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14674 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY 'OF''CUPERTINO4674 �`. INSPECTION DIVISION JOB INSPECTION RECORD . 'F - PERMIT EXPIRATION 5oB,ADDRESS 10699• RANDY . LANE uNlr# _Lor# -• 2 1 L,. . PERMIT EXPIRES IF WORK OWNER Robert Fisher CONTRACTOR IS NOT�STARTED WITHIN INSPECTION DATE- INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS'FROM FOUNDATION NOTE: UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ! UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL 77, ELECT, PLc. MECH,, o o DONOTPOUR FLOOR UNTIL ABOVE HAS BEEN SIGNED uILDING PERMIT INFORMATION, WOOD FLOOR en VALUATION SIFT. PLUMBING MECHANICAL - - V PERMIT i0 .. ELECTRICAL FRAMING - - oU•v— //L)j"4444__/ JIT INSULATION - STORIES TVPECONSTR. 1'DEC,GROUP RES UNITS KPLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50.IT FLOOR AREA TOTAL ACREAGE ! ROOF' NOTE:NO FINAL[NSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ' BUI j LDING USE ROOF SHEATHING' RES IND CON PBoil", . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSFI ASSESSORS PgHCEL NO, ROUGH SAN.W PLUMBING - ELECT,ENERGY TRACT NO PARCEL NO. TUBS 8 SHOWER PAN' - � PLUMBING ENERGY I MECHANICAL. ' MECH.ENERGY. ' ELECTRICAL - BUILDING ENERGY,; ACC,OATE ACC,FILE NO ' FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION � � PLUMBING GAS TEST - GAS MECHANICAL FIRESPRINK ENERGY.T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING `' ❑ N❑ Y - N[] LLODD ZONE A,L U C. EXTERIOR SHEAR ELECTRICAL RELEASE .2-2. r❑ N❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK' - GRADE FEE SUMMARY EXTERIOR LATH _ BUILDING I INTERIOR LATH TEMPORARY APPROVAL BUILDING el SCRATCH COAT ELECTRIC PLAN CHECK c GAS - - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM " ARRANGE FOR,INSPECTION BY PHONING 252=4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX' PLEASE READ REVERSE SIDE BEFORE , TOTAL. % CALLING FOR FINAL INSPECTION. OFFICE COPY i hAPPLIGANT'TO FILL IN INFORMATION WITHIN RED LINES.- USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATION - ,PERMIT NUMBER BUILDING APPLICATION & PERMIT' - ADDRESS - 14674 6 /Aqt BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S - - PLAN CHECK VALIDATION "AME QTY. ELECTRIC PERMIT FEE .s/4r PRONE 's NAIVECONTRACTOR - UTLETS-SWITCHES-RECEP 10.00/1.00 O' NAME uc.Na. LIGHTING FIXTURES 10.00/1.00 - ADDRESS TORS - / PPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION OgcIUTECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER ' LIC.No. SIGNS TRANS. 3.00ARCH OR ' ` ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 - - APPLICANT S MOTORS SEE FEE SCH. ADDRESS 11,6 /V4 NA �Y SAnV v SQ 7 J SERVICE CHANGE 20.00 p p a o LICENSED CONTRACTORS DECLARATION <ow 1 hereby affirm that 1 am licensed under provisions of Chapter 9 - ISSUANCE DATE y a (commencing with Section 7000)of Division 3 of the Business mad F V,i Professions Code,and my license kin full furca and effect. LECT. PL❑G. MECH. ' (D.- License Class Lic.Number - O yw -o Dale Contractor r Q - E ¢ w OWN(?WOUILDER DECLARATION G PERMIT MISC.- ' REFER TO ORD 1 ORMATION w ; LL y I hereby affirm that I am exempt from the Contractor's License qq 04 Law for the following roasoa.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE• C �jD�LrrrUsnI q� S/FT. Code:Any city or county which requirese permit torn astride alter, 10.00 fl'r 8 Q Q ¢0 improve,dell101I5I1,Or repair any st(Iletllrl',prior IO Its ISSl1a0Ce,aI50 ELEC.CONTR. LIC.NO. ELEC. ��J,N,, ' a. w m LL requires the applicant for Such permit to file a signed statement that TOTAL r�_ PERMIT TO he is licensed pursuant to the provisions of the Contractor's License 74-a-4 'i Law(Chapter 9(commencing with Section 7000)of Division 3 of the ss/��.f•Q1T i 01 c Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE, O�' l v e T F $ the basis for,the alleged exemption.Any violation Df Section 7031.5 STORIES TYPE CONSTR. d ;- by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,m nhy employees with wages a5 BACK FLOW PROTECT.DEVICE 4,00 their sole compensation,will do the work,and the structure is not OCC.GROUPRES.UNITS 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 properly, who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- menis ore not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11PIC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did nal build or int- BUILDING USE - prove for purpose ofsale.). INDUSTRIAL WASTE INTER. - 30.00 RES IND CON PB Other ❑ 1,as owner of the property,am exc uswoly contracting with ❑ ❑ ❑ ❑ , ❑ 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 Contractors License Law docs not apply to anowner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law, SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ 1 it,exempt under Sec. R&P.C.for this WATER HEATER W/VENT 6.00 rea50p��_/_.,,a_��' Owue/"X^ Late�'L%dp->3' WATER SYSTEM 5.00 ACC.DATE ACC:FILE NO, WORKERS'CO 1PIiNSATION UIiCIARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certiticaze ofconsclt to self-insure, TONING or a certificate of Workers'Compensal ion Insurance,or'u certified ENG.SITE NO. copy thereof(Sec.3800,Lab.C.L Policy No. Company - O ❑ Certified copy ishemby furnished FIRE SPRINK ENERGY T-24 Z Z ❑ 'Certified copy is filed with the city impietwo division. ,FO Applicant MISC.- REFER TO ORD. v ❑ N Y 'N❑ N CE RTI PKAT E OF EXEMPTION FROM WORK FRS' PERMIT ISSUANCE 10.00 FLOOD 20NE A.L.U.C. UJ > COMPENSATION INSURANCE PLG.CONTR. LIC.N0, PLG. 0. 0 (This section need not be completed if rhe permit is for one TOTAL Y❑ N[_ - Y C_ N C3D'Z hundred dollars(5100)or less.) U O I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- out is issued,I shall not employ any person in any manner so as to O w become subject to the Workers'Compensation Laws of California. IS. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING /�- } W NOTICE T'O APPLICANT': If,after making this Certificate of Ex- F ? emotion,you should become subject to the Worker Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE V such provisions or this permit'shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=11C.F.M.) 6.00 SEISMICFEE I 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 HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC =12Q I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) - 4.00 information is correct. 1 agree to comply with allcity and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6,00 PLUMBING ordinances and state laws relating trip C building construction, and hereby authorize representatives txlives aainspfof ion purposes.this city to enter upon the above-mentioned property BOILER-COMP (Over 100,000 BTU)SEE FEE SCH, MECHANICAL (We) agree to save, indemnify and keep Imrnless the City of MISC.- - REFER TO ORD. Cupertino against liabilities,judgmer costs and expenses which - CONST.TAX may in any way aconic against t' City In consequence of the PERMIT ISSUANCE 10.00 matin o lispennit. MECH.CONT, LIC.NO, MECH. S gnaNrc of APPesat/Cntrucrmr �+a� TOTAL TOTAL 393.E OFFICE COPY