14499POST THIS CARD NEAR FRONT OF BUILDING
CITY -OF CUPERTINO,' :.
INSPECTION: "DIVISION
JOB INSPECTION RECORD
s 10627 BANDLEY -DRIVE
'JOB ADORE SS UNIT# _LOT*f
•'
OWNER APPLE COMPUTER FITNES�oN�R�oR. JACK&COHENS BLD
PERMIT NUMBER
149
PERMIT EXPIRATION.
PERMIT EXPIRES IF WORK
IS NOT'STARTED WITHIN
188 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
LASTCALLED INSPECTION..
INSPECTION DATE INSPECTOR
INSPECTION RECORD-
FOUNDATION
.,
NOTE:
ALL GRADINGAND DRAINAGE SHALL .BE INSTALLED:
COMPLY WITH THE APPROVED PLANS AND CITY OF
'CUPERTINO STANDARDS.
LIFER
PREGUNITETO
- PERMIT VALIDATION ,
- ,•
j
ISSU niviceDATE
'GARAGE SLABS,*•
POUR NO CONCRETE UNTIL ABOVE HASSEEN SIGNED,
-
UNDERGROUND/SLAB
PLUMBING
ELECTRICAL
MECHANICAL
'ilk
eLD ,,T, PLG. MECH.
C ❑ a
00 NOT POUR FLOOR UNTIL ABOVE HAS'BEEN SIGNED.
`• ' - .'. - 'CI
at CuNGIRMPER NI [
WOOD FLOOR. '•
PLUMBING d -.
vALUATIDN srFT.
"•^Y� ' } .
MECHANICAL -�
ELECTRICAL.. - _
PERMIT TO
FRAMING
INSULATION S '
.,
STUDIES
TYPE CONSTR:
•
OCC GROUP
RESIUNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF - .;
.NOTE: NO FINAL INSP. SHALL BE MADE BEFORE ,
THE CONSTRUCTION TAX IS PAID
SG. FT ELLICH AREA
-
TOTAL ACREAGE
DIAPHRAGM -
-
ROOF SHEATHING"
BUILDING USE
HES IND CON Pe 0,I •
❑ ❑, , ❑ ❑ ❑
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
FINALS' DATE INSP.
. ROUGH : -
SAN.k �
n55 ESSORSPAHCEI. NO
.
PLUMBING -
ELECT. ENERGY
TUBS 8 SHOWER PAN
PLUMBING ENERGY
TRACT NO,
PARCEL NO
'
MECHANICAL
MECH.ENERGX
ELECTRICAL..
.BUILDING ENERGY'' �• �
Acc. On TI:
/
T
ACC. Pi cE NO.
'
FRAMING• -
ELECT. FINAL TEST
INSULATION. ,
PLUMBING
ZONING.
ENG. SITE NO.
GAS,TEST -
GAS
MECHANICAL
'FIRESPRINK'
• Y ❑'L 'N❑'
ENEHGVT.24 �
Y ❑ •N❑
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING
EXTERIOR SHEAR - '"
ELECTRICAL RELEASE',
FLOOOZONE
' ° ❑ N❑
AL U
Y L,. NE]
INTERIOR SHEAR"
FIRE DEPT.
SHEETROCK -
GRADE
.'FEE SUMMARY
EXTERIOR LATH - - `•
BUILDING --
BUILDING
�, a ., 1
INTERIOR"LATH
TEMPORARY APPROVAL$ ` . --
SCRATCH COAT
ELECTRIC
_
PLAN CHECK
FEE
' -
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY,
SEISMIC FEE
,.
OCCUPANCY p BUILDING ISNOTPERMITTE D UNTILBOILDING FINAL ISSIGNED BY BUILDI NG I NSPECTOR.
MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,.
LONE WORKING DAY.BEFORE REQUIRED INSPECTION.. ;
�
Z YYY PLEASE GIVE JOB ADDRESS.WHEN PHONING.
—SEE PERMIT.FOR EXPIRATION DATE'.—
ELECTRIC
.PLUMBING .
.I.
