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15252 (2) POST THIS CARD NEAR FRONT OF BUILDING � - Pf.RMR NUMBER CITY .OF CUPERTINO 15252 INSPECTION DIVISION / ' \ JOB INSPEC'TIC)N RECORD PERMIT EXPIRATION - -'" JOB ADDRESS UNIT# LOT# PERMIT EXPIRES IFWORK OWNER 7Lc_" �O(`-/7L,T CONTRACTOR T pC IS NOT STARTED WITHIN INSPECTION ` DATE - INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT.ISSU- ANCE OR 180 DAYS FROM FOUNDATION �. NOTE: - LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED ' PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VAUDAPON CUPERTINO STANDARDS. , GARAGE SLABS . POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ' _.V ISSUANCE DATE MECHANICAL (Am+110U I\I C„ hjW /z or ELECT, vLG. MECR CZ El 00 NOT POUR FLOOR UNTIL.ABOVE HAS BEEN SIGNED , ILDING PERMIT WOOD FLOOR - INFORMATION B TION SIFT. PLUMBING `vup MECHANICAL ry ELECTRICAL PERM ro / FRAMING - M'nC-I,�- NTG.PC/O2JLJ.OI�C'C... INSULATION _/ sroRiEs TYPE CO STR. - Ssoe S eelale n.- ojv.lye tLNT.LS OCC GROUP RES UNITS PLACE NOS UBFLOOR UNTIL ABOVE HAS BEEN SIGNED sN.Fr.FLooR ARFA TDTAL ACREAct f ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE . DIAPHRAGM THE CONSTRUCTION TAX IS PAID , �y BUILDING USE ROOF SHEATHING ' RES IND CON PB 0"', APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. Q ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SANA , PLUMBING ELECT,ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT No PARceL No MECHANICAL lip IlIZZ4 9-1/- MECH.ENERGY " ELECTRICAL BUILDING ENERGY Acc.unre ACO FILE No FRAMING ELECT.FINAL TEST - zaNING ENG.SITE NO. . INSULATION PLUMBING JV GAS TEST GAS - MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING DD Y ] N❑ Y NEI FLOOD ZONE A.L.UC EXTERIOR SHEAR '- ELECTRICAL RELEASE /-2/- Y N� v ❑ N INTERIOR SHEAR FIRE DEPT. ° r SHEETROCK GRADE 'FEE SUMMARY EXTERIOR LATH BUILDING -Z INTERIOR LATH TEMPORARY APPROVALS"" BUILDING , SCRATCH COAT ELECTRIC PLAN CHECK ,2 GAS FEE NO TAPE OR PLASTER UNTIL BOVE HAS BE SIGNED-1OCCUPANCY SEISMIC FEE LXi OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHO=NSPECT ELECTRIC H ONE WORKING DAY BEFORE REQUIPLUMBING O� 'PLEASE GIVE JOB ADDRESS WHEN P Z MECHANICAL — SEE PERMIT FOR EXPIRATIIMPORTANT! CONST. PLEASE READ REVERSE SIDE•BEFORE TOTAL SLo CALLING FOR FINAL INSPECTION., OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BG I LDING'PROJECT IDENTIFICATION .PERMIT NUMBER BUIL ING APPLICATION & PERMIT, n rj ADDRESS (J (' BUILDING-ELECTRICAL-PLUMBING -MECHANICAL OWNER 5 - PLAN CHECK VA D TION "AME QTY. ELECTRIC PERMIT FEE _ rv,, ONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00 NAr,E, yy - t Larva (] LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S ' PPLIANCES � -RESIDENTIAL 4.00 AOOj1E5 � . dd((JJ , PHONE -i-4'O PANELS 10.00 DATE OF APPLICATION . ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE Fa;No. OR E 1 E c.No. - SIGNS TRANS. 3.00 ' A CR.ORE G. PERMIT VALIDATION AooREss q� SPECIAL CIRCUIT 5,00 V. Kv�P EMP.METER OR POLE INS. 20.00 ^ ADDRESS MOTORS SEE FEE SCH. ((//'1 i-F-/, ADDRESSMOTORS // V. SERVICE CHANGE 20.00 // �� - W o 2 LICENSED CONTRACTORS DECLARATION (/ v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE w Q y (commencing with Section 7000)Of Division 3 of the Business and BLDGll,. ELECT. PLG. MECH. AJ o z Professions Code,' d my license is in full force a ABeet ❑ ❑ ❑ z o License Class Lic.NumberyJZlti12_.� , o m r w ale Cont raetmr AsL�- -dL a m s , BUILDING PERMIT X IS w 4 OWNER"BUILDER DECLARATION FORMATION w;a h I hereby affirm that I an exempt from the Contractor's License MISC.