONSTR INSULATION OCC GROUP RES UNITS' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • 511,`T PLooR AREA TOTAL ncHCAGL ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND CON PB 0,1,,., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ Cl ❑ ❑ ❑ ROUGH SAN.k ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY TRACT N0 PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY - FRAMING ELECT,FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING GAS TEST GAS ' FIRE SPRINK ENERGY TQ< MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v M1� v N[:] FLOOD/ONE AI.UC. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. v N� v ❑ N� SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH BUILDING - INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LU WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O� PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL T2( CL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL (Xj CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY P1dl LDI NG PROJECT I DENT]FICATI ON PERMIT NUMBER p APPLICATION & PERMIT ADDRESSjd 0�� SW 7574_ =l/V) BUILDING- ELECTRICAL-PLUMBING-MECHANICAL -,, OWNER'S It PLAN CHECK VALIDATION NAME OTY. ELECTRIC PERMIT FEE •A/ 1,09M PHONE GorvrRAcroRs NUTLETS-SWITCHES-RECEP 10.00/1.00 AME .A q� LIC NO.g,2Zd5r_7 LIGHTING FIXTURES 10.00/1.00 NTRAAcrOR's ADDREPPLIANCES-RESIDENTIAL 4.00 CO 425 AL-DO Avg PHONE 8 874 PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR - ENGINEER LIC.N04 SIGNS TRANS. 3.00 ARCH,On ENG. - SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ADDRESS ZIP TEMP. METER OR POLE INS. 20.00 zA� ( APRLIcarvr's MOTORS SEE FEE SCH. rt AOOR,E,55/ 7 0d AP5 r,,- ISERVICE CHANGE 20.00 ID, 00 LICENSIiD CONTRACTORS DECLARATION n1 1988 a u U 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE G ac (commencing with Section 7000)of Division 3 of the Business and BL G. ELECT. PLG. MECH. F w Z Professions Co _aW license is in full fn � ! of�.I pf`6nQ ❑ ❑ z 0 w- Licensg�,I ss !rf/ Lic.Number O Z H¢ Uatc J((.r1�. Contractor-*i&Vn se y f -a BUILDING PERMIT ¢ ¢ w ¢ OW'NFR-BUILDER DECLARATION o d Uw MISC.- REFER TO ORD INFORMATION LL H I hereby affirm That I am exempt from tle Contractor's License VALUATION $/FT. u 0 a Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 � -0` Code:Any city orcounly which requires a permit uo construct,alter, 5 2 < 2O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. O ¢ requires the applicant for such permit t0 file'a signed st.nelllenl that TOTAL PERMIT TO n w m he is licensed pursuant to the provisions of the Contractors License HZi Law(Chapter 9(commencingwilh Section 7000)ot'Division 3 Tribe M}�ui(LIIC'� ¢ Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE "-9 Y`I'1 ¢ r o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. n ;'e by any applicant for a permit subjects the applicant Ica civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(8500).1: ' ❑ 1,as owner of the properly,or my engiloyces with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole conlp,mattirn,will do the work,and the sloclo a is art intended or offered for sale (Sec. 7044, Business and professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Con[ramor's License Law docs not apply to au owner of properly whit builds no unlooses there n,and wllr docs said,work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such inlpruvo ments are not intended oroffered for sale.If.however,the buil ding GAS-EA.SYSTEM-11INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that It,did not build or im- provefor purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PR Ou., 0 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not apply to an owner of property who builds or improves Il ercon,and who LAWN SPRINKLERS-OVER 5(EA,) 1.00 contracts for such projects with a contmctods)licensed pursuant to the Contractor's Lice osc Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exrmpt under Sec. .B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Duce WATER SYSTEM 5.00 ACC.GATE ACO.FILE N0. WORK ERS'COMPHNSA TION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm 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 rhery2Se//V O,Lah.C.). (�/�• ,////1 I'olicY No..33 .Z((.'ompany 0 O CeHilied copy is hereby furnished. FIRE SPRINK ENERGY LY4 Z Z VCertifed�$' pq nl�l•J/witl r 751 j' ion. 0 Applicant X- l L MISC.- REFER TO ORD. Y❑ N❑ Y ❑ IN[:J i m C Ii R'1'I P I CAIE OI'1 XI'M 11110N PROM WO RK Ii RS' PERMIT ISSUANCE 10.00 FLOOD ZONE A L.U.C. COhll'EN'SATION INSURANCE PLG.CONTR. LIC.NO. PLG. 1 0 (This section need not be completed it the permit is for one TOTAL V❑ rv❑ V❑ IN ::) Z hundred d.11...(SHOO)or less.) U O 1 certify that in the performance of the work for whicG this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,1 shall not employ any person in any planner sr as to O become subject to the Workers'Compensal ion Laws of California. 0 Ed Dale Applicant ALTER OR ADD TO MECH. 5.00 q BUILDING } Do NOTICE TO APPLICANT: If,after making this Certificate of Ex. ? cloptioa,you should become subject to the workers'Compensation APPLIANCE 5.00 PLAN CHECK provision' of the Lahor Code, you most forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M) 4.00 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE I hereby affirm that there i-0 u construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work lot which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lenders Name ELECTRIC I certify that 1 Imvc read this application and alar,that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING BOILER- ordinances and state laws relating to building construction. and BOILER-C(M5P 13H.P.or100,000B.T.U.) 6.00 hereby auHwrize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against lixhililies,judgments, costs and expenses whichCONST.TAX may in any way accrue against Said City in consequence rf the PERMIT ISSUANCE d&BB Ila ranlin lis permit. CH.CONT. LIC.NO. MECH. 0 1% TOTAL -�� TOTAL CC`> Sigma. of Applicant/ oactor Date OFFICE COPY ,i