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18023 POST THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER . CITY OF CUPERTINO - 18028 INSPECTION DIVISION „ JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS `� S �E.VS '£�'UN I T# _LOT# /f PERMIT EXPIRES IF WORK OWNER / CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE -INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: - UFER ' ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION.. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. J�-' GARAGE SLABS �' QAJ!0A e,�f �ll, `j • POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED "'f -`•{' • UNDERGROUND /.SLAB PLUMBING - - ELECTRICALISSUANCE LATE MECHANICAL BLDG- ,;ELECT} PLG, M�. E] ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED iG' BUILDING PERMIT INFORMATION WOOD. FLOOR - vnwnnON $JET. PLUMBING JUN 141989 •"'" ' MECHANICAL ELECTRICALIII PERMIT TU.ppe -no J`71:�G� FRAMING - - INSULATION - - - - STORIES TYPE CONSTR. OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 5O-FT FLOOR AREA TOTAL ACREAGE • . - DIAPHRAGM - THE CONSTRUCTION TAX IS PAID BUIL.DING use ROOF SHEATHING I111:5 IND CON PB 00- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ Cl ED ❑ ❑ A55E55UR5 PARCEL ND .ROUGH SAN.N 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 ZONING ENG.SITE NO. INSULATION PLUMBING GAS TEST GAS FIRE SPRINK ENERGY T 24., - MECHANICAL . I ' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y.❑ "❑ '•v ❑ NE] EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE - ALUc. " INTERIOR SHEAR � FIRE DEPT. Y NE] Y ❑ 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 JOCCUPANCY LSEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BYBUILDING INSPECTOR. MICROFILM ARRANGE FOR. INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUM9ING Z PLEASE GIVE JOB.ADDRESS WHEN PHONING. O.QQcHnNICAL — SEE PERMIT FOR. EXPIRATION 'DATE = Me3 IMPORTANT! CONST.rnx PLEASE READ REVERSE SIDE BEFORE TOTAL 3217. CALLING FOR FINAL INSPECTION. . ... OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDING PROJECT 1 DENTI FICATIO - 'PERMIT NUMBER BUILDING APPLICATION & PERMIT 1' 8023. ADDRESS BUILDING_ 1 ELECTRICAL-PLUMBING -MECHANICAL f0 '1 NA EL'S I PLAN CHECK VALIDATION - 1/ OTY. 'ELECTRIC PERMIT FEE Y( 5 PHONE LONTRANAME croR's UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 ADDRESS oR's APPLIANCES-RESIDENTIAL 4.00 CONTRA ��K//✓yg,w NE PANELS 10.00 DATE OF APPLICATION �- ARRCHITECr PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. O ENGINEER c LIC.No. ISIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT ,5.00 I ZIP EMP.METER OR POLE INS. 20.00 J•4�p,�JN 0'14/ APPu ESS MOTORS SEE FEE SCH. a64 0OREss 1 l /' 17 O zpG//✓ r/r. .<V • SERVICE CHANGE 20.00' G. l q:. �Q o o LICENSFD CONTRACTORS DECLARATION - t Fi w I hereby aCOnn Ilial 1 um licensed under previsions of Chapter ISSUANCE DATE a u (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.. H w i 1'rofesslons Code and my license is in full force and effec -- ❑ ❑ ❑ License Iu 28 Lie.Numbers �.Q� .. _ O H H w Dare Conlmcl.r - rc Y ¢a OWNER-BUILDER DECLARATION BUILDING PERMIT o d o _ INFORMATION E: ;a- I hereby affirm that 1 am exempt from the Contractor's License MISC.- TO ORD H ¢ o J Law for the following reason. 7031'.5,Busirlessand Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. 00 Code:Any city or County which mquiresu permit toconstruct,alter, er ¢ ¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTRA - LIC:N0.- ELEC. O u requires tire m e applicant for such permit to file a signed statement that TOTAL K m s. he is licensed pursuant to the provisions of lite Contractor's License PERMIT TO HIQ , Law(Chapter 9(connmemmngwhh Section 7000)ofDjvision 3 ofthe E o Nosiness and Professions Code)or that htherefrom e is exempt and QTY. PLUMBING PERMIT FEE ¢H o the basis for the alleged exemption.Any violation of Section 703 L5 STORIES TYPE CONSTR. w. w- by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 ' of not more then five hundred dollars($5001.): ❑ 1,as owner of The property,or my employees with wages as BACK FLOW PROTECT,DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 " Code:Tic Contractor's License Law does not apply to an owncl of property who builds or improves thereon,and who does such work. FIXTURES,PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenot intended or offered for sale.It,however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have file burden of proving that he did not build or im- BUILDING USE Prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES ]No Co PS Oma, ❑ I,as owner of the properly,ons exclusively contracting with El ❑ 9 11 0 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 does not apply to ua owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts forsuch projects with a con,rac,orsHiceused ptusomt,to the L'.nlraCIOTS License Law. \ SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. C I am exempt under Sec.--,BAP.C.for this WATER HEATER W/VENT 6.00 rcusnn Owner Date - WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, WORKIiRS'COMI''N TI�gN3�)yyc. �yTION WATER TREATING EQUIP. 5.00 I hereby'u m t let wv0c.9iLinsln1 To se l Ginsure, or a certifical of Workers'Compensatio n Insur IJJcc��,��or��a��certified 'ZONING ENG.SITE N0. 'opy l No ( a.3800,Lab.C�17(lsel� Policy ere Company 0 C Certified copy ishereby furnished. FIRE SPRINK ENERGY T-24 Z Z �l.CCertured c py is •d, gi the y t lie 'di I' n. p Applirlm MISC.- REFER TO ORD. v N v No My Cl: FICATE OP EXEMPTION I7ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU J COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Q. O (This section need not be cocipleted If the permit is ILL one TOTAL Y❑ NY C] NQ D Z hundred dollars(S 100)or I.S.) 0 O 1 certify that in the performance of the work for which this per- OTY MECHANICAL PERMIT FEE FEE SUMMARY IL I- mil is issued,1 shall not employ:my person in any Drum, so as to 0 W become subject to the Workers'Compensation Laws of Calilbrnia. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } In NOTICE: '1'O APPLICANT: If,after making this Certificate of E.. F ? emprior,you should becwne Subject m lite W.,keri Compeuutmn APPLIANCE 5.00 PLAN CHECK Provisions of the Labor Code, you must forthwith comply willi FEE C) such provisions.,this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M:) 4.00 " CONSTRUCTION LENDING AGENCY HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency For EXHAUST HOOD (WITH DUCT) 5.00 the performance of t e work for which this permit is issued(Sec. MICROFILM 3097,Cie.C.). �� HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC 1 ccrtily fire,I have read this applies,.....and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct, I agree to comply with all city and county PLUMING ordinances and state laws relating In building construction, and BOILER-COMP(3 H.P.or 100,000 ^ hereby authorize representatives ec this city es enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL •KO• 0O above-mentioned pro etly forinsp of purposes, ��,..JJJ (We) agre to e, indemnify and keep harmless the City of misc.- REFER TO ORD. Cupe,1 0 a ins abilities,judgments, costs andexpenses hi h PERMIT ISSUANCE 10.00 CONST.TAX may i an wa ceme agnins id Cityh on quencc tt c - ra g o his mit. SFJH,.CONT. LIC.NO. MEC Y/lill ' TO AL TOTAL 130. O i atur o Applicu Co reel ale er ^L, ..� OFFICE COPY