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18739- POST THIS CARD NEAR FRONT OF BUILDING' - CITY "0F CUPERTIN' INSPECTION DIVISION .. JOB INSPECTIONRECORD JOB ADDRESS �_�O �E/ IDCI C( UNIT# LOT# " L OWNER , `C' •r�/✓ CONTRACTOR' I TERM IT NUMB EH 18739 PERMIT EXPIRATION ' PERMIT EXPIRES IF WORK IS NOT STARTED. WITHIN ,180 DAYS OF PERMIT ISSU ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION. NOTE: •' ALL GRADING AND DRAINAGE SHALL,BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. LIFER. PR EGUNITE PERMIT VALIDATION t I.. Y,. !T I<'•al rf ISSUANCE DA IE _ GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED OCT 5:1989' UNDERGROUND /SLAB PLUMBING .' .. F _ ,Crit}sof CuportiDD ELECTRICAL MECHANICAL - BLuc ELECT. PLG. MECH � ❑ ElA DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - '. BUILDING PERMIT INFORMATION WOOD FLOOR - 'VA`UAT ION SIFT. PLUMBING MECHANICAL ELECTRICAL - - PBENUT TO -)� ..1.. .147 �C FRAMING INSULATION ST )RIe$ I V INSIH, - _ - OCC. GROUP HES UNITS, PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ' .ROOF NOTE: NO FINAL INSP. SHALLBE MADE BEFORE. THE CONSTRUCTION. TAX IS PAID, a - III, IT, E LDUII ARLA IUTfiL ACRLACl �' DIAPHRAGM ROOF SHEATHING - bulLUlNc use HE$ ,IND CON VB L)11••1 '1:1 L ❑ L L APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE, INSP. - ROUGH' SAN.N. A$$E$$(JH$ PARCEL NO PLUMBING ELECT. ENERGY .. TUBS &SHOWER PAN ) PLUMBING ENERGY - TRACT NO. PARCEL NO . MECHANICAL ; MECH. ENERGY ELECTRICAL -- BUILDING ENERGY Acc. DATE - ACC FILE NO FRAMING ELECT. FINAL TEST - INSULATION PLUMBING ZONING ENG. SITE NO. GAS TEST - - GAS" 1 ' MECHANICAL FIRE SPRINK °� ENERGY T94 NL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING. EXTERIOR SHEAR _ ELECTRICAL RELEASE ILOOD zoNE NL aL.0 c. I L NL INTERIOR SHEAR � � FIRE DEPT. SHEETROCK •GRADE . - FEE SUMMARY EXTERIOR LATH BUILDING BUILDING '.I NTERIOR LATH - TEMPORARY PPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE . -:. GAS, NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED _ OCCUPANCYSEISMIC FEE Sd OCCUPANCYOF BUILDING ISNOTP.ERMITTED UNTILBUILDING FINAL ISSIGNED•BY BUILDING• INSPECTOR. MICROFILM , ARRANGE-FOR INSPECTION BY PHONING 252-4505, F�. ONE WORKING DAY BEFORE REQUIRED INSPECTION' PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - SEE PERMIT FOREXPIRATIONDATE' ELECTRIC. PLUMBING MECH MECHANICAL /[ a G O.� CONST. TAX IMPORTANT!' PLEASE READ, REVERSE SIDE BEFORE ' CALLING FOR FINALANSPECTION. -1 TOTAL U D OFFICE COPY I , APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATION APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL), - PERMIT NUMBER .; O J (� - o eDILDwG" 5 I1REss - OWNERS i PLAN CHECK VALIDATION NAME ' ' PHONE9 a5 QTY. ELECTRIC PERMIT FEE DATE OF APPLICATION rvOMERACTORS 1 (5�,OI ore. rvo. 3,0 O.L 5 OUTLETS - SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 C,ONTRACTOR ADDRSSS.5-/• OORES_ 54; %1%nvh4JQ PHONE F Yo APPLIANCES -RESIDENTIAL 4.00.' r PANELS 10.00 ARCHITECT ARC .. - ENGINEER uc.NO. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. N0. . SIGNS TRANS. 3.00 ADDRESS ENG. CIRCUIT ' 5.00 PERMIT PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 1 , nP / lU kvcc APPLICANT s SS`9,N ADDRESS ADOR J 36 a Lo 11Aul MOTORS SEE FEE SCH. SERVICE CHANGE20.00 LICENSED CONTRACTORS DECLARATION PAID. 1 hereby affirm that I tun licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code' my license is it, force q Jiff;cL 9 License Class Lie N'wnber $ads ISSUANCE DATE BLDG. ELECT. ❑ PLG. MECH. ,❑ /E-� -/�y Date Contractor s CI,� fL-CI PERMIT INFORMATION OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor. License Law for the following reason. (Sec. 7031.5, Business and Professions Code: An 't hreounl I p Any city ywatchrerreture omit Loco issuance,also improve, demolish, or repair any Strad arc, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law lChapter 9(cmnmencing with Section 7000) o'Division 3 ofthe