14400 POST THIS CARD NEAR FRONT OF.BUILDING
PERMITNUMBER
CITY ,OF CUPERTiNO d 61
JOB INSPE INSPECTO ON RI CORD SION 4400',;.
JOB ADDRESS 101.01 . BUBB ROAD I • ' PERMIT EXPIRATION
UNIT# LOT#
OWNER APPLE' COMPUTER CONTRACTOR LECON ELECTRIC PERMIT EXPIRES IF WORK.j
INSPECTION .IS NOT STARTED WITHIN .
DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU:,
FOUNDATION
NOTE: - - ANCE OR 180 DAYS FROM',
LIFERALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PR EGUNITE " TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
GARAGE SLABS CUPERTINO STANDARDS. .
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
LINDEP.GROUND /SLAB
PLUMBING
ELECTRICAL
MECHANICAL • �l!r k� ISSUANCE DATE
9L
P
ELEC?,9 LG.' MECR,.'
' -G e�iw•o° � Q � � '
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BuaDINc PERMIT
'
PLUMBING WOOD FLOOR ICA°t; INFORMATION
- C
VALUATION 5/FT.
MECHANICAL - - - -
ELECTRICAL
' PERMIT i0
FRAMING - - 6'?'
INSULATION- STORIES TYPE CONSTR,
OCC.GFIOUP
RES UNITS
r PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE . SO,ET FLOOR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID i
ROOF SHEATHING BUILDING USE
APPLY NOROOFING UNTIL ABOVE HAS BEEN SIGNED - - REs IND CON PB OIhr,
FINALS DATE INSP. ❑ 11 El El ElROUGH SAN.N ASSESSORSPARCELNO
PLUMBING' ELECT.ENERGY '
TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO, - PARCEL No
MECHANICAL PLUMBING
N ENE
RGY
ELECTRICAL MECRBUILDING ENERGY ACC DATE ACC,FILE NO, T
FRAMING
INSULATION ELECT,FINAL TEST.
GAS TEST PLUMBING zoNWc ENG.SITE NO,
GAS - •
• , MECHANICAL .FIRE SPRINK ENERGY T.]i -
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ ❑ �❑
EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE
INTERIOR SHEAR - FIRE DEPT. '�' Y ❑ N❑ v (] N❑ t,
SHEETROCK, GRADE
EXTERIOR LATH . FEE SUMMARY
BUILDING
- ' INTERIOR LATH TEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC
PLAN CHECK .
NO TAPE ORPLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY .. SEISMIC FEE
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR.
MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC /`S =1
I—� ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLEASE GI,VE JOB ADDRESS WHEN PHONING. Pwmemc
— SEE PERMIT FOR, EXPIRATION DATE — MECHANICAL
r IMPORTANT! CONST:TAX
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. TOTAL
OFFICE COPY ',
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES.- USE BALL POINT PEN ONLY
-1: 13 iLOINGRROJECT IDENTIFICATION -PERMIT NUMBER
uILDING
APPLICATION & PERMIT '` 4400
pO/O DRESS . BUILDING -ELECTRICAL-PLUMBING-MECHANICAL r
OWNER'S PLAN CHECK VALIDATION
AE OT�yI, ELECTRIC PERMIT FEE
VNONE / �f
"--" CON q TORS
N Mg a
//--- . UTLETS-SWITCHES-RECEP 10,00/1.00
IGHTING FIXTURES 10.00/1.00 LIC.NO/,�
`
cONTHACTOH'I
X 1 APPLIANCES-RESIDENTIAL 4.00
-
Nco
PHONE PANELS 10.00 DATE OF APPLICATION
ION
r .PLAN CHECK FEE P.C.NO.
OR O - ILLS I reaaa$ PANELS (OVER 200 AMPI 20.00
ENGINEER
LIC.NO. SIGNS TRANS. 3.00
ARCH.OR ENG. PERMIT VALIDATION
ADORES I- t SPECIALCIRCUIT 5.00
.M1 k,-_F . S2r. nP?57 EMP.METER OR POLE INS. 20.00 /1 '
APPLICANTS MOTORS SEE FEE SCH.
