18270 POST THIS CARD-NE-AR FRONT OF BUILDING A/
'( PERMIT NUMBER' !
CITY` OF :CUPERTINO 18270
` INSPECTION DIVISION'
JOB INSPECTION RECORD. „
. 2Z ,vRMI�•EXP,IRATi19N
JOB ADDRESS `. '1S1_B_N LINT T'# LOT,#—( ..•ss
�LL ''II n C `�' PERMIT EXPIRES IF WORK
S OWNER (�u�M '1�'q��TFJm1ogONTRACTO���.,(✓` 'Q `T`[ � IS NOT STARTED 'WITHIN
I INSPECTION I DATE 1 INSPECTOR I INSPECTION RECORD `180 DAYS OF PERMIT ISSU.
(FOUNDATION.., cf (_)RCS (]�91 1 NOTE:, ' ' , , rc' ANCE OR,180 DAYS'FROM
Q y_,r�, �"}„�iL - LASTCALLEDINSPECTION.
UF.ER 177J`l l_J�-� ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE ,•-, TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLRMLI VALIDATION
IGARAGESLABS CUPERTINO STANDARDS. , ^,2.Sf"'���C/
Ih1t�rfd�l-J�wj /
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
++ PLUMBING
IELECTRICAL, I ISSUANCL UAI E' I
MECHANICAL BLDG., LECi vLC bnECR.
I DO NOT POUR FLOOR UNTIL ABOVE-HAS BEEN SIGNED BUILDING PERMIT
I WOOD FLOOR ' INFORMATION
�-
IPLUMBING; )6_ { nwnnnN a. ,SIFT
IMECHANICAL
]ELECTRICAL
.[FRAMING,..,
-I INSULATION : - I STORIES IvPE CONSTR
1 ] .00C GROUP RES•UNITS
y I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ /V/.. / V'. ' I '
50 F .F O N� EA IOtAL PCHI AGI
I ROOF NOTE:NOFINAL SP: ALL BE MADE BEFORE � � �/
DIAPHRAGM �• T •I I HE CONSTRUCTION TAX IS PA ID I I 6 � �
ROOF SHEATHING IIZ l�' ( I: RES 'BUILDING USE
0 LON Py.. OAP,
.,.APPLY NO ROOFINGMNTIL ABOVE HAS,BEEN SIGNED ,, „FINALS' . I ,:,,DATE „,- INSP. I � SE � "�" El I ROUGH SAN.N I4q 5D,� _ I essORS PAI CEL No
I PLUMBING " I - .. I ELECT.ENERGY I. I • AID
,
(TUBS&SHOWER PAN I + - - IPLUMBING ENERGY I� "- ,-.� TRACT NO PARCEL NO
IMECHANICAL • IMECH.ENERGY . -
ACC DATE ACC FILE NO
' I ELECTRICAL � 7� � ��5,��� I BUILDING ENERGY
I FRAMING ' - II Z59Oif1l\'k�._ I ELECT.FINAL TEST '
_ - TONING ENG.SITE NO.
"( INSULATION I' IPLUMBING ,
IGASTEST ., :. .. IGAS . . .. 1 .. I :
IIMECHANICAL , „ I I I FIDE BPRINKmaRGV T,aa
I
FIOO
COVER NO WORK UNTIL ABOVE HAS BE IN SIGNED' (HEATING I . I I ` []'. N7 0 c '
"
- DtONE
(EXTERIOR SHEAR 112 `_W) ---(.ELECTRICAL RELEASE I I I
�INTERIOR SHEAR., `' (FIRE DEPT. - I I 'I vE '"❑ ` L, N❑ I
SHEETROCK IGRADE - I + ' ., I FEE SUMMARY
.EXTERIOR LATH BUILDING I
INTERIOR LATH . I TEMPORARY APPROVALS .[BUILDING. , 1367,
(SCRATCH COAT. .. I .. .' • (ELECTRIC PLAN
IGAS ' CHECK•
.I FEE ' I .
I e '.....,, ' ^1....._.
I NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED (OCCUPANCY I' i SEISMIC FEE
OCCUPANCY OF BUILDING IS NOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDINGINSPECTOR:I MICROFILM" I '
ARRANGE, INSPECTION BY PHONING 252-4505, I ELECTRIC
6A -0 ONE-WORKING DAY BEFORE REQUIRED INSPECTION.-' "'. . "' I PLUMBING, ld? 7d'
z PLEASE GIVE JOB ADDRESSRHEN PHONING'.',
MECHANICAL l/a
- SEE PERMIT FOR EXPIRATION DATE -
IMPORTANT! 4 CONST.TAX
PLEASE READ REVERSE SIDE,BEFORE ','' ' '� TOTAL
CALLING FOR FINAL INSPECTION.
