17988 lw
i POST.THIS CARD-NEAR%FRONTT OF BUILDING
• - -,`' PERMITNUMBER
'CITY, CUPERTINO : 17988
INSPECTION•DIVISION
JOB INSPECTION RECORD i
-.� / ' p,1�0 e • _U- '+•� P MTj EXPIRA�TIO� .
$/ D��!1�__'''� '�'" NIT# '
_LOT#
JOB ADORES - _ PERMIT EXPIRES IF WORK
OWNER CONTRACTOR • IS NOT STARTED'-
WITHIN
I INSPECTION DATE INSPECTOR INSPECTION RECORD I 180 DAYS OF PERMIT ISSU.
FOUNDATION "�1 ANCE'OR 180 DAYS FROM
NOTE.'•' LAST CALLEDINSPECTION.
UFER " - ,L`, q FALL GRADING AND DRAINAGE SHALL BE INSTALLED. ",TO COMPLY WITH THE'APPROVED:PLANS'AND CITY OF PEH nm vnu DA TION
IPR EGUNITE CUPERTINO STANDARDS. (j / / `1'°
GARAGE SLABS ,. - l ,L/A/`r' �(/! °P , •-':r .
I POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I '
,UNDERGROUND./SLAB
IPLUMBING .. •�
(ELECTRICAL t —� ..' .• - ..I {'-
F ISSUANCE DA iE '.
IMECHANICAL I - B1i+G ELEsy .PLC -m If
DO NOT POUR FLOOR UNTILABOVE HAS BEEN SIGNED - Bu1LUwG PERMIT
I WOOD FLOOR
IOINFO
PLUMBING VALUATION DR�MN
A.
T:II ON
SIFT
IMECHANICAL `4r
IW I' q _aJ q
(ELECTRICAL U��- I 4�5A.all amewl1 - •�.nl ✓ 'PD'i UL I
I FRAMING ?�7Erpp � _ I rl{v/WAYIB'
( INSULATION Iq- 7l_d l �',� G�y/,/ "F(/,// STORI FS TvPE COmsTH
I
OCC.GHDUP .RES,UNITS
rh-,yam I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
I ` POOP - I-SO 11.11 R APb4 TOTAL ACPr A.1
!T 'I NOTE'NO FINAL INSP.SHALL BE MADE BEFORE ems/
DIAPHRAGM II HE CONSTRUCTION TAX IS PAID - ( 1'
+ RUILOING UsE
ROOF SHEATHING , '( 'I�,`d IT ' . RLS 1NO .cON PB om.,
I, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SI'G ED `- - FINALS ' "DATE,I .INSP. ; �' ' L '
i �'��._nSSEASSORS PAR CEL NO,
I ROUGH _ ELECT,I'h93S 326—W,-0.51)
IPLUMBING -�-('f(�.I�•'� '� `L{� I ,ELECT.ENERGY .'. I � •
,]' THACT N0. : .,PARCEL NO I •^
' (TUBS&SHOWER PAN � (-r'(;� '`�j�. IPLUMBING ENERGY I I ,
MECHANICAL MECH.ENERGY I I
' ACC DATE ACC FILE NO
,I ELECTRICAL - ��ICI W I� I BUILDING ENERGY I I I -
( FRAMING •' - - In IqlAq I __ .`IELECT.FINALTEST I I I
�p� 'e `�1 ]ONING LNG SITE NO,
I INSULATION 117�� W"L/� IPLUMBING
. I GAS TEST.'' I .. I - IGAS I 11
I' I IMECHANICAL I' I I FIRE SPHINK ENERGY T 24 .
I . COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED '(HEATING I I 1:3 N D I Cj N0
(EXTERIOR SHEAR I(� �, II]�� ' (ELECTRICAL RELEASE( I i. FLOOD TONE A L U C.
(INTERIOR SHEAR ` (FIRE DEPT. ' I I I �� N❑ ❑ N❑'
ISHEETROCK /=/Z—90 ..%ay „ ' IGRADE - - I I 1 FEE SUMMARY
IEXTCRIOR LATH (BUILDING I ,; ,I -
INTERIOR LATH BUILDING'
II 9 I , ' TEMPORARY APPROVALS
I SCRATCH COAT II' 3 Ole)I J (ELECTRIC . I I PLAN CHECK M --•;r.
I I O• IGAS I FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED (OCCUPANCY �,° I. SEISMIC-FEE
(OCCUPANCY OF BUILDING IS NOT FERMI TTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR:� 'MICROFILM
uJ
AARRANGE FOR INSPECTION BY PHONING 252-4505, I. ELECTRIC'
h ONE WORKING DAY BEFORE REQUIRED INSPECTION. _ PcuMMNG
:r PLEASE GIVE•JOR ADDRESS WHEN PHONING.
