18629 POST•THIS CARD NEAR•F,RONT OF BUILDING
PERMIT NUMBER'
CITY OF CUPERTINO.: 18629
INSPECTION•DIVISION, . ,, .
JOB INS PECTION'RECORD
yIL �� - /J�j `�• '� - ' •' '_ - PERMIT E%PIRATION '
µ �'L. / y /D PY rl/�/AYT , '1Ars .
I JOB ADDRESS UNIT# ' - LOT#
PE E%PIKES IF WORK'
4 oInNER c4.hi. ii U�c�S L s1^. ;, .,CONTRACTOR He �t /,(�' Pp /w IS NOT STARTED ,WITHIN
INSPECTION • • .;DATE INSPECTOR INSPECTION RECORD'- 18o D4YS:OF:PERMIT ISSu-
ANCE.O ,�180DAVS FROM -
.L FOUNDATION'; - 1 I -
r - NOTE:- - mL ALINSPECTION.
LIFER - "�•�-" • BALL GRADING AND,DRAINAGE.SHALL BE INSTALLED ' -="i...,.
PR EGUNITE TO COMPLY WITH THE'APPROVED PLANS AND CITY'OF, -Per+mIT VALIDATION
'CUPERTINO STANDARDS. -GARAGE SLABS. � -
FOUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
L"
UNDERGROUND'/SLAB
PLUMBING' _ ,+ - 1•
ELECTRICAL, - " t ISSUANCE DATE
• • MECHANICAL • - BLur.. ELECT, PLG. e R
El ❑ ❑ ' ' ,
DO NOT POUR FLOOR UNTIL.ABOVE'HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR FAO!'-"• • _ ' INFORMATION
PLUMBING
.VALUATION SIFT.
u
. MECHANICALS' , - '�C0 9,•1989 - .
ELECTRICAL wit .,,�i.w PERMIT To
FRAMING }e{—`
INSULATION • ' - STORIes A IT ICONNSir`rv/..
T,, _ - _ OCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
' ,. sa FT.Fl.Doff 49oA roTAL ACRIA61
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAXIS PAID - -
_ -
BUILDING USE
ROOF SHEATHING' ;L.'. - _ Rues 'INu CON PB o"'., '
AP,PLY-NO ROOFING UNTILABOVE'HAS BEEN SIGNED . FINALS " DATE, ''.INSP. �`� 0 ❑ ❑
ROUGH
ASSESSORS PARCEL NO
` - ' SANS, ` _
PLUMBING ELECT.ENERGY
IHAr7 NO. .PARCEL NO.
TUBS 8 SHOWER PAN * PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ACC DATE ACC FILE NO.
ELECTRICAL BUILDING ENERGY T
FRAMING ELECT.-FINAL TEST
INSULATION'. ZONING, ENG.SITE NO.
PLUMBING �` - ..
GAS TEST _ - GAS ,
'
MECHANICAL '
FIRESPRINK - ENERGY Tpn '
TCOVER NO WORK UNTIL ABOVE HAS BEENSIGNEDHEATING - •� -Y N�
EXTERIOR'SHEAR '
ELECTRICAL RELEASE - FLOOD ZONE 'n,L.u.C.
INTERIOR SHEAR,-, - TIRE DEPT YO- ^N❑ Y.L. N❑
SHEETROCK - GRADE i, FEE SUMMARY
EXTERIOR'LATH rBUILDING' BUILDING
- • -
-INTERIORLATH TEMPORARY APPROVALS',,,
SCRATCH'COAT ELECTRIC PCAN CHECK
,FEE
• NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN'SIGNED- OCCUPANCY - SEISMIC FEE U
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUI LDING FINAL.IS SIGNED BY BUILDING'INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION B,Y PHONING 252-4505,. ELECTRIC '
f ONE WORKING DAY BEFORE'REQUI.RED INSPECTION. PLUMBING ! '
z PLEASE GIVE JOB ADDRESS WHEN PHONING.'
