14604 POSTTHIS'CARD NEAR FRONT OF BUILDING, PERMIT NUMBER
.CITY OF CUPERTINO
114604
INSPECTION-DIVISION
' JOB INSPECTION RECORD
�•J--. • PERMIT EXPIRATION
JOB ADORESS ���� VU 6e4 '�- UNIT# "_LOT# -
PERMIT EXPIRES IF WORK
OWNER _ ��E• �O%'Y��O. CONTRACTOR �a-/� G e �Rdc,v /� IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAL,IOATION
CUPERTINO STANDARDS. _
GARAGESLABS '
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED r/- n (�,�,� •,,�
UNDERGROUND /SLAB
"
PLUMBING
ELECTRICAL - - ISSUANCE DATE
MECHANICAL _ - - Uc. ELILI I PL;. MECH-
❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED auILDING PERMIT
WOOD FLOOR ORMATION
LUArION
PLUMBING � - \ -
MECHANICAL .. q h
' PERMIT To
ELECTRICALS.
FRAMING
INSULATION - - STORIES TYPE CONST". 1
/
OCQ DROOP RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
SO FT FLOOR AREA TOTAL ACREAGE `
- ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID -
P - •
ROOF SHEATHING Res ,NU CON9llILOING USE PR 0m.,
"APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑
ASSESSORS PARCEL NO
ROUGH SANA
PLUMBING : ELECT.ENERGY -
TUBS&SHOWER PAN• PLUMBING ENERGY - TRACT rvo, PARCEL No
MECHANICAL ' MECH.ENERGY ' .
ELECTRICAL BUILDING ENERGY Acc:onrE ACC.FILE NO^
FRAMING ELECT.FINAL TEST
INSULATION - PLUMBING ZONING ENG-SATE NO.
GAS TEST - GAS •
MECHANICAL - FIRE SPRINT( ENERGY n}a'
%
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATINGYLl v E-) "❑
.EXTERIOR SHEAR - ELECTRICAL RE - FLOOD ZONE
ALuc.
Y❑ - N❑ Y ❑ N❑
INTERIOR SHEAR FIRE DEPT. '
SHEETROCK GRADECON FEESUMMARY
EXTERIOR LATH BUILDING
INTERIOR.LATH TEMPORARY APPROVALSY BUILDING ii{J
SCRATCH COAT ELECTRIC PLAN CHECK -
GAS - - FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY _ SEISMIC FEE
' OCCUPANCY OF BUILDING,IS NOTPERMITTED UNTIL.BUILDING FINAL ISSIGNED BY BUILDING I NSPECTOR. MICROFILM
LU I. ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
r ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
O� PLEASE GIVE JOB ADDRESS WHEN PHONING.. '
ZMECHANICAL
- SEE PERMIT FOR EXPIRATION DATE —
. .IMPORTANT! CONST.TAX-
PLEASE READ REVERSE SIDE BEFORE — . e
CALLING FOR FINAL INSPECTION. TOTAL
OFFICE COPY
POST T CARD NEAR FRONT OF BUILDING'-'
PFRNIi NUht BER
CITY OF CUPERTINO 14604
INSPECTION DIVISION
JOB INSPECTION RECORD
^4 /
JOB ADDRESS I `�.3.e R4 —UNIT-a _LOT# PERMIT EXPIRATION
/� �.p^1' PERMIT EXPIRES IF WORK
OwrvER C,c `-Oti 7J'�- CONTR AC'. 1 - p p IS NOT STARTED WITHIN
INP CTICN DATE INSPECTOR - INSPEC ION RECORD 180 DAYS OF PERMIT ISSU
ANCE OR 180 DAYS FROM
FOUNDATION NOTE: LASTCALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERNIIT VALIDATION
CUPERTINO STANDARDS.
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED U^
UNDERGROUND /SLAB I GG /N2qIti4/iLf
PLUMBING /�[ //���v /aa — gyp..-F /e(-/ 7 •
ELECTRICAL Z ISSUANCE LATE
BLDG ELECT PLG NIECH
MECHANICAL ❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED PIKI3.0. BUILDING PERMIT
INFORMATION
WOOD FLOOR 1 Anory FdSIFT.
PLUMBING
MECHANICAL PERIT TO
ELECTRICAL /EvC I
FRAMING 0.4/L -OU
$TORIES TYPE CONSTR.
INSULATION
OCC,GROUP RES UNITS
:PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED;
$O.FT.FLOOR IRE• TOTAL ACRf RGf -
'�` ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
77;��AOPPLY
PHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
F SHEATHING RES IND CON pB DIN,
NO.ROOFING UNTIL ABOVE HAS BEEN SIGNEDi's sem? ?'=FINALS js; : DATE' t .i1NSP:`,: ClclclD C3
ASSESSORS PARCEL N0ROUGH SAN.MMBING ELECT.ENERGYTRACT NO. PARCEL NO
S 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ACC FILE NO
ELECTRICAL BUILDING ENERGY Act.GATE
FRAMING ELECT,FINAL TEST ZONING ENG.SITE NO.
INSULATION PLUMBING
GAS TEST GAS
FIRE SPRINN ENERGY T 2
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1HEATING . ❑ N❑ C] N[D
FLOOD 20NE AIU C.
