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18638 (2) POST THIS CARD NEAR FRONT,OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 18638 INSPECTION.DIVISION JOB INSPECTION RECORD' 'V♦7 ,-b PERMIT EXPIRATION JOB ADDRESS J o't 2_3 N• Wa - UNIT# _LOT# U yAP S PERMIT EXPIRES IF WORK WNER Oa. ACTOR a (e-c IS NOT STARTED WITHIN INSPE CTION DATE INSPECTOR INSPECTION RECORD 180 DAYS,OF PERMIT ISSU- . FOUNDATION - ANCE OR '180 DAYS FROM NOTE: ' LIFER -ALL GRADINGAND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. I PREGUNITE TO COMPLY WITH THE AP .ANS AND CITY OF. PERMIT VALIDATION , CUPERTINO STANDARDS. ,r !' ", GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED SEF UNDERGROUND /SLAB PLUMBING - � pwiply ELECTRICAL . - ISSUANCE DA I MECHANICAL - _Z n I �-,�^ - BLDcr� ELEcr. PLc. MEC. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR '� VALUATION $IFT. ' PLUMBING - MECHANICAL ' ELECTRICAL - PERMIT To FRAMING " `}��-'�I e ` of C-1 ' INSULATION STORIES TYPE CONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE s°.vT.`coon AREA roTaL ACREAGE DIAPHRAGM THE CONSTRUCTION'TAX IS PAID BUILDING USE ROOF SHEATHING - RES IND CON PB OIm, APPLY NO ROOFING UNTFL ABOVE HAS BEEN SIGNED FINALS IDATEINSP. ❑ L L EASSESSORS'PARCEL NO ROUGH SAN.# PLUMBING ELECT:ENERGYTUBSBSHOWERPAN PLUMBING ENERGYIRACT No PAHCEprTo MECHANICAL - MECH.ENERGY ELECTRICAL r1-r,' BUILDING ENERGY ACC.DATE AGE.FILE NO FRAMING ELECT.FINALTEST ZONING ENO.SITE NO. INSULATION / PLUMBING - GAS TEST. GAS - - MECHANICAL - FIRE SPRINK ENERGY T.pa COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING y F ^ N❑ ' � Qt-] FLOOD ZONE A.L U.C. EXTERIOR SHEAR - - ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. Y❑ No v L NQ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING ' SCRATCH COAT ELECTRIC .PLAN CHECK GAS, FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING.IS NOT PERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �U H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX 7. PLEASE READ REVERSE SIDE BEFORE TOTAL73 CALLING FORFINALINSPECTION. 7G OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY - . „BUILDING M6JECP IDENTIFICATION PERMIT NUMBER 0U11DING as APPLICATION & PERMIT1 o J C f� ���' Aapr1E5$ I BUILDING-ELECTRICAL-PLUMBING-MECHANICAL s, OWNER'S PLAN CHECK VALIDATION NAME (Wam,eN s QTY. ELECTRIC PERMIT FEE ' cozs- 'NONE 3g OUTLETS-SWITCHES-RECEP 10,00/1.00 S. LIGHTING FIXTURES 10.00/1.00 - CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 AO RES / PHO E ,3-_ 1d2 PANELS 10.00 DATE OF APPLICATION ' ORCRI CT PANELS (OVER 200 AMP) 20.00 ' PLAN CHECK FEE P.C.NO. ENGINEER SIGNS TRANS. - '3.00 nooaess ENG. - SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 �/- 2- APPLICANTS APPLICANTS MOTORS SEE FEE SCH. ` 1 ADDRESS �; 6 /�r. S! .69-- S-/2.1-1 SERVICE CHANGE pp 20.00 �'j-T ✓LL� woo LICENSED CONTRACTORS DECLARATION rt u U 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE Ga lu (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT, PLG. MECH. w Z Professions Code,and my license is in full farce and effect. ❑ ❑ ❑ 0 2L W License Class Lic.Number Date-Contractor a .,,.N < Y PI OI cow" O BUILDING PERMIT ¢ Ic w a OWNIi R-BUILDER DECLARATION INFORMATION ode' MISC.- REFER TO ORD E 3 u.w 1 hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. Yu0 J Law for the following reason,(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 -017 Iw04 Code:Any city orcounty which requires a permit to construct,alter, ¢ Q ¢ O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. DLL requires the applicant for such permit to file a signed statement that ' TOTAL 73. 7o PERMIT TO wm he is licensed pursuant to the provisions of tire Comrndor's License HZQ Law(Chapter 9(contmencing with Section 7000)of Division 3 ofthe Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE X the basis for the alleged exemption.Any violation of Section t,5 O STORIES TYPE CONSTR. I- $ a3 � by any applicant fora permit subjects tire applicant fee civil penenally ALTER-DRAIN -WATER (EA.) 5.00 of not more than live hundred dollars($500).): ❑ 1,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 License Law docs not apply to an owner of property who builds or improves thereon,and who docs 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-11 NC.4 OUTLETS 6.00 or improvement is said 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 am- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ - ❑ licensed contractors to construct 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(EA.) 1,00 contracts for such projects with a contractor(s)licensed pursuant to the Co tractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner - Date WATER SYSTEM 5.00 - ACC.DATE ACC.FILE NO. WORK IiRS'COMPENSA'IION DECLARATION WATER TREATING EOUIP. - 5.00 1 hereby affnm lhut 1 have a certificale of consent to sel Ginsum, . - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance•or a certified copy thereof(Sce.3800,Lab.C.) µ��.,rms�d� ec�-,frs Policy No. Company4ins /r. '.4c 0 Certificjl Copy is hereby furnished. FIRE sPRINK ENERGY T$4 Z Z C t" p 's filed with the city inspection division. MISC.- REFER TO ORD. O A plicant Y ❑ N❑ Y ❑ N❑ ~ wPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U. LU > CER'fI FICA i I P EXEMPTON PROM WORKERS' DJ _ CO ENSATION NSURANCE: PLG.CONTR. . LIC.NO. PLG. Q. a (This action need not be completed if the permit is for one r TOTAL. Y❑ N❑ Y ❑ N❑ :D Z hundred dollars(S100)ar less.) 0 O 1 certify that in tire performance of tire work far which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F- 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. w Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } rail NOTICE 1'0 APPLICANT:Jf,after muki ng this Certificate of Ex- emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of file Labor Code, you must forthwith comply with FEE (..1 such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10,000CF.M.1 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=CF.M.) 6.00 [ELECTRIC IC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST'HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 + OFILM 3097,Cls.C.). - Leader'sName HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4,00information is correct. I agreeto comply with all city and county Brdinances and state laws relating to building Construction, and - BOILER-COMP(3 H.P.Or100,000B.T.U.) 6.0(1hereby authorize representatives of this city to enter upon the BOILER-COMP (°VBr 100,000 BTUI SEE FEE'SCH. ANICAL above-mentioned properly for inspection purposes.OVE) agree to save, indemnifymd keep harmless the City of MISC.- REFER TO'ORD. upertino against iabilities,judg nt , costsa T.TAX NSiVallp6 wa awrue u sail City in c 1 •yucnce of t e PERMIT ISSUANCE 10.00 - f IL MECH.CONT. LIC.NO. MECH. 921 TOTAL TOTAL Applicant/Contractor Date OFFICE COPY r .