— SEE PERMIT FOR EXPIRATION`DATE = MECHANICAL
:.IMPORTAN'T! CONST.TAX• : r
PLEASE READ REVERSE SIDE BEFORE]
CALLING FOR FINAL INSPECTION.'. ' TOTAL; / SG'
0FFICE COPY
APPLICANT TO`FILL IN INFORMATION WITHIN-RED LINES — USE BALL POINT PEN ONLY
•� .r BUILDING PROJECT IDENTIFICATION - , -PERMIT NUMBER
BUILDING APPLICATION & PERMIT /{�J '/�/A
AODRE55
9gin1S6 G J
,r .1 Jp E•� BUILDING—ELECTRICAL—PLUMBING—MECHANICAL v.. V
OWNER'S PLAN CHECK VALIDATION
NAME OTY: � ELECTRIC PERMIT FEE l
p PHONE
CONTRACTORS .
NAME - UTLETS-SWITCHES-RECEP ,10.00/1.00
7/r •P .. ) LIC-a311,1711 rr LIGHTING FIXTURES 10.00/1,00
CI RI - AP,PLIANCES-RESIDENTIAL 4.00
ApOR '
yd wNl7. ',PHorvE O- aj9, PANELS 10.00 DATE OF APPLICATION
ARCHITECT - PLANCHECK FEE - P.C.NO,
DR PANELS (OVER 200 AMP) 20.00 i
ENGINEER
- cic.No. . SIGNS TRANS. - 3.00
. none Ess:ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
'• ,,. '.ZIP TEMP.METEWOR POLE INS. 20.00
APPLICANTS MOTORS SEE FEE SCH. '
ADDRESS - ( �
-'a SERVICE CHANGE 20.00
o
i
woo
H
LICENSED CONTRArTORS LC•
LA RA'f10N
Q U I hereby affirm Ilia( I nm Titrated under..... ionsof Chaptcr9 � ISSUANCE GATE
,HA
to (commencing with Section 7000)of Division 3 of the Business rad'
•< n BLDG. ELECT. PLG. MECH.
Lice ions C and nhy license is in follNumber
force and effect - �-
2 o h Lice 'Lin.Number 'T" -$ }� ,
9 z r� Untt 7 f��T�f "�Contractor
_ac ¢ w 4 OWNER-BUILDER DECLARATION _ BUILDING PERMIT
w ;a- r , • I hereby affirm that I am exempt from the Contradict's License
MISO.` O.ORD INFORMATION
u o a Law for the following reason.(Sec:7031.5,Businessund Professions VALUATION $/FT.
- PERMIT ISSUANCE 10.00
Code:Any city or county which requiresa permit Ioconstruct,alter,
_
'Q In< impnive,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0, ELED. "
IF
permit requires the applicant for such to file a Signed statement that TOTAL PER TO,
A w m he is licensed pursuant to the provisions of the Contractor's License s
H z a
Law(Chapter 9(commencing with Section.7000)of Division 3 of the
4 O Business and Professions Code)or that he is exempt therefrom and QTY. r PLUMBING PERMIT FEE II lla�
. M F o the basis for thealleged exemption.Any violutlon of Section 7031:5 iI 'STORIESPE CONSTR.
i 3 m by any applicant for a permit subjects the applicant to a civil penalty - - -
ofnot more thanfive hundred dollar,($500).): - 'ALTER-DRAIN&VENT-WATER (EA.) 5.00 '
❑ 1,as owner of the property,or my employees with wages as - BACK"FLOW PROTECT. DEVICE 4.00 - OCG GROUP RES.UNITS
sole compensation,will do the work,and the structure is not
'- intended or offeredfor sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 -
Code:The Contractor's License Law does nut'apply'to an owner of
Property who builds or improves hereon,and who lines SOCA work FIXTURES-PER TRAP 5.00 SQ FT.FLOOR AREA TOTAL ACREAGE
himself,or through his own employees,provided that such improve=
inerts are not intended or offered for sale.'11,however,the building GAS-EA.SYSTEM,-11NC.4 OUTLETS'6.00
or improvement is sold within one year of completion, the owner ' GAS-EA.SYSTEM-OVER 4 (EA.) 2.00
builder will have the burden of proving that he did_not build or fill- •BUILDING USE
prove for purpose of sale.., INDUSTRIALWASTE INTER. , - 30.00 ES IND CON PB Omer
❑ I,as owner of the property',am exclusively commoring with
licensed contractors to construct the project(Ser 7044;Business' LAWN SPRINKLERS-I INC 5 V.B.' 6,00 ASSESSORS PARCEL N0:
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.)- s.1.00
contracts for such PnhjeclYwith a eoitO.eQns)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/.10.00
the Contractors License Law. TRACT NO, PARCEL NO.
