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18034 (2) I POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 18034 \ INSPECTION DIVISION JOB INSPECTION RECORD . /I(((//////��)))/(/n/I PERMIT EXPIRATION JOB ADDRESSA�I_/ —UNIT# LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAY�EFROM NOTE: LAST CALL EDINSP CTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED DATICN 9 PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PIT T VALI CUPERTINO STANDARDS. P D GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED o UNDERGROUND /SLAB .'UU + 1909 PLUMBING � ELECTRICAL City Of Cup"nQSUANCI'.LATE SLUG R.ECT PLG. MLCH MECHANICAL ❑ El ' ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT, PLUMBING MECHANICAL ' PERMIT LO ELECTRICAL FRAMING siovlEs TYPE corvsrR INSULATION , UCC GHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED s0 IT nLoov Aven TLTAI.ncwenc,L • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - RES IND CON PR 011– APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ 0 - 0 ASSESSORS PARCEL NO. ROUGH SANA PLUMBING - ELECT,ENERGY TRACT NO, PARCELING TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING . ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION PLUMBING GAS TEST GAS FINE SPflINK ENERGY T,aa MECHANICAL Yo No I ❑ No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLooD roNL ALuc. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. yo NO v L I, SHEETROCK GRADE FEE SUMMARY EXTERIOR LATHBUILDING BUILDING , INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY I I SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDMG FINALISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC UJ ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING IS PLEASE GIVE JOB ADDRESS WHEN PHONING. ZMECHANICAL �7 ( . ( � — SEE PERMIT FOR EXPIRATION•DATE — IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT I DENTIFICATI ON .PERMIT NUMBER BDILDING APPLICATION & PERMIT A A flE55 BUILDING-ELECTRICAL-PLUMBING -MECHANICAL n., 18034 OvINER'S PLAN CHECK VALIDATION "neeX^1 ELECTRIC PERMIT FEE I-1^,l I ,-C9-KP.DNE CONTRACTORS TLETS-SWITCHES-RECEP 10.00/1.00 NA E 1k� '�'y�� ``// �las('/LU"'"`^v LIC.NO.7 52 1` LI TING FIXTURES 10.00/1.00 CONTRACTOR'S APPLI CES-RESIDENTIAL 4.00 ADO/R E�55A� yyy/ /1' /� �,(\1 +/�� rA Sj 60 rylult..WJ �a vHCN,7 PANEL$ 10.00 DATE OF APPLICATION V ARCHITECT PANELS (O 200 AMP( 20.00 PLAN CHECK FEE P.C.NO. OR ^_ ENGINEER �+J Ia NO. SIGNS TRANS- 3.00 ARCH,OR ENG. PERMIT VALIDATION ADOREss SPECIAL CIRCUIT 5.00 t ZIP EMP. METER OR PON INS. 20. U • At JM1,A x'L1 -Y APPLICANTS MOTORS SEE FEE SC A ORE s_13 ennm ocd (� SERVICECHANGE il,20.00 .99woO LICENSED CONTRACTORS DECLARATION a vG I hereby al tion that I con licensed under provisions of Chuptcr 9 ISSUANCE DATE y a H (commencing with Section 7000)of Division 3 of the Business and - DG. ELECT, PLG. MECH. F w z Professions Codc license is in full force a J fe Z,O Ie- License Class - Lia Nndir, ❑ ❑ ❑ ❑ 0 N ,� W Li. Lie,CcinNo...h a y s w �- BUILDING PERMIT ¢ ¢ w ¢ O Ii R- UILD6R DECLAR ION INFORMATION OdUMISC.- REFER TO ORD LL w I hereby affirm find 1 um exempt from the Contractor's License VALUATION $/FT. w a- as Law for the following reason.(See.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city c r county which requires a permit to construct.alter, ¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC CONTR. LIC.NO. ELEC. O¢ retlulre5 the applicant for such permit to file a signed statement(list TOTAL PERMITTO d w m" Ile is licensed pursuant to Ole provisions of Ole Contractors License , so z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe a liusincss and Professions Code)or that he is exempt therefrom and O V. PLUMBING PERMIT FEE a--h1AI A IIC✓J.I F i o ¢ H $ by naris for the alleged exemption.Any violation oto action malty STORIES TYPE CONSTR. d ; by any applicant fora hundred subjectsthe$500).licam toacivil penalty LTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than Coo hundred dollars(...y q1: Q o m owner of file property,e my,.,,it with wages as gA K FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS intinsole compensation,will(S the work,and thestructureand ois'not intended or offered for sale (Sec. 7044, Rosiness and Professions DRAINS-FLOOR,ROOF,AREA,GOND. 5.00 Code:The h Contractor's r License Law docs not apply to an owner of property who builds h or improves thereon,and who docs such work F IXTU S-PER TRAP 6.00 SD.FT.FLOOR AREA TOTAL ACREAGE himself re through his own mered for s provided tnal such inlprove- memsarcnot intended oroffered for sale lf,however,the building GAS-EA. VSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS-EA.$ TEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- proveforpurposeofsaleJ. INDUSTRIAL STEINTER. 30.00 RES IND CON PB Omer ❑ 1,as..net of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKL S-1 INC 5 V.B. 6.00 ASSESSORS PARCEL No. and Professions Code:The Contractor's License Law does nnl apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLER -OVER 5 IEA.) 1.00 Contracts lin such projects with a cnntracmus.licensed pursuant to file Comructnra License Law. SEWER-SANITARY-S RM EA.200fl/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-.R.&P.C.lin this WATER HEATER WIVEN'Ti, 6.00 reason Owner Dade WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPENSAt'[ON D17CLARATION WATER TREATING EQUIP. - 5.00 I hereby alfirnl that 1 have a ccnil Bate(it consent to self-insure, ZONING ENG.SITE NO. t � certi�f�i�ca�tayec„ofWaorkers'C.mFvblxnua Ir,umnee,m S (fed Pert merctr(jlt$py�i.�f.IJ.Lan.0 Na.� '1 s O ❑ Ccr1i17eJ copy is hereM1y fumislced. FIRE SPRINK ENERGY T-24 Z 2 Ctrtih 1 is filed III Ih• silty n"pecllon division. _ � _-A- MISC.- REFER TO OR Y N❑ v ❑ N❑ T PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Applicant- CC ] CERTIIICATIi OF IiXIiM PTION I'R(M OR KIiR$' LU _ CObIPFNSATION INSURA E PLG.CONTR. LIC.N0. PLG. d O (This section need not he completed if the permit is fin one TOTAL V❑ N❑ Y ❑ N❑ Z) 2 hundred doIIars(S100)mIvxx.) U O 1 tunny that in the performance of the work lin which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- 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. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } Go NOTICE 'I'D APPLICANT': If,after making this Cludicate of Ex- t.. ? emplion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must linthwilh comply with FEE U such provisions or this penult shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 CONSTRUCT ION LENDING AGENCY AIR HANCLING UNIT(OVER 10000C.F.M.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 lire performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) n n0 MICROFILM 3097,Gv.C.). 84 t7� Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I.C.de r'AJ dress 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 • in urn firm is correct. 1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP 13 H.P.or 100,000 B.T.U.) 6.00 hereby authonic representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertimo against liabilities,judgments, costs and expenses which nn CONST.TAX Y in way accrue against said City in quem- of the PERMIT ISSUANCE 2•Vb •con in I Is permit. C MECH.CONT. LIC.NO. MECH. D�YGP/L 2- FS5 g9 �I 'GZS �C G 7 OT I TOTAL p` �. Signature of Applicam/Contractor UattCQ OFFICE COPY