14599OFFICE00I
POST THIS -CARD NEAR FRONT BUILD'I,NG ;
-OF
'
CITY OF CUPERTINOG(�(�
IERMIT NUMBER -
'
INSPECTION DIVISION ,WJN-
JOB -INSPECTION RECORD
• - "' -
PERMIT EXPIRATION;;
JOB ADDRESS .7539.BARNHART PLACE '''JNirJt '_LOT# „
•
' -. IA. - i -.•
PERMIT EXPIRES IF WORK '
_
OWNER '• .David' FUTl CONTRACTOR
IS NOT .STARTED WITHIN
i80 DAYS OF PERMIT ISSU.
ANCE OR "180 DAYS'FROM
INSPECTION." , DATE INSPECTOR
INSPECTION RECORD
FOUNDATION;
"
-
NOTE:.'
ALL•GRADING DRAINAGE SHALL
LAST CAL�ED INSPECTION.
UFER -
{
AND BE INSTALLED
TO COMPLY WITH .THE APPROVED PLANS AND CITY OF
PREGUNITE> '.
PE.nm uacloanoN -
CUPERTINO STANDARDS.
- -
/• �` -
'� A-!, •r.71��-�•%
GARAGE SLABS,
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
"' - ., • -
-
UNDERGROUND /SLAB
ISSUANCE DATE'
PLUMBING a -
-
-
ELECTRICAL _ �';y�^
MECHANICAL " ' -
.�
.BLDG.,
ELECT.
,PLc� MEC.,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
..
- .,
BUILDING PERMI4
INFORMATION
WOOD FLOOR
PLUMBING
-
, - -
VALUATION
?. ✓ r'rJ
SIFT.
MECHANICAL
ELECTRICAL
- -
PERMIT TO
-
FRAMING
INSULATION
- -
STORIES
TVP EDONSTR.
• -
'
'OCC GROUP
RES. UNITS '.
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
'SO,
` -ROOF,.
NOTE: NO FINAL INSP. SHALL BE MADE BEFORE
THE CONSTRUCTION TAX IS PAID - s °
FT. FLOOR PREA
TOTAL ACREAGE ,
J
DIAPHRAGM,
T
ROOF SHEATHING -
BUILDING USE
RES :INC , CON. „PB oln.,'
❑ ❑ ❑ 0 • o '
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
'FINALS '. DATE INSP.,,
ROUGH
SAN.q
ASSESSORS PARCEL NO
PLUMBING ' _ -'1r
ELECT, ENERGY,
TUBS & SHOWER PAN .•
,PLUMBING ENERGY , '
, TRACT NO..
PARCEL NO. i
MECHANICAL ` - -
MECH. ENERGY- '
ELECTRICAL IT
BUILDING ENERGY. .
ACC.DATE
-
ACC. FILENO.
'
FRAMING.. - °
ELECT. FINAL -TEST'•;
INSULATION -.. +i, .
PLUMBING •
"-20NING \
- ENG, SITE NO.
GASTEST. - ��-
GAS 1,"
MECHANICAL
'FIRE SPRINK'
-
"�
ENERGY T 24 l
P •"�
COVERING WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING
EXTERIOR SHEAR
ELECTRICAL RELEASE
ELDOD-ZONE
Y ❑ 1�
' A.I.. U
"Y ��- NQ;
INTERIOR SHEAR"
FIRE DEP.T`' --� -
SHEETROCK -
GRADE,, ,: - -
FEESUMM RY
EXTERIOR LATH -
BUILDING- i
Buil-DING,
.INTERIOR LATH
TEMPORARY APPROVALS •
SCRATCH COAT -
ELECTRIC.
Y-•
PLANCHECK
FEE..
.GAS
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NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY
SEISMIC FEE
a
OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR.
"r
MICROFILM
AR RANGE. FOR -INSPECTION BY PHONING 252-4505,
ELECTRIC
-fA
.'
Iw—� ONE WORKING DAY BEFORE REQUIRED'INSP,ECTI O N:.`:-:`
—
z PLEASE GIVE JOB ADDRESS WHEN PHONING'., }
PI.uMBwc
'
MECHANICAL.
