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18236POST THIS CARD NEAR FRONT OF BUILDING. PERMIT NUMBER • CITY OF CUPERTINO 18236 INSPECTION DIVISION JOB INSPECTION RECORD tit,wI,- `.tv SIS ,.+F2Sl V44 -i--. JOB ADDRESS ` 3 0 I"I l`�. O V1T'C .. C� UNIT# LOT# 1 P.E F�fjWT EXVIR�ION /� _ ,_^, C" Ge. I � b PERMIT EXPIRES IF WORK ER OWNER .�,� O COFtTRACTOR y-`., e v IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. ANCE,OR.180 DAYS FROM LAST CALLED INSPECTION. INSPECTIO DATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE:': ALL GRADING AND•;DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF UFER PREGUNITE PEHMIT VALIDATION ` CUPERTINO STANDARDS. PAID,F �/- GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIONE - S --. '� :-1 V, ISSUANCE DATE UNDERGROUND/SLAB- PLUMBING - ' _ ELECTRICAL MECHANICAL Zd(� u `RLDu ELECT. ❑ PLG, MECH. ❑ ❑ DO NOT POUR FLOOR UNTI E AS EN Sir J' act D V�Pi" UILDING PERMIT WOOD R U' CJ INFORMATION VALUATION ,g O S/F T. PLUMBING MECHANICAL I,/ v A ELECTRICAL _ �ERM Ir To�,,.{/� FRAMING w A INSULATION STORIES TYPE CONSTH. OCC GHOUP RES, UNITS PLACE NO SUBFLOOR UN L ABOVE HAS BEEN SIGNED - RCYOF ADE BEFORE THECONSTRUCTION OCONTAX IS PAID S0,11 ,110 AREA 1`I i iA ACi1EAGE DIAPHRAGM � ROOF. SHEATHING BUILDING USE -RES IND CON PR GR..•, - ❑ ❑ ❑ 1:11 ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.a ASSESSORS PARCEL NO PLUMBING - ELECT. ENERGY TUBS &SHOWER PAN - PLUMBING ENERGY THO ACTN PARCEL NO , MECHANICAL MECH.ENERGY' ELECTRICAL BUILDING ENERGY ACC,�DATE ' ACC. FILF. NO FRAMING ELECT. FINAL TEST INSULATION - PLUMBING ZONING ENG. SITE NO. GAS TEST GAS MECHANICAL FIRE SPRINK Y ❑ NE] ENERGY T 24 Y ❑ NC] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE . FIRE DEPT.'' FLOOo ZONE Y❑. N❑ A L U.C. TL N❑ L-: INTERIOR SHEAR SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING D L INTERIOR LATH . 'TEMPORARY APPROVALS SCRATCH COAT '•- .ELECTRIC PLAN CHECK FEE 77 - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE E OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR•INSPECTION BY PHONING 252-4505, ELECTRIC WORKING DAY BEFORE REQUIRED INSPECTION.. 0O PE JOB: ADDRESS WHEN PHONING. LEASE GIVE PLUMBING' MECHANICAL Z = SEE.PERMIT FOR EXPIRATION DATE — CONST. TAX .'. -'IMPORTANT! PLEASE READ REVERSE SIDE'EIEFORE TOTAL 711j, CALLING FOR FINAL INSPECTION. F E OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE.BA'LL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION - APPLICATION & PERMIT' BUILDING - ELECTRICAL- PLUMBING - MECHANICAL' PERMITNUMBER , - 1 0 r) /] C I o G J v BUILDING _ 1 11 -, ADDRESS pO30 /� LOAJ;V OWNER'S . CITY. ELECTRIC PERMIT FEEPHONE PLAN CHECK VALIDATION R'S t UTLETS-SWITCHES-RECEP 10.00/1.00LIGHTING DATE OF APPLICATION FIXTURES 10,00/1.00 ADRESS Rs 1LOt. APPLIANCES -RESIDENTIAL 4.00 PANELS 10.00 ARCHITECTv, ENGINEER. A,, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.Cf ND. SIGNS TRANS. 3.00 ARCH, ORE G. oRFss ADDRESS SPECIAL CIRC-'UIT' 5.00 .PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 . v . ZIP 9 ..�- 7� ADDRESs>•s MOTORS - SEE 'FEE SCH. f SERVICECHANGEk 20.00 ' - T1• - LLI ' LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am'licensed under provisions of Chapter 96111 (commencing with Section 7000) of Division 3 of the Business andJw. professions (,' nd y license is in full for -�rffsgl. License CI `� Lic. Number- `7 Date7_ Contractor aN.!