❑ I am exempt under Sec ,B.&BC.for this
reason WATER HEATER W/VENT 6.00 -
I
Owner'. Date'� WATER SYSTEM 5.00 'ACC.DATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARATION { WAT.ER,TREATING EQUIP. 5.00 '
I hereby affirm that I have a cendicate of consent to self-insure.
a or mcnrtihcLw of Workers Compensation Insurance,or u attificd - ZONING ENG.SITE NO.
'ropy'thereof(Sce.3800,Lab.C.). - - •-
Pcdi,,Nn (onhpahy -
,0 ❑ Certified copy is hereby furnished. - - ->
+-, - '
Z Z "❑ Certified copy is filed with the city mhrpecnfdFIRE SPRINKENERGY T�24,iyision. -
O Apphuml - MISC.-, REFER TO'ORD. YE], N❑ t Y ❑ No
CL to CCRTIFICATIi OFIix1iMPTION1;ROMWORKERS' -PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C.
LU >' - , COhIPENSATION INSUIZANC17 . - -,. PLG.CONTR. I.C.NO, - - PLG_
0- O •(Thii.wc ion need not be completed if the permit is forgone - TOTAL Y,❑ NO. Y Q N❑
D Z hundred dollars IS 100)or less.)
U O 1 certify that,in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I shall not employ any person in any manner so as it, h
- O w bit om sub' tag}I Workers C n nsatinn L' sol'C.difomia. -
U1 Darc &i Applicant �i-� - -- BUILDING
�- 0NO'fl Cl TO APPLICANT': II,a(t making this Cert il'icate of lix- ALTER OR ADD TO MECH. 5.00 -
f— Z emption,you should become subject m the Workers Compensation APPLIANCE - 5= PLAN CHECK ./
provisions of the Labor Code, you most forthwith comply with FEE
U such provisions or this permit shall be(totaled revoked. AIR HANDLING UNIT(TO 10=C.F.M.).. 4.00
CONSTRUCT ION LFNDING AGENCY, AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE .' O
I hereby'affiran that there is�a construction lending r,mmy-for EXHAUST HOOD(WITH,DUCT) 5.00
the performance of the work for which this permit is issued(Sec. - - MICROFILM '
o 3097,Civ C.). .� �. HEATING UNIT(TO 100,000 B.T.U.) 'SBB L7
Lender's Name
Leaders Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC -
' 1 certify that I have road this applicwimi and state That the ab.Ga VENTILATION FAN (SINGLE) 4.00
information is correct I agree to comply with all city anti county - PLUMBING
" ofdlnances and state laws relating to building construction. anti BOILER-OOhnP(3 H.P.cr 100,000 B.T.U.) 6.00 .
hereby archon" representatives of this city tO elver+u Pon the BOILER-COMP Inver lO0,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes. .
(We) agree to at,, indemnify and keep harmless the City of MISC.,;' REFER TO ORD.
upmrino against liabilities,judgments, costs and expenses whiclh '(9'90 CONST.TAX
may in any way accrue against said City in consequence of the PERMIT ISSUANCE
rants 0f 1 lispennit. - MECH.CONT. LIC.NO. MECH. -
9 TOTAL o TOTAL
ignalure Of A ppli nt
t/Coractor Dare - - I G '�
OFFICE COPY -