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14087 POST THIS CARD NEAR FRONT OF BUILDING ER CITY 01 CUPERTINO RERM11TQD0 87 INSPECTION DIVISION •O JOB INSPECTION RECORD Id PERMIT EXPIRATION JOB ADDRESS ��' U IT �d`� LRLOT# `- •- /� l C QL�e0/, /E G'-y�•='/'u¢.ff��.J� PERMIT EXPIRES IF WORK OWNER` u ��p T'./'O Alf QXel;l CONTRACTOR /F/L,✓J 'IS NOT STARTED WITHIN INSPECTION DATE I IASPECTOR INSPECTION CORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LASTCALLED INSPECTION.. UFER PREGUNITE - PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL - ISSUANCE DATE ELECT. PLG. I MECH. MECHANICAL ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - uIL ORM PERMIT 1 ORMPERMIT WOOD FLOOR ON SIFT. PLUMBING MECHANICAL ELECTRICAL - PERMIT To FRAMING /1/f�.'• � /��%-.S. ✓.-. INSULATION STORIES TYPE CONSTR. OCC.GROUP RES.UNITS I� PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SD.FT,FL ROOF AREA TOTAL ACREAGE DIAPHRAGM SOI LDING USE RES - IND CON PB Ober APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED SP ASSESSORS PARCEL NO. ROUGH PLUMBING - - TRACT NO. ' PARCEL N0. GAS TEST MECHANICAL , ELECTRICAL FINALS DATE INSP. ACC.DATE ACCFILE NO. FRAMING SAN,* ZONING ENG,SITE NO. INSULATION PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y E] N❑ Y ❑ N[]LATH-INTERIOR - ELECTRICAL Z. FLOOD zorvE L.U.C.a LATH-EXTERIOR FIRE DEPT. Y❑ NYo N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE, NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE If OCCUPANCY OF BUI LDING IS NOT PERMITTED UNTI L BUI LDING FI NAL IS SIGNED BY BUl LDlNG INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING.ol - 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 BUI LOI NG PROJECT I DENTI FICATION PERMIT NUMBER Booq,sG APPLICATION & PERMIT D( BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 14087 OWMEE RJ vM-�1 OTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION yIrJu 1411(12 C1J~0 CONTRACTOR'S I NAME , U - q UTLETS-SWITCHES-RECEP 10.00/1.00 //7� ,-{�- Or �'Iy� li LIC.No.' OOs LIGHTING FIXTURES 10.00/1.00 T 99CONTRACTORS y/s/ / III PPLIANCES-RESIDENTIAL 4.00 • OWr ON FA-11/gD PANELS 1Q,QQ DATE OF APPLICATION ARCH l"I - PLAN CHECK FEE P.C.NO. OR !� �_01") PANELS 200 AMPI 20.00 ENGINEE F'G W 1(-�Z1 Ki uc.N SIGNS TRANS.NS. 3.00 ARR.yCCH�s OFENG Cr IITCj SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION w./T' C/ vi r'••-r S Jr (J� z, "I�() EMP.METER OR POLE INS. 20.00 APPLICANT'S MOTORS SEE FEE SCH. -F(�r'l� AOOREss ��, g SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION eY�/ C a < U u I hereby affirm that I am licensed under provisions of Chapter 9 �, ISSUANCE DATE FAQ% (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. F 7 i Professions CoJ and my license is in full for a g�f2 a o License Cl-ss_ - Lie Num her " 1 + ❑ ❑ 9 H Date Card mctor iL F t' s BUI D NG PERMIT s ¢w u OWNER-BUILDER DECLARATION MAT IN x ;LL N 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD w u o Q V, Law for the following reason.(Sec.7031.5,Businessand Professions -PERMIT ISSUANCE 10.00 VALUATION S/FT. F,Amo Code:Any city or county whichrequiresa permit to construct,alter, ¢ ¢¢ 0 improve,demolish,or repair an structure,prior to its issuance,also ELEC.CONTR. LIC.NO. P P Y P ELEC. J - DLL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO F m he is licensed pursuant to the provisions of the Contractor's License /jV e7z,u,Q /MA,A05.: Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe 4 o Rosiness and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE ¢ F$ the basis for the alleged exemption.Any violation of Section 7031.$ I STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN III VENT-WATER (EA.) 5.00 of not more than live hundred dollars($500).: ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not - intended or offered for sale(Sec. 7044, Business and Professions Code:The Contractor's License Law dues not apply to an owner of DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-11NC.40UTLETS 6.00 marts are not intended or Offered for sale.If,however,the building or improventem 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 0me, prove 1,asofor neeose of sale.. INDUSTRIAL WASTE INTER. 30.00 ❑ 0 0 ❑ ❑ ❑ d as owner of the property,he exclusively. 7044,Bu with licensed contractors to construct Contra 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 anowner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. 'TRACT NO. PARCEL NO. ❑ I am exempt under Sec..,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.GATE ACC,FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby al'fum that I have a certificate of consent to self-insure. or a certificate of Workers'Compenwtion Insurance,or a tificJ ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C..ati-17�} � 1-5 -� Policy N Company- O ❑ rto ed copy is herebyfurm md. FIRESPRINK ENERGY T 24 Z Z erotic copy is d d wIt1� Ilse ity inspection division. - O Ap 'cant f '� MISC.- REFER TO ORD. Y ❑ rv❑ Y ❑ N❑ ~ va PERMIT ISSUANCE 10.00 Lu - CERTIFICATE FMATMPTINS FROM WORKERS' FLOOD 20NE A.L.UF. W � COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O (Phis section need not be completed if the permit is for one TOTAL Y❑ N[] Y ❑ N❑ Z h nand dollars(5100)Or less. U O I certify that in the performance of the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY W {- I is issued,I shall not employ any person in any manner so as to O U b one subject to the Workers'Compensation taws of California. y D tc Applicant ALTER OR ADD TO MECH. 5.00 BUILDING Q } In N TICE TO APPLICANT: If,after making this Certificate of Ex- F ? em tion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK Pro 'sions of the Labor Cade, you must forthwith comply with FEE U Such rovi�i�or/�s orpthis permmiittsl�eyp be I ed cooked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 CO SOC91 LENISIN�AGENCY AIR HANDLING UNIT(OVER IOAWCF.M.) 6.00 SEISMIC FEE 6� 1 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.) 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC • 1 certify that 1 bloc read this application and slate that the above VENTILATION FAN (SINGLE). 4.00 information is Correct.I agree to comply with all city and county .PLUMBING ordinances and state laws relating to building construction, and BOILER-OOMP(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)SEE FEE SCH. MECHANICAL above-mentioned properly for inspection purposes. (We) agree to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. C if against liabilities,judgments, casts and expenses which CONST.TAX ay 'n any w LOC ag st s C'ty in riseque a of the PERMIT ISSUANCE 10.00 1 g of thi p nti /o MECH.CONT. 41C.N0, TOTAL TOTAL TOTAL ignalure of A p n o rector Date OFFICE COPY