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18634 POST THIS CARD NEAR FRONT OF BUILDING PERM IT NUMBER CITY OF CUPERTINO 18634 INSPECTION DIVISION JOB INSPECTION RECORD `/}� 'PE F{N11T`EXP�TION JOB ADDRESS & .:�M 1 ` 'y,\P' bR UNIT# _LOT#j 'may P, \ PERMIEXPIRES IF WORK OWNER - CONTRACTOR - CJU6M NQTG�A RTEDCIYYITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 189 DAYS OF PERMIT ISSU- FOUNDATION NOTE: ANCE OR 180 DAYS FROM � UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED 4A4T+,4....��''5 ED INSPECTION. PREGUNITE TO COMPLY WITH'THE APPROVED PLANS AND CIN OFJ PER N1 I vALI1 n0 GARAGE SLABS N ' CUPERTINO STANDARDS. P !/ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I /�� UNDERGROUND /SLAB PLUMBING U"G'lle� � ELECTRICAL 4'llll ISSUANCE.DATE MECHANICAL NO,f BLDG ELECT PLG. NIECR 1 U ;; l ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR n{ r-m-r1r1 INFORMATION PLUMBING VALUATION S/FT, F/ MECHANICAL � �wo'bo J ELECTRICAL '^,�J I'ERMII TO FRAMING - T H %Q c'—o vL+ C- INSULATION - STORIES I TYPE CCOµONSTR Ln OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ` ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE - s° IT FLOOR AveA ,TOTAL ACREAGE ' DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING I IND CON PB Omn IN APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE. SP. ❑ ❑ ❑ ❑ ROUGH SAN.q ABBESBORS PARCEL NO 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 ZONING ENG SITE NO, GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T za COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING , ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR I ELECTRICALRELEASE FLOOD ZONE ALUC INTERIOR SHEAR FIRE DEPT. Y ❑ N❑ v ❑ No SHEETROCK GRADE _ FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING ph 1I1I00 SCRATCH COAT ELECTRIC PLAN CHEK �I�� GAS FEE 0 NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ,SEISMIC FE" ,SES+ OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR.)MICROFILM — ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 1 U, ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX -- PLEASE READ REVERSE SIDE BEFORE TOTAL ' CALLING FOR FINAL INSPECTION. w + OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT ADolj Kt� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 4 OWNER' I�L NAME PLAN CH VALIDATION " ( J6- hPANELS ECTRIC PERMIT FEE �\\/ C� l/V n vHONe F c NTRA�71K�Q l�/m ITCHES-RECEP 10.00/1.00 Of PIC LIC.NO, XTURES 10.00/1.00 �4- '� A Ac s ZIANJ JOSS -RESIDENTIAL 4.00 AooTRAlip /p�//11 Li (/W VIP NONE + 10.00 DATE OF APPLICATION ARCHrt i PLAN CHECK FEE P.C.NO. OR >cr R 200 AMP) 20.00ENGIrvE LIC.No. . 3.00 ARC .OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT 5.00 ZIP EMP.METER OR POLE INS. 20.00 /u/.M1�.ie ' APPLICANT'S J', ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 , 00 LICENSBU CONTRACTORS DECLARATION a v u 1 hereby affirm that I am licensed er Pr in Chapter 9 ISSUANCE DATE m 2 w (Commencing with Section 7000)of ivision 3 rf the siness and BLDG ELECT. PLG. MECN. y z Professions Code, my license is N fore P.1(1 J 11 ��T`I o z m o License C' 1.C.Numb Um .._ m r J Datc _ Contractor ¢ ys EJ ¢ ¢ w OWNER-BUILDER DEC tR n:a., n6 M1nnrFillT BUILDING PERMIT is ;n r 1 hereby affront that 1 am exempt from on chr's License MISC.- ' ' - REFER TO ORD INFORMATION LL o j Law 1'or(hI followin reason.