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18223 POST THIS CARD-NEAR FRONT OF BUILDING �• • � �I � PER MIT NUMN[R CITY . OE_CUPERTINO 18223 �. INSPECTION DIVISION , A, JOB INSPECTION RECORD n I PERMIT EXPIRAT,LON; JOB ADDRESS.— 03 // 1� I/A ✓ IShL DAIV UNIT# _LOT# -) 1 4 , '^- //(� ((`` I-_ PERMIT EXPIRES IF WORK OWNER III IJYu- -I'C. PfA-�"1'1 CIti ��S CTOR Seryl S'4Pk mj Z CA - IS NOT STARTED WITHIN INSPECTION j DATE- INSPECTOR INSPECTION RECORD leo 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 PERNVT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED p- \ `, UNDERGROUND /SLAB PLUMBING ELECTRICAL lly-of ISSUANCE DATE MECHANICAL ELDp ELECT PLG, MECH ❑ ❑ ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATIONT / sIET, PLUMBING I 7 _ l 7-- 3 �-o MECHANICAL 7aww /00t✓2K. �oe,.t ELECTRICAL �/ v- I TO FRAMING INSULATION STORIES TYPE CONSTR OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO FT FLOOR AREA TOTAL ACREAGE p ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE , dyG' jj n F: THE CONSTRUCTION TAX IS PAID P .I. DIAPHRAGM N .V� BUILDING USE ROOF SHEATHING RES IND CON PB On.., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ 1:1 ASSESSORS PARCEL NO ROUGH SAN,N PLUMBING p— _ 3 ELECT.ENERGY bY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT N0. PARCEL NO MECHANICAL - p. _ ,la MECH.ENERGY ELECTRICAL b Q) l0) BUILDING ENERGY Acc.DATE Acc,FILE No FRAMING 0 ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION T-6-C PLUMBING - GAS TEST aCj. GAS FIRE SPRINK ENERGY i.24 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ` 11 " ` "� EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE ALUC INTERIOR SHEAR FIRE DEPT. Y❑ No v L N SHEETROCK 0 GRADE FEE SUMMARY EXTERIOR LATH - Q BUILDING 13UILDING INTERIOR LATH TEMPORARY APPROVALS 6 SCRATCH COAT ELECTRIC PLAN CHECK, GAS FEE ...- NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 3, j G OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC . o Z � ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING, PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.Tnx kb PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. G4Vv OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY va : ORBEsUs IL ING PROJECT IDENTI FICATION PERMIT NUMBER APPLICATION & PERMIT 1Y AILDING1D3'pMra VI57& BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 23 - OWNE NNAMERS8I" 3(I.L'YY I-U �97y-✓d PLAN CHECK VALIDATION ,725-184 DTV. ELECTRIC PERMIT FEE 1 L70. QYI PHONE WNTRBCTOR'a NAME OUTLETS-SWITCHES-RECEP 10.00/1,00 ^j LIC.NO. LIGHTING FIXTURES 10.00/1,00 2 3 F CONTRACTORS APPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.N0. OR fJ PANELS (OVER 200 AMP) 20.00 ENGINEER Richard L Heck C.NO 4S SIGNS TRANS. 3.00 ARCH OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT 5.00 2-409 ApP Ie4 �a5 . ! •- .ZIP 'JS)2q TEMP.METER OR POLE INS. 20.00 "�\1 t3 APPLICANT'S ADORE ss Ji-73o AlCAZ0.s Aye-rive MOTORS SEE FEE SCH. Ir kll -- SERVICE CHANGE 20.00 POP �. w2 LICENSED CONTRACTORS DECLARATION a u v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE n< w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. F D z Professions Code,and my license is in full force and effect. - ❑ ❑ ❑ z o at- License Class Lie.Number , . L Dido-Contractor - W a se s ���® BUILDING PERMIT ¢ a OWNER-BUILDER DECLARATION 0 a u INFORMATION LL N I hereby affirm that I um exempt from the Contractor's License MISC.- REFER TO ORD Fuoa Law forthe following reason.(See.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. Ew> Code:Any cityorcounty which requires a permit to construct,alter, I[ ¢ ¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. , (� i iiO LL req aims the applicant for inch PermO la filen signed slulament that - TOTAL PERMIT TO w $ he is licensed pursuant to the provisions of the Contractor's Licensem r Z a Law(Chapter 9(aamercingwith Section 70001 of Division 3 ofthe �I i 4 D Business and Professions Code)or that hfr e is exempt therefrom and QTY. PLUMBING PERMIT FEE &VA il-t X F-m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a ; - by any applicant for a permit subjects the applicant toaeivil