= SEE PERMIT FOR EXPIR'ATION;DATE — I MECHANICAL �I� .. .F ' ,I
,
CONST.TAX '
:IMPORTANT! I I
PLEASE READ REVERSE SIDE BEFORE r TOTAL } I �/1
' CALLING FOR FINAL INSPECTION.
.. �
'OFFICE COPY
q.kPP,J_'ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .
BU I LDING PROJECT IDENTIFICATION PE HIM(T
NUMBER
BUILDING APPLICATION & PERMIT -
ADDRESS _ _ _ _ _ ..1798.8-
',q•,t BUILDING—ELECTRICAL-PLUMBING—MECHANICAL
OwNER'S PLAN CHECK VALIDATION
kk+1Tj� � �I� irG-l..l//� ,��,^ • OTC: . U ELECT RICPERMIT -FEE
r CONTRACTORS
/�•--�
NAME OUTLETS-SWITCHES-RECEP; 10.00/1.00
Lie.NO. LIGHTING FIXTURES 10.00/1.00 [
ADDRESC7ORs - APPLIANCES-RESIDENTIAL 4.00
PHONE PANELS .. 10.00 • DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE PC NO
OR PANELS (OVER 200 AMP) 20.00
ENGINEER `+
�Q9�7 LIC NO SIGNS TRANS. 3.00
ARCH OR ENG MI
ADDRESS / ' (�J SPECIALCIRCUIT - 5.001 P T VALIDATION(/ /j''�
- yoS9�6��t v Wmr U ZIP 9_s.Y TEMP.METER OR POLE INS. 20.001
APPLICANT'S 1 MOTORS SEE FEE SCH.1
ADDRESS.' z:e
.yL� r '
,iYy—T„�� ^n�t SERVICE CHANGE .. 20.001
r 0
0 o 2 -
r o LICIiNSEU CON'I'RACT'ORYI)BCf,ARA'fION
a i,� 1 hereby affirm that I am licensed under provstons of Chapter 9 r 0Azr Z 41 2R IT [03• 155UANCE_DATE s;
y <a tcommencing wnb Sectmn 7000)of Diviemn 3 of the Business and \/+ BLDG ELECT. PLG. CH/
H H i Lucers,Cla Codc,unJ my bccnu•is m full rorcr and effect - , EJ-1
z o,n License Class Lic.Number `L� ✓I I
Date - Contractor
Q y f J
f ¢ o a o
OWNER-BUILDER DECLARATION - BUILDING PERMIT
x ; I herchy 5fl'irm'tlml I unP exempt Innn the Contractor's rucroi+License MISC.— - •REFER TO ORD - INFORMATION
w w - VALUATION $/FT.
H 1 o e Law for the following reason (Sec.7031 5,Busmessand Professions >ERMIT ISSUANCE - /y � /�
7 so
J ,-Code Any city orcointy whichrequiresapermttmconstrueLalteq V
u, ¢0 unprove,demolish,Or repair any structure,prior to its issuance,also ELEC.CONTR LIC.NO. ELEC. ,,// q; ��f ./O/ O D
DLL requires the applicant for such permit to file a signed statement trial' TOTAL//O, fN - PERMIT TO
'a w °m he is Iiernsed pursu:ud to the porvisions of the Contractor's License ���
Hzi
Law(Chapter 9(conuncncmg with Sectrou 7000)of Drvrsion 3.1 the -
4 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT - FEE '
Ie 1- the basis for_the alleged exemption.Any violation of Section 7031 5 STORIES TYPE CONSTR.
h an applicant for permit subjects then applicant to civil mall a
3 ) ) o p )l p) p y - ALTER-DRAIN& VENT-WATER (EA. . O
' of not more than five hundred Jnllnrsl$SOOLI '
❑' 1,as owner of the property,or my employees with wages as I BACK FLOW PROTECT. DEVICE !1 ry OCC GROUP RES UNITS
their sole cumpensmmn;will do tire work,and the strucLLVe a nut 4 a
intended or otfered for sale (Sec 7044, Business and Profssons DRAINS-FLOOR,ROOF,AR EA,COND. 5.0 -
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 _ SO.FT FLOOR A*1 TOTAL ACREAGE
himself'or through his own employees,provided that such tmproveg /p
menu are not mtenJcJ or offered for sale.If,however,the buildim GAS-EA.SYSTEM-11NC.4.OUTLETS- .00 f •Z Y
Or Improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.001
builder will bave the burden of proving that I a did not bund or im- - BUILDING USE
prove purpose of sale I. INDUSTRIAL WASTE INTER. 30.001 RES INO CON pe Omar
y� I,as owner Of fire property,em r,elmrvely,onlractur,with ❑ ❑ ❑ , O ❑
rree6sed contractors to construct the protect(Sec:7044,Business LAWN SPRINKLERS- 1 INC 5 V.B, - 6.001 1i��ASSESSORS PARCEL NO.