- REFER TO ORD .. o a Law for the following reason.(Sec.7031.5,Businessand Professions TION SIFT. E - Code:Any city or county which requiresa permit teconstruel,alter,fe PERMIT ISSUANCE - 10.00 ' IS� ELEC.CONTR. LIC.NO. 4 p improve,demolish,or repair any structure,prior to its issuance,also ELEC. or O is requires Ilse applicant for such permit to file a signed statement that TOTAL ERMIT T IL w $ he is licensed pursuant to the provisions of the Contractors License UQ ti > Law.(Cuipter 9(commencing with Section 700()of D9visioa3 ofthe Qp'� �rv-s-+r-�� 4 o Business and Professions Code)or that Ile isexempt therefrom and QTY. PLUMBING PERMIT FE� / IC thebasis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a ;_ by any applicant for a permit Subjects the applicant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).1: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC,GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for vie (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,Provided that such improve- ments are not intended or offered for sale.If,however-the building GAS-EA.SYSTEM-I1NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA.) 200 BUILDING USE builder will have tile . . . e burden of proving that he did not build or im- RES IND CON PB Other th prove for purpose of e.)' INDUSTRIAL WASTE INTER. 30.00 ❑ as owner of the property, 1:1 11 dd contractors to construct the exclusively contracting with ❑ ❑ ❑project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORSPARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 contracts for such projects with a contmctons)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPHNSAIION DECLARATION WATER TREATING EQUIP. 5.00 I hereby atfirm that I have Certificate of consent to selGinsure, - ZONING ENG.SITE NO. ar a Certificate of Worke$,5pensation Insurance,or a certified opy theP DD...33311100088B CCCCCC - policy No!w ompany 4^a✓Jr I 0 ❑ Certified c'opy is he by furnished. FIRE SPRINK ENERGY T@4 .� Cer d Iled with tire city inspection division. Z-. b(Pr, mt(�(f/��/yc��QQy[r _ -_ p _ MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑ It m CISRTI F ICATE F EXI'MPI'ION F ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. UJ >_ - COMPENSATION INSURANC17 PLG.CONTR. LIC.NO. PLG. 0 (This section need not he completed if the permit i5 for one TOTAL V[:] NO V E] N❑ Z hundred dollars(SHOW or less.) U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. 0. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } to NOTICE TO APPLICANT: If,after making this Certificate of fix- ' {- ? emplion,you should became subject to the Workers Compensation APPLIANCE 5,00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE, U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=0C.F.M.) 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 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 UN IT(OV ER 100,000 B.T.U.)9.50 'ELECTRIC- I Certify That I have read this application and state that the above 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 construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100.000 BTU)SEE FEESCH. MECHANICAL above-mentioned properly for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities dgments, costs and expenses which - CONST.TAX may in any way ac ue gai t said City in consequence of the PERMIT ISSUANCE 10.00 mim fthis per IL MECH.CONT. LIC.NO. MECH. rZ t � TOTAL TOTAL Si ureofApplicant/Contra for I Date I OFFICE COPY