Y OFFICE,COPY '
APPLICANT TO-FILL IN INFORMATION WITHIN RED LINES -.USE BALL POINT PEN ONLY
BUILDING PROJECT'I DENTI FICATION • .PERMIT NUMBER .
BUILDING APPLICATION & PERMIT I] O
ADDRESS e r
fV ZZ3 M �an4 BUILDING—ELECTRICAL—PLUMBING—MECHANICAL r'a�
Y OWNER'S - 1 PLAN CHECK VALIDATION
CITY. ELECTRIC PERMIT I FEE
~�. CONTRACTORS , C
NAME , , 1 OUTLETS-SWITCHES-RECEP 10.0011.00 s�d �7� Jv 2�Y
uC NO LIGHTING FIXTURES 10.00/1.00 jS (
CONTRACTORS I - „
ADDRESS - APPLIANCES-RESIDENTIAL 4.00
ADDRESS -
PHONE PANELS 10,00 DATE or APPLICATION .
ARCHITECT • PLAN CHECK FEE I PC NO
OR PANELS (OVER 200 AMP) 20.00
ENGINEER
uc No 7 '
SIGNS TRANS. 3.00
PRCH OR ENf�/ I_ Pj SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
"PD9€ s"�y/y �6�-['a�9O�J�}•,-' `" [TEMP. METER OR POLE INS.' 20,00
aoWoleessTy 2S/d� fy��PtaC�{ ,��'I [MOTORS SEE FEE SCH.
„�- �F 0 • �A q5�0/f/' I [SERVICE CHANGE 20.00
o o LICENSE[)CONTRACTORS DECLARATION
Q,ia w I hereby affiDn Thai I ain bcensed under provisions ol'Chapter`) // ISSUANCE DATE
y za°w (eommemm.g will air,[my 7000)of rdl.Gr 3 of the Business and - pG. I ELECT, I P MFC�.
H m z Professors Code,;mil my Imense n In lull force;uu]cffecL JOLD-.''1 L��.y7 .ill
a O m - Lilt,.w Clan Le.Number
4 w H w Dale Contmnor,
a m I ,BUILDING PERMIT.
w u OWNER-BUILDER DECLARATION '' - INFORMATION
w ;LL N I hereby afllrm that I am evempt from the Contractor's Llceree IM ISC.q REFER TO ORD - _
LL O Law for the city or c reason. Sec 7 3 1'n
VALUATION
S/
FT
,a g ( O.I S,Dullness and r fesslons 10.00
L - PERMIT ISSUANCE 30 7�
Code:Any my or county which requiresu permit tuconstrl¢Caller,
SE Q o improve;(ICmohsh,ul repute any sUUCluru,pro{In its Issuance,also ELEC.CONTR, LIC.NO
ELEC. R
n w m LL requires the applicant For such permit to file a signed shltwnent that - [TOTAL/f v -�P ♦"PE MIT TO
he Is bcensed pursuam to the with Seel r the Contractor's License
�IT
E sE Business i andrProfes Professions(commencing with
olr than or is excro t therelo"ll S A' QTY. .,. PLUMBING PERMIT _ FEE
SE I-$ the basis for the alleged enemptiori.Any violation of Section 7031.5 - STORIES TYPE CONSTR
in
by any applicant for a Penn+)subjects the applicant to a civil penalty ) ALTER-DRAIN -WATER (EA.) 5.00
I of not more than five hundred dollars(S500))
• _ ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 Oce GROUP RES UNITS
their sole compensation,will do the work;"and the structure a not _
intended or offered for sale (Sec. 7044, Business and Professions - DRAINS-FLOOR,ROOF,AR EA,COND. 5.00
Code The C.Luawtor's License Law does not apply to an owner of
properly who builds or Improves thereon,and who does such work FIXTURES-PER-TRAP 5.00 So FT.FLOG�g7,�pggEA TOTAL ACREpAGE,
himself or through his own empfoyceS,provided that such unprov g 1 3 Y�p•'W 6 2D o'tl
'ments are not Intended or oftered for sale If,however,the hulldm GAS-EA.SYSTEM-11NC.4 OUTLETS 6.00 O T
or Improvement Is sold within one year of.completion,the owner-I IGAS-EA.SYSTEM-OVER 4 (EA.) 2.001 BUILDING USE.
builder will have the burden oPpnrvmg thaYhe did not build or am.