Business and Professions Code) or that he is exempt thercfmm and of Cupertino LlBUILDING 415C. - REFER TO ORD VALUATION VV 3'00 .Of1 • $/FT.. PERMIT ISSUANCE 10.00 ELEG CONTR. LIC. N0. ELEC. TOTAL PERMIT TO e QTY. PLUMBING PERMIT FEE 1 1STORIES TVIPE CC5NSTR. the basis for the alleged exemption. Any violation of Section 7031.5 1 by any applicant for a permit subjects the applicant ma civil penalty of not more than five hundred dollars(S500t): ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of Ire propert, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees. Provided that such improve retails arc not intended or offered for sale. If, however, the building _ F IXTUR ES - PER TRAP 5.00 So. FT. FLOOR AREA TOTAL ACREAGE GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or int piece lei purpose ofsale.).INDUSTRIAL .❑ 1, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB ower ❑ , ❑ ❑ ' ❑ ❑ WASTE INTER: 30.00' licensed contractors to construct the project (Sec. 7044. Business and Professions Code The Contractor's License Law docs not apply to un owner of property who builds or improves thereon, and who LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. , - contracts forsuch projects with a amtmcto0h) licensed pursuant to theComolettinSLicenseLaw. - SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. .❑ E at,, exempt under See. ,B.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date (t- - WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO� WORK 6RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affintt that l have u certificate of consent to self -insure. or u certificate 0 Workers Compensation Insurance, or a certified - ZONING ENG. SITE NO. copy thereof (Sec. 3800, Lab.C.l. Policy 'No Company' ❑ Certified copy is hereby famished Ccrtvic y i.�//_th,led r with the ciiy inspection division, lican LL,%4q_'=/Q--�� _ _ FIRE SPRINK Y ❑ N❑ ENERGY T.24 - Y ❑ N❑ MISC- REFER TO ORD: CERTIFICATE' OP EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. PLG. CONTR. LIC.NO. '• PLG. TOTAL COMPENSATION INSURANCE - section need not be completed if the permit is for one YE] YE] NE] QTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars (S I00) oI less.) I certify that -in the performance of the work for which this per- LOT is issued, I shall not employ any person in any manner so as to BUILDINGQ Sa hectare subject to the Workers''Compensation Laws of California. � Date Applicant NOTICE TO APPLWAN'C If, after making this Certificate of Ex ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK entption, you should become subject to the Workers'Conhpensatiun provisions of the Labor Code, you most forthwith comply with such provisions or this pennil shall b, dcem,d revoked FEE AIR HANDLING UNIT (TO 10,000 C.F.M.) , 4.00 AIR HANDLING UNIT (OVER 10,000C.F.W) 6.00 SEISMIC FEE �ff CONSTRUCTION LENDING AGENCY I hereby ufl tont mal taco, is a ou,tructicIn Iendlog agency En EXHAUST HOOD (WITH DUCT)5,00 the performance ofihe work for which "this permit is issued (Sec. 3097, Civ.C. ). ' MICROFILM - HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATI NG UN IT (OVER 100,000 B.T.U.) 9.50 ELECTRIC Lender's Name - Lender's Address I cerlify Ilial l have read this application and state tmtmcabov, VENTILATION FAN[SINGLE) 4.00 information is correc[..I agree to comply,witIT all city and co only ordinances and state `laws relating to building construction, and hereby authurio, representatives' of this city to enter upon me above-mentioned.properly for inspection purposes. PLUMBING BOILER-COMPI3 H. Ron 100,000 B.T.U.) 6.00 BOILER -C OMP[ Over 100,000 BTU) SEE' FEE SCH. - MECHANICAL MISC. - REFER TO WD. - (We) agree to save, indemnify and keep [harmless the City or Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the CONST, TAX - PERMITISSUANCE 10.00 �.. op MECH. CONT. �LtC. NO. MECH. -. TOT L S D �� TOTAL 3 �• ailingoflh}permy-, Signatureo'APpllcan t/Contractor" Date OFFICE COPY