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12461 POST THIS,CARD NEAR FRONT OF BUILDING . �Ar - —,PERMIT NUMBER CITY OF. CUPERTINO " 6 ,INSPECTION DIVISION ; JOB'INSPECTION RECORD, ,,�(5 �` ��•Cn/ /�/J� . PERMIT EXPIRATION JOB ADDRESS;�r / �`� ��'/�� ���_I (L.�PNIT P -LOT# . �— 'PERMIT EXPIRES IF WORK OWNER C `` CONTRACTOR �1;0 IS NOTSTARTEDWITHIN INSPECTION DATE I INSPECTOR I NSPECTION RECORD 180 DAYS OF PERMIT AISSU- FOUNDATION - - NCE OR 180 DAYS FROM t r LASTCALLED INSPECTION. UFER I PREGUNITE - - PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN'SIGNED �� f UNDERGROUND'/SLAB f PLUMBING . ELECTRICAL - - ISSUANCE oarE MECHANICAL BLq .` ELE . PL MF R! - - - e - © r DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR vAlllanoN- $JET, • .PLUMBING - 5;r MECHANICAL .ELECTRICAL' PERMIT TO .. 7" f .FRAMING - .. ii ✓' ""�,./ ✓ .INSULATION - _ - - -STORIES TYPE,cONSTIR OCC.GROUP RES,UNITS I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF ' - sa IT,FLOOR AREA TOTAL ACREAGE DIAPHRAGM ,BUILDING USE ESI IND CON PB . Otllur " APPLY'NO ROOFING UNTIL ABOVE HAS BEEN SIGNED + ❑ ❑ + ❑ ❑' ROUGH SSESSOHS PARCEL NO. PLUMBING - ` GAS TEST - .TRACT ND. PARCEL NO. • MECHANICAL ACC:DATE• ACC,FILE NO. ELECTRICAL.' - FINALS " :;.:DATE INSP. 3 FRAMING SAN'# INSULATION - - _ PLUMBING, ZONING -ENG,SITE NO. GAS- � ', • FIRESPRINK ENERGY T 24 MECHANICAL " COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ "❑ No ' LATH-INTERIOR �, FLOODZONE ALU.C. ELECTRICAL. ' LATH-EXTERIOR - FIRE•DEPT.". Y❑ N Y ❑ N❑• . • SHEETROCK GRADE` . •" 9 ' - FEE SUMMARY SHEAR INTERIOR ��, " BUILDING SHEAR EXTERIORTEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC P,LAN CHECK ... ` GAS .. FEE. r. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE . OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR•. MICROFILM r 'ARRANGE FOR INSPECTION BY PHONING'252-4505,'4 ' ELECTRIC o� ONE WORKING DAY'BEFORE REQUIRED,INSPECTION. PLUMBING, PLEASE%GIVE JOB ADDRESS WHEN,PHO "INGp Z — SEE PERMIT iCIR EXPIRATION DATE — '' MEc+nNICAL IMPORTANT , ' covsT,Tnx PLEASE READ.REVERSE SIDE BEFORE _ TOTAL, CALLING,FOFt.FINAL INSPECTION f,. ,.OFFICE COPY' _ .. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY PERMIT NUMBER BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT wLm c ADO.Ess �j//yam ./1 .T/ ,(�' BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 12461 - Owry En's• '�`' //YD//lam / '. PLAN CHECK VA�QATION "AME / �y� �ZC'��"'' 7-/Y��OTV. ELECTRIC PERMIT " FEE Fn tt :- ;��/ CONTRACTOR'S OUTLETS-SWITCHES-RECEP 10.00/1.00 NAME uc.No.'/9�� LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 ADDRESS \i ,l ,, I PHONE ZVI.7�S ' PANELS 10.OQ DATE OF APPLICATION /\ AcwiECT / PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR C ErvcwEER bSIGNS TRANS„ 3.00 LIC. / ARCH OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS EMP.METER OR POLE INS. 20.00 �L].r APPLICANTS JR-{rr''lLl MOTORS S E 2SC.H. ADDRESS 000-n 10 ERVn o o LICENSED CONTRACTORS DECLARATION - u I hereby affirm that I am licensed under provisions of Chapter 9 `w< w cpmmeueing with Section 7000)of Division 3 of the Business and BL G. L T. PL MECH. F m z Professions Code y licensn is in full fore d 'C rt z o m- Licensc Lia Number 1 9 Y t t Date Contractor ¢ ewe WNER-BUILDERDECLARATIONV -� - BUI DING ERMIT, ^ REFER TO ORD INFORMATION w3 u y 1 hereby affirm that 1 aT . m exempt from the Contractor's License MISC.