and Professions Code The Contractor's License Law does not apply /�La��/� .Y
' 1o'an ownerOil Property who hands OF FrProvesrhercon.and Who I ILAWN SPRINKLERS-,OVER 5(EA.) 1,001
contracts fur such projects with a contractors)licensed pursuant to
the Contractor's License Law. - SEWER-SANITARY-STORM EA.200ft/10001 TRACT NO. PARCEL NO.
U. I em exempt under Sec ,B&P.C.for this) I WATER HEATER W/VENT 6.001
reasor ++ '
owner ',DUt,�40$ - (WATER SYSTEM 5.001 ACC DATE Ace FILE NO
WORK FRS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.001
I hereby affirm that I have a.c10hem,of consent W self-insure,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENDS SITE NO.
ropy uierear(So, 71300,Lah C.) i o OZ'S 9 CA/29 tf/ 1473.20
pulse,No I Compares r
U ❑ Cenifiedcopy is hereby furnished 1 FIRESPRINK ENERGY T 24
Z Z- d
' U Certified copy n tiled wrh th"Llty impaction drveion +I
0 Applicant - MISC.- - REFER TO ORD. ; v ❑ N 0 Y ❑ N❑
PERMIT ISSUANCE _ /�,Q'�
,� W CI?RT'I FICA'Ili OP Iik1iMPTION FROM WORKIi RS' FLOOD ZONE A.L.U.0
LU > COMPFNSATION INSURANCE PLG CONTR LIC NO PLG. /
- d 0 ('This section nixed nut he completed it the permit is for one I TOTAL//O• K/ Y❑ N❑ Y❑ N❑
Z hundred dollars 1S 100)or less)
U O I cerhly that m the perfrrmunce of tire work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- not is-issued,1 shall not employ any person In any manner so as to '
0 w become subject to(lie Workers'Compensation Laws of Cahfonua I 1
d Dare " Applicant ALTER OR ADD TO MECH. 5.001 I BUILDING
} to NOTICE TO APPLICANT. If .]Is,nlakmg this CcrtiOcate of lie-
. . N Z empDOn,you should became subject to the Workeri Compensation APPLIANCE 5.00
provivions of the Labor Code, you must forthwith comply with [PLAN CHECK
FEE
U such provisions or this Petra shall be deemed revoked. AIR HANDLING UNIT(TO 10,000OF.M.) 400 -
CONSTRUC'HONLENDINGAGENCY 1 .1 AIR HANDLING UNIT(OVER 10MC.EM.) 6.001 � SEISMIC FEE C�l• 701
r I hereby affirm that there is a construction Icnd ng agenty for EXHAUST HOOD (WITH DUCT) 5.001 ,I
the perlornance ul r e work Ior w tel his pe�nq Is nsoed(Sec MICROFILM
3097,Cie C.1. ✓ / HEATING,UNIT(TO 100,000 B.T.U.) -8.001 '
Lender's Name 'P HEATING,UNIT(OVER 100,000 B.T.U.)9.50
Lender's Adimss— �.A _ I ELECTRIC ��b,7J0I
I cFrtdy that I have read this app c.ihon and state that the above 1 VENTILATION FAN (SINGLE)1, 4.00
s i formaflOn n correct. I agree fo conlpl> wdh all coy and County g010ER-CUMP(3 H.P,or 100,0006.7.11.) 6'.00 PLUMBING >�6',-20
J.7��antes and slat, laws relating io budding construction, and
"above- aulhnnd representatives inspection this any es enter upon the IBOI LER-COMP Over 100,000 BTU)SEE FEE SCH MECHANICAL Q
above-mea Boned property for o th purposes,
(We) agree to save, indemnify and keep harmless the City of MISC.- + ' REFER TO ORD.K,3-x
Cupertino against liobliries,judgments, costs and expenses which PERMIT ISSUANCE �gfl0 CONST.TAX QQ
may in any way accrue against stud City In cauequence of the I' /Z� OV'O6
grantngg��f this pert L / MECH.CONT.,,, LIC.NO. .MECH
h/Q�_ R+. le TOTAL 2-0 TOTAL 6 cgrg'�
Signature of Applicant Contractor Dare
_- OFFICE COPY„ .