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17642 POST THIS CARD NEAR FRONT OF BUILDING T - •PERMIT NUMBER• CITY OF CUPERTINO . 17642 " INSPECTION DIVISION , JOB INSPECTION RECORD Ij �^ (PERMIT EXPIRATION JOB ADDRESS `u-1�I�(�F'j'' UNIT# _LOT# � •M PERMIT EXPIRES IF WORK OWNER ACTOR t_J_ IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR ,180 DAYS FROM LIFER - - NOTE: ' LASTCALLED INSPECTION. ALL GRADINGTAND DRAINAGE SHALL BE INSTALLED PREGUNITE - TO COMPLY WITH-THE APPROVED PLANS AND CITY OF PER-Kill VALIDATION CUPERTINOSTANDARDS.- GARAGE SLABS - _ . . CJ_ 2- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PAID PLUMBING o ( C iA 1 ELECTRICAL wort 2 8.1989 'ISSUANCE DATE MECHANICAL - BLD ELECT I PLG. MEC. city Of CD m ❑ ❑ ❑ OO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOORINFORMATION PLUMBING . VALUATION $IFT., � � M MECHANICAL . /'� 0 64 ELECTRICAL - E�RRNIITTTTO 'FRAMING - -Y 4 P N INSULATION - STORIES STYPE CONSTR OCC GROUP •RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' SO.FL FLOOR ANE4 TOTAL ACREAGE ROOF ,NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IDD CON PB +O,., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ 0 ❑ ❑ s❑ ROUGH SAN.# ASSESSO RS PARCEL NO. PLUMBING ELECT.ENERGY - ' 7UBS&SHOWER PAN � � PLUMBING ENERGY TRACT NO. PARCEL NO. MECHANICAL - - MECH.ENERGY ' . ELECTRICAL• — BUILDING ENERGY ACCDATE ACC.FILE NO ' , • ' FRAMING ELECT.FINAL TEST ZONING ENG,SITE NO. INSULATION PLUMBING GAS TEST GAS ' MECHANICAL FIRE SPRINK ENERGY T.]a - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N� "•[:] NO EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE A uC. INTERIOR SHEAR FIRE DEPT. : Y❑ N❑ Y 0 N SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING - INTERIOR LATH TEMPORARY APPROVALS . BUILDING .1 • SCRATCH COAT - ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE I� OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC a� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE_JOB ADDRESS WHEN PHONING. . Z T MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL 86 go CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT-TO FILL IN INFORMATION WITHIN. RED LINES - USE BALL POINT PEN ONLY ' ~ BUI LDI NG PROJECT 1 DENTI FICATION• - PERMIT NUMBER FUILDING /� C `` II APPLICATION,&,PERMIT r� A aooRess?J�✓�� `l� l'IihnllY ., f 9' �.lC Vi BUILDING -.ELECTRICAL-PLUMBING-MECHANICAL DwrvER's • PLAN CHECK VALIDATION � � TV. ELECTRIC PERMIT FEE GNE S 7-321 NANTRycT �S. O ��_ . OUTLETS-SWITCHES-RECEP 10.00/1'.00 '7 � � NAME 100100 L¢.No334f03 LIGHTINGFIXTURES . 0/ . , CONTRACTORS/0",J 3 I 9 ' 3 JAPPLIANCES-RESIDENTIAL 4.00 ADDRES YC dJS - - ..- PANELS 10.00 CH K APPLICATION . ARCHITECT - PANELS IOV ER ZOO AMP) 20.00 PLAN CHECK FEE P.C.NO.. OR' ENGINEER LIC.No. SIGNS TRANS: 3.00' ARCH.OR ENG, SPECIALCIRCUIT5.00 PERMIT VALIDATION -' ADDRESS I , ZIP rrEMP.METER OR POLE INS. •. 20.00 I _ nPPLICA DDRESSTe J MOTORS .SEE FEE SCH. Z� C.kAe 1,,r , r.JO SERVICE CHANGE _ 20.00 1 wo o LICENSED CONTRACTORS DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter 9 .ISSUANCE DATE ' wG m (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. PLG. MECH. H y z Professions Code,and my license is in full force and effect.-' ❑ zo i m o License Class m Lic.Nuber pilo r ❑ c' ❑ . H w Date Contractor YlV a r 2 � - BUILDING PERMIT a:w OWNER-BUILDER DECLARATION INFORMATION oa MISC.- REFER TO ORD w S LL,y I hereby affirm that 1 am exempt from the Contractor's License - VALUATION $/FT. HLLoa Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE - ,10:00 Code:Any city or county which requiresa permit to construct,altel, l O U D[/ •d 4 0 improve,demolish,or repair any structure,prior to its issuance,also' ELEC.CONTR. LIC.NO. ELEC: DLL requires the applicant for such permit to file a signed,s clement that TOTAL PERMIT TO x he is licensed pursuant to the provisions of the Contractor's License FZT Law(Chapter 9(commencing with Section 7000)OfDivisi6n3ofthe � 1�� 11'1e a Business and Professions Code)Or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE Imo-O the basis for the alleged exemption.Any violation of Section 7031.5 - STORIES TYPE CONSTR. 