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18339 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMIIER .E CITY OF CUPERTINO 19339 INSPECTION DIVISION JOB INSPECTION RECORD �� (� I PERMIT EXPIRATION JOB ADDRESS�Lat-V L& l UNIT# _LOT# / PERMIT.EXPIRES IF WORK OWNER •Ca S �- CONTRACTOR. A=ualgyp,, IS NOT STARTED WITHIN INSPECTION . ATE 4NSnCTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION 'ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFERALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF - PERMIT VALIDATION CUPERTINO STANDARDS. - ' GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED . .UNDERGROUND /SLAB �+ PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG ELECT.I PLG. .•MELH ❑ ❑' ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT, PLUMBING MECHANICAL ' ELECTRICAL PERMIT To FRAMING M eL INSULATION TORIES TYPE CONSTR. . OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - so FT iLOORAREA tOI ACREAGE - ROOF � NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID' BUILDING USE ROOF SHEATHING RES IND CON PB O,— . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.N ASSESSORS PARCEL NO PLUMBING ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL N0 MECHANICAL MECH.ENERGY ACC.OATE ACC.FILE NO. ELECTRICAL - BUILDING ENERGY FRAMING ELECT.FINAL—TEST —'—'^^--' roNING ENO slrE No, INSULATION PL MBING - GAS TEST - GAS MECHANICAL FIRE RINK ENERGY Lpr ❑ Y NN[_]❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE /V LooO zorvNe A.LUC. N� 7 NE) INTERIOR SHEAR F DEPT. SHEETROCK GRADE - FEESUMMARY EXTERIOR LATH IBUILDING .INTERIOR LATH- TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �� 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. OFFICE COPY- APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT � ��[]J A oEss 7/ 10k�i . W BUILDING -ELECTRICAL-PLUMBING-MECHANICAL ) OWNER'S PLAN CHECK VALIDATION ME ELECTRIC PERMIT FEER,/ JCNJ-rol Ma 7_flit) O NOMERACroRs�� TLETS-SWITCHES-RECEP 10.00/1.00 IQ•s LIC.NO. g246LI TING FIXTURES 10.00/1.00 CONTRACTOR', V APPANCES-RESIDENTIAL 4.00 a ��Es3/� SgCtm1WCtR-14P104E'739 CTS PANEL 10.00 DATE OF APPLICATION aRmTECT PLAN CHECK FEE P.C.NO. One PANELS 10 R 200 AMP) 20.00 ENGINEER Is- LIC.No, SIGNS TRANS. 3.00 ARCH,SS ENO' SPECIALCIRCUI 5.00 PERMIT VALIDATION ZIP EMP.METER OR E INS. E 20.00 / !I �j(.y AP�PLeIC�5A5NT5�.� eA / • r MOTORS SEE FEE SCH. ( ( 1/ aLJ` J '^+" �'�.�✓N SERVICE CHAP20.00 J. t W J�`�/ o ZO LICENSED CONTRACTORS DECLARATION )I'L("`_ a u L, I hereby affirm that I am licensed under provisions of Chapter 9 (Commencingwh Section 7000)of Division 3 o The Business and A�lD ISSUANCE DATE to a w - BLDG. ELECT. PLG. ECH. 1., D Z Professions Cod t icense is in full fare c Z O !-n - License Closs_ Lie Number m O Dalc�_ Contract - City (1f 011l81f{IiD a u EPIP BUILDING PERMIT ¢ ¢ < OW :R.BUILDERDECLARA'TION a a 0 INFORMATION w ;¢ _ I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD m VALUATION $/FT. FLLOa Law for the following reason.(Sec.7031.5,Business Professions PERMIT ISSUANCE 10.00 Code:Any city intercity which requires a permit to construct,alter, - ELEC.CONTR. LIC.NO. ¢ Q a improve,demolish,or repair any structure,prim n its issuance,also ELEC. O LL requires the applicant for Such permit to file a signed Statement that TOTAL PERMIT TO n w$y he is licensed pursuant to the provisions of the Contractor's License H Z t Law(Chapter 9(commencing with Section 7000)of Division 3 oflhe a Business and Professions Code)or that he is exempt therefrom and QT PLUMBING PERMIT FEE ¢ 1, the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. 03$. by any applicant for a permit subjects the applicant to a civil penally A TEfl-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BA 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 DRAT -FLOOR,ROOF;AR EA,COND. 5.00 ` Code:The Contractor.', License Law does not apply to an owner of property who builds or improves thereon,and who does such work F IXTUR -PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improvr ments are not intended or offered for sale.If,however,the building GAS-EA.S TEM-1INC.4 OUTLETS 6.00 or inirrovement is sold within one year of completion,the owner, builder will have the burden of proving that he did not build or im. GAS-EA.SV EM-OVER 4 (EA.) 2.00 BUILDING USE _ prove for Purpose of sale.). RES IND CON PB Oroer T' p" INDUSTRIAL W TE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. 7044,Business LAWN SPR INKLE 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. 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- V ER 5 IEA.) 1.00 contracts for such projects with a contmcton s)licensed pursuant to SEWER-SANITAR V-STO EA.200ft/10.00 the Contmdor s License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-,H.&P,C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE AOC.FILE No. WORK F-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm That I have a certificate of consent to self-insure, ZONING ENG.SITE NO. nr a ccrtifmatc of Workers'Comp nmtinn Insurancc, a ccr I� copy[heru�/fiL•pa3N110,�b,C.1� r•1 Policy No._ al an UU [^' O T� Certified copy is hereby furnish FIRE SPRINK P: ENERGY L]4 Z Z �(1 Cerb o y is file ith 0 city inspection division. O O Applicant - MISC.- REFER TO OR Y N❑ V ❑ N❑ LUyCER'TIFICA'1'1'-OleliXEMPTION FRO WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A1.U.C.. W - COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG, 1 Q � Y � N� 0 (This section need not be completed if the permit is for one TOTAL YN ::) Z hundred dollars IS 100)or less.) U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued,I shall not employ any person in any manner so as to become.subject to the Workers'Compensation Laws of California. O Is.W Date Applicant ALTER OR ADD TO MECH. '5.00 BUILDING } m NOTICE '1'0 APPLICANT: If,after making this Certificate o1Ex- F 2 emption,you should become subject to Ilse Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10OMC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=11F.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 the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state that Ills above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county BOILER-COMP 13 H.P.Dr 100,000 B.T.U.i 6.00 PLUMBING ordinances and state laws relating to building Construction, gid hereby authored representatives ec this city to enter upon the BOILER-COMP (Osm 100,000 BTU)SEE FEE SCH. MECHANICAL �• herebymma Toned properly for iespoft this purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE CONST.TAX ue a may in any way accrgainst said City in conseT Ience the rent' this permit. MECH.CONT. LIC.NO. MECH. .�.. ' TOA/ a TOTAL aI• �fJ iare of Applicant/Contractor ale Q.S (AGI4 SZ b f OFFICE OPV