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14578 r POSTTHIS''CARD NEAR FRONT OFBUILDING r.. PERMIT NUMBER CITY OF CUPERTINO 14578' , INSPECTION DIVISION JOB INSPECTION.RECORD PERMIT EXPIRATION _ JOB ADDRESS � Ou63 Long OGc% (YINIT Jk _LOT# ,L -- // L• = .PERMIT EXPIRES IF WORK, OWNER YIJCL CO 6.YS CONTRACTOR IS NOT 'STARTED WITHIN INSPECTION DATE INSPECTOR 'INSPECTION RECORD ' i80 DAYS OF PERMIT ISSU. ' FOUNDATION -ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. ' UFER - T ALL GRADING AND DRAINAGE SHALL BE INSTALLED " PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERM17 VALIDATION CUPERTINO STANDARDS. .- GARAGE SLABS f. - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' UNDERGROUND /SLAB - PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL'. ., 1 - BLOC ELECT. PLtI. MEcI+ . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION srF T. ' , :- MECHANICAL 'ELECTRICAL PERmrt To. c/0� FRAMING - INSULATION STORIES TYPE CONSTR, - OCC GROUP I RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $0,FT.FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID • —816 7L 6IF7G US ROOF SHEATHING RES INO CON Pe Go... APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El ❑ '❑ '❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.R PLUMBING - ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT No. PARCEL No MECHANICAL MECH.ENERGY . ACC.OATE ACC.FI LE NO: ELECTRICAL BUILDING ENERGY FRAMING - ; ELECT.FINAL TEST ' - INSULATION PLUMBING ZONING '.ENG,SITE NO. GAS TEST - GAS MECHANICAL - FIRE SPRINK ENERGY T.24 COVER NO WORK,UNTIL ABOVE HAS'-BEEN SIGNED HEATING ' Y - NO Y Q "•N❑ FLOOD ZONE A,L.U.C. EXTERIOR'SHEAR ELECTRICAL RELEASE ' v❑• N� vL , -ID INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING -.�( . INTERIOR LATH - - TEMPORARY APPROVAL BUILDwc� SCRATCH COAT ELECTRIC PLAN CHECK'. GAS _ FEE . . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE J OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM' ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC LU ARRANGE ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING ." Z� PLEASE GIVE JOB ADDRESS WHEN PHONING. F SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! covsT.TAX PLEASE READ REVERSE"SIDE BEFORE ° CALLING.FOR FINAL INSPECTION. TOTAL • i t!? OFFICE COPY APPLICANT TO FILL.IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY `BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER . aD,LD;NG APPLICATION & PERMIT 1 [pj rh 7 8 vAoge(/sb(j3 /_'/G ,{}��' BUILDING -ELECTRICAL-PLUMBING-MECHANICAL I ,T�/ 1 S OWNERS , (J L NA rr PLAN CHECK VALIDATION M q� 2'-f`7-1 3a DTY. ELECTRIC PERMIT FEE ' l 1-To JCIV066._p Y/'> PE I NAIVE CONTRACTORS NAME- i • OUTLETS-SWITCHES-RECEP 10.00/1.00 , ' LIC.NO. a "LIGHTING FIXTURES 10.00/,1.00 r-DNTRACTOR'S PPLIANCES-RESIDENTIAL ` 4.00 _ ADDRESS t ' PHONE PANELS - 10.00 DATE OF APPLICATION' {Y ARCHITECT - h PLAN CHECK FEE P.C. OR PANELS (OVER'200 AMPI­ 20.00 t , " ENGINEER' uc.NO. ISIGNS.TRANS. - 3:00 ' ADD ESS ENG . - r SPECIAL CIRCUIT '' 5.00 PERMIT VALIDATION . - ZIP TEMP.METER OR.,POLE INS. --, 20.00 ^ h APPLICANTS '- - MOTORS ''SEE FEE SCH. ADDRESS ' - SERVICE CHANGE 20.000 ac woo . LICENSED CONTRACTORS DECLARATION �® /O Q es:v u I hereby affirm that I am licensed under provisions of Chupler 9 NCE DATE N <"' (commencing'with Section 7000)of Division 3 of the Business and, - L06, T. LG. . MECH. E. DO i ' Professions Code,and my license is'm full force and effect. - ❑ ❑ o 0 Ino License Class - Lic.Number I_ Date - Contractor - a y.� - NG PERMIT a as OWNER-BUILDER DECLARATION - " c ii u - INFORMATION X guy 1 hereby affirm that 1 am exempt from the Contmcmr's'Lmense MISC.- REFER TO ORD vawaTlON $/FT. r oJ. Law for the following reason (Sec.]0315,Businessand Professions PERMIT ISSUANCE 10.00 ENi Code:Any city'or county whmhregnresu permit to construct,alter, O .s Gf� Q 0O improve;demolish,or repair any"structure,prior to its issuance,also ELEC.CONTR. LIC:N0. ELEC. . - d iG u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO E: m he is licensed pursuant to the provisions of the Contractor's License ,F Z i Law(Chapter 9(commencing with Section 7000)of Division 3 cfthe a Ex rC!