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14637 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER _ . CITY - OF CUPERTINO 14637 INSPECTION DIVISION JOB INSPECTION RECORD • JOB ADDRESS��SG 16A; Z' Zc••�/ �L PERMIT EXPIRATION UNIT# _LOT# / PERMIT EXPIRES IF WORK OWNERS-rA+e. CONTRACTOR .�'.� LIS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION NOTE: ANCE OR 180 DAYS FROM LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PR EG UNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF vERMN vaLmnrioN CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING :.. ELECTRICAL - issuaNCE DATE MECHANICALBLOC ELECT PLc. meCH ❑ El ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS-BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING - VALUaT10N S/PT, MECHANICAL ELECTRICAL PERMIT To FRAMING INSULATION STORIES 7PECONSTR RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE TO.FT.FLOOR AREA TOTAL ACREAGE •. DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING - auILDmc USE „ IND CON PIT Otlov _ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ElEl 11 • El SAN.N ROUGH nssessoas PaRCEL No PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT No. PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE Acc.RILENO FRAMING ELECT.FINAL TEST INSULATION - PLUMBING Z0N1M10 ENc.srtE No. GAS TEST GAS MECHANICAL EIRE SPRINK .ENERGY T 2 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ° ❑ NO ` ❑ N❑ EXTERIOR SHEAR - ELECTRICAL RELEASE BLOOD ZONE A.L.0 C. INTERIOR SHEAR FIRE DEPT. Y❑ N❑, . L No SHEETROCK GRADE EXTERIOR LATHBUILDING FEE SUMMARY • INTERIOR LATH TEMPORARY APPROV BUILDING 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 BUI LDING FINAL IS SIGNED BY BUILDING INSPECTOR. - MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F-ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL I IMPORTANT! CONST. TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. ?/ 1 - OFFICE COPY. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING - APPLICATION & PERMIT 14637 , Aoontss BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION • 3* QTY ELECTRIC PERMIT FEE vH0 J �(.os/ NAMERAcroRs nq nn UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 rorvrRAcroRs PPLIANCES-RESIDENTIAL 4.00 AooREss /L PANELS 10.00 DATE OF APPLICATION A CITECi - PLAN CHECK FEE P.0.N0. OR PANELS (OVER 200 AMP) 20.00 ENGINEER uc.No. SIGNS TRANS. 3.00 ADDRESS ENG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP rrEMP. METER OR POLE INS. 20.00 ASMOTORS SEE FS •. ++' ADDREDDRESSS EECH. (� IS in z SERVICE CHANGE 20.00 Foo LICENSED CONTRACTORS DECLARATION a u 0 1 hereby affirm that 1 am licensed under provisions of Chapter 9 a z w ISSUANCE DATE mw (conunemang with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. E m z Professions Com,ayyl qIy license is in full fou}gpdpfl 1 7 ❑ ❑ im o License Class-[_--)U Lic.Numbers/ La Dater KfgiI,j_Contranor ay EJ J L ` DD ¢ ¢ w a OWNIi R-BUILDIiR DECLARATION BUILDING PERMIT ` O' er MISC.- REFER TO ORD INFORMATION w g n w I hereby affirm that I a.n exempt from the Uettraid License u O j Law far the following rmsan.)Sec.]031.5,Business anJ Pmfessians VALUATION - PERMIT ISSUANCE 10.00 Code:Any city or county which requiresa permit to construct,alter, ¢ ¢ ¢ EO improve,demolish,or repair any structure,prior In its issuance,also ELEC.CONTE. LIG NO: ELEC. U, w m w rttluircs the applicant for such permit to file a signed statement that TOTAL PERMIT TO he is licensed pursuant to the provisions of the Contr,ICtor's License T T- F z a Law(Chapter 9(commencing with Section 7000)of Division 3ofthe - I�L 4 o Business and Professions Code)or that he is exempt therefrom andDTV. PLUMBING PERMIT FEE ¢ I-m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. n 3 by:my applicant for a permit subject,the applicant to a civil penally of not more than five hundred dollars($500).): ALTER-DRAIN&VENT:WATER (EA.) 5.00 ❑ 1,as owner of the property;or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP REB.UNITS their sole compensation,will do the work,and the structure Is not intended or offered for sale(Scc. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,CONgpom 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 Sa FT.FLDOR AREA TOTAL ACREAGE himself or through his own employees,providede that such improv meats arc not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4OUTLET . 0 or improvement is suld within one year of completion, the owner builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA. .00 BUILDING USE prove for purpose ofsale J. RES IND CON PB Otne, ❑ 1,as owner.1 file Property,ani exclusively contracting with INDUSTRIAL WASTE INTER. 1:1 1:1 11 ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. .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 contme(s for such projects with a contractors)licensed pursuant to the Contractor,License Law. SEWER-SANITARY-STORMEA.200ft/10.00 TRACT NO. PARCEL NO. ra . nl am exempt under Sea B.&P.C.for this WATER HEATER W/VENT ,�r00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. woRKEkS'coMPt;NSnl'IUN DECLARATIONWATER TREATING EQUIP, 5.00 I hereby affirm that 1 have a certificate of consentro'elf-insure. or a certificate of Workers'Compensation Insurwmc 'a certified ZONING ENG.SITE NO. copy N V -31500,Lab Cmy . n,// _ Policy N e0oang-/�Hr_ 0 ❑ C- by furnished. Z Z erled with the city inspection division. FIRE SPR INK ENERGY 1 2 H O ApplicantC4�.1s MISC.- REFER TO ORD. y N� v N� CC > CERT EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 '00 FLOOD ZONE A.LUL. 'W COMPF,NSATION INSURANCE PLG.CONTR. LIC.NO. CL O (This section need not be completed if the permit is for one TOTAL _6? V[Jt N Y NEI Z hundred dap a,,1$100)or CO.)l U O 1 certify that in the performance of the work for which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY W U mit is issued,I Shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. n Dale nppl"wtt ALTER OR ADD TO MECH. '5.00 BUILDING _ 2 NOTICE'I'O APPLICANT: If,after making this Certificate of Ex- F _ emption,you should become subject to the Workers Compensation APPLIANCE 500 PLAN CHECK provisions of the Labor Code, you must forthwith comply with . U such provisions or this permit sleall be deemed revoked. AIR HANDLING UNIT(TO 10/000C.F.tA) 4.00 FEE CONSI'RUC'I'[ON LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performanee of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.L HEATING UNIT(TO 100,000 B,T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state that the above - VENTILATION FAN (SINGLE) 4.00 cudirnation n cornet. 1 agree to comply with all City and county - PLUMBING ordinances and state Taws relating to is building Construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 above-hereby entioed representatives for ins ec this city es enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE$CH. p p y P P P MECHANICAL (WC) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Caper Ono agar t liabilities,judgments, costs and expenses which CONST.TAX may in any w accrue against said City in consequence of the PERMIT ISSUANCE 10.00 og of this crmit' MECH.CONT. LIG NO. MECH. e TOTAL TOTAL Sig a re of Applicant/Contrmee actor v OFFICE COPY