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18395 (2) POST THIS CARD NEAR FRONT OF.BUILDING a+nIITNUMRER CITY .OF CUPERTINO 18395 INSPECTION DIVISION JOB INSPECTION RECORD L_ PERMIT EXPIRATION JOB ADDRESS—�O Goc Pa ' t.M�LFp--P UNIT�� ' _LOT# L Q PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 780 DAYS OF PERMIT FOUNDATION OR 180 DAYS FROM NOTE: LAST LAST CALLEDINSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLRMIT VAI.IDATro CUPERTINO STANDARDS. 1 I GARAGESLABS �- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB- PLUMBING r1 L ELECTRICAL ISSUANCE DATE MECHANICAL RLUG ELIiCI PLDMEGM - ❑ 1:1 11 ❑'. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING ,�•�l'..G MECHANICAL C] I•-�-V PERMn ro ELECTRICAL - FRAMING � LO - STORIES TYPECONSTR INSULATION OQCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED BI I� 50 fi FEOOR AREP TOTAL ACREAGE ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE � DIAPHRAGMTHE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING .Res IND ,CON PR 01,11.1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ASSLSEON' 'AHGEI.NO ROUGH SANA PLUMBING ELECT,ENERGY 111AC1 NO PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL - MECR ENERGY ACC DATE ACC.FILE NO ELECTRICAL BUILDING ENERGY j FRAMING ELECT.FINAL TEST ' ZONING ENG SITE NO. INSULATION PLUMBING hao I GAS TEST GAS FIRE SPRINK ENERGY L.2G MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE Flow zoNE ALuc INTERIOR SHEAR FIRE DEPT. Otto; Y ❑ N❑ SHEETROCK GRADE FEESUMMARY EXTERIOR LATH BUILDING - _ BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRICPLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O� PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APP;-IgJNT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY • BUI LDI NG PROJECT I DENTI FICATION PERMIT NUMBER BUILDING W APPLICATION & PERMIT 18395 ADDRESS 1 0 5co BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME V yip OTV. ELECTRIC PERMIT FEE �^ CONTRACTORS SCJ ` PHONE CDNrBAcrORs UTLETS-SWITCHES-RECEP 10.00/1.00 NAME L LIE No LIGHTING FIXTURES 10.00/1.00 OTORS APPLIANCES-RESIDENTIAL 4.00 CONTRA II If vHOrvE • _21fflF14 PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR O ENGINEER LIC.No. SIGNS TRANS. 3.00 ADDRESS ENc' SPECIAL CIRCUIT 6.00 PERMIT VALIDATIOI`J APPLICANTS ZIP TEMP.METER OR POLE INS. 20.00 AOOREss MOTORS SEE FEE SCH. J cr- ' D &7X 125L M SERVICE ffi CHANE . (r^ n ` 0 CORS DECLARATION o LICENSED CONTRA ¢ v I hereby al fna that I an,licensed under provisions of Chapter 9 _ ISSUANCE DATE y a N (commencing with Section 7000)of Division 3 of the Business unJ V BLDG. ELECT. PLG. MECH. H w z Professions Code,and my license is in full force and effect 'All I .,V J ❑ ❑ ❑ ❑ o 0 w o License ClassLie.Number IH m r w Datc_-_ ��Inl ructor " a ¢ OWNER-BUILDER DECLARATION CD BUILDING PERMIT U MISC. INFORMATION P` ;LL N I hereby allirn that I am exempt from the Contractor's License _ _ 16 ,T 2""Lp,*10,", .. oa Law for the following reason.(Sec.7031.5,Busincssand Professions pERMIT'ISSUf.AN E.•rl - VALUATIONCode:Any city or county which reyuiresa permit to construct,alter,pimprove,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NOrequires the applicant for such permit to file a signed statement that .� PERMIT TO a w m he is licensed pursuant to the provisions of the Con Ulmmi s License FZQ Law(Chapter 9(conunencingwiCt Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE Ufa M r o the basis for the alleged exemption.Any violation of Section 703 L5 � SJORIES TYPE CONSTR. aim by any applicant mr a permit subjects the applicant a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than five hundred dollars(8500)-: 0 1,as owner of the property.or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will du the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 'B Code:The Con t racmr's License Law does not apply to an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO,FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such ini . ntmtts are not intended or offered for sale.It,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 m improvement is sold within otic 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 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 construct the piolva(Sec. 7044,Business LAWN SPRINKLERS=1 INC 5 V.B. 6.00 ASSESSOFYS PARCEL NO. and Professions Code:'I'lie Contractor's License Low does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contractor(s)Iiccnsed pursuant to the Contractor's License Law. SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ Inmcxcmptwd•r c. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSA'IION DECLARATION WATER TREATING EQUIP, 5.00 1 hereby affirm that I have a certificate of consent to self-insure. or a certificate of Workers'Compensation Insurance,or a certified ZONINGENG.SITE NO. copy thereof(Sec.1800,Lah.0 I Policy No. Company_W_n.{.. - I O ❑ Certified copy is hereby furn d. FIRE SPRINK ENERGY T.24 Z Z O Certified copy is fled with the city inspection Division. MISC.- REFER TO ORD. 0 Ap plicCer - Y❑ N❑ Y E] NE] w CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W >_ COMPENSATION INSURANCE PLG.CONTH. LIC_.NO. PLG. EL Q ('1'11:5 section L,Cd nat be completed If tiro per11 Ix I., one TOTAL Y E] N❑ Y[J N❑ a Z hundred dollars(4100)lir 1"1.)EL O I certify That in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued, I shall not employ any person in any ntannerso as to V beconsu object to the Workers'Compensation Laws of California. O w num Applicant ALTER OR ADD TO MECH. 5.00 BUILDING a } I6ia NOTICE TO APPLICANT: If,after making this C,,ificate of Ex- ♦- Z emplion,you should became subject to the Workers'Conspensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you mast forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IOPMC.F.M.) 6.00 SEISMIC FEE I hcivhy affirm that there I,a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of(lie work lin which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 6.00 MICROFILM 3097,Civ.C.). '` , _ Lender's Name_` HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Ad J rens -- I comity Ora(I have .it&his application and nate that me aboveVENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and cornu, g01LEA-COIvfl(3 H.P,or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of this city m enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned properly for inspection purposes. (We) agree to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in consequence of the m.yng ofthm permit MECH.CONT. LIC.NO. MECH. I p-� TOTAL TOTAL ��V® Sig um of Applican/Contraclni r Dat jr l- COPY