MECHANICAL
covsr'. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR 'FINAL'INSPECTIOI
TOTAL,
OFFICE COPY
... � t
APPLICANT -TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY _
. BUILDING PROJECT IDENTIFICATION•"PERMIT NUMBER <
BUILDING
OFFICE COPY
APPLICATION'& PERMIT
BUILDING — ELECTRICAL'=PLUMBING- MECHANICAL
_
;•..:`� .•14«49.9
?`
44
A9��q
OWNER'E
W„ri�V AGR PHONJE
ELECTRIC PERMIT - FEE
PLAN CHECK VALIDATION
✓ -
CONTRACTORS d�UTLETS-
1
1
SWITCHES ;RECEP10.00/1.00
IGHTING' FIXTURES 10.00/1.00 '=It.
Jon
�a�pp�t
1"M/h7 LIG NO,
_
DATE OF APPLICAT ON,ARCHITECT
ADDRESSCONTRACTOR s
�n PHONE
PPLIANCES-RESIDENTIAL•,'. -001;107\
R
ANELS ` , 10,00 -
OR
ENGINEER
ANELS,IOVER200AMP) , X20.00
PLAN CHECK FEE' P.C. NO.
-
IGNS TRANS. - - 3.00
ARCKORENG. '- --
ADDRESS -
SPECIAL CIRCUIT ",'5.00 r
PERMIT VALIDATION
_ -
EMP: METER OR POLE INS. ',"20,00
' ZIP
"0 u/-a�L•�� ` .
ADDRESS
ADDRESS ":
MOTORS - 4 SEE FEE SCH
..
SERVICE CHANGE 2000
' -
a.
LICENSED CONTRACTORS DECLARATION
I hereby. affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and
Professions Cod{{-LIand my license is m full fo�rLff�� C c�
License/ Class W_ � Lrc Number.Q— -
Datc(�_�p.9.__Contrador' - n.K
OWNEERVBUILDHR DI'CLA A ION 7r,
1 hereby affirm thin I am exempt Crum the Contractor's License
Lawforthefollowingreason.(Sec: 7031.5: Business and Professions
Code-Anycity crcounty which requiresa permit wemoslrucfalter,10.00improve,
'ISSUANCE DATE -
BLDG: 'ELECT
PLG '" MECH.
+❑
• r "•
- '. <-'.JIAIUADON
11�DING PERMIT
MISC.— ' REFER TOORDVIdFORMATION
PERMIT -ISSUANCE ,
-S/FT.
demolish, or repair any structure, prior to its issuance, also
requires the applicant for such permiflofile a signed statement that
islicensed pursuant to the provisions ofthe Contractor's LicenseLaw(Chapter9(commencing with Sc.tion 7000)of Division3 oCtheBusiness and Professions Code) or that he is exempt therefrom and
ELEC.CONTR. UC. NO. ELEC.
- --TOTALPERMITTOhe
DTV. PLUMBING PERMIT
the basis for the alleged exumplion. Any violation of Section 7031.5
by any applicant for a permit subjects the applicant too civil penalty
ofnot more than five, hundred dollars ($500f)
STORIES -a
+ '
TYPE CONSTR.'
WATER (EA)
ALTER -DRAIN . 5,00
O Las owner of [he property, or my 'employees with wages as
their sole' compensation, will do the work, and the structure is not
- BACK FLOW PROTECT. DEVICE 400
,
OCC.
RES. UNITS
DRAINS -FLOOR, ROOF, AREA, COND. '5.00 .
- -
intended or offered for sale (Sec. 7044, Business and Prol'essiom
Code: The Contractor's License Law does not apply to an owner of
',-•„ • .