(Sec.7031.5.Nosiness and Professions ~ VALUATION . - g PERMIT ISSUANCE S.If��1G(� $/FT. Code.Any city or county which requires a permit to construct,alter, 10.00 ¢ Q 0IS 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CDNTH. LIC.N0. ELEC. ` o u requires the applicant for such permit to file a signed statement that TOTAL / w m m he is licensed pursuant In the provisions of hPERMIT TOe Contractor's License A F i Q Law(Chapterand Professions odeng )or than he is 00)exempt therefrom o and FEE I O C OV e Q_ p i D Business for he alleged eCode)or that he is exempt therefrom and QTY. PLUMBING PERMIT ¢ r o the basis for the alleged exemption.Any violation of Sect ion 7031.5 by any applicant fur a permit subjects the applicant too civil penalty STORIES TYPE CONSTR. of not more than five hundred dollar,(55000.): ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 their sole compensation,will du the work,and the structure is not OCC.GROUP RES.UNITS Codedor offered for sale (Seca 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code The Contractor's Lirensc Law does not apply to an owner of himsPropelf who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE himself or through his sewn employees, n,a provided that such cl, ove- mentsarenotintendedorofferedforsalelf,however.the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or ins- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RE IND CON PB Omer .❑ 1,as owner of the property,am exclusively contracting with 13 El ❑ ❑ licensed Contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 and Professions Code:The Contractors License Law does not apply' ASSESSORS PARCEL NO. 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 comtmema.$)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec - ,B.&P.C.for This reason WATER HEATER W/VENT 6.00 Owner _ Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE-NO ENO. WORrm that I have NSAT10N U[CLARA'TtoN WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 haven cati0cazc ofcomscnt or a �entra•. or a Certificate( ee Work.re'Conipensution Insurance,or o cettifivvl ZONING ENG.SITE NO. copythereof(Sec.3600.Lany . Policy No.rt_Company. O ❑ Certified copy is hereby furnished. Z ❑ Certified copy is filed with the city inspection division. FIRE SPRINK ENERGY T 24 - 0 O Applicant MISC.- REFER TO ORD. Y F] N❑ Y O N[] D- T CFRT'IFICA'TF:OI'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU O COhIPENSAI'ION INSURANCE PLG.CONTR&WITH LIC.NO. Z5.00 IL 0 (This section need not be completed if the permit is for one Y N Y 0 N❑ hundred dollars IS 100)or less. U O 1 certify that in Orn Pcrf m:&UfCid, for which his per- CITY. ICAL PERMIT FEE SUMMARY LL I- mit is issued,1 shall not cm ny manner so as to bee.uKu Workersws of Culin/,who U NOT ANr:nALTO MECN. BUILDING1VV} H NOT T P ANT: If, nificale of lix- mnption,You should become SaCompensation APPPLAN CHE K U such)sions of provisions fle Labor Code or his pens t shall be dou eemed revoked comply will, AIR (TO 10FEE F� ,000 C.F. C'ONSTRUC'T ION LENDING AGENCY AIR (OVERIO=C. SEISMIC FE" 1 hereby affirm that there is a construction lending agency I'.. EXHWITH DUCT)the petfonn ante of the work for which this permit is issued(SIC. MICROFILM 3097.Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lenders Address HEATING UNIT 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read his application and state that he above VENTILATION FAN (SINGLE) 4,00 nforInation is correct, 1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER H.P.or 100,000 B.T.U.) 6.00 hereby Buhorize representatives of this City to enter upon tlm ub •- mntioneJ property I'or inspection purports. 601 LER-COMP(OW:r,100,000 BTU)SEE FEE SCH. MECHANICAL (We) e, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino gains. I` dries,judgments, costs and expenses which CONST.TAX Sty in an w true against said City in consequence of he PERMIT ISSUANCE 10.00 Fir tin MECH.CONT. LIC.NO. MECN. TOTAL TOTALd1 P A plicant/ vtmc r Date 1 OFFICE COPY - -. - - - - - ---- - --- y - A