– SEE PERMIT FOR EXPIRATION DATE=; ;
CONST. TAX
IMPORTANT!':
•
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. ••
TOTAL : -
f•;. :.f..
OFFICE00I
Af�rCICANT TO FILL. IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY "
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- BUILDING PROJECT IDENTIFICATION
-
APPLICATION &PERMIT
- ' -
BUILDING -ELECTRICAL -PLUMBING -MECHANICAL`
i PERMIT NumBER-- ,
ryq q "
I L� 599
;,,T.,,
BDILOTG
AOORESs •
77539 DAM
OWNER -
NAME- {['�1��II /
D 1✓f� - .1 V/V PHaNE9 -
OTV. :'ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION .
COAMtERACTOR'5 �
UTLETS- SWITCHES -RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
-' ur. NO.
,
CONTRACTOR S, - -
ADDRESS
APPLIANCES-RESIDEN TIAL 4.00
PANELS 10.00 1
PHO
DATE OF APPLICATION
ARCHITECT
OR ..
ENGINEER
Lm. NO.
PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. NO.
" -
"
SIGNS TRANS. 3:00
ARCH. OR ENO.
ADOREss �, -
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION. '
TEMP. METER OR POLE INS. 20.00
' - ZIP
//If
APPLICANT
SS -
ADDRESS
MOTORS � t L SEE FEE.SCH.
SERVICE CHANGE" 20.00
-
.1p^y�ry� frf�
' LICENSED CONTRACTORS DECLARA'T'ION
-
I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of lite Business and
Professions Code, and my license is In full force and effect.
License Class Lia Number_
ISSUANCE DATE -
B
wF.1Af
PLG. MECH.'
Dote Contractor
I
OWNER -BUILDER DECLARATION
1 hereby uolr wing I ani exempt 03t. 1.5 Bu Contract ors License
Professions
Lawfortheity orcountywhih regH's.permit
emit to ness
a p o COnsuaICL alter,
Code: Any city Or county any
'BUILDING PERMIT
INFORMATION .;
MISC.- RE F ER TO ORD _
-
PERMIT ISSUANCE 10.00 O -
VALUATION
p7
$/FT.
ELEC. CONTR. LIC. NO.
-
_
ELEC: .L /
-TOTALI 3 b
tine riot t
p rmit tofile prior its ate met also
str
reqiniuires
requires the applicant for such permit l0 file a signed acmmnCm that
the applicant for such
pursuanten the provisions of the Contractors License
he is (Chapter
Law (Chapler9(Commencing)anthalion 7000) is"mafDlvisiefoofthe
mon.11'r.fiessimns on.tAn he is therefrom and
I I •
-
PERMIT -
'S�%9 -
•
DTV. 'PLUMBING PERMIT `.FEE
alleged eCode)
theBusiness;a
the basis for the alleged exemption. Any tionlf
oto
STORIES -
TYPE CONSTR.
actidn malty
subjects S500).licum fo acivii penally
applicant
by afoot applicant fora hundred -
of nut more than five hundred dollars (55001.
'
ALTER -DRAIN & VENT -WATER (EA.) 5.00
❑' I, as owner of the property, Or my employees with wages an
p
their sole compensation, will do the work, and the structure is not'
intended -or offered for sale (Sec. 7044, Business and Professions
Code: The Contractor's License Caw does not apply to an owner of
BACK FLOW PROTECT'? DEVICE 4.00
OCC. GROUP
RES. UNITS
`
DRAINS -FLOOR, ROOF, AREA,COND. 5.00
FIXTURES- PER TRAP - 4! 5.00
GAS-EA.SYSTEM-11NC.40UTLETS 6.00 -
SD, FT. FLOOR AREA
.1
TOTAL ACREAGE -
property who builds of lmpolves thereon, and who does such work
himself or through his own employees, provided that such improve-
mems are not intended or offered for sale. If, however the building
or improvement is sold within one•year of completion, the Owner-
builder will have the burden of proving that he did not build or in,-
pro for purpose olaleJ'
I,ps owner of the property, am exclusively contracting with
- - x ..