�''- /
F IXTUR ES = PER TRAP 1 5.00
GAS: EA. SYSTEM =I INC.4OUTLETS-6.00
property who builds or improves thereon, and who does such work
himself or through his own employees„provided that such improv. -
huntsarenotintendedoroffered for sale. If, however, the building
SO. FT. FLOOR AREA
_
TOTAL ACREAGE
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that lie did. not build or im-
proveforpurposeofsaleJ.'INDUSTRIAL
❑ 1, as owner of the property, ani exclusively contracting with
GAS - EA. SYSTEM. -OVER 4'(EA.) -2.00•
_
BUILDING USE -
RES, IND' CDN PB- Other
1:1. ❑ ❑ ID El
WASTE INTER -3000
. .
contractors to construct the project (See. 7044, Business
and Professions Core: *The Contractor's License Law does not apply
to an 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
gSSEssoas PARCEL NO.
contracts forsuch projects with a contractors) licensed pursuant to
tire Contractor's License Law. '” -
❑ I am exempt under Sec. ;BAP.C. for this.
reason
SEWER -SANITARY -STORM EA. 200ft/10.00
TRACT NO,
«
-
PARCEL NO.
WATER HEATER W/VENT 6.00
owner - . Date
WATER SYSTEM 5.00
ACC.DATE-
ACC: RUE No.
- WATER -TREATING EQUIP. 5.00
WORKERS'COMPENSATION DECLARATION
1 hereby affirm that Phave.a-certificate ofcon:uht to self -insure, or a certificate of Workers' Compensation Insurance, or codified,
ZONING
ENG SITE NO.
copy
Policy N
❑ Cc,T r here furnished di ^p QQQ
❑ Cedlficd o r h the i '.11 eL cif division.
Applicanen \
i-,
MISC. - '- REFER TO ORD,.
FIRE SPRINK
Y' N
❑rt ❑'
ENERGY T 24
V N
❑ ❑
CERTIFICATE OF EXEMPTION FROM WORKERS'
'COMPENSATION INSURANCE -
(This section need not be completed if Permit is"for one
r PERMIT ISSUANCE: 10.00
.•'FLOOD ZONE
-
❑, N❑
A.L.u.c.-
V,❑ N❑
PLG. CONTH. LIC. NO.
PLO' -
TOTAL 'r
_tire
hundred dollars (5100) or less.) 11" ` ' -
-
-
I certify that in the' performance of iihe work'for which this per/
mil is issued, I shall not employ any person in any manner so as to
CITY MECHANICAL PERMIT FEE
FEE SUMMARY
.- -
i
become subject to the Workers' Compensation Laws of California.
Date Applicant
- - -
_ALTER OR ADD TO MECH. 5.00 '
'
NOTICE TO APPLICANT: if, after muking this Certificate of F. -BUILDING
emptio'n, you should become subject to.lhu.Workers' Compensation
provisions of the Labor Code,•you'most forthwith'.comply with
such provisions or this permit shall be deemed revoked:
APPLIANCE - .5,00
-
AIR HANDLING UNIT (TO 10f)00C.F.M.) 4.00
PLAN CHECK
FEE
AIR HANDLING UNIT (OVER 10=C.F.M.).6.00'
SEISMIC FEE
- CONSTRUCTION LENDING. AGENCY ,
EXHAUST HOOD (WITH DUCT) 5.00
1 hereby affirm that there is a construction lending agency for
-
the performance of the work for which this permit is issued (Sec.
3097, Cie C.). .. > ,,
hender'sNa
Addr y•.
Lender's Address
HEATING UNIT (TO 100,000 B.T.U.) '8.00
MICROFILM ;
-
HEATING UNIT 100,000 B.T.U,19.50
LELECTRIDI
'
VENTILATION FAN (SINGLE) 4.00
I certify that I have read this application and stilt❑ that the above
information n correct I agree mpoto ly Imilwith all c city and county
ordinances and state laws relating to building construction, and
PLUMBING
y
BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00
hereby authorize representatives of on Purp to enter upon the
above-mentioned properly for inspection purposes.
BOILER -COMP Over 100,000 BTUI SEE FEE SCH.
",MECHANICAL
(We) a Be to save, indemnify and keep harmless the Cityof
Cupertin ago' st liabilities, judgmenls, ecists and expenses which
may in y ay accru ainst said City inconsequence of the
ranfin ft s em
Y
-, MISC. - '_ REFER,TO ORD
PERMIT ISSUANCE - '. , 10 00
- -.
CONST.'TAX
MECH. CONT. "'" LIG NO. MECH
TOTAL
TOTAL
6
Signature of ApplicanlrContractor _ - Date
OFFICE COPY