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT-. ❑ N� T L' N❑
SHE ETROCK GRADE FEE SUMMARY .',, 4`
EXTERIOR LATH BUILDING
BUILDING
INTERIOR LATH TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC PLAN CHECK
FEE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. -MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE.PERMIT FOR EXPIRATION DATE - MECHANICAL
CONST:TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
APPLICANTS POSTING COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
t, PERMIT NUMBER '
"` UIEDING PROJECT IDENTIFICATION APPLICATION & PERMIT
DING
aDDRE55 ,I
d 1 - BUILDING-'ELECTRICAL-PLUMBING-ME,CHANICA14604
L „
OwNEH'S � •.,,✓�C� PLAN CHECK VALIDATION
NAME !'r/5!I [415�j��,.�� OTV. ELECTRIC PERMIT FEE
.. "`
PHONE ,WWW
ONTRACTOR'S
aME C UTLETS-SWITCHES--RECEP '10.00/1,00
>; S uo No. LIGHTING FIXTURES 10.00/1,00 -
foNTRACTOR's aooREss (54WPPLIANCES-RESIDENTIAL 4.00PAW_ - -
p
Z 1..NE 3,24- 3 Z PANELS 10.00 . DATE OF APPLICATION -
ARCH, ECT PLAN CHECK FEE P.C.NO_
OR. PANELS (OVER 200 AMPI- .20.00
ENGINEER
LIC.No, SIGNS TRANS. 3.00
AARCW 08 DDRESS ENG. SPECIAL CIRCULI. 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00 ^ '
Ars
ADDDRESSDRESS MOTORS - SEE FEE SCH.
SERVICE CHANGE - - 20.00 - . .
w o o LICENSED CONTRACTORS DECLARATION
a i W I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE.
N a'. (Commencing with Section 7000)of Division 3 of the Business and - ELECT. PLG. MECH.
F, D i Professions Cod an my license is in full force. I e. •c ❑ ❑
o f=D License Cla Lic.Number fl
t. ,
Date Contmcmr 311,%eIY
@ R NG PERMIT
= a wOWNER-BUIL DER DECLARATION O INFORMATION
w3: a'w I hereby ufmm that I am exempt from the Contractor's License MISC.- REFER TO ORD qq ,S/FT.
F LL a a Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.000
Code:Any city or county which requires a permit to construct.alteq
Z
a Q Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. .LIC.NO. ELE �
DLL requires the applicant for such permit to file a signed statement that - TOC.
OT
'
x 2 hPERMIT TO
e is licensed pursuant to the provisions of the Contractor's License -
w 'i Law(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe /'`/
i o Business and Professions Code)or that he is exempt therefrom and LUMBING PERMIT FEE �LrfT /�/rGR<''�•J
,e H $ Ihe basis for the alleged exemption.Any violation of Section 7031.5 DTV. PSTORIES TYPE CONSTR.
u by any applicant for a permit subjects the applicant EGA civil penalty ALTER-DRAIN -WATER IEA.) 5.00
of not mora than Ove hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCL.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
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SQ FT.FLOOR AREA TOTAL ACREAGE
himself or of intended
his own employees,provided that such offered for that such
building GAS-EA.SVSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of complelion,the owner- - GAS-EASYSTEM-OVER 4 (EA.) 200
builder will have the burden of proving that he did not build or on. . . .
BUILDING USE
prove for purpose of sale.).- INDUSTRIALWASTE INTER. 30.00 RES IND CON PB Omer
❑ 1,as owner of the property,am exclusively contracting with .❑ ❑ El 11licensed 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 docs not apply -'
to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OV ER 5(EA.) 1.00 ` t
contracts for such projects with a contractors)licensed pursuant to -
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lumexempt,undersec. .B.&P.C.hlr this WATER HEATER W/VENT 6.00 •-.
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKF-RS'COMPENSA'r10N DECLARATION WATER TREATING EQUIP. 5.00
hereby affirm that 1 have a certificate ofconsent to self-insure, -
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.0ny IXW138Rnr ALg1 t.1/
Policy No. Company -
O ❑ CP nfied copy is 1,
bynished. FIRE SPRINK ENERGY T-29 .
Z 2 B�CeHifi coy s µh-the airy irispection division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑
O Applicant_ f1J V N V N
$ PERMIT ISSUANCE 10.00
fY CIiR1'I FICA'Tli OPTION FROM WORKERS' FLOOD ZONE A.L.U.C.
W > •COMPN INSURANCE' PLG.CONTR. LIC.NO, PLG.
EL 0 (This Section Beed not be completed if lhr permit is for one TOTAL Y❑ N❑ Y F] N❑
hundred dollars(S 100)or less.) '
U O 1 certify that in the performance-of the work for whichthis per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I shall not employ any person in any manner so as to ,
U become subject to the Workers Compensation Laws of California. 'Z
U ED Date Applicant ALTER OR ADD TO MECH' 5.00 - BUILDING pSZ f
} N NOTICE TO APPLICANT: If,after making this Certificate Gf Ex- '•
F ? emption,you should become subject to the Workers'Compensation 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 1O=C.RM.) 4.00
e CONSTRUCTION LENDING AGENCY AIRHANDLING UNITIOVER IO,OODC.EM.) 6.00 SEISMIC FEE J
I hereby 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.). HEATING UNIT(TO 100,000 B.T.U:) r 8.00
Lender's Name ' HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lender's Address- ELECTRIC '
1 certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
ordinances and state laws relating to building'construction, and BOILER-CJMPI3 H.P.or 100,000 B.T.U.) '6.00
_�• hereby authorize representatives of this city to enter upon the 801 LER-COMP.IOber 100,000 BT61 SEE FEE SCH. MECHANICAL.
. above-mentioned property,for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.: - REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which CONST.TAX
may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10,00
ra ' gof thi it. - MECH.CONT. LIC.NO. TOTAL . s
j�
i atureo'Applicant/2114cl.r ate TOTAL
• OFFICE COPY