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14015 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14015 INSPECTION DIVISION • JOB INSPECTION RECORD. �..�'�--c;�„s-Fr -ts•-��..� PERMIT EXPIRATION JOBADDRESS_ 0345C.CLIFDO WAY - _ ` UNIT# LOT# PERMIT EXPIRES IF WORK OWNER HEYMAN CONTRACTOR INTERNATIONAL KITCHEb IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR - INSPECTION RECORD o 180 DAYS OF PERMIT ISSU FOUNDATION _ tNCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ~ PLUMBING ELECTRICAL h;, �''.' . ISSUANCE DATE MECHANICAL BLDG. ELECT. PLG. M'EEC�HH' 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT - INFORMATION WOOD FLOOR VALUATION PLUMBING MECHANICAL - PERMIT TO ELECTRICAL ' FRAMING " ' STORIES TYPE CONSTR. INSULATION OCC.GROUP RES.UNITS r PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED FT.FLOOR AREA TOTAL ACREAGE ROOF 'f jr DIAPHRAGM I BUILDING USE RES IND CON PB Olne, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El ElCD ❑ ❑ nSSE$SOR$PARCEL NO. ROUGH PLUMBING -} TgACT NO. PARCEL NO. GAS TEST - - MECHANICAL _ . ACC.DATE ACC FILE NO. ELECTRICAL _ _�f FINALS DATE INSP. FRAMING 94SAN # ZONING ENc,SITE No. INSULATION PLUMBING GAS FIRE SPRINK ENERGYT24 MECHANICAL v ❑ N❑ Y ❑, N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING- —FLOOD ZONE A.L"U C. LATH-INTERIOR ELECTRICAL LATH-EXTERIOR FIRE DEPT. YE) "❑ v ❑ ry❑' SHEETROCK GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORA wovA $ BUILDING �j •` FIREWALLS ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY j VA ' SEISMIC FEE / OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BYB LDING INSPECTOR. MICROFILM ELECTRIC. ARRANGE FOR INSPECTION BY PHONING 252-4505, 4+ H ONE WORKING DAY BEFORE REQUIRED INSPECTION. P uMBINc o� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL ' — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL > ! CALLING FOR FINAL.INSPECTION: OFFICE COPY - ,SFPLICANT TO FILL IN INFORMATION WITHIN RED LINES USE BALL POINT PEN ONLY PERMIT NUMBER BUILDING PROJECT IDENTIFICATION . APPLICATION & PERMIT 9UILDING 1401'} AiFO6 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 5 ' PLAN CHECK VALIDATION OWNER'S DTV. ELECTRIC PERMIT FEE • • PHONE CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00 Q NAME pp6 LIC.No.3 / LIGHTING FIXTURES 10.00/1,00 CONTRACTOR s. APPLIANCES-RESIDENTIAL 4.00 ' ADDRESS H pq°ry PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS'(OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. Ofl ENGINEER'- • u 3.00 - ' c.No, SIGNS TRANS. ARCH.OR ENG.' - SPECIALCIRCUIT T."1.uy 5,OO PERMIT VALIDATION , ADDRESS ZIP EMP.METER OR POLE INS.' 20.00 GS,„y APPLICANTS MOTORS �, -SEE,FEE SCH. ADDRESS - S� SERVICE CHANGE \" - 20,00 w o a LICENSED CONTRACTORS DECLARATION ¢u u I hereby affr n that I am licensed under provisions of Chapter 9 vi ' n:'ELECT.�EIOATEI�O vHi<c (commencing with Section 7000)of Division 3 of the Business and - BLDG.x' 'ELECT. PLG. ,MECH. Y i Professions Cod d my license is in full farce a�yy,�'f � I:1 �Q') rVI , 0.—,' cense Class Con NumbeJf, J BUILDING PER O � H° Date Contractor_ BUILDING PERMIT J ¢ ¢ w u OWNER-BUILDER DECLARATION INFORMATION MISC.