qES IND CON. PS Omer
K vc r purpose of sale.).' . [INDUSTRIAL WASTE INTER. - 30.001 ❑ ❑ ❑ ❑ ❑
I,as owner of the'property,am caulusively contracting wit 11 -
lee led contractors to construct the project(Sec.7044,Busaness 1 ILAWN SPRINKLERS-1 INC 5 V.B. 6.001 ASSESSORS PARCEL NO.
and Professions Code The Contractor's License Law does not apply
to an owner of property who builds or Improves ihebeon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.001 yJrz�„,rZO_r�O
eon lr.rRS for Sw31 pro)eels with a ec ntrarlono licensed pursuant to G G
the Contractor's License Law SEWER-SANITARY-STORM EA.200ft/10.001 1 .TRACT NO. PARCEL NO
• ❑ lame mPt under c. ,B&PC for this WATER HEATER W/VENT 6.00 1 '
reason_�J/�� ♦ — / _
Ow re HHJ_ - A6. i f^'� e. /j WATER SYSTEM 5.001 I ACGDATE ACC FILE NO
WORK ERS'COMPENSATION DECLARATION " WATER TREATING EQUIP., 5.001
I hereby efflrm that I have a certificate of,consem to xIf-insurr, q '`
or a certlhcdle of Workers'Conlpelnatiun Inurance,or,serf ll mA .I 1�•�U ZONING ENG SITE NO
copy[hereof!Sec 3800,Lah.C.t.
policy No' Company .. ,
0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 '
Z 2 ❑ Cenif,rd.uipy Is filed with the Illy. Inapeation annum.[ MISC.= REFER TO ORD. .
F O APphcant Y ❑ IN Y ❑ N❑
rn A PERMIT ISSUANCE 10.00�,)D
L.— CI:RTIFICA'I'I.OFI!X[:NIPTIONFROMWORKERS' FLOOD ZONE. s A.L.U.C. _
W — - COMPENSATION INSURANCE' PLG.CONTR.' - LIC.NO. . PLG.
d O (This svetion need nu l"he completed If the pe'rmil is Inr one . s I TOTAL„O.70 Y❑• N❑ Y❑ N❑
Z) Z hundred dollars t S 1001 or less')
U 0 1 certify that Ili the performance of lire work for which Ihn per- FEE SUMMARY
LL H Inn Is Issued,I Shall not employ any person In any Dianne r so aS In QTY. MECHANICAL PERMIT FEE II"
O W becOMU subject to the Workers'Compensation Laws of Calif orma: ` 77
a Dale Appllcan' I (ALTER OR ADD TO MECH. 5.001 'I BUILDING 1361.S' i
} m NOT CIE IO APPLICANT. If,after making this Certificate of Ea
I— ? emplion,you should become SubjeLl to Dm Worker+Compensation I I APPLIANCE . .h ;5.001 PLAN CHECK '
pro r"ons of the [Alma Coda, you mull Intl oVith comply with FEE
CJ such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10p001C.F.M.) 4.00I
C6NSTRUC'11ON LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.001 ' , SEISMIC FEE
I hereby affirm that +here is a constnmtion lending agency tar EXHAUST'HOOD(WITH DUCT) 5.00
the perlornlance of Ie work Ibr whleli[h1_s?rrL.R Is Issued(Sec. ' MICROFILM
3097,CIv.C.I. ` 'HEATING UNIT(TO 100,000 B.T.U.) 6.00
• Lender's Name HEATING UNIT 100,000B.T.U.0.50
Lender's - +'ELECTRIC !'D. 70 I'
-I certify that I have read this applied I and state that the above VENTILATION FAN (SINGLE) 4.00
information is wrrea I agree to comply with all city and county BOILER-COMP(3 H:P.or 100,000 B.T.U.) 6.001 ' PLUMBING 70
t 1, honees and stale laws rcletmg m building construe❑nn, and
hereby ailhorme representatives of ILn city to enter upon the 1 BOI LER-COMP(Over 100,000 BTU)SEE FEE SCH.1 I MECHANICAL //� . 719
r above-menlianed property for inspect ion purposes..'
(We) agree HO save, Indenlmfy and keep harmless the City of MISC.-•,' ' REFER TO ORD.IW-70 I
Cupertino against liabilities,judgments, costs and expenses whir CONST.TAX z 7 L/
'Tiny m any way accrue against said City In consequence of the PERMIT ISSUANCE . 10.00[ 30 750
gran�'n�gof l�h�p nut �� MECH.CONT. LIC.NO. MECH.
�, ��.r /" orAL FAD 70 I TOTAL �O1KL
.Ignature of Applmant/Conimcli6 1• e 1
OFFICE COPY