13558 N POST THIS CARD NEAR FRONT OF•BUILDING
PERMIT NUMBER
CITY ' OF CUPERTINO
INSPECTION"DIVISION 13558
JOB INSPECTION RECORD
PERMIT'EXPIRATION',"
.JOB ADDRESS 7'4'40 BARNHART 'PL UNIT# - LOT#
PERMIT EXPIRES IF WORK
OWNER GUY AND SUSANNE'. BERRYONTRACTOR CONST. DYNAMYCS IS NOT STARTED WITHIN
INSPECTION •- DATE 7INSPECTORINSPECTIOWRECORD 0180 DAYS OFPERMIT ISSU-
FOUNDATION - ANCE OR 180 DAYS FROM
UFER
'LAST CALLED INSPECTION.
" PREGUNITE ' - ., I - PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE•,HAS BEEN SIGNED,,
UNDERGROUND /SLAB G
' PLUMBING
pI
ELECTRICAL � - - � �i`I19 IssuUSCE TE��Are � •
MECHANICAL - D J �E PLG. MECH. -
Cit { ❑. ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED f BUILDING PERMIT:
WOOD FLOOR INFORMATIONJ.a
VALUATION
PLUMBING /FT:
MECHANICAL ! ,i I 'r. k,
ELECTRICAL - PERMIT TO , /
FRAMING _ Abbi oN/
INSULATION - STORIES TYPE CONSTR.
OCC,GROUP RES,UNITS
P,CACE NO_SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF SO.FT.FLOOR AREA TOTAL ACREAGE
1 .DIAPHRAGM BUILDING USE
HES IND CON PB • GRnq,,
APPLY NO ROOFING UNTIL ABOVE HAS.BEEN SIGNED ❑ ❑ ❑ ❑', ❑
ROUGH ASS ESSORSPAHCELNO.
• _ 'PLUMBING t5 our. - " -
GAS TEST - - - TRACT No. - PARCEL NO.
MECHANICAL
ACC.DATE ACC.FILE NO.
ELECTRICAL - Lv:'a,F,INALS ,hijw
`,.' + i.DATE;,. �'INSP. '
FRAMING �'( SAN #
/� .ZONING ENG.SITE NO.
INSULATIO PLUMBING
_ - GAS .
MECHANICAL. FIRE SPRINK ENERGY T24
COVER NO WORK UNTIL'ABOVE HAS,BEEN SIGNED!, HEATING ❑ "0 ❑ "❑
FLOOD zorvE A.L.u.c.
LATH=INTERIOfl ,' ELECTRICAL
LATH-EXTERIOR.' FIRE DEPT.
YL❑ No' Y ❑ No
SHEETROCK - GRADE ••
i „FEE SUMMARY
SHEAR INTERIOR BUILDING d' _
SHEAR EXTERIOR - - TEMPORARY APPROVALS)gg BUILDING n,t
. FIREWALLS I ELECTRIC PLAN CHECK'"
• - GAS I .FEE
NO TAPE OWPLASTER ABOVE;HAS"BEEN SIGNED: OCCUPANCY SEISMIC FEE
OCCUPANCY•OF BUILDING IS NOT PERMITTED UNTIL BUILDING,FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM -
t. ,
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
LU
o� ONE WORKING DAY'BEFORE REQUIRED INSPECTION. PLUMBING
PLEASE GIVE JOB ADDRESS WHEN-PHONING.
Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
• ' CONST.TAX
IMPORTANT!•..•
PLEASE,READ REVERSE SIDE BEFORE TOTAL ?
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -'USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION _ PERMIT NUMBER
BUILDING
APPLICATION & PERMIT
. Y AooRess r .� : - 13558
BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
,J OW ER'S ,(J_ - b e £ PLAN CHECK VALIDATION,
-'t ""M � QTY: 4
: r 'ELECTRIC PERMIT rFEE- 11
-
�n C TRACTO^'E, I - ,/' � OUTLETS'-SWITCHES-RECEP 10.00/1.00 Qi
uc.'No7 LIGHTING FIXTURES 10.00/1.00 _
CONTRACTORS APPLIANCES-RESIDENTIAL 4.00
aoo Ess
�Q�'% V�, vHONE PANELS - 10.00 DATE OF APPLICATION
ARcwrecT - - - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO,
OR
ENGINEER '
uc.No. SIGNS TRANS. 3,00
ARCH,OR ENG. .. SPECIAL CIRCUIT 5.00 . PERMIT VALIDATION
r I ADDRESS - -
PEMP.METER OR POLE INS. 20.00
ADRESS -s' MOTORS "' SEE FEE SCH.
• SERVICE CHANGE 20.00
woo LICENSED CONTRACTORS DECLARATION RS d1xAG�1 /v C I:J clr
¢ w H Y PChapter ( ISSUANCE DATE
L,U 1 hereby affirm that 1 am licensed ander revisions of 9
¢ O1 (commencing with Section 7000)of Division 3 of the Business and
• vi ¢ c O BLDG. ELECT, iL,. MF,CN.
