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16532 ..POST THIS CARD'NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 16532 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION ' JOB ADDRESS Z/`S^7 UNIT# LOT# A PERMIT EXPIRES IF WORK OWNER .� /N/tl� CONTRACTOR 4?R_6YI-' . k04A,1, IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISS U- FOUNDATION - - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PEHMIT VAL,OAnaN PR EGUNITE CUPERTINO STANDARDS. GARAGE SLABS .. - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED l UNDERGROUND /SLAB - • PLUMBING �• i " I ELECTRICAL ISSUANCE )ATE MECHANICAL BLDG ELECT PEG. MECH ❑ I ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT ORMATI ON WOOD FLOOR ALUATTON sicr. PLUMBING MECHANICAL ' ELECTRICAL - - PERMIT TO FRAMING 4.8-6 ST RIES iYPE'EONSTH . INSULATION - OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE So.ET FLOOR AREA TOTAL ACREAGE DIAPHRAGM 'THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING I I - RES IND CON PB, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ROUGH SAN.H ASSESSORS PARCEL NOI PLUMBING ELECT.ENERGY t RACT NO. PARCEL NO TUBS 8 SHOWER PAN - PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC GATE ACC FILE N0, ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG,SITE NO, INSULATION PLUMBING GAS TEST p may_ GAS MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ "❑ ° ❑ "❑ EXTERIOR SHEAR,- ELECTRICAL RELEASE FLOOD to"E A.L uc. INTERIOR SHEAR FIRE DEPT. Y ❑ N❑ r ❑ N(] SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH ` BUILDING " INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC 'PLAN CHECK I GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPAINCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC Lu ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Dv 00� PLEASE,GJVE-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 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -. USE BALL POINT PEN ONLY I LD1 NG PROJECT IDENTIFICATION FICATION� PERMIT NUMBER pOI AFs:BUAPPLICATION & PERMIT 16532 k" On..K,3HIYZ� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION Nae'f IY4h K0 ^ ' OTV. ELECTRIC PERMIT FEE PHONE CONTRAC R'S NAME ➢7� �yjP�-[�rJ�� fS OUTLETS-SWITCHES-RECEP 10.00/1.00 ((��'IC_bc NO.,S'Q1gG- uC LIGHTING FIXTURES 10.00/1.00 rorvTRacTOR's APPLIANCES-RESIDENTIAL 4.00 oOR s �K G G�Ug IAS. P/ GON Q`1�[ PANELS 10.00 - DATE APPLICATION C 1- OORRCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECKK FEE P,.C:NO. ENGINEER LIC.No. SIGNS TRANS. 3.00 ADDRESS ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 APPLICANT$ ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 /L6 woo LICENSED CONTRACTORS DECLARATION <i w I hereby affirm "tat 1 am licensed under provisions of Chapter 9 ISSUANCE DATE ✓ (cm.nonneing with Section 7000)of Division 3 nl'1he Business and - BLDG. ELECT, PLO. MECH. E. m i I'rofessians CoifJJuu....�rpp�l y license is in full fort effeG ❑ ❑ ❑ z O m- Licens Cep__ass_ Con rNo act O(o o r O Date /fes Contract a x p P,W BUILDING PERMIT ¢ a - OWNER-BUILDER DECLARATION M o a " MISC.- REFER TO ORD INFORMATION w ;LL s- I hereby affirm"tut I son exempt from the Contractor's License u O a Law for the following reason.(Sec.703 t.5,Business and Professions VALUATION $/FT. y Code:Any city or county which requiresa permit to construct.alter, PERMIT ISSUANCE 1 rt ¢ O improve,demolish,or repair any structure prior to its issuance,also. ELEC.COINER. - LIC.NO. ELEC. E a¢ requires tine applicant for such permit to file a signed statement that TOTAL o. w he is licensed pursuant to the provisions of the Contractor's License �PERpMIT TO r. ii Law(Chapter 9(commencing with Sections 7000)of Division 3 of the PA'"V�Y E a o Business and Professions Coda)or that Ile is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ I- o the basis for file alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. La 3 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollurs(S500).): ALTERA)RAIN& VENT-WATER (EA.) 5.00 ❑ 1,as owne,of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:'I'lie Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 a0.FT.FLOOR AREA TOTAL ACREAGE himself Or through hisown employees,provided that such improve. •, ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11 NC.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 not build or im- BUILDING USE RES IND CON PB Other prove foraspurpose owner off the')' INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑_ ❑ ❑ 1,as owner of the property,ant 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 cenjecL with a enntractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ laam exempt under Sec.-.B.&P.C.lot this reason WATER HEATER W/VENT 6.00 Owner Date - WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO, WORK RRS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a eertilicule ofconsent to self-insure, 02- ZONING ENG.SITE NO. or a certificate of Workers'Connpinsation Insurance,or u certilietl AS 16-ItS 7- copy thereof(Sec 3800,Lab,C.� vAft NS. �d• Policy No. _Company Q O ❑ Cer he she coshed' FIRE SPRINK ENERGY T-24 Z Z t�� li(i f with the city inspection division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ ' F 0 AP{tliC t V N V N CC N Cli EXEMPTION FROM WORKERS' ERMIT.ISSUANCE FLOOD ZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. I.G.P CL Z( This section need not be completed if the Pcr;nit is lin one TOTAL V❑ N❑ Y C] N❑ hundred dollars(S 100)or less.) - U Q 1 certify that in the performance of the work'or which"lis per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY U_ U mit is issued,I shall not employ any person in any manner so as to become subject to the Worker''Compensul ion Laws of Calikornia. '� Ul Date ApplicantALTER OR ADD TO MECH. 5.00 BUILDING } W NOTICE'10 APPLICANT: If,after making this Certificate of fix ♦- Z emption,you should become subject to the Workers Compcnsalion APPLIANCE 5,00 PLAN CHECK provisions of the Labor Code, you must forthwith com Ply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=r-F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.FMJ 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 Ibr which this permit is issued(Sec. MICROFILM 3097,CIv.C.). I 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.)9.50 ELECTRIC , I certify that I have read this application and slate that the above V ENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply wit 11 all city and county PLUMBING ordinances and stale laws relating to building construction, and BOILER•CUMP(3 H:P.or 100,000 B.T.W 6.00 hereby authorizerepresenlahs' is city to enter upon the BOILER-COMP(Ova,100,000 BTU)SEE FEE SCH. MECHANICAL above-me in If property Inspecti n purposes, (We) ,cc to ve idemnify d keep harmless the City of MISC.- REFER TO ORD. Cupert g ns 1' ililies,judge its, costs and expenses which CONST.TAX May n a c ue again, said City in consequence of the PERMIT ISSUANCE 10.00 Sir tin o t s- of. MECH.CONT. LIC.NO. MECH. TOTAL TOTAL Signa r lice rector a OFFICE COPY