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17247 (2) y POST THIS CARD NEAR.FRONT OF BU I LDING . PERMliNUMRER CITY OF CUPERTINO , INSPECTION DIVISION a , 1724 JOB INSPECTION RECORD /S I PERM .EXPI A� ION/� JOB ADDRESS I �� 'Ir. UNIT# _LOT# J •'+ CJI/! I PERMIT'EXPIRES 4k,ORK OWNER - �'Y' CONTRACTOR. q IQ YI¢p� IS NOT START.E� WITHIN INSPECTION DATE- INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM NOTE: - LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED Pq EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF. PERMIT VALIDATION• bUP RTIN STN gS. GARAGE SLABS ` Ii.DwrA w w( - / d F. 1 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED kQ. Q UNDERGROUND /SLAB - - r PLUMBING ' 4?j tp) (�PtIL -�� 5 ELECTRICAL '_`'�.JISSUANCE DATE MECHANICAL LILCO ELECT'I, PLG. mecH: ❑ ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED `jljlBUILDING PERMIT INFORMATION WOOD FLOOR - citv VALUATION $/FT. - PLUMBING - � - �. r] ' MECHANICAL " 2? coo ELECTRICAL PERMIT To 2^ l FRAMING ;{ � t'.�-Q'1�� INSULATION - SrORIES T(3 cON.STIR OCC GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - - • ROOF 'NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.IT.FLOOR AREA TOIL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ' BUILDING USE ROOF SHEATHING Res - IND CON PR on.,•. I APPLY NO ROOFING UNTIL ABOVE HAS BEEWSIGNED .FINALS- DATE INSP. r ROUGH SAN.k - ASSEssURSPARceL NG•. • ' PLUMBING - ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY - TRACT No. PARCEL No. MECHANICAL MECH.ENERGY ' ' ELECTRICAL - BUILDING ENERGY ACC.DATE ACC.FILE NO;1 ' FRAMING .. ELECT.FINAL TEST INSULATION PLUMBING ZONING ENC.SITE No. GAS TEST GAS - MECHANICAL EIRE SPRINK ENERGY r.aa" COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - ", ` No EXTERIOR SHEAR - ELECTRICAL RELEASE ' FLOOD ZONE A.L.u.C. V '.NO VL NO INTERIOR SHEAR " FIRE DEPT. SHEETROCK - GRADE. FEE SUMMARY EXTERIOR'LATH BUILDING , INTERIOR LATH ,- - TEMPORARY'APPROVALS - - suILOING. SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS 0 TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY q:],SEISMIC FEE CCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN-PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL ' -'IMPORTANT! - coNST.TAX . Y PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL J' T OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LDI NO PROJECT I DENTI FICATION -PERMIT NUMBER BUILDING APPLICATION& PERMIT �]� � ADDRESS I oo N✓1'N'✓1 Vtt�� I C.�, BUILDING —ELECTRICAL—PLUMBING—MECHANICAL 41 0WNER's ( r 0i,, sr, rP�p�1�r^ PLAN CHECK VALIDATION NAME L �f7Q GJO' DTV. ELECTRIC PERMIT FEE IGHONE 3-3 �. CONTRACTORS �� NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 �i GI Airco%L sec NO 2 0 LIGHTING FIXTURES 10.00/1.00 ADDAEACTOR's ss PPLIANCES-RESIDENTIAL 4.00 CONTRA ,�Pj pl'IA PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECi� ry �, PLAN CHECK FEE P.G.NO. OR L' Y N4�AC PANELS (OVER 200 AMPI 20.00 - - ENGINEER LIC NO. SIGNS TRANS. 3.00 - ADDDRESS ENa. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. JU 20.00 � ��, _ APPLICANT'S MOTORS I' EE .�,1'TE�a '•�IU 014' ADDRESS SERVICE CHANGE 2000 •� I'0�� . O o LICENSED CONTRACTORS DECLARATION a i W I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE GATE H (commencing with Section 7000)of Division 3 of the Business and y ¢H BLDG. ELECT. G. MECH. H Z Professions Code and ny license is in full fort•unJ effe 1 ❑ ❑ ❑ Z f= o License lass Lic.N, To I O , Date Contractor BUILDING PERMIT a o n O OWNER-BUILDER DECLARATION CVAC - INFORMATION w ; LL H I hereby afNnm that 1 am exempt from the Contractor's License MISC.