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18709POST THIS'CARD NEAR FRONT OF BUILDING ' CITY OF CUPERTINO. INSPECTION DIVISION JOB. IN/LSEPECTION RECORD JOB ADDRESS -�[.1V �• '•. , UNIT# _LOT.# _ OWNER - CONTRACTOR PERMIT NUMBER 18709,. PERMIT EXPIRATION PERMIT EXPIRES IF WORK ISNOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- N.C. OR 180 DAYS FROM LAST CALLED INSPECTION. , INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION -' NOTE:. ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. - LIFER- PREGUNITE - PERMIT VALIDATION J ISSUA EUATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING - ELECTRICAL MECHANICAL ',. BLDG ❑ ELECT. I ❑ PLG. MECH. ❑ ❑ ' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED .- - - BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION C>7MECHANICAL iz-- STET. PLUMBING ELECTRICAL • ' ^� 1 FRAMING - INSULATION ' STORIES TYPE CONSTH. OCC. GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF','' NOTE: NO FINAL INSP. SHALLBE MADE BEFORE. THE CONSTRUCTION TAX IS PAID ' SO.FL FLUOR NREA TOTAL ACREAGE. DIAPHRAGM + - - ROOF SHEATHING -" RES IND LoCON `ISEPB Om,, I] El I] ❑ I] APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED-FINALS -DATE INSP. - ROUGH SANA ASSESSORS PARCEL NO PLUMBING - ELECT: ENERGY TU858SHOWER PAN •. .PLUMBING ENERGY'- TRACT NO,. PARCEL NO MECHANICAL MECH. ENERGY ELECTRICAL BUILDING ENERGY ACC. DATE ACC. FILE NO FRAMING ELECT. FINAL TEST INSULATION PLUMBING a ZONING ENG SITE Na. GAS TEST GAS - MECHANICAL FIRE SPR INK 11, - El ENERGY T.74 ❑ N[] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOU ZONE v ❑ "❑ A.LUC Y ❑ "❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH ' BUILDING_ BUILDING co INTERIOR LATH S- TEMPORARY APPROVALS SCRATCHCOAT ,, ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE- OCCUPANCYOF.BUILDING ISNOTPE RMITTEDUNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM uJ ARRANGE FOR INSPECTION BY. PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. 'o PLEASE PLEASE GIVE JOB ADDRE55WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! #' PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION, ELECTRIC �- PLUMBING MECHANICAL CONST. TAX �- TOTAL % -- OFFICE COPY O Z CC T LTJ CL o Z) z 00 LL U Ow im APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATIONPERMIT APPLICATION'&.PERMIT ' BUILDING - ELECTRICAL- PLUMBING - MECHANICAL NUMBER `.. /9 1 /8 7 ' 1 V 1 OV BIAt.,NG , ADDREss _ GSI N OWNER'S NAME n r� I c 1 PHONE DTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION ONTRACTORS CNAME C0 .7 4) CO'III uC.NO, VLf 344 UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 ADDRESS CONTRACTOR'S �! ^� p'!' A01' PHONE ?.23- T/ PPLIANCES- RESIDENTIAL. 4.00 PANELS 10.00 ogcurtecT ENGINEER LIC. NO, PANELS (OVER 200 AMP)' 20,00 PLAN CHECK FEE' P.C. No. - SIGNS TRANS. 3.00 ARCH. OR ENG. ADDRESS ZIP ISPECIALCIRCUIT 5.00 PERMIT VALIDATION 1 �J • A ONUC k ISSUA DA E EMP. METER OR POLE INS. 20.00 APPLICANTS ADDRESSDREss ' MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION I hereby uffino Thal I am licensed under provisions of Chapter 9 (commencing with Seetlon 7000) .t Division 3 of the Business and Professions Code, and my license Is In full force and effect, License Class Lie, Number Date Contract., OWNER-BUILDERDECLARATIONBUILDING I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Businessand Professions Code: Any city or county which re9uiresa permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also t0 fnl:ll signed statement Li dist heQ mlec the d pursallt for such provision; he is licensed pursuant tri the provisions of 00 Contractor's License of Division 3 0l the Lew (Chapter 9 (commencing with Section is exempt Business and Professions Code) or that he is exempt therefrom and the basis for