H w i Professions Code, i my license is in full forcf�a_nd�[fecG� '{r t I ❑ .�•It 1 c�:u{el�1�i
o i m,O License s Liu.Number--�2 �r�u JJ YY
1- Datc - r Contractor
v
cr s- - . .BUILDING PERMIT.'.
¢ ¢ ¢ - OWNER-BUILDER DECLARATION nR,� T 1�I RD .IOU -
w U .INF RNIAT,ION��
Boa � MISC.- REFER TO ORD _ � •
as g LL y I hereby affirm that 1 so .exempt from lite Contractor's License
u Car Law for the following reason. 7031.5,Business Professions PERMIT ISSUANCE 10.00 VALUATION $/FT.
Code:Any city or county which requiresa permit to construct,alter,
s ¢ Q p improve,demolish,or repair any structure,iprior to its issuance,also ELEC.CONTR. LIC.N0. ELEC.
n wO K requires the applicant for such permit to file a signed statement that TOTAL ��! PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License : 4 s �r l
F z r Law(Chapter 9(commencing with Section 7000)of Dwision3 ofthe y k d s I n }
E 4 c Business and Professions Code)or that he is exempt therefrom and QTSY-, iJ 4 ffi+5 4 PLUMBING PERMIT r . FEE
tr: r m the basis for the alleged exemption.Any violation of Section 7031 5 A w 1 $> k i _ c Y �'e e STORIES TYPE CONSTR.
by any applicant for a permit subjects lite applicmit toacivilpenalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
otter more than five Imn, ed dollars($5007.
❑ I,as owner of the property,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 '
'intended or offered for sale(Sec:7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of
^"x- property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00
himself or through his own employees,provided that such improve. SC.ET.FLOOR AREA TOTALACREAGE
ments are not intended or offered for sale.If,however,the budding GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA.) 2.00
)' builder will have the burden of proving that he did not build or I'D. .- BUILDING USE
prove for purpose of sale.). INDUSTRIAL`WASTE'INTER3000 RES IND CON PB Orbe,
❑ I,as owner of the property,am exclusively contracting with . . -❑ El . ❑ 11 1:1licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B.' 6.00 ASSESSORS PARCEL NO.
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 for such projects with a Contractor(s)licensed pursuant to SEWER-SANITARVSTORM EA.200ftI10.00
the Contractors License Law. TRACT NO, PARCEL NO.-
❑ l am exempt under Sec. I ,B.&P.C.forthis WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC:FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that 1 have' mri ficale of consent to self-insure, ZONING ENG.SITE NO.
or a ce[ifiyG/ytogpof 7Wyor rs' Penta a e IIJ�_suran/cy r a Unified
'✓
copy Ih ! ! V t 73 .[yM
Policy N � ompany -
(] ❑ Certified copy is hereby furnished. - FIRE SPRINK ENERGY T 24
Z Cl Certif 'm y is filed t ith the ity inspectiol sien. MISC.- REFER TO ORD:
O Applicant - Y❑ N❑. Y N❑
;,mow CERTIFICATE OF EXEMPTION FR MWORKERS' PERMIT ISSUANCE;'' 10.00 FLOODZONE A.L.u.c.
ECL u COMPENSATION INSURANCE. PLG.CONTE. LIC.NO. PLG. V AL. ❑ ❑ 1:1 N 1:1ZIs TOT(This section need not be completed If the permit is for one V N
hundred dollars IS 100)or less,) -
U O I certify that in the performance of the work for which this per- OTyYt.,u ' 9 ` )MECHANICAL PERMIT`x s a FEE, FEE SUMMARY
LL I- mil is issued,I shall nal employ any person in any manner so as m
V become subject to the Workers'Compensation Laws of California-
Dy Date Applicant ALTER OR�ADDRTO MECH. 5.00 'BUILDING ��'
} W NOTICE TO APPLICANT: If,after making this Certificate of Ex-
H ? emptier,you should become subject to the Workers'Compensation APPLIANCE 5.00 - PLAN CHECK /
provisions of.the Labor Code, you must forthwith comply with FEE .lp 2-J^
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 2--)t
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10PWC.EM.) 6.00 SEISMIC FEE' J V
Thereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec, - MICROFILM
3097,Civ.C:). t HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)8.50 - ELECTRIC
Lenders Address - Q'C/P
c.
I certify,that I have read this application and state that the•above VENTILATION FAN (SINGLE) 4.00
V. information is correct.1 agree to comply with all city and county PLUMBING
Ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTUI SEE FEE SCH. MECHANICAL
(We) agrsave, indemnify a keep harmless the City of MISC.- REFER TO ORD. -
Y Cupertino ggggg9 t liabilities,jud s, costs and expenses which PERMIT ISSUANCE 1000 CONST.TAX
may in� ay accrue e t id City in consequence of the
4 gran' { ape�it, MECH.CONT. LIC.NO. _ MECIT
TOTAL TOTAL 73
i
Sifnature of Applicant/Contractor Date -
- OFFICE COPY - - -