GAS EA. SYSTEM -OVER 4IEA) 2.00
BUILDING USE
RES IND CON Pa Omar
❑ El 1:1. ❑
INDUSTRIAL WASTE INTER. 30.00
t eased contractors to construct the project (Sec. 7044, Business
and9'rofessions Code; The Coalmoor's License Law docs not apply
to an owner of properly who builds or improves thereon, and who
LAWN SPRINKLERS-- 1 INC 5 V.B. 6.00
_ -
LAWN SPRINKLERS - OVER'5'(EA.) 1.00
ASSESSORS PARCEL NO.,,
-
contracts,igyr such projects with acontiuctor(sl licensed pursuant to
the Con ac oh Ce se La
SEWER-SANITARY-STORMFA.200ft/10.00
TRACT NO.
PARCEL NO.
❑ I arm t der .B.&P.C. tiir rids
reason
Owne Uate _
"
' WATER HEATER W/VENT 6.00
-
,. WATER SYSTEM - 5.00'
ACC. DATE'
ACC. FILE NO.
•WATER TREATING EQUIP. 5.00
• WORkERS'CO iNSATION DECLARATION ., .,;
I hereby affirm that ave acertificate of consent tuself-insme,'
or a Certificate of Workers' Compensation Insurance, or a certified
ZONING
ENG. SITE NO.
copy thereof (Sec. 3500, Lab C.). S
policyNo. Company
-
❑ Ceflilied copy is hereby furnished.
❑ Certified copy is. filed with tire city inspection division.
Applicant
'
FIRE SPRINK
_.Y❑ -'N❑
ENERGY T.24
Y❑,' IN
MISC.- - REFER TO ORD.
CERTIFICATE OF EXEMPTION FROM WORKERS ".•
PERMIT ISSUANCE 10.00 Old
FLOOD ZONE.
A.LU.C.
- COMPENSATION INSURANCE
1'fhis-V,,hon reednorbe completed if the permit is for one
Y ❑ NO
Y.❑ NO
PLG. CONTR. LIC. NO.
- ly,
TOTAL 6
hundred dollars 051001 or less.)
-
I Certify that in Ore performance ol'tire work for which This per-n
mit is.issued, I shall let employ any person in airy manner so as to
DTV. MECHANICAL'PE RMIT -FEE
•,
'FEE SUMMARY'
BUILDING
iII4 S�
becane subject to the Workers' Compensation Laws of California'.
Date Applicant
NOTICE 10 APPLICANT: If, after making this Certificate of Ex-
emption, you should become subject m the Workcrs' Coutpensatiun
provisions of the Labor Code, you must forthwith comply WrAr
such provisions or this permit shall be deemed revoked.
ALTER OR ADD TO MECH. 5.00
'
APPLIANCE 5.00 f!
PLAN CHECK
FEE:.
'� Z
AIR HANDLING UNIT (TO 10=C.F.M.) -4.00
AIR HANDLING UNITIOVER 10=C.EM.) 6.00
SEISMIC FEE
CONSTRUCT ION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
EXHAUST HOOD (WITH DUCT) 1 5.00 -
the performance of Ihe'work for which this permit is issued (Sec.
3097.Civ.C.). -
MICROFILM
-
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Nome
Lender's Address
HEATING UNIT (OV ER 100,000 B.T.U.19.50", ',
'ELECTRIC .J6
"77
I clarity that l have read this application and slate final lire above'
s VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county
ordinances and stale laws relating to'.building,c'onslruclicn, and
PLUMBING. .16-
- BOILER-.COMP(3 H.P. or 100,000 B.T.U.) 6.00
BOILER-COMP IOver 100,000 BTIll'SEE FEE $GH. .,
-
MECHANICAL`�
.•� '
�V'
hereby authorize representatives of this city. to enter upon the
above mentioned property for inspecfioo purposes,
MISC. - ' y REFER TO ORD.
CONST. TAX
'
(We t gree save, indemnify. and keep harmless the pity of
Cape n a,at st liabilities, judgments, costs and expenses wbbir
may h Y w y ac He a sl aid City in consequence of the
PERMIT'ISSUANCE - 1 0.00 '
r li 1 i. porn 1.
MECH, CONT. LIC. NO,
MECH.
TOTAL �3 - '
TOTAL
I c of Applicant/ lra rate
I
OFFICE COPY