the a or it exemption. Any violation t to actin 7031.5 by any applicant fora permit subjects S501Dlicanttoueivilpenalty' of not more than five hundred dollars (5500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Businessand Professions Code: The Contract",', License Law does not apply to an owner "I' properly who builds or Improves thereon, and who does such work himself or through his own employees, provided that such improve- .Cutsare not intended or offered for sale. If. however, the building or improvement is sold within one year of completion, the owner- wner builder builder will have the burden of proving. that he did not build or Ino- Prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: rhe Contractor's License Law does not apply Io an owner or property who builds or'improves thereon. and who contracts for such projects with a contractorts) licensed pursuant to the Contractor's License Low. ❑ l am exempt under See. ,B.&PC, for this reason - BLDG. ELECT. PLG. - MECH. EJ ❑ 11❑ PERMIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE10.00 VALUATION �J ar QU $/FT. ELEC. CONTR. LIC. N0. ELEC. 'TOTAL DTV. PLUMBING PERMIT FEE SER IT/TO �1 _I]r'(, STORIES TYPE CONSTR. ALTER-DRAIN-WATER(EA.)5,00 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTALACREAGE GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 .GAS - EA. SYSTEM -OVER 4 IEA.) 2.00 BUILDING USE !RES IND CON PB Giber ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 - LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. _ LAWN SPRINKLERS : OVER 5 (EA.) 1.00 SEWER-SANITARV-STORM EA, 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self-inslne, or a certificate of Workers' Compensation Insurance, or it certified copy thereof Bea. 3800, Lab.CJ. Policy No. Company X Certified copy is hereby furnished. qq CerH C py ' fed yyyyb the city rope o rvi am. Applicant_ 4= ACC. DATE - ACC. FILE N0. WATER TREATING EQUIP. 5.00 ZONING , ENG. SITE NO. FIRE SPRINK Y❑ N❑ ENERGY T 24 Y N❑ MISC.- REFER TO ORD. CE RTI FICA1'1: OP EXEM PITON FROM WORKERS' COMPENSATION INSURANCE This section need not be completed it ' the permit is for one hundred dollars I S 100) or less.) I certify that in the performmncc of the work to, which this per- mil is issued, I shall not employ any person in any mariner So as to become subject to the Workers' Compensation Laws of California. Date- Applicant Da NOTICE, TO APPLICANT': If, ulie, making this Certificate of Es. emption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions .r this permit shall be deemed revoked. CONS FRUCfION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). PERMIT ISSUANCE 10,00. FLOOD ZONE .Y ❑' N❑ A.L.U.C. Y ❑ N❑ PLG.CONTR. LIC NO. TOTAL QTV MECHANICAL PERMIT FEE FEE SUMMARY BUILDING r.., G ALTER OR ADD TO MECH. 5.00 _ APPLIANCE 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIR HANDLING UNIT (OVER 10=C.EM.) 6.00 SEISMIC FEE �(� O EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM 4- HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address I certify that I have read this application and state that life above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authcmioriie representativesofthisurposeu enter upon the above -m authored property for insp ofth i Purposes. (We) agree to save, indemnify and keep harmless life City of upertino against liabilities, judgments, costs and expenses which ey in any way accrue against said City in consequo the matin I't(r1$penniL HEATING UNIT (OVER 100,000'B.T.U.)9.50 ELECTRIC �. VENTILATION FAN (SINGLE) 4:00 . BOILER•COMP 13 H.P. Dr 100,000 B.T.U.) 6.00 PLUMBING BOILER -COMP 100,000 BTU) SEE FEESCH.' MECHANICAL ' MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. - LIC. NO, MECH, TOTAL TOTAL Signature of Applicant/ContractorUate OFFICE COPY