- � VALUATION - $/FT. F.. O J Law for the following reason(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 q Code:Any city or county which rerjuires a permit to construct, I(/1 //n� Qio Q � Improve,demolish,or repair any structure,prior to its Issuance,also ELEC. NTR. LIC.N0. ELEC. L (/00 O M requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO ,v w m u he is licensed pursuant to the provisions of the Contractor's License - Fii Law(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe .: ' Pt Business and Professions Code)or that he is exempt iherefrem and DTV, T , -PLUMBING PERMITFEE r 0 the basis for the alleged exemption.Any violation of Section 7031.5 I I # IIYOR�E% TYPE CONSTR. i; by any applicant Cor a permit subjects the applicant loo civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more titan five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as ggCK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure Is not , intended or offered for sale (Sec. 7044, Business and Professions - DRAINS+FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES.PER TRAP 5.00 SD.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6,00 or improvement is sold within one 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- RE IND CON PB Ohba, prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 El El ❑ El I,as owner of the property,-am exclusively contracting with licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCELNO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER A.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-ST OO1t/10-00 the Contractor's License Law. TRACT N0. PARCEL N0. ❑'I am exempt under Se,-,B.&P.C.I'or this WATER HEATER W/VENT 4 Y'76.00 , reason _ .Owner Date WATER SYSTEM t " 5.00 ACC.OATE ACC.FILENO. WORK ERS'COMPENSATION DECLARATION WATER TREATING E IP. §00 ' 1 hereby affirm I have a certificate of consem toself-insure, (AIN Ui or a certifies Wo kers'Com Pensalion I�hs ranee,of a certified ZONING ENG.SITE NO. copy cher (Sec. Lab.CJ. LH7/('�.�� Policy hNe /-w"i r� �Y O ❑ Certified O here furnished. FIRESPRINK ENERGY T 24 d with the city inspection division. - MI C.- REF OORD. Z Z V❑ N❑ V ❑ N❑ O pPlic'it _ � CER FICATEOF EXEMPTION FROM WORKERS' PERMITISSUANCE 10.00 FLOOD ZONE A.L.UA. LU _ COMPENSATION INSURANCE PLG. TR .NO. PLG. CL O (This section need not be compacted if the permit is for one TOTAL V❑ N❑ V ❑ - N❑ Z hundred dollars(S I00)or less.) - - U O , I certify that in the performance of the work for which this per- OTV. MECHANICAL PERMIT - FEE ' FEE SUMMARY LL I- mit is issued,I shall not employ any person in any manner so us to - U become subject to the Workers'Compensation Laws of California. w Date Applicant ' ALTER OR ADD TO 5,00 BUILDING �- m NOTICE TO APPLICANT: If,after making this Cetil'icale`of ExfW - F-. ? emption,you should become subject to the Workers'Compensation •APPLIANCE ,� 5.00 PLAN CHECK / Provisions of the Labor Code, you must forthwith comply with FEE C.) such provisions or this Permit shall be deemed revoked. AIR HANDLING UNIT(TO 0 0' :M.) 4.00 , CONSTRUCTION LENDING AGENCY AIR HANDLINGU I 1 ER 10,000OF, 6.00 SEISMIC FEE `. I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH 11"- 5.00 the performance,of the work I'Or which this permit is issued(Sec. HEATING UNIT(T 0,000 B.T'.U.) 8.00 MICROFILM 3097,Civ.0.). ' Lender's Name HEATI NG UNIT(OVER 100,000 B.T.U.0.50 ELECTRIC Lender's Address 1 certify that 1 have read this 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 aws relating to building construction, and BOILER H.P.or IO0,000B.T.U.) 6.00 hereby Sup ere c entatives of this city to enter upon the BOI LER-C P was, 100,000 BTU)SEE FEE SCH. MECHANICAL abovEn. oned prop t r inspection purposes. We agree to sa and City and keep harmless the City of MISC:- REFER TO ORD. C pe ilio against alalic,jud m t costs and expenses -1- . PERMIT I SUANCE 10.00"/-) CONST.TAX a in any wa ,To get t cone quence o the Cling of Ili nn' MECH. NT. I LIG N01 MECH. ' d TOTAL / TOTAL Applicant Date OFFICE COPY - - '