18837POST THIS CARD NEAR FRONT OF BUILDING ','
OF CUPERTINO `^
RMI;NUM9Eq v
:CITY
1$$3?
INSPECTION DIVISION .
.
JOB INSPECTION:RECORD
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ADDRESS '� (�+{D IOC�i/(�
PERMIT. EXPIRATION
'JOB �L-y`
UNIT[ #f - _LOT#
_
owNER I' .l�- CONTRPCTO S'�. e2C�
T EXPIRE
S NPERMOT STARTED WITHRIN
188 DAYS OF PERMIT ISSU.
ANCEOR 180'DAYS FROM
LAST CALL ED I NSPECTI ON.
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INSPECTION DATE INSPECTOR
INSPECTION RECORD
FOUNDATION
----7
'
NOTE: :'".r: 'r
ALL�GRADING AND DRAINAGE SHALL BE INSTALLED
TO'COMPLY WITH THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS.
LIFER' "
.PREGUNITE " -
P N9IT VALIDATION
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLAB
PLUMBING
'. ELECTRICAL
'
ISSUANCE+DATE
MECHANICAL'
^
dLOG. EJECT.
PLc MEL".
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
., -
�!aSi9litlO
BUILDING PERMIT
INFORMATION
WOOD FLOORsly}^6f
PLUMBING
LunnON;.•
SIFT.
MECHANICAL
ELECTRICAL
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P I r0�
.FRAMING
INSULATION ' "•
STORIES
T.vPE,coNSTR
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L'
}'
e -OCC. GROUP y
RES. UNITS
PLACE NO'SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
+
'•' - 'ROOF
NOTE: NO FINAL INSP. SHALL' BE MADE BEFORE!
THE CONSTRUCTION TAX IS PAID, _
-
SID FT„FLOOR ARBA
TOTAL ACREAGE
DIAPHRAGM, "
• ROOF SHEATHING
ew LOING USE
a
res' NO,, CON PIT . •otR,
❑"❑ ❑' '❑ ❑
'APPLY NO'ROOFING UNTIL ABOVEHASBEEN SIGNED
FINALS' "'DATE” ;,'INSP:-.
ROUGH
SAN.#,
A_s LSSORSPARCELNO.
PLUMBING
ELECT. ENERGY 7•'
TUBS & SHOwERIPANPLUMBING
ENERGY
,` rHAcrwo.
'
PARCEL No
'ACC
MECHANICAL. - _
MECH. ENERGY"
ELECTRICALBUILDING
ENERGY
ACC.OATE
.PILENO +
FRAMING .
ELECT. FINAUTEST
INSULATION'-
PLUMBING _
ZONING
NG. SITE NO.
GAS"TEST. "-
GAS
}
'
MECHANICAL
FIRE SPRINK
❑ N ❑, `.
ENERGY T 2
Y,❑ N❑
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING -
EXTERIOR.SHEAR
ELECTRICAL RELEASE
Fy'a zgNE
Y ❑ '' N❑l.
.aL.0 c:
Y ❑; N❑
INTERIOR SHEAR"
FIRE DEPT:' ' „
SHEETROCK _
GRADE.
FEE SUMMARY
EXTERIOR LATH-
BUILDING
'BUILDING
INTERIOR LATH'.
TEMPORARY APPROVALS,
SCRATCH GOAT
ELECTRIC
PLAN CHECK
•'.'f
. .. ..
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY^
SEISMIC FEE
OCCUPANCY OF BUILDING ISNOT PERMITTED_UNTIL BUILD ING FINALISSIGNED BY BUILDING INSPECTOR'
MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505;'
ELECTRIC .'
ONE WORKING DAY,BEFORE REQUIRED INSPECTION-
.
PLEASE GIVE 'JOB;ADDRESS', WHEN PHONING.
PLu.nnelnc
MECHANICAL'.
j
—7,
— SEE PERMIT FOR EXPIRATION DATE `—
IMPORTANT]'
CONST. TAX
' PLEASE READ REVERSE SIDE' BEFORE ''
CALLING FOR. FINAL INSPECTION
TOTAL.
• w OFFICE COPY.: •, ..