penalty ALTER-DRAIN -WATER IEA.) 5.00 .fuel more than five lumdred dollars($5001): ❑ I,as owner of Ilia property,or my employees with wages as BACK F LOW PROTECT.DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP REB.UNITS intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Cade:'I lie Contractors License Law does not apply to an owner of • property who builds or improves thereon,an,who does such work FIXTURES-PER TRAP 5.00 SO.FT,FL ooB AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- NT ments are not intended or offered for sale.If,however,file building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 � n or improvement is Sold within one year of completion,the owner- ' OVER 4 IEA) 2G•� builder will have the burden of proving that he did not build or hit- GAS-EA.SYSTEM- . - ,00 'BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CDN PB Other 13I,as owner of the Properly,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sea 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6,00 ASSESSORS PARCEL NO. and Professions CodC:'fhe Contractor's License Law docs 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 it contructor(sl licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 - theContou�orsLicenseLaw. TRACT NO. PARCEL NO. ❑ Iant exempt under Sea.-,B.&P.C.for this WATER HEATER W/VENT 6.00 Holo1 Owner Data WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKRRS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have u certificate of consent to self-insure. ZONING ENG.SITE N0. or a certificate of Workm Workers'Compensation Insurance,ora certil'ial copy tlmreof(Sec.3800,Lab.C). - Policy No. Company O ❑ Certified copy is hereby furnished FIRE BPRINK ENERGY T-24Z 2 ❑ Certified copy is Filed with the city inspection division. MISC.- REFER TO ORD. O Applicant Y ❑ N❑ Y ❑ N❑ rnPERMIT ISSUANCE 10.00 � - CIiRTIPICAT[OP EXEMPTION PROM WORKERS' PLDOD ZONE A.L.u.c. LU > COMPENSATION INSURANCE PLG.CONTE. - LIC.NO. pLG. CL a (This section need not be completed if the permit is for one TOTAL Y❑ N F] Y [:] N❑ hundred dollars IS 100)or less.) U O 1 certify thin in the performance of Ilia work for which this per, DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL F mil is issued,1 shall not employ:my person in any manner so as to Ow becomesubjecf to the Workers'Compensation Lawsof California. d Date Applicant ALTER OR ADD TO MECH. 5,00 BUILDING J >_ Do NOTICE TO APPLICANT: If,after making this Certificate of E.. ~ Z enlptian,you should become subject to the Workers'Compcnsmion APPLIANCE 5.00 PLAN CHECK �b provisions of the Labor Code, you nmsl forthwith comply with FEE U Such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10O00C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10030C.F.M.) 6.00 SEISMIC FEE 3 I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5,00 . the performance of the work for which this permit Is Issued(See. MICROFILM /" 3097,Civ.C). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certily that lleve«ad this upplicalion andoide lhal 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 BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE$CH. MECHANICAL (WC) ugrce to save, indemnity and keep harmless the City of MISC.- REFER TO ORD. Cupertino 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 granting of this permit. MECH.CONT. LIC.NO. MECH. TOTAL TOTAL �UO Signature of Applicant/Cnntraclor Data OFFICE COPY ELECTRIC SERVICE NOTICE P G.a E.COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO o�(, To jYou are hereby authorized to Connect eleclrical's(eerrvice for Owner or Tenantvl — j At H",IPIF\ V i GT tR No.of Wires Size of Wires Size of Switch - 1 Motor Load Voltage Phase Heoti ng Load K.W. Voltage fL;yhl 11 O_New Servicey Reconneo Na.of Meters Heat 120Three Wue More Service No.of Add.Meters Power �f Three Phase Move Meter OP • ELECTRICAL INSPECTOR n CITY OF CUPERTINO OFFICE GAS SERVICE NOTICE 29 119- To You are hereby authorized to connect the GAS service for Owner or Tenant R, L--- New Service— No. ervice No. of Meters I Reconnect No. of Add. Meters Move Service Move Meter PLUMBING INSPECTORG (D. 1