- ISSUANCE DATE BLDG. ELECT. v ❑ PLG. MECH. ❑ ❑ 9t woo BUILDING PERMIT INFORMATION INF OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Conlmclor's License Law for the following reason. (Sec. 703 1.5, Business and Professions Code: Any city or county which requires a permit to construct, alter. MISC. - REFER TO ORD VALUATION M - SIFT. PERMIT ISSUANCE 1000 . SLED. CONTR. LIC. NO. ELEC. TOTALPERLi11T - improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensedpursuant to the provisions at [be Contractor's License Law (Chapter 9(commencingwith Section 7000) of Division 3 ofthe1- Business and Professions Code) or that bell exempt therefrom and TO - % el 1 1� M� L % QTY. PLUMBING PERMIT FEE STORIES �TVRE CONSTR. the basis for the alleged exemption. Any violation of Section 703 L5 by any applicant for a permit subjects ilia applicant tea civil penalty of not more than five hundred dollars (55001.): - ALTER -DRAIN & VENT -WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as Iheir sole compensation, will Jo the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC GROUP RES. UNITS - DRAINS -FLOOR, ROOF, AREA, CON D. 5,00 intended or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License Law docs not apply to an owner of F IXTUR ES - PER TRAP 5.00 GAS - EA. SYSTEM - 1 INC.4 OUTLETS 6.00 50. FT. FLOeR AREA v D �(� ^ TOTAL ACREAGE •� / property who builds or improves thereon, and who docs such work himself or through his own employees, provided that such improve. ments are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that h e did not build or im- prove for purpose of e.). C1th as owner of the property, y, aexclusively contracting with GAS - EASYSTEM =OVER 4(EA.) 2.00 . BUILDING USE RES IND CON Pa Other 1:1 O 0 F-1 1:1•I; INDUSTRIAL WASTE INTER.' "30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who LAWN SPRINKLERS- 1 INC 5 V.B. '6.00 LAWN SPRINKLERS - OVER 5 IEA.)- hOO ASSESSORS PARCEL NO. _ contracts for suchprojects with a comractoRs) licensed ponuant to the Contractor's License Law. ❑' 1 am exempt under Sec. ,B.&P.C. for this reason SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT, NO. ( PARCEL NO.. WATER HEATER W/VENT 6.00 - Owner - Dais - WATER SYSTEM , ,'5.00 ACC. GATE ACC. FILE NO. .w6RKERS'COMPENSATION DECLXRATION 1 hereby affirm that'I have a certificate ofcnnwnt Io Self -insure„ WATER TREATING EQUIP, .5.00 II - ZONING ENG. SITE N0. Or a' cer1lfiCate'of Workers' Compensation Insurance, or a acrtlhed copy thereof (Sec: 3800, Lnb.C.). Policy No. Company �❑,J Certified copy is hereby 'furnished. J�� Certified is filed��wit I•�•,I�•-� y inspection division. Applh'ant�/11EI5_II!_f=/- FIRE SPRINK ENERGY T 2 l" G _ MISC.- REFER TOORD. _ sCERTI FICATE OF EXEMPTION PROM WORKERS' I- -.COMPENSATION INSURANCE (This.section. need not be completed if the permit is for one, PERMIT ISSUANCE 10.00 - ,PLOOO ZONE •V� N� A. L. U.C. V� N� PLG. CONTR. _ LIC. NO.PLG. '' TOTAL' hundred dollars($100) or less.), 1 certify that in the performance of the work lir which this per. mit is issued, I shall not employ any person in any manner so as to - QTY. MECHANICAL PERMIT FEE - FEE SUMMARY - BUILDING 7 6J r Qd become subject to the Workeri Compensation Laws of California. Data - Applicant ALTER OR ADD TO MECH. 5.00 NOTICE. TO -APPLICANT: IL after making this Cerlificatc of liz- App LIANCE 5.00 AIR HANDLING UNIT (TO IO=C.F.M.) 4.00 PLAN CHECK FEE emption, you should become Subject In the Workers' Compensation provisions OIL the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY AIR HANDLING UNITIOVER 10AMCF.M.) 6.00 SEISMIC FEE t J V I hereby affirm (hat'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. 3097, Civ.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT (OV ER 100,000 B.T.U.) ELECTRIC I certify that l have read this application and state that Ilia above VENTILATION FAN (SINGLE) 4.00 - information is correct. I agree to comply with all city and county ordinances and stale laws relating to building Construction, and hereby authorize representatives of this city to enter upon the above-mentioned propertyfor inspection purposes. PLUMBING BOILER -COMP 13 H.P. Of 100,000 B.T.U.) 6.00 BOILER -COMP (Over I00,000BTU) SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertin against liabilities, jsWgmenis, costs end expenses which e ' ny 'y car against said City in cce of the u of % PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL , TOTAL/\r �S 'nate of pplicen[ Contractor"Z,/ OFFICE COPY