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16461 POSTTHIS CARD NEAR FRONT OF BUILDING PERMIrNUMBER CITY W CUPERTINO 16451 . .. ' INSPECTION.DIVISION" JOB'INSPECTION RECORD ' PERMIT EXPIRATION 4 . ° JOB ADDRESS, ,�-SCJ •Fv/ �E�-�C_(l'� UNIT# 'LOT# a PERMIT EXPIRES IF WORK • OWNER "CONTRACTOR [.w meg.." L,�� ISI-NOT STARTED"WITHINI INSPECTION . DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT iSSU-- FOUNDATION - ', ,r ANCE OR 180 DAYS FROM NOTE: LIFER - - 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' - - �' ISSUA;aCE DATE MECHANICAL , BLDG, I.ELECT. PLG., ,MECH, . �: El. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR - - VALUATION PLUMBING � � r - � - MECHANICAL '.. . •• - - - E PERMIT TD ELECTRICAL / p� FRAMING - INSULATION STORIES TYPE CONSTR, ' OCC,GROUP RES:UNITS• PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' SG FT FLOOfUREw v TOTAL ACREAGE ROOF ;, NOTE'NO FINAL INSP.SHALL BE MAf�B E I w - r{ DIAPHRAGM; THE CONSTRUCTION TAX IS PAID p BUILDING USE ROOF SHEATHING ` "- - ES wD cory Pe'" om,•, j APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DAT INSP: ❑ ' `ED El El ❑ ' AS SSORS PARCEL NO, ROUGH SAN.N pt ' PLUMBING ELECT,ENERGY " n " TRACT NO, PARCEL NO TUBS&SHOWER PAN PLUMBING.ENERGY - - MECHANICAL MECH.ENERGY• Acc.Dare• Acc.FILE NO. .+ ELECTRICAL - '.i BUILDING ENERGY . • FRAMING a - ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION .. PLUMBING , - .. GAS TEST. - - GAS MECHANICAL. FIRE SPRINK ENERGY T,24 - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ `."❑ EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE �, A.L aL uc, i.+ INTERIOR SHEAR . M1 FIRE DEPT. o N❑ -71 ,�❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR' LATH - BUILDING , INTERIOR" LATHTEMPORARY APPROVALS BUILDING SCRATCH COAT - ELECTRIC PLAN CHECK GAS - FEE NO-TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE E OCCUPANCVOF BUILDING IS NOT PERMITTED UNTILBUILDING FINAL ISSIGNEDBY"BUILDING INSPECTOR. - " „ MICROFILM ,{ ARRANGE FOR INSPECTION BY PHONING 252-4505,'• ELECTRIC LU 'ONE WORKING DAY BEFORE,REQUIREb INSPECTION. PLUMBING z0�. PLEASE GIVE JOB ADDRESS.WHEN PHONING. ' SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! t CONST.TAX J . PLEASE READ REVERSE SIDE BEFOREM, IzA. .,�x TOTAL " CALLING FOR`FINAL INSPECTION. ... -OFFICE COPY APPLICANT TO FILL IN INFORMATION,WITHIN RED LINES — USE BALL POINT PEN ONLY PERMIT NUMBER BUILDING PROJECT I DENTI FICATIO r. - IfDILoiNG APPLICATION & PERM 16461, . ADDRESS BUILDING-ELECTRICAL-PLUMBING-MECHANICAL P' ►� A. owry R'S ., - PLAN CHECK VALIDATION "A �- (—S,E ` CITY. ELECTRICPERMIT FEE PHONE -. C TRACTORS UTLETS-SWITCHES-RECEP. 10.00/1.00 N LI No.` LIGHTING FIXTURES 10.00/1.00 CON c R's APPLIANCES-RESIDENTIAL, 4.00 , PHONE PANELS 10.00 DATE OF APPLICATIONI_ PLAN CHECK FEE ., P.C. O. ARcmrtscT PANELS (OVER 200 AMP) , 20.00 OR ENGINEER LIC.No. SIGNS TRANS. 3.00 _ ARCH.OR ENG. - S.DD .. PERMIT VALIDATION , ADDRESS SPECIAL CIRCUIT ' - xIP TEMP.METER OR POLE INS. 20.00 l' ADDRESrvrs . MOTORS SEE FEE SCH. (/L�`p-r'r^'`�•-✓ AOOREES SERVICE CHANGE 20.00 G O¢ i /rs/�'.02 LICENSIiU CONTRACTORS DECLARATION G6 r M u u I hereby affirm that Lam licensed under provisions of Chapter 9 ISS ANCE DATE y 3 i (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. H 7 i Professions C y license is in full ind (rent ❑ . ❑ (� ❑' z o N— Lice Class Lic.Numb I.'-\. tel. O.(, O L F Da[c�� �_—L l�ConvactorCKuk � a r J . BUILDING PERMIT Is ¢w u OWNER tlUILUF:R DECLARATION INFORMATION w; . 0 I hereby affirm that 1 an exempt from the Commcto,',License MISC.