5_; any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER IEA:) '5.00 of not more than five hundred dollars($500).): - ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sale compensation,will do the work,and the structure is not - - - intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 - Code:The Contractor's License Law does not apply to an owner of - - ' - 5.00 property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 50.FT.FLOOR AREA TOTAL ACREAGE. himself or through his own employees,provided that such improve- mems are not intended or offered for sale.If,however,the building • GAS-EA.SYSTEM-1 INC.4 OUTLETS 16.00 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 im- RES IND CON • PB Other prove for purpose Of sale.). INDUSTRIAL WAS TE'INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with - ❑ El El ❑ •� ❑ licensed contractors to construct the project(Sec. 7044,Business ILAWN SPRINKLERS-1 INC 5 V.B. 6.00 ••ASSESSORSPARCEL 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(EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law.• SEWER-SANITARY-STORM EA.200ft/10.00 -TRACT NO. PARCEL NO. ❑ I am exempt under Sec ,B.&P.C.I'or this WATER HEATER W/VENT 6.00 reason OwnerO p Date WATER SYSTEM , 5.00 ACC.5ATE ACC.FILE NO. O WRKERS'COM .N ATI DECLARATION WATER TREAT:ING,EQUIP.- 5.00 ' - - 1 hereby affirm that I have a certificate of consent to self'-insure. ZONING ENG:SITE N0; or tificate of Workers'Compensation Insurance,ar a certified ropy lh f Sec.3800,Lah.C.). F �� - Policy No. Company & ' 0 ❑ Certified copy is hereby furnished - FIRE SPRINKENERGY T-24 Z Z ><Cerli' dxco y is fled w�lh the city inspection division. MISC.- REFER TO OR D. O AFlPlicanl ..1� Ve❑ N❑ Y ❑ N❑ tw CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE „ 10.00 .FLOOD ZONE' A.L.U.C. LU > COMPENSATION INSURANCE. PLG.CONTR. LIC.NO. - PLG: O N❑ Y ❑ N❑ d O (This section need not be completed 1f lite permit is for one TOTAL 0 Z hundred dollars IS 100)or less.) l L) O 1 certify that in the performance of'the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY 'LL I- mit is issued,'I shall not employ any person in any manner so as to 0 w become subject to the Workers'Compensation Laws Of California. BUILDING ' Date Applicuni ALTER OR ADD TO'MECH. 5.00 I' ,} N NOTICE TO APPLICANT: If,after making this Certificate of Ex- - - F Z emption,you should become subject to the Workers Compensation APPLIANCE ', 5.00 'PLAN CHECK provisions of the Labor Cade, you must forthwith comply with „ FEE L.1 such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10A000.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.RM.) 6.00 SEISMIC FEE I r �• I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5100 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,0,C.). HEATING UNIT(70100,000 B.T.U.)- 8.00 Lender's Name HEATING UN IT(OV ER 100,000 B.T.U.)9.601 ELECTRIC Lender's Address I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 . _ information stat is correct, I agree to comply with all city and county PLUMBING ordinances and state laws relating m building construction, and BOILER-COMP(3 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)SEEFEESCH. ,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 ,. CONST.TAX may in any way accrue against said City in consequence of the 'PERMIT ISSUANCE - 10.00 ragtin ofhis per MECH.CONT. - LIC.NO. MECH. TOTAL TOTAL i gnature of Applicant/Contractor Until OFFICE COPY