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18721POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECOR1D. r -- y( — 1N u `T JOB ADDRESS_ 0 OS V lV_ WQ( �OL UNIT# _LOT# OWNER �V's�1r.`. CONTRACTOR Q �i �,'� T--' PERMIT NUMBER 18721 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE I INSPECTOR INSPECTION RECORD FOUNDATION- NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS., UFER - PREGUNITE PERMIT VALIDATION �, .� .' f• �_ -`STV ISSUANCE DATE / GARAGE SLABS 'POUR NO C NCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING J J ELECTRICAL MECHANICAL City, ff. __ BLDG ELECT PLG. MEC.. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ' BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION s/FT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO _i5li--r 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 THE CONSTRUCTION TAX IS PAID sa rr FLOORAREA TOTAL ACREAGE DIAPHRAGM auaolrvc USE RES IND CON PB 00 � L L L ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.N PLUMBING ELECT. ENERGY TUBS & SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO MECHANICAL MECH.ENERGY ACC DATE ACG FILE NO ELECTRICAL BUILDING ENERGY - FRAMING ELECT. FINAL TEST zoNlrvG ' ENG SITE No. INSULATION PLUMBING GAS TEST - GAS FIRE SPNINK v NL ENERGY L40 v rvL MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 'TO 00 ZONE v❑ NL A,LUC YL NL EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH IBUILDING BUILDING INTERIOR LATH . TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK' EE F GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING ISNOTPERMITTEO UNTILBUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM w ARRANGE FOR INSPECTION BY PHONING 252-4505, H ONE WORKING DAY BEFORE REQUIRED INSPECTION. Oz PLEASE GIVE JOB ADDRESS WHEN PHONING. —SEE PERMIT FOR EXPIRATION DATE — ELECTRIC -:. D EA PLUMBING MECHANICAL covsT. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE. CALLING FOR FINAL INSPECTION. TOTAL ��PQ OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING -ELECTRICAL- PLUMBING -MECHANICAL PERMIT NUMBER 1 �7�� I I BUILDING ADDRESS - 2ef u V' OWNER'S NAME QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE DATE OF APPLICATION N RACTORS AME ^ p LIc. No.7sa % UTLETS-SWITCHES-REDEP 10.00/1.00 3S,AQ LIGHTING FIXTURES 10.00/1.00 Q DORESTORS `� CF 95 V51 G J'/ APPLIANCESRESIDENTIAL 4.00 PANELS 10.00 ARCHITECT On ENGINEER uc. NO PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P.C. NO, ISIGNS TRANS. 3.00 ARCH. oR ENG. ADDRESS ZIP SPECIAL CIRCUIT 5.Q6 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESS SERVICECHANGE 20.00_ - '• Y`✓ LICENSI:DCONTRACTORS DECLARATION - 1 hereby album Ihal I am licensed under provisions of Chapler 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Liefl'SSIU113 Code an(I,1ylicense Liia iii full force and effect. i CIan (/ Number BLDG. ❑ ELECT, PLG. I UECH. ❑ ❑ w �L�-i te'7 C. Date LlJ=1=�/� Contractor Date' BUILDING PERMIT OWNER -BUILDER DECLARATION 1 hereby of llo that I ant exempt Go.5 the Contractor's License Law for the and Professions or countywhi(Sec.7Wsa MISC.- R b ORD INFORMATION VA WATION $/FT. PERMIT ISSUANCE 10.00 2. permit tocO Code: Any city or county which rqulture permit m construct, alter* ity improve, demolish, or any structure, prior its issuance, also ELEC. CONTR, LIC. NO. L forrepair such n he vires the applicant for such permit ro file a signed statement that he is licensed purnant to the provisions of the Contractor's License Law (Chapter 9(commencingwith Section 7000) of Division 3 ofthc Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of5ection 7031.5 TOTAL TOTAL V D PERMIT TO DTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN -WATER IEA.) 5.00 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).1: ❑ 1.., owner of the property. or my employees with wages as their sale compensation, will do the work. and the structure is net intended or offered for sale (Sea 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code; The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work FIXTURES - PER TRAP 5.06 SG. FT. FLOOR AREA TOTAL ACREAGE himself or through his own employees. provided that such improve- mmas ure not intended or offered for sale. If, however, the budding GAS-EA.SYSTEM-I1NC.4OUTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the harden of proving that he did not build or im- prove for purpose ofs:le.). ❑ I, as owner of the property.:un exclusively contracting with l icetued coatradors to construct the projem (Sea 7044, Business GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES - IND CON PB Omar ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.60 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO, and front., sions C•odu1'he Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts fur such projectswilh a contractor(s) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft110.00 TRACT NO, PARCEL NO. ❑ 1 ... mcmpl.ner S,c. .B.&P.C. for On, reuse. WATER HEATER W/VENT 6.00 Owner Dat, WATER SYSTEM 5.00 ACC.DATE ACG FILE NO. WATER TREATING EQUIP. 5.00 WORK F RS'COMPHNSA'I'ION DECLARATION I hereby affirm Ilnat I have a certificate ofconwrtt to self -..... ,. or a certificate of Worker's Compensation Insurance, or a cerlificd ZONING ENG. SITE N0. copy therepfV($c•jl_lMo lgb y'.1 'g7 SFiH Policy No, n c•Yr FIRE SPRINK Y ElN ❑ ENERGY T 24 v [3 N[3C: ❑ Certified copy is herebyfurnished G-Cerlil'i- opy is hl with c it s coon division. APPlicxnl MISC.- REFER TO ORD. i� 1171 ATE O' uXFMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L. U.G. PLG. CONTR. LIC. NO. PLG. TOTAL COMIPENSATION INSURANCF section need not be completed if the permit is for one y❑ NE] V❑ NE] DTV. MECHANICAL PERMIT FEE FEE SUMMARY Hundred dollars IS 1001 or less.l I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so as to BUILDING become subject to tine Workers' Compensation Laws of Calil'orni.. Date Applicant NOICE TO APPLICANT: If, after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE eroption, you should become subject to the Workers'Compensation pvisions of the Labor Code, you most forthwith comply Willa ro such provisions or this permit shall be deanled revoked. AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIR HANDLING UNIT (OVER 10=C.F.M.) 6.00 SEISMIC FEE CONS' I' RUCTION LENDING AGENCY I hereby affirm flat there is a construction leading agency for line pe,lonnance of the work for which this pernif is issued (Sac 3097, G,C.). EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) -8.00 HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC Lenders Addr Lender's AAdrees I certify that l have read INS application and slate than the above Infornalion is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER-COMP(3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTUI SEE FEE SCH. MECHANICAL Hereby nation, representatives of this city to enter upon the above-mentioned property Ior inspection purposes. ' MISC. - REFER TO ORD. (We) agree to save, indemnify and keep harmless the City of upertmO against liabilities, judgments, costs and expenses which may m a way accrue against said City in consequence of the CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. rantyy��g lhis pe,ryyIL.� 1 X4, 7/1.�n� /U? WF TOTAL TOTAL �^ / (<I ISIgirghture of Applicant/Contractor Dam OFFICE COPY