I
APPLICANT TO FILL IN INFORMATION WITMIN'REC1' LINES -.USE BALL POINT PEN ONLY
BU I LDING PROJECT, I DENTIFICATI ON
,r' " I - -
APPLICATION & :PERMIT
BUILDING=ELECTRICAL- PLUMBING -MECHANICAL
, PERMIT NUMBER
o J
BUT
(J' q.
BUILDING
ADDRESS
a-33��r�; -
OWNER'S i
NAME
M0. ^1t r^ to "DTV.
AISti I' v.ONQLig"
_ --
ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION,
k
,
CONTRACTOR'S
NAME _
OUTLETS-SWITCHES-RECEP 10,00/1.00'.'?
"'. uC NG51
-
- LIGHTING FIXTURES. 10.00/1:00
CONTRACTOR'S
ADDRESS - IL1-t
APPLIANCES, -RESIDENTIAL I' 4.00
o
I PHONE a-680
DATE OF APPLICATI ON -
' PANELS 10.00
ARCHITECT -
OR
ENGINEER
LICsO.
PANELS (OVER 200 AMP( - 20.00
PLAN CHECK FEE P.C. NO. '
_
"
SIGNSTRANS:;; 3.00
ADDH, ORRESS ENG.
ADDRESS p
+ ZIP -
SPECIAL CIRCUIT - 5.00
,P tdlT VT 10Z -
5�
/)'r ,(
EMP. METE_RfOR POLE INS. 20.00
APPLICANT'S.
ADDRESS -
- - MOTORS SEE FEE SCH.
SERVICE CHANGE20.00 ''
• ''
;•'/�(y/�(I_
LICENSED CONTRACTORS DECLARATION
,
�, , a ..-.n.n
I hereby affirm that I am licensed under provisions' of Chapter 9"
(commencing with Section 7000) of Division 3 of the Business and
Professions Code, and my license is in full force apd effect.
License Class C?,(. Lic. Number 5W71 LJ
Date JL -S- Contmet. .
ISSUANCE DATE 4
"BLDG.- ELECT. PLG. MECH.'
❑ ❑ '
-
BUILDING PERMIT '
INFORMATION
OWNER -BUILDER DECLARATIONI"
I hereby affirm that 1 am exempt from the Contractor's License
Law for the following reason. (Sec. 703 1.5, Businessand Professions
Code: Any city or county which requires a permit to construct, alter,
r
'MISC. - . °`�l E RL'f0 ORD
PERMIT ISSUANCE 10.00
VALUATION
,)$/FT.
ELEC. CONTR. LIC. NO.. ELEC..'j,-
' ' ' ' TOTAL 1
improve, demolish, or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that
he Is licensed pursuant en the provisions of the License
PERMIT TO -
9 (commencing sionswith that he is e.cmf t Division the
) of
Law fess ad
Business and Professions Code) or that he is exempt nd
QTY. PLUMBING PERMIT FEE
Section
by any applicant
by basis for the alleged exemption. Any violation of Section enilty
an fee five permit subjects the 0).): anttoacivilpenilty
of not more than five dollrty, rs
STORIES,
-
TYPE CONSTR.
'
ALTER-DRAIN-WATER(EA')5.00
the prop
❑' I, as owner at the property, b wor employees with wages as
army amp
their sole compensation, will the work, and the structure is not
BACK FLOW PROTECT. DEVICE 4.00
OCC. GROUP
�, RES. UNITS
DRAINS -FLOOR, ROOF; AREA, COND. 5.00
intended or offered for sale (Sec. 7044, Business and Professions
(S
Code: The Contractor's License Law does not apply loan owner of
'
FIXTURES -PER TRAP • 5.00
GAS- EA:SVSTEM - I INC. 4OUTLETS 6.00
SD; FT. FLOOR AREA
yTOTAL ACR EAGE.
-
property who builds or improves thereon, andel to does such work
himself re through his own employees, -provid ed that such improve -
nts however, the
notnt
or improvemeis within one year thebuilding
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that he did not build or ire-
prove for purpose of sale:). -RES.
