13431 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY' OF CUPERTINO 13431
INSPECTION DIVISION
JOB INSPECTION RECORD'
PERMIT EXPIRATION
JOB ADDRESS CHARSAN LANE UNIT# LOT# 8 & 7
PERMIT EXPIRES IF WORK
OWNER MASTERS/ZANKICH CONTRACTOR STEVE ZANRICH YS NOT STARTED WITHIN
- INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OFPERMITISSU-
FOUNDATION - ANCE OR 180 DAYS FROM
LASTCALLED INSPECTION.
UFER
PREGUNITE - PERMIT VALIDATION
POUR N CONCRETE UNTIL ABOVE HAS BE N SIGNED �''
UNDERGROUND /SLAB 1
r
PLUMBING W,
ELECTRICAL A&
' E DATE
MECHANICAL - BLDG. I 1"IOCT. PLG. MECH.
❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED Buaowc PERMIT
INFORMATION
WOOD FLOOR VALUATION $/FT.
PLUMBING - / •�
MECHANICAL -
ELECTRICAL jj PERMIr ro
FRAMING - YPEC ON
STORIEESS TYPE CONSTR.
INSULATION'
OCC,GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
• ' SO.FT,FLOOR AREA TOTAL ACREAGE
ROOF
DIAPHRAGM
BUILDING USE
RE$ IND CON PB Olhm
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ 0 ❑
ASSESSORS PARCEL NO.
ROUGH
PLUMBING
TRACT NO. PARCEL N0.
GAS TEST -
MECHANICAL. • -
ACC.DATE ACC.FILE NO.
ELECTRICAL - FINALS DATE INSP. -
FRAMING SAN # ZONING ENG SITE NO.
INSULATION PLUMBING '
GAS
MECHANICAL FIRE SPRINK ENERGY T-24
Y NO Y ❑ NO
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED '` HEATING
FLOOD ZONE aL.0 c.
LATH-INTERIOR ELECTRICAL
N N�'
_ .
LATH EXTERIOR FIRE DEPT.
SHEETROCK GRADE I FEE SUMMARY
SHEAR INTERIOR BUILDING - -/
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING
FIREWALLS ELECTRIC PLAN CHECK
.. - GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR.INSPECTