18587 POST THIS CARD NEAR'FRONT OF BUILDING
•y V 1 • PERMIT NUMBER
CITY OF CUPERTINO • 18587
INSPECTION'DI ISON
JOB INSPECTION ECORD" - !
'AIP
RMI E PIRATil N
. '
JOB ADDRESS' .UNIT# • _LOT#' c�r .y
PERMIT Ekeel SaI F, WORK
- OWNER - co TR'ncTOR IS '''1111,,07 STARTEO`WITHIN n
INSPECTION DATE INSPECTOR I SPE TION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION' ,ANCE OR ,180 DAYS FROM
NOTE: LAST CALLED INSPECTION. •
UFER - ALL GRADING AND DRAINAGE SHALL BE-INSTALLED
PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIPNED - - ` t�
Q%UNDERGROUND /SLAB : - l.,
PLUMBING 0,
ELECTRICAL -
issunNCF:unrE.
MECHANICAL - RLDc ELE LG. MECR.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
" WOOD FLOOR INFORMATION
PLUMBING. VALUATION $/FT.
. MECHANICAL
\L `PERMIT TO .r
ELECTRICAL � '�1%12
FRAMING _ � 1
INSULATION - •STORIES TYPE CONSTR.
OC- C GBptlP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -a
.. SO FL FLOUR AREA TOTAL ACREAGE
ROOF NOTE:NO FINAL INSP.SHALL:BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
RUILDING USE
ROOFSHEATHING .. RES IND Co PR o,n••,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ � ❑
.ASSESSORS PARCEL NO.
` ROUGH - SAN.#
PLUMBINGELECT.ENERGY
TRACI N0. PARCEL•NO
TUBS 8 SHOWER PAN' PLUMBING ENERGY ' -
MECHANICAL MECH.ENERGY
ELECTRICAL' - BUILDING ENERGY _ ACC,DATE ACC;PILE NO
.FRAMING ELECT.FINAL TEST
INSULATION PLUMBING
ZONING ENG.SITE NO.
-
- GAS TEST GAS -
FIRESPRINK ENERGY T.27
--
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N Y ❑ N❑
FLOOD ZONE A.LUC,
^ EXTERIOR SHEAR ELECTRICAL RELEASE �� '
INTERIOR SHEAR - - FIRE DEPT. -' _ Y❑' N❑ I Y ❑ N
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH - BUILDING
INTERIORLATH 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 ISNOTPERMITTED UNTILBUILDING_FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
LU 'ARRANGE FOR INSPECTION BY PHONING 252-4505,• ELECTRIC
F ONEWORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
Z PLEASE-GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT, FOR EXPIRATION DATE = MECHANICAL`
IMPORTANT! CONST. TAX:: =---
PLEASE READ REVERSE SIDE BEFORE TOTAL ,` . l
CALLING FOR FINAL INSPECTION. 4� r
OFFICE-COPY .
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -FUSE BALL POINT PEN ONLY
•BUILDING PROJECT IDENTIFICATION" - PERMIT NUMBER
BUILDING APPLICATION & PERMIT,,°. - 8 J 1--
AODness J
c � BUILDING —ELECTRICAL—PLUMBING'—MECHANICAL c�r.�
OWNER'S .••+ - PLAN CHECK VALIDATION
"AME �'rr�(( OTY. ELECTRIC PERMIT FEE
•
PHONE
CONTnACTORE
•
NAxhEOUTLETS-SWITCHES-RECEP 10.00/1.00 (��^
a /= L U N -7 LIGHTING FIXTURES - 10.00/1.00 •t/\��
CONTRACTORS - APPLIANCES-RESIDENTIAL 4.00
ix/ DIL PHO /µyr PANELS ,10.00
DATE OF APPLICATION
ARCHITECT - - - PLA CHECK FEE P.C.NO.
OR PANELS (OVER 200 AMP) 20.00
ENGINEER
uc,No. ISIGNSTRANS. 3.00 '
ARC OR END. SPEOIALCIRCUIT S.00 PERMIT VALIDATION
SS
ZIP ' EMP.METER OR POLE INS. 20.00
aPPucaNrsADDRESS MOTORS - SEE FEE SCH. ' •�'
SERVICE CHANGE IMAND00
r02
Do o LICENSED COME RACTORS DECLARATION '
rto L I hereby affirm that I am licensed underprovisions of Chopler 9
r z w ISSUANCE GATE xr
(commencing with Section 700e)i of Division Sof the Business trot - BLDG. ELECT. LG. .MECH.
r m i Professions Co I my license is in full uyy. n�.�d eff}lL ❑ ❑ ❑
License Class Lic.Numbfr/_
ww Da[e ��C�Contractorl_J J—�.,•.(
¢ >! JDECLARATIONw BUILDING PERMIT
¢ � w a DWNIi WBUILUIiR ' '
Z o R. " INFORMATION
to ;LL ar I hereby affirm that 1 am exempt (Toro tire Contmctof's License MISC.— REFER TO ORD
.. o¢ Law far the following reason.(Sec.7031.5,Business and Professions - 'VALUATION
H — PERMIT ISSUANCE 10.00
LEC
Code:Any city or county which requires a permit m construct,alter,
ELEC.CONTR. LIG NO.
E
a a o Improve,demolish,or repair any structure,prior to its issuance,also '
E m or requires the applicant for such permit to file a signed statement that TOTAL'
u w he is licensed pursuant to the provisions of tire Contractor's License PER TO
r z a
Law(Chapter 9(commencing with Section 7000)of Division 30
f and
4 c Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
¢I- $ the basis for the alleged exemption.Any violation of Section'7031.$ S RIES .TYPE CONSTR.
by any.applicant for a permit subjects the applicant loo civil penally
of not more than five hundred dollars(SS00):): ALTER-DRAIN IEA.) 5.00
❑ Las owner ofthe property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GR , RES.UNITStheir sole compensotion„will do the work,and the structure Is not
intended or offered for sale(Sec. 7044, Business acid Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of
Properly who builds or improves thereon,and who does such.,,,it `�, FIXTURES-PER TRAP 5,D0 50.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mentsarenotintended or offered for sale.If,howeverthe building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner-
border will have the burden of proving that he did not build or inn- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING u
prove for purpose of sale.). INDUSTRIAL WASTEINTER. 30.00 RES wU c0 PB Omer
❑ 1,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.
11 1:1
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(or such projects with a contraetons)licensed pursuant to
the Contractor's License Law, SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ I an,exempt under Svc,�,B.&P.C.for this
reason WATER HEATER'W/VENT 6,00
Owner Date WATER SYSTEM 5.00 ACC.DATE ACG FILE NO.
WORKS RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affum that I have a certificate of consent to self-insure, ,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.CJ. - -
O Policy No. Company
SCrtified copy is herehy to fished. FIRE SPgINK ENERGV,4 Z4
Z Z C7 Cetlified copy is- FIRE inn he'citY inspection ivision.
F” O Applicant MISC.- REFER TO ORD. y ❑ 'NE] V [-] N[3
LU W CERTIFICATE AT' IFROM WORKERS' PERMIT ISSUANCE
FLOOD ZONE A.L.u.C.W COMPENSATION INSURANCE
PLG,CONTR. LIC.N0. PLG. '
CL (This section need not be completed if the permit is for one TOTAL V F] N V ry
0 Z hundred dollars IS 100)or less.)
U O , I certify that in the performance of the work for which this per- OTY MECHANICAL PERMIT FEE FEE SUMMARY
LL U . mit is issued,1 shall not employ any person in any nanner so as to
become subject to the Workers'Compensation Laws of California.
LU Date - Applieml BUILDING
W NOTICE '(0 APPLICANT: If,after making ALTER OR ADD TO MECH. 5.00
} b this Certificate of fix-
F-'? emption,you should become subject to the Workers'Conhpeasation APPLIANCE 5.00 PLAN CHECK
provisions of the labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
- CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE —
I hereby affirm that there is a construction lending agency for. EXHAUST HOOD (WITH DUCT) 5.00
the performance o1'the work for which thispermitis issued(Sec. - MICROFILM
3097,CF.C.f HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
Lender's Address HEATI NG UN IT(OV ER 100,000 B.T.U,)9.50 ELECTRIC
I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 -
inforoation is correct. Canter to comply with all city and county PLUMBING
ordinances and stute,Livs-relating to building construction,•and' BOILER-COMP.(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize represebt6tives of this.city to enter upon the BOILER-COMP IOver 100,000 BTU)SEE FEE SCH. MECHANICAL' m�
above-mentioned property for inspection purposes,
'(We) agree to-save, indemnif and keep 6 a less the'City of MISC.- REFER TO ORD..'
upertino a 'nsi liabilities,'ju meats, costs and exponses.wlhich CONST.TAX
ay ' o way Sc Suga' St said City in consequence of the PERMIT ISSUANCE 10.00
r3 [his per L MECH.CONT. LIC.NO. MECH. �p
TOTAL TOTAL Qyl\�V
of on factor ' - Date
OFFICE COPY