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18072 POST THIS CARD NEAR FRONTOF BUILDING . PERMIT NUMBER CITY 'OF CUPERTINO 18072 INSPECTION DIVISION JOB INSPECTION RECORD I ��p 1 PERMIT EXPIRATION JOB ADDRESS�—1 2 Y� L Ihl t&- N so UN, '_LOT# PERMIT EXPIRES IF WORK 'OWNER V � eV' CONTRACTOR I C� IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTIONRELORD . 180 DAYS OF PERMIT ISSU. FOUNDATION - ANCE OR 180 DAYS FROM NOTE: UFER � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAS TCALLED INSPECTION. PREGUNITE - TO COMPLY WITH THE"APPROVED PLANS AND CIT'OF PERMIT VALIDATION GARAGE SLABS CUPERTINO STANDARDSb A'^ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 6'NV •�- z •��. UNDERGROUND./SLAB Jim rQ a" 1989I d U ✓C.0 ✓t PLUMBING - _ J• /41A . ELECTRICAL - C.lty O[CUgertln� ISSUANCE GATE MECHANICAL BLDG ELECT. PLG MEC. ❑ X ' ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - eu1LDINO PERMIT INFORMATION -WOOD FLOOR - VALUATION STET. PLUMBING MECHANICAL ELECTRICAL /fie PERMIT TO FRAMING INSULATION STORIES/ TYPE CONSTR. - OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE . 5O IT.FLOOR AREA TOTAL ACAEAG e DIAPHRAGM THE CONSTRUCTION TAX IS PAID LOIN,use ROOF SHEATHING .Es IND CON PB 'Go.... APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 0 0 0 0 A SSESSORS PARCEL NO ROUGH SANA PLUMBING ELECT,ENERGY TRACT NO PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY , ' ELECTRICAL BUILDING ENERGY ACC DATE ACCFILE No FRAMING - ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION - PLUMBING'• GAS TEST GAS FIRE SPRINK ENERGY Th 24 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "� NC] COVER EAR - ELECTRICAL RELEASE FLOOD LONE A L U C. INTERIOR SHEAR FIRE DEPT. Y❑ "❑ Y ❑ No SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC; .PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSI GNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC IW—�. ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING o PLEASE GIVE JOB ADDRESS WIZEN PHONING. ZMECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL �,d✓) OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LD1 NG PROJECT I DENT(FICATION ` PERMIT NUMBER O al;oaEss � APPLICATION & PERMIT �•' O T Z I.i DING-ELECTRICAL-PLUMBING-MECHANICAL 72 OWNER'S �l W PLAN CHECK VALIDATION NAME - OTY. ELECTRIC PERMIT FEE D 14 CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 t- LIE,No. LIGHTING FIXTURES 10.00/1.00 CTOR's ADDRESS APPLIANCES-RESIDENTIAL 4.00 PROrvE � PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. On PANELS (OVER 200 AMP) ,20.00 .. ENGINEER ' LIC.NO. SIGNS TRANS. 3.00 ADDRESS ErvG' SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION ZIP FrEMP.METER OR POLE INS. 20.00 10.09 AS - MOTORS SEE FEE SCH. - v ADDREDDRESSS SERVICE CHANGE 20.00 0 LICENSED CONTRACTORS D17CLARA'fION _ v• �� Ef`NC`• a u w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE w Q w (commencing with Section 7000)of Division 3 of the Business and V(� BLDG. ELECT. PLG. MECH. F N Z Professions Code,and my license is in full force and effect. ❑ ❑ ❑ o0 to ti License Class Lie.Number a w Date.Contractor CIhl Of CUp digo BUILDING PERMIT Or ¢ OWNER-BUILDER DECLARATION ¢ R w U - INFORMATION oe. MISC.- REFER TO ORD w Law for the following reason.(Sec.7031.5,Busiticssand Professions PERMIT ISSUANCE 10 a I hereby al Taco that I am exempt from the Contractor's License VALUATION SOFT. .00 r LL o¢ Code:Any city of county which requiresa permit to construct,alter, MOOD, ¢ at¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. wo u requires the applicant for such permit to file a signed statement that , TOTAL tae PERMIT TO m m he is licensed pursuant to the provisions of the Contractor's License > Law(Chapter 9(commencing with Section 7000)of Division3ofthe Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ler$ Due basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. c3 � by any applicant for a pemsit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 .four more than five hundred dollars(5500).): O-I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 400 their sole compensation,will do the work,and the structure is not . OCC.GROUP RES.UNITS intended or offered for sole (Sec. 7044, Business and ProfessionsDRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law it...not apply to an owner of property 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- mentsarenotintendedorofferedforsale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that hu did not build or all- provefor purpose ofsale.). INDUSTRIAL WASTE I NTE R. 30.00 RES IND CON PB Other ❑ I,as owner of the properly,am exclusively 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 Contractor's License Law does not apply to an owner 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 Contractor's License Law. SEWER-SAN ITARY-STORM EA.20011/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 rcuson Owner Date WATER SYSTEM 5.00 ACC.DATE ACG.FILE N0. WORK ERS'COMPENSAIION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certifleatn of consent to self-insure. or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG,SITE NO. copy thereof(Sec.3800,Lub.C.). Policy No. Compuny ❑ �ertilied copy is hereby furnished' FIRE SPANK ENERGY T-24 Z Z $C.,Iifi Id o y k led Oh lite city inspection division. � O Applicant � /� - MISC.- REFER TO ORD. Y ❑ N Y ❑ IN L6 CERTIFICATI:01 EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU COhIPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. 1 (This action need not be completed if the permit is for one TOTAL Y❑ N Y❑ No Z) Z hundred dollars(SIOB)or less.) U O 1 certity that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY 'LL I- alit is issued,I shall not employ any person in any manner so as to OW become subject to the W 6rkers'Compensation Laws of California. Q. Date Applicant 5.00 BUILDING >_ N NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. Z eruption;you should become subject to the Workers'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 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 SEISMIC FEE 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 pmmit is issued(Sae. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 Lender's Address ed e ' ELECTRIC I certify that I have ,all this spplicallon and state that the ahOve 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 conMruClion, and BOILER-COMP(3H.P.or100,000B.T,U.I 6.00 hereby authorize representatives of this city to enter upon the BOI LER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL alcove-mentioned property for inspection purposes. (We) ugrec to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX lay in any way accrue against said City in consequence of the ranting ofthis permit. MECH.CONT. LIC.NO. MECH. =�/ 1�� - Gri G_Yr9 TOTAL TOTAL a�, OD Stgnalure ('Applicant/�ontrac[or Date OFFICE COPY