❑ I, as owner of the property, am exclusively contracting with
GAS "- EA. SYSTEM - OVER 4'(EA.) 2.00 '
� BUILDING USE
IND ;CON PB Orbe,
❑_x ❑, ❑ , ❑, ❑.
' INDUSTRIAL WASTE INTER.., 30.00
licensed contractors to construct the project (Sec. 7044, Business
and Professions' Cade: The Contractor's. License Law does not apply
to an owner of property who builds or improves thereon, andwhoLAWWSPRINKLERS
- LAWN' SPRINKLERS- 1 INC 5 V.B. -6.00
-OVER 5 MAY 1.00
- g55E550R5 PARCEL NO.
-
contracts for such projects with a contractors) licensed' pursuant to
the Contractor's License Law., '
SEWER-SANITARY-STORMEA.200ft/10.00
TRACT NO.'
PARCEL NO.
❑ I am exempt under' Sec:' ,BA P.C. for this
reason
WATER HEATER W/VENT 6.00
Owner UutC
WATER SYSTEM - 5..w 31,00
. ACC. DATE, :".
•, ACC. F ILE W.
WATER TREATING EQUIP. 5.00
-
- WORKERS'COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of.cursent to self -insure.
or a certiflcnle of Workers' Compensation Insurance, or a certified
copy thereof (Sec 3800 Lab.C.).
Policy No\O$.O6'�Cd�tQlmy g -r e rmolo
+ 4
P
ZONING _
- �, . .
.• y ,�
'
,ENG. SITE NO.
• - '
❑" Certified copy is hereby furnished. +
L3Certified copy is filed with the city inspection division.
Applicant
.,.'+
I4.FIRESPRINK
V ❑. N.❑.
ENERGY T-24
,.. V ❑ N❑
MISC: -- REFER TO
�: ORD. -
(CERTIFICATE OF EXEMPTION FROM WORKERS'
PERMIT ISSUANCE
"' FLOOD ZONE
+' A.L.U.C.
' COMPENSATION INSURANCE - -
(Toil: section need not.be completed if the permit is,for'one
v ❑ N ❑
v ❑ N❑
PLG.CDNTR. �.. LIC. NO. PLG.: "
6$ p TOTAL
hundred dollars(S 100) or less.) ,-..
-
I certify that in the performance, of lire work for which this per-
. mit is issued, I shall not employ any person in any, manner so as to
QTY'. M CHANICAL PERMIT EE
•,.� ,
FEE SUMMARY
BUILDING
become subject to the Workers' Compensation' Laws of California.
Date 'Applicant' `-
. ALTER OR ADD TO MECH.. 5.00 ',
"
NOTICE TO APPLICANT: If, after ranking this Certificate of Ex-
APPLIANCE , 5.00 :
AIR HANDLING UNIT (TO 10OODOF.M.) 4.00 +:
PLAN CHECK
'FEE '
emptionj you should become subject n6the Workers' Compensation
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT (OVER 10p00C.RM.16:00 "
"SEISMICFEE
- CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for
EXHAUST HOOD (WITH DUCT) 15.00
- - _ -
the performance of the work for which this permit is issued (Sec.
3097, Civ.CJ:. ..
'MICROFILM '
,
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's No
HEATI NG UNIT IDV ER 100,000 B.T.U.) 9.50
ELECTRIC -
r
Lender's Address'•
VENTILATION EAN;(SINGLE) 4.00
applicatiou'and stale that the above
I certify that l have read this 90 comply with all city and county
information is correct, Iagree
ordinances and state laws' relating to building construction, and
PLUMBING:; /'�
-
BOILERr COMP(3 H.P.or 100,000B.T.U.) 6.00
BOILER -COMP (Over 100,000 BTU( SEE FEE SCH.
-
MECHANICAL
hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
MISC. = r ` REFER TO ORD. .
o save, indemnify and keep harmless the City of
st liabilities, judgments, costs and expenses which
y accrue 'against said City in consequence of the
.. CONST. TAX
PERMIT ISSUANCE 10,00 -
Linany
¢rmitMECH.
TTOTAL
plicant Contractor Dare
CONT- - LIQ NO.
i I
OFFICE COPY
C