18325 POST THIS CARD NEAR FRONT OF BUILDING. -
'' ., PERMIT NUMBER
�. CIT.YsOFTION CUPERTINO 183.25IJI
DIVISION
-JOB INSPECTION.RECORD
i
` PERMIT EXPIRATION
208'63 v P C
JOB ADDRESS.''D-08-6 y UNIT# PERMIT EXPIRES IF WORK
• OWNER L CONTRACTOR le 2L IS NOT STARTED:WITHIN
1 SP,ECTION DATE JINSPECTOR INSPECTION RECORD180 DAYS OF PERMIT ISSU-
_ ' ANCE OR 180.DAYS FROM .
FOUNDATION NOTE: ' - - LAST CALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED. -
' TO COMPLY WITH THE APPROVED PLANS AND CIN OF Pr.Rhul vnu On noN
:. PREGUNITE - •' 'CUPERTINO STANDARDS. -
GARAGE SLABS '' " PAID
POUR NO CONCRETE UNTIL ABOVE HAS BEEMSIGNED �'7 N v C,,. '?`
' UNDERGROUND /.SLAB - JUL
f
PLUMBING
ELECTRICALtil. cuporw - .IssunNCE un d3
MECHANICAL 7777777r,r PLG.-- Mnc -A
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED • BUILDING PERMIT
INFORMATION
WOOD-FLOOR vALunnoN slFT.
PLUMBING. /H'RC� liisc�-oC- �-G/
MECHANICAL
ELECTRICAL - PERn+n r°
- FRAMING. r.0 /=�7, 'S V•C-. p !,
l
ST HI IYPE CONSTR.
INSULATION
OCC.THOU RES.UNITS
PLACEAO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED '
SO.r T.iLOORAH"A TOTAL ACREAGE
• ROOF' NOTE:NO FINAL INSP�SHALL BE MADE BEFORE /
_ THE CONSTRUCTION TAXI&PAIM ' "
DIAPHRAGM. ., .�: ` .: � �' � � auiL INT usE
ROOF SHEATHING -' "� l , 7 HEs IND ` coN Pe' U
-APPLY NO ROOFING UNTIL ABOVE HAS BEEN.SIGNED ' INALS' - ATE TI V IfI
_
ASSESS O iS PARCEL NO.
ROUGH SA
PLUMBING E GY - n+ACI NO., FARCE LNO,
TUBS B SHOWER PAN M ING ;�, ,
MECHANICAL - ECR.ENE
ELECTRICAL, BUILDING GY% - ACC OAT_. ACC.FILE NO.
FRAMING" - a ELECT.TINALTEST"
INSULATION - PLUMBINGZON G 'EN SITE No.
2
G_AS TEST _ GAS '
. `
MECHANICAL FIRE SPR INK ENERGY T;24 ...
- Z— - ✓91 - •
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' Y [] ND ` '` ❑ • NO
I '
• EXTERIOR SHEAR ELECTRICAL-RELEASE LOOD ZONEA.Luc
. .INTERIOR SHEAR FIRE DEPT. Y❑ N❑ Y ❑ ' N❑
' SHEETROCK- - GRADE - - - FEE SUMMARY
• EXTERIOR-LATH BUILDING
INTERIOR' LATHTEMPORARY-APPROVALS BUILDING.
SCRATCH COAT ELECTRIC- PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE
OCCUPANCY,OF BUILDING-IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM'
., .-'.ARRANGE FOR-INSPECTION BY'PHONING 252-4505, - . ELECTRIC
0� ONE WORKING DAY BEFORE REQUIRED.'INSPECTION..' . PLUMBINGCJD.
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — - MECHANICAL FJ
:IMPORTANT! CONST,TAX
- - PLEASEREAD'REVERSE SIDE BEFORE , ; - V
,CALLING.FOR FINALINSPECTION'. TOTAL, CIO.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL PO9AN JNLY
'151.111-DING PROJECT I DENTIFICATION - - PERMIT NUMBER
BUILDING , ' APPLICATION & PERMIT' 18�]25
ADDRESS ,� ae J
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL r3' G
OWNER'S _ - - - j PLAN CHECK VALIDATION
NA E CITY. ELECTRIC PERMIT FEE
PHONE
CONTRACTORS
NAME UTLETS-SWITCHES-,RE_CEP 10.00/1.00
Lt., ILIGHTING FIXTURES10.00/1,00
CONTRACTOR 5 APPLIANCES--RESIDENTIAL .4.00
%feLy rvE ! PANELS 10,00 - DATE OF APPLICATION
11ECT PLAN CHECK FEE P.C.NO.
OR - PANELS (OVER 200 AMP) 20.00
ENGINEER
LID,NO: SIGNS TRANS. ' 3.00
ADDRESSs E"G' _ SPECIAL CIRCUIT 5,00 PERMIT VALIDATION, .
nP TEMP.METER OR POLE INS. 20.00 /G4 f
APPLICANT'S . MOTORS SEE FEE SCH.
ADDRESS
SERVICE CHANGE 20.00 TVV(,{_(,
wo oy. LICHNSt 6 CONTRACTORS DECLARATION• - _ �- w ' f
a i w I herehy affnn that I am licensed under provisions ot'Charact 9 - ISSUANCE DAT
(connnencing with Sectio 7000)OI'Division 3 at the Bu a and
�' BLDG. ELECT. PLG. MEC
H y i Professions Co J cerme is in full r �[p c / JUL 1:1
❑ �.
zoo, License Class L'-•�' Lia Numherd_V��/
o N � Date. C.rH,0or - 'f/.4�� ,s r� �p,fit
P Y F -' Ci VL Cuperdeu BUILDING PERMIT
No u At _ '_OWNF-R.BUILDER DECLARATION INFORMATION
w ; N I hereby affirm That I am exempt from lire Contractor's License MISC.- REFER TO ORD
u.oj Law.for the following reason.(Sec.7031.5,Businessland Professions VALUATION $/FT.
