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13611 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 13611 rl INSPECTION DIVISION JOB INSPECTION RECORD i' PERMIT EXPIRATION JOB ADDRESS 10460 TULA LANE UNIT# LOT# - PERMIT EXPIRES IF WORK OWNER TOM TANAGUCHI CONTRACTOR, SOUTH BAY PLUMBING" IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB �\ PLUMBING, ELECTRICAL ISSUANCE DATE _ BLDG. ELECT. PLG. MECH. MECHANICAL ❑ ❑ f ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED AA BUILDING PERMIT WOOD FLOOR ,la INFORMATION VALUATION $IF T. PLUMBING ' MECHANICAL v� PERMIT TO F ELECTRICAL FRAMING STORIES TYPE CONSTR. • INSULATION - OCC.GROUP REB.UNI TS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO,FT.FLOOR AREA TOTAL/,CREAGE ROOF DIAPHRAGM RES USE ES INDCON PB Olnn, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED S "-P,3147a40 ❑ ❑ ❑ ❑ [I ASSESSORS PARCEL NO. ROUGH PLUMBING _ 9 _. TRACT 60. PARCEL NO. GAS TESTCt6`rta./ ' MECHANICAL 7�r ry,{Y p,G QoIA ACL;GATE ACC.FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING ZONING ENG.SITE NO. - op INSULATION PLUMBING _3 GAS F IRE SPR I NK ENERGY L]< MECHANICAL Y ❑ NEJ Y ❑ NEI COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH-INTERIOR - ELECTRICAL FLOODZONE A.L.U.C. LATH-EXTERIOR FIRE DEPT. YNE:] Yo NE) SHEETROCK GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING - BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS ' FIREWALLS ELECTRIC - PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE • OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING • 0� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z — SEE PERMIT FOR EXPIRATION DATE — ECHAMCAL CONST.TAX/ IMPORTANT! PLEASE READ REVERSE.SIDE BEFORE TOTAL CALLING,FOR FINAL INSPECTION. OFFICE COPY �" i APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY 13U LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT N ADDRESS � BUILDING-ELECTRICAL-PLUMBING-MECHANICALI E)4G TVLIN L11 b OWNER'S PLAN CHECK VALIDATION ill �x NAME QTY. ELECTRIC PERMIT FEE 1 'TV h j�1tJNE}vvCl}a PHONIC CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 NAME SD.1/r1 �`1 LNF aJN( . LIC.NO. yea 14 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS APPLIANCES-RESIDENTIAL 4.00 ;�J- PANELS 10.00 GATE K APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE .C.N0. OR ENGINEER uc.No. SIGNS TRANS. - 3.00 ARCH.OR ENG. SPECIAL CIRCUIT $.00 PERMIT VALIDATION ADDRESS ZIP TEMP. METER OR POLE INS. 20.00 ^ APPLICANT•% MOTORS SEE FEE SCH. I..O ADDRESS SERVICE SERVICE CHANGE 20.00 p '7 O o o LICENSED CONT RACfORS DECLARATION ��O�d <L, I hereby affirm that I am licensed under provisions of Chapter 9 S.SUANCE DATE Z (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. z Professions Code dicense i nsc ass s in full lure d (pn. ❑ Licct he Number- Contractor umber 1 ❑ ❑ 9 w H Dara Contractor_ F: L t BUILDING PERMIT II: wa OWNER-BUILDER DECLARATION INFORMATION w ;LL H I herebyform that I am exempt from the Contractor's License MISC.- REFER TO ORD a P VALUATION S/FT. H a_ '0 law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to construct,alter, QQ Q 2 Improve,demolish.or repair any st NCtum,prior to Its Issuance,also ELEC.CONTR. LIC.NO. ELEC. al ar O LL requires the applicant for such permh to file a signed statement that TOTAL PERMIT TO a w m he is licensed pursuant to the provisions of the Contractor's License , p Hzi Law(Charter 9(COmmcncing with Section 7000)u f Division 3n(the a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE the basis for the alleged exemption.Any violation of Section703L5 STORIES TYPE CONSTR. a3 - by any applicant fora pennil subjects the applicant to a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than five hundred dollars(5500).): Cl I,as owner of the property or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure or not intended or Offered for.1c (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of • property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 Sp.FT.FLOOR AREA TOTnLACREAGE himself or through his own employees,prtlAided that such improve. GAS-EA.SVSTEM-11NC.40UTLETS 6.00 mems are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or in, RES IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. w4 30.00 ❑ I•as owner of the property,am exclusively contracting with ❑ [D ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 .B. 6.00 ASSES RS 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-OVER 5 IEA.) , 1:00 contracts for such projects with a contmctods)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORMf00 'A.2ftIl0.fb • 1 TRACT NO. PARCEL NO. ❑ Iamcxcmptunder Sec. ,B.&P.C.]or this WATER HEATER W/VENT reason Owner [)art WATER.SYSTEM G\ 5.00 ACC.OATE ACC.FILE No. WORKERS'COMPENSA'fION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate of consent to self-instars, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or it certified 1� Copy there db(Se 381X),Lab.C-)-S�1T>�P+�O Policy No.b . company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certitie cop is fiyLd wi�ltiiWype-tion division. MISC.- REF ER TO ORD. ❑ ❑ ❑ ❑ Applicant II I '3 ` Y N V N lir y CIiRTI FICATIi OP fix EMPI'[0N I'ROA1 WORKERS' PERMIT ISSUANCE 10.00 A FLOOD ZONE A.L.U,C. LL ? COh1PENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. YE] NE] Y ❑ N❑ OL 0 (Thu section need or be completed if the pennil is for one TOTALC ::) Z hundred duller,IS 100)or IessJ U O 1 Certify that in the perfomranee of the work fur which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mil is issued,1 shall not employ any person in any manner so as to V become subject to the Workers'Compenation Laws of California. Of Datc Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >_ Us NOTICE TO APPLICANT: If.after making this Certificate of Ex. r Z eruption,you should become subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this Permit shall N deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.DO SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 rm the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Ci,CA HEATING UNIT(TO 100,000 B.T.U.) 6.00 Lender's Lender's Add dd HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC 0 1 Certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 0-2) information is correct. I'agree to comply with all city and county PLUMBING •�J ordinances and state laws relating to building construction, and BOILER-COMP I3 H.P.or 100,000 B.T.U) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection 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 10.00 CONST.TAX may in any way accrue-against said City in consequence of the grantin permit. MECH.CONT. LIC.NO. MECH. �1 wp�:J �l-Zl t$ TOTAL TOTAL Signature of Applicant/Contractor ate -✓ OFFICE COPY