ADDRESS
SERVICE CHANGE 20.00 / /'y�(�•+
w
02 LICENSED CONTRACTORS DECLARATION /././(/p a=7
< U I.hereby affirm that 1 am licensed under provisions of Chapter9 D, ISSUANCE DATE" x-
w<u (commencing with Section 7000)of Division 3 cf the Business and BLDG. ELECT. -PLG.- MECH.
F i Professions Code,��{f11it qqI license is in full tor�rey •f '1
z O fe- License fl.a O Lia Numbe Y32 ❑ '❑ ❑ 1
o N r� Dale = Contractor
`¢ m 2 a D�C - BUILDING PERMIT
M
< OWNER-BUILDER DECLARATION - INFORMATION
wo A. D MISC.- D .
3 u H I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT.
Huy J Law l'or the following reason.(Sec.703LS,Ousinessund Professions PERMITISSUANCE 10,00
y Code:Any city or county which requires a permit toconstrucq alter, - " .
Q p improve,demolish,or repair any structure,prior to its issuance,also ELEC CONTR. IC.NO.LELEC.
O Ie requires the applicant for such permit,to file a signed statement(hat TOTAL �V PERMIT TO p,-
w$ he.is licensed pursuant RI the provisions of the Contractor's License
H r Law(Chapter 9(commencing with Section 7000)of Division 3 of the
io Business and.Professions Code)or that Ile is exempt therefrom and CITY. PLUMBING PERMIT FEE
Ec H $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
5,: any applicant for a permit subjects the upplicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 '
of not more than five hundred dollars($500).): -,
❑ 1,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 as owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve- GAS-EA.SYSTEM-1 INCA OUTLETS 6.00
mends are not intended or offered Ior sale.If,howevm,the building s-
or improvement is sob within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA) 200 BUILDING USE
barber will have the burden of proving tbaLh . . .
e did not build or int- RES IND CON Pb Omar k
prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00
❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code'.)-he Contractor's License Law does nofapply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for Such projects with-contractor(s)licensed pursuant to SEWER-SAN ITAR V-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
the Contractor's License Law.
❑ Iam exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00
as.nI ll
Owner Date WATER SYSTEM 5.00
ACC.DATE ALC.FILE NO,
WORKHRS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 f
I hereby affirm(hat I have a certificate of conserd to self-insure. ZONING ENG.SITE N0.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.C.).c •�,,{, -
Policy No. Company "�t�nq /✓�A
Q ❑ Comilied copy is hereby Blrnjah FIRE SPRINK ENERGY T$4
Z Z )Q Certified py a file + t cjy inspection division. MISC.- REFER TO ORD.
O ApplicanC - Y C] NE] Y❑ N[3
lL `� CE'IG1ICATI?OP EXEMPTION FROM W KE PERMIT ISSUANCE -10.00 FLOOD ZONE ALOX.
C.
LU COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG,
CL O (This section need slot be completed if the permit is for one - 'TOTAL Y❑ N C] Y❑ N[3
0 Z hundred dollms($100)or less.)
U O I certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- 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.
i Date Applicant - ALTER OR ADD TO MECH. 5.00 BUILDING
} m NOTICE TO APPLICANT: IL after making this Certificate of Ex- -
F ? emplion,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you most forthwith comply with FEE sal
'U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.); 4.00 .
f
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IQOOOGPRM.) 6.00 SEISMIC FEE
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the•perfonnance or the work 1'or which(his permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ.C.l.
Lender's Name
Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
-
f certify that I Im,c 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 slate 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 order upon the BOILER-COMP(Over 700,000 BTU)SEE FEE SCH. MECHANICAL
ry above-mentioned properly for inspection purposes.
(We) agree to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD,
Cupertino against liabilities,m encs, costs and expenses which CONST.TAX
May ' way aceto s•'' s said City in consequence of the PERMIT ISSUANCE 10.00
r m80 Isp - ME CH.CONT. LIC.NO. MECH.
/2- TOTAL TOTAL
i -[oleo
Spplica 1Contractor Date
OFFICE COPY