— REFER TO ORD A. 3 n H 1 hereby affirm that 1 am exempt from the Con Vaclor's License VALUATION $/FT. F LL 04 Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 d Code:Any city or'county which requires o per m construct,alter, ¢ 2 Q 0 improve,demolish,of repair any structure,prior to its issuance,also ELEC.CO TR. LIC.NO. ELEC. L/S�b i aC o u¢. requires the applicant for such permit to file a signed statement that ' TOTAL �� PERMIT TO w$m he is licensed pursuant•to the provisions of the Contractor's LicenseCMOd rzQ Law(Chapter9Commencingwith Section 7000)ofDivision 3ofthe _ ' PLUMBING PERMIT FEE �/I/T, F t Business and Professions Code)or that he is exempt therefrom and GTY. STORIES TYPE CONSTR. ¢ I- the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00IS- of not more than five hundred dollars(85000.)'. ❑ 1,is owner Of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 DCC.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 License Law does not apply to an owner Of property,who builds or improves thereon,and who does such work FIXTURES-PER TRAP FT,FLOOR AREA TOTAL ACREAGE �I himself or through his own employees,provided that such improve- mentsarenotintended or offered for sale.If,however,the building GAS-EA.SVSTEM-l 6.00 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 Oreer prove for purpose of sale.). I INDUSTRIAL WASTE INTER. 30.00 ❑ El Q ❑ 1:1- ❑ I,as owner of the property,am exclusively contracting with licensed contractors to constiuct 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 IEA.) 1.00' contracts for such projects will a contractors)licensed pursuant to SEWER-SANITARY-STORNjEA:200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ Iain exempt under Sec. ,B.&P.C.f6rths WATER HEATERW/VENT a 6.00 . ' reason' , Owner Date WATER SYSTEM '(\1.- 1 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATINGEQUIP�.! - pt•.,r34(5100 I hereby affirm that 1 have a cerlificate'Of consent to self-insure, W J �'.` ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lal. �...AT _ Policy No. Company Q Verified copy iadse Pay�jufnishe 1. FIRE SPRINK ENERGY T-24 Z Z,? �Ce cp is fi edli a itY its i ' °110 MISC.- REFER TO ORD. y� N❑ Y ❑ N❑" O APPlican I yC. � - CERTIFICATE EXE TION FROM WORKCRS', PERMIT ISSUANCE 10.00 FLOOD ZONE A.VU uJ > COMPENSATION INSURANCE' ' . PLG.c R. - c PLG. V Y 0- N❑ 1 GTOTAL (This section need not be completed if the permit is for one -Z hundred dollars IS 100)or less.) FEE SUMMARY U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE LL I— mit is issued.I shall not employ any Person in any manner so as to O ad ct to thews become subjeWorkers'Compensation Laof California. BUILDING Date Applicant >_ N NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 �O FZ caption,you should become subject to the W°rkers'Compensation gppLIANCE 1. - ',:) 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 UNI-r(TO 10=C.F.M.) 4,00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 1000C.F.M,) 6.00 SEISMIC FEE O I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT)_q 5.00/0 MICROFILM the perf°rmanec'of the work for which this permit is issued(See. HEATING UNIT(TO 100;000'6.T.0-) B-00 3097,Civ.CJ.' Lender's Name HEATING UN IT(0V ER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address information that correct. read agrees application and staall c that d countyhe above VENTBOILS LOTION FAN (SINGLE) PLUMBING Q ordina ccs is correct.I agree to comply with all city and county BOILER-COMP13 H.P.Or 100,000 B.T.U.) 6.00 ordinances and-state 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 d above-mentioned property forAnspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE' 10.001//7— CONST.TAX may in any way accrue.against sai try-in consequence of,the sIx "Igrunting of this p2tmit. ECH.CONT. LIC.NO. MECH. s E 39�,�� 3 TOTAL d0 TOTAL as Signature of Applicant/LontracTy Dale OFFICE COPY