— REFER TO ORD w VALUATION $/FT. HLLOj Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE -10.00 Code:Any city or county which requires a permit to construct,alter, ¢ ¢ ¢ o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. - UG NO. ELEC. - 12 V/, � isO u requires the applicant for such permit to file a signed statement That TOTAL PERMITTO m^ he is licensed pursuant to the provisions of the Contractor's License - HiQ Law(Chapter 9(commeneingwith Section 7000)of Division 3 of The i o Business and Professions Code)or that he is exempt Therefrom and QTY. PLUMBING PERMIT FEE s n �I/✓O ¢ 1-$ the basis for the alleged exemption.Any violation of Seclion703L5 STORIES TYPE CONSTR. by any applicant for a pemnilsubjects The applicant to a civil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(5500).): ❑ 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 sale (Sec. 7044, Business and Professions DRAINS-FLOOR;ROOF,AREA,COND.. 5.00 Code:.The Contractor's Licenr1��e:Law does not apply to an owner of properly who builds Or Int prsfves 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-1 INC.4 OUTLETS 6.00 r or improvement is sold within one year of completion,the owner. GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im. - RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 11I,as owner of the properly,am exclusively contracting with ❑ ❑. ❑ ❑ ❑ licensedcontractors to construct The project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractors 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 contractorls)licensed pannier to the Contractor's License Law. , SEWER-SANITARY-STORM EA.2001t/10.00 TRACT NO, PARCEL NO. C1 am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPF,NSATGN DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to salt-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof See.3800,Lab.0.L Policy No.1A=ompanyS-� t• O ❑ Cerliliedcopyishercbyfurnis�ed. - FIRE SPRINK ENERGY T24 Z Z ❑ Certified pY filed with Ore c spection division. - s,-- � '�R MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ O Applicants `_l n Y N V N N CERTIFICATE 01'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10,00 FLOODZONE -A.L.U.C. LU > COMPENSATION INSURANCE PLC.CONTR. 'LI C.NOu ,N• PLG. CL 0 (This section need not be completed if The permit is for one Y TOTAL Y[]t N❑, Y❑ N❑ M) Z hundred dollars 1$100)or less 'q.� t U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mil is issued,I shall not employ any person in any manner so as Du .g OU become to the Workers Compensation Laws of California. w ecome subject - BUILDING 3� y . Date Applicant ALTER OR ADD TO MECH. 5.00 . Y m NOT[CF.TO APPLICANT: If,after making this Certificate of Ex. - F ?' emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK / L1 •-1 provisions of lire Labor Code, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 00 SEISMIC FEE tt I hereby affirm that There'is a construction lending agency for EXHAUST HOOD(WITH DUCT) .0 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T. MICROFILM 3097,Civ.C.l. Lender's Name HEATING UNIT IOVER100,0008. .UV Lender's Address ELECTRICI certify that I have read this application and slate that the above VENTILATION FAN (SINGLE)information is correct.I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COW(3 H.P.or 100,000 B. hereby authorize representatives of this city to enter upon the BOILER-COMP (Own 100,000 BTU)'SEE FEE SCH.. MECHANICAL i I:io: above-mentioned property for inspection purposes. `^ (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. , Cuter fino against liabilities,judgments, costs and expenses which - OONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 ranting of 11" permitMECH.CONT. LIC.NO. - MECH. �� _ a_/2.:]M- TOTAL TOTAL Signature ofplic Apant/Confaclor Date OFFICE COPY