— REFER TO ORD VALUATION S/FT. FLL04 Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or County which requires a permit to construct.alter, Su, 40 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR; 'LIC.NO. ELEC. O¢ requires the applicant for such permit to file a signed statement that TOTAL - PERMIT TO A w m w he is licensed pursuant to the provisions of the Contractor's License - Lg Hi > Law(Chapter 9(commencing with Section 7000)of Division 3 of 0a LT Q Business and Professions Code)or that he is exempt therefrom and CITY• PLUMBING PERMIT FEE ftp rTOR I-ES TYPE CONSTR. ¢I_ $ the basis for the alleged exemption.Any violation of Section en LS c ; � oby anyfmo applicant for agernreddosubjects the applicant too civilpenaltyPGAS-EA.SYSTEM-1 DRAIN -WAT 5.00 . of not more than flue the prop dollars(8500).): ❑ I,as owner of the property,or my employees with wages asLOW PROTECT. DEVI oCC.GROUP RES.UNITS their sole compensation,will(S the work,and the structure is not _ intended or offered for sale (See. 7044, Business and nProfessionsneof -FLOOR,ROOF,ARE Code:The h Contractor's r License Law does not apply to an owner of property who builds or improves thereon,and who does such workES PER TRAP so.FT FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- .SVSTEM-11NC.40UT Tmeats are not intended or offered for sale.If,however,the buildingor improvement is sold within one year of completion,the owner- .SYSTEM-OVER4(E 2.00 BUILDING USE builder will have the burden of proving that he did not build or im. RES IND CON PB Other prove for purpose of Sale.). RIAL WASTE INTER., 30.00 ❑ ❑❑ 1,as owner of the property,am exclusivelycontractingwitlicensed contractors to construct the project(Sec. 7044,BusinessPRINKLERS- 1 INC5'V:B. 6.00 ASSESSORS PARCEL NO. and Professions Code.The Contractor's License Law does not applyto an owner of property who builds or improves thereon.:md whoPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a cantractorts)licensed pursuant to SEWER-SANITARY-STOR EA.20 (10.00 TRACT NO. PARCEL NU. - the Contractor's License Law. ... ❑ lamexemptunder Sec. ,Is.&P.C.for this WATER HEATERW V r+2 � reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKF-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent 10 self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lah.C.). Policy No. Company .. Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z Cer' o y is h he c inspec' division. MISC.- REFER TO ORD. y❑ N❑ Y ❑ N❑ App icon W CERTIFICATE OIs EXEMPTION FROM WORKERS' PERMIT ISSUANCE FLOOD ZONE A.L.U.O. LU COMPENSATION INSURANCE PL .C r LIC Nuk.,CL D PLG. '�' , Y❑ N❑ Y [:] N❑ TOTAL �� This section need not be completed if the permit is or one 0 Z hundred dollars IS 100)or less.) FEE SUMMARY V O I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE LL h mit is issued.I shall not employ any person in any nuo ner so as to O W becomesubject to the Workers Compensation Laws of California. BUILDING Dnne Applicant ALTER OR ADD TO MECH. 5.00 tail NOTICE TO APPLICANT: If,after making this Certificate of Vs. 5.00 PLAN CHECK emption,you should become subject to the Workers'Compensation APPLIANCE PT visions of the Labor Code, you must lorthwith comply with FEE (� such provisions Or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10M0C.F.M.) .4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IQOODC.F.M.) 6.00 SEISMIC FEE s 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(See. HEATING UNIT(TO 100,000 B.T.U.) 8.001MICROFILM - 3097,Civ C.). Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.501 ELECTRIC Lender's Address Q Icertify that l have read this application and slate that the above VENTILATION FAN (SINGLET' 4.001 PLUMBING O . information is correct. I agree to comply with all city and county gO1LER-COMP13 H.P:or 100,000 B.T.U.) 6.00 ordinances and.slate laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (Wet.agree to save, indemnify and keep harmless lite City of MISC.- REFER TO ORD. upertino against liabilities,judgments, Casts and expenses hmh PERMIT ISSUANCE - 10.001CONST.TAX pgal.,!� T!A any way c me a Inst said 'ly in ase ence o the _ Ofpe — �� MECH.CONT. LIC.NO. MECH. R TOTAL TOTAL plwart Contractor Dute OFFICE COPY'