✓f7 �✓Q-� 'a Business and Professions Code)or that he is exempt therefrom and' QTV. PLUMBING PERMIT FEE' in F_ $ the basis for the alleged.exemption.Any violation of Section 7031.5 STORIES -TYPE CONSTR. aR _ by any applicant for a permit subjects the applicant to a civil penalty q'LTER-DRAIN -WATER (EA.) 500 - of not more than five hundred dollars($500).): . - '❑ Las owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP •R ES.UNITS iheii sole compensation,will do the work,and the structure is not ., intended or offered for sale(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 - prOperlywhObulldSorlmprovesthereon,and,who does such work FIXTURES-PER TRAP5.00 SO.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employeesf Provided that such improve- 'M1 marts are not intended or offered for sale.If,.however,the building GAS=EA.SYSTEM-11NC,4OUTLETS 6.00 t or improvement is-sold within one year of completion,lhrowner 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 Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ ,I„as owner of the property!am exclusively contracting with s ' ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the,project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. ' '6.00 ASSESSORS PARCEL NO. and Professions Code:.The Contractor's License Low does not apply , to'an owner of property who builds orimproves thereon.and who - LAWN SPRINKLERS-OVER 5(EA.) 1.00 _ contratpq.for such pr 'eets with a contractors)licensetTmInuarl to SEWER-SANITARY-STORM EA,-200ft/10.00 the motor'-Lice Law. - _ TRACT NO. PARCELNO. re❑ eh h toh le, ec. ' ,BAP.C.fo t1' WATER HEATER W/VENT 6.00 - r Owned TFat _ WATER SYSTEM' 5.00 ACC.OATE ACC.FILE NO. a _W0RKF 'COMPENSATION DECLARATION WATER TREATING EQUIP.. 5.00 " - I hereby affir that I have a certificate of consamt to self-insure, ZONING ENG.SITE N0, or z certificate of Workers'Compensation Insurmhce,or a certified Copy thereof(Sec.3800,Lab.C.). - Policy No. Company _ Q. - ❑ Certified copy is hereby.furnished " - -FIRE SPRINK• ENERGY 744 "Z_ 2 ❑ Certified.copy is filed with the city inspection division. MISC - REFER TO ORD. O . Applicant _ v❑ IN 1:1 Y.❑ N.❑ PERMIT,ISSUANCE 10.00 - FL000 zoNE• A.L.u.c. - ;CERTIFICATE OF EXEMPTION FROM WORKERS', J CONTE,W _ ; COMPENSATION INSURANCE •PLG.co .LIC.No: �PLc. , CL C. (This section need.not be completed if the Permit is for one - _ _ TOTAL Y❑ , N❑' 'V❑ NE] hundred dollars(SI00)or less.) - U O 1 certify that in the performance of the work for which this per- QTV. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to UU become subject to the Workers'Compensation Laws of California. c_ LU Datc Applicant -- ALTER OR ADD TO MECH. 5.00 - BUILDING /Q' . .} r7 NOTICE TO APPLICANT: If,after making this Certificate of Fit- �. ? emption,you should income subject to the Workers CompensationAPPLIANCE - 5.00 - PLAN CHECK / S� provisions of the Labor Code, you must forthwith comply with FEE K/ U such provisions or this permit slhall be deemed revoked, AIR HANDLING UNIT(TO 10=r-F.M.) 4.00 - CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.)'6.00 SEISMIC FEE; `. I hereby affirm that there is a construction landing agency for EXHAUST HOOD(WITH DUCT) • 15.00 the performance of the.work for which this permit is issued(Sec. HEATING UNIT(70'100,000 B.T.U.) 8.00 MICROFILM;. 3097,Cie.C.). Lender's Name - HEATI NP�UN IT(OV ER 100,000 B.T.U.)9.50 ' ELECTRIC ' Lender's Address - - tti. I certify that have read this application and store that the above VENTILATION FAN•(SING LE) 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-COMP(3 H.P.or 100,000 B.T.U.) 6:00 . - / hereby authorize representatives of this city to enter upon the - V ,h above-mentioned property for inspection purposes. BOI LER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL' (We) agree-to save, indemnify and keep harmless the City of MISC.'- - ' REFER TO ORD. e tiro again liabilities,judgments, casts and expenses which - CONST.TAX - - - an wa accrue,age at said City in consequence of the PERMIT ISSUANCE 10.00 C t 'sp mit MECH.CONT. - LIC:NO. -' MECH. - TOTAL Z- TOTAL iignalure of A cant/Contractor Date OFFICE COPY.