I- - PERMIT ISSUANCE 10.00
Code:Any city ur county which requires a pormit tO CrngtnUcL alcr,
er i ¢o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIG NO. ELEC. + -
n
LL requires the applicant for such permit to file a signed statement that TOTAL
a,m he is licensed pursuan Y to the provisions of the Contractors License PERMIT TO
Law(Chapter 9(commencing with Section 7000)ofDivision 3 of the `
E i o Boniness and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE -pG y
W H$ the basis blithe alleged exemplion.Any violation ol-Seeflon 7031.5 ST IES TYPE CONSTR,
by any applicant for,a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 f
of not more than five hundred dollop(5500).1: •��
❑ I,as owner of the properly,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
immrded or.)fared for mIc (Sec. 7044, Business and Prol'essionn = DRAINS-FLOOR,ROOF,AREA,COND. 5.00 _O -
code *file Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such workFIXTURES-PER TRAP 5,00 � 0 so.FT FLOOR AREA TOTAL ACREAGE
ou
himself or thrgh,his own employees,provided that such improve.
monis are not intended or offered for sale.R.however,the building GAS-EA.SVSTEM-11NC.40UTLETS 6.00 ,0b
or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00
builder will have the burden or proving that he did not build or im . BUILDING USE
RES IND CON PB Other
prove 1,asowner
of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 13 ,❑ 11 1:1❑ f u ownperr of the property,am exclusively contracting with
- licensed contractors In construct the protect(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 gssEs3oR9 PARCEL No.
and Professions Code:The Contractor's License Law docs 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 contractorls)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 570-V TRACT NO. PARCEL NO.
El
Ium exempt under Sec. ,B.&P.C.for Ibis
meson WATER HEATER W/VENT 6.00
Owner Data WATER SYSTEM 5.00 a6 00 BCC.DATE ACC.FILE NO.
t
WORK l:RS'COMPENSA'I ION OLCLARATION WATER TREATING EQUIP. 5.00
1 hereby offinn that I have a certifleme of consent to self-insure,
or a cCRHa.0 Of Workers'Compensation Insurance,or a ecrllfied ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.L
Policy No -Comp
❑ Y- co Is herehyl'urplshet
Z Z Ce nfI p rs fit• with t illy nnzpeCl In slog FIRE$PRINK ,ENERGY T24
O Applical -�_ MISC.- REFER TO ORD. Y❑ . N❑ Y ❑ N❑
Ir y CERTIFICATE 017XE,MPTION PROM WORKERS' PERMIT ISSUANCE 10.00 2.0 FLOOD ZONE - A.L.U.C.
W > - COMI'El, A'1'ION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL Z' This section Reed not be completed if the permit is for one TOTAL I .QD Y E] N❑ Y ❑ N❑,
hundred dollars($100)orlon,.)
U O 1 Certify that in the perfonnanCe of the work for which this per- CITY. ' MECHANICAL PERMIT FEES FEE SUMMARY
IL I- mit is issued,1 sIm11 not employ any person in any manner so as ill0 Or become subject to the Workers'Compensation Laws of Californin. ,
a
Data Applicant - - ALTER OR ADD TO MECH. 5.00 BUILDING
} to NO'I'ICG'10 APPLICANT: 11,after making this Certificate of El-
APPLIANCE 5.00 LQQrELECTRiC
provisions'of lire Labor Codc, you must forthwith comply with
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00
CONSTRUCTION LENDING AGENCY- AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) . 5.00
the performance of lire Work for which INS permit is issued(Sea
3097,Civ.C.L HEATING UNIT(TO 102000 B1--U.1 B 0-
Lender'sName .HEATING UNIT(OV ER 100,000 B.T.U,)9,50 _OD'1 certify that I have read this_application and elate that the above - VENTILATION FAN (SINGLE) , 4.00 �n onnution is correct, I.agrea to comply.with'all city and county
ordinances and stale lows relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B;T.U.) 6.00
hereby. atlllmriec representatives folies of this rpos' enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL b. _(�D
herebymentiorb property forinsp of this
purpose'.to -r
=CApp (/
` ave, indemnify and keep harmless lire City of MISC.- REFER TO ORD.
liabilities,judgmmnts, costs and expenses which CONST.TAX
accrue agai Said City 'n couse9uence.of'the PERMIT ISSUANCE 10.00 2-(7D
IrQI. MECH.CONT. LIC.NO. MECH.
TOTAL L,fjOD I TOTAL r�(6.�D
ant/ onhac[or sae - V 11
OFFICE COPY
� a
1.
,
1
f t
4 Ill
7 a.
/3
!. �� OFFICE x.. :.'. •` t
COPY 1
CITY OF CUPERTINO,
\ GAS SERVICE NOTICE //�jJ�/
•19v 1
To
You are hereby authorizeyd to connect the GAS service for
Owner or Tenant -
.
- f New Servicey_-
_ No. of Meters Reconnect _
Move Service
No. of Add. Meters ,
Move Meter
PLUMBING INSPECTOR
' l SIS^...�� ✓Y I ;
I
• �`