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14887 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY M71 LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER - Bu,LO, APPLICATION & PERMIT 14887 ADDRESS y / BUILDING—ELECTRICAL—PLUMBING—MECHANICAL :, OwrvER'S p dG PLAN CHECK VALIDATION NAME (- M �yyl ITV ELECTRIC PERMIT FEE 01bPHONE q NomERAcroRs OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.NG. GHTING FIXTURES 10.00/1.00 Qt' nooeess Des LIPPLIANCES-RESIDENTIAL 4.00 Q'9 PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 E NGINEEH uc.NO. SIGNS TRANS. 3.00 ADDRESS ENG' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIv rrEMP.METER OR POLE INS. 20.00 AoaREssrs MOTORS SEE FEE SCH. v SERVICE CHANGE 20.00 0 0 aO aC Foo LICENSED CONTRACTORS DECLARATION a o I, I hereby'affirm that I am licensed under provisions of Chapter') m2 w -BLISSUANCE DATE , N (commencing witM1 Section 70001 0(Division 3 of the Business and DG. ELECT. PLG. MECN. F o a Professions Code,and my license is in full force and effect. 0 z'� License Clens Lis.Number ,A r Date.Contractor a Y E a w ¢ OWNER-BUILDER DIiCLARATION BUILDING PERMIT E: o a OINFORMATION X 3: 1 I hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO F LL o j Law for the following reason.(Sec.]031.5,Business and Professions PERMIT ISSUANCE 1 00 •�XALUATION Code:Any city or cowlly which requires permit to construct,alter, \N• oimprove,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. �t o w requires the applicant for such pmol,to file a signed statement that TOTAL W S� K m he is licensed pennant to the provisions of the Contractors License PERMIT TO F z a Law(Chapter 9(commencing with Section 7000)of Division 3 oflhe .—/r-(V�I�-jQ` I —q i O Business and Professions Code)or that he is exempt therefrom and ITV. PLUMBING PERMIT FEE � cD F-o the basis for the alleged exemption.Any violation o($ecl ion 7031.5 STORIES TYPE CONSTR. a 3 i9 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollar,(5500j) ALTER-DRAIN& VENT-WATER (EA.) 5.00 Cl 1,as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 400 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,CON D. 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.PT.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-1 INC.4OUTLETS 6.00 5�� or improvement is sold within one year of completion, the owner- GAS'-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove for purpose of sale INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ I,as owner of the properly,am exclusively contracting with licensed contractors m construct the project(Sec. 7044,Business and Professions Code:The Contractor LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. Contractor',License Luw Anes not apply to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a cuntmetons)licensed pum,anl to ](lieComractorLicens-Law. SEWER-SANITARY-STORMEA.200ft/10.00 TRACT NO. PARCEL NO. plu rSec. B.&P.C.for miWATER HEATER W/VENTfeaso6.00 OwneDate WATER SYSTEM5.00ACC.DATE ACC.FILE NO. iR COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm t rut 1 have a certificate of consent to vIHinsure, nr a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab C.). - Policy No. Company O ❑ Certified copy is hereby furnished. z 20 Certified copy is filed will, Om city inspection dwnr.... FIRE SPRINK ENERGY T-24 F- O Applicant misc.. REFER TO ORD. Y❑ N❑ Y ❑ No CC h C17RTIFICATI'017EXI-MMION FROM WORKERS' PERMIT ISSUANCE 1 /d FLOODZONE A.L.U.O. L COMPI?NSATION INSURANCE PLO.CONTR. LIC.NO. PLG, EL O (This section need not be completed if fire permit is for one TOTAL V N� Y NEI U O hundred dollars($100)or less) I certify that in the performance of the work for which this per- I-ry MECHANICAL PERMIT FEE FEE SUMMARY L I— mit is issued,I shall nor employ any person in any nwnncr so as Io O L) become subject to the Workers'Compensation Laws of California. °' Dat` ICANr:nr ALTER OR ADD TO MECH. 5.00 BUILDING a1 } Va aleNOTICE TO APPLICANT: If,after making this Certificate of Ex- F Z emplion,you should become subject to the Workeri Compensation APPLIANCE pr vision, of the Labor Code, you most forthwith comply with - 5.00 PLAN CHECK U such provisions or this permit shall be deemed revoked. �, AIR HANDLING UNIT(TO 10=C.F.M.) 460 — FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 3 �' I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 500 the performance of rh . e work for which this permit is issued(Sec. MICROFILM 3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lenders Andress HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that have read Ihis application and state that We anove VENTILATION FAN (SINGLE) 4.00 information n Cstate I agree to comply with all city and county BOILER COMP PLUMBING ordinances and state lows relating m building construction, the (3 H.P.or 100,000 B.T.U.1 6.00 hereby enthorire representatives of this city m enter upon the abuvrmentioned properly for inspection purposes, BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL V r/ (We) ogre o save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cay in y liabi hies,judgments, costs and expenses which CONST.TAX ay in n ay a e against said City in consc Vence 1 rhe PERMIT ISSUANCE _ �- mnling lis pe MECH.CONT. LIC.NO. MECH. TOTAL ZJ Cr:li Sig u of pplir /Contractor a? TOTAL 77 Oft 1 OFFICE COPY POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PERM1,I�Na88� INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 874 E. Estates Dr1Ve, UNIT# _LOT# OWNER Greg JonescoNrRAcroR PERMIT EXPIRES IF WORK. IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- . FOUNDATION ANCEOR 180 DAYS FROM NOTE: LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PEHMIT VALIDATION GARAGE SLABS CUPERTI NO STANDARDS. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL RLuc eEECT PLc. MECR DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED PN BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING �� 88 VALUATION SIP MECHANICAL ELECTRICAL PERMIT To /- Dp FRAMING -.C`. '�� I, M_ (� i t-; INSULATION 07-I3_e x STORIES TYPE comSTR OCC GROUP RES.UNITS ^# PLACE NO SUBfLOOR UNTIL ABOVE HAS BEEN SIGNED 1` ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sD Fr FLooR AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID 1 ,.. BUILDING USE ROOF SHEATHING t ALE, 9' fV-w RES MD CON PB 0111" APPLY NO ROOFING UNTIL ABOVE HAS BEft SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ AssessoRs PARCEL No ROUGH SAN.p PLUMBING —`n-� U117 ELECT.ENERGY TUBS B SHOWER PAN PLUMBING ENERGY Q TRACT No PARCEL NO MECHANICAL MECH.ENERGY Q ELECTRICAL F- BUILDING ENERGY ,Q ACC DATE ACC.FILE No FRAMING ELECT,FINAL TEST INSULATION - �./3_ PLUMBING O ZONING ENG SITE NO, GAS TEST GAS MECHANICAL FIRE$PRINK ENERG�L]n COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ° ❑ "❑ ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE AL UC. INTERIOR SHEARFIRE DEPT. V❑ 'N❑ Y ❑ N❑ SHEETROCK GRADE EXTERIOR LATH FEE SUMMARY '9 ' BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING ? .1 SCRATCH COAT ELECTRIC , PLAN CHECK GAS' FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUI LOING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z - PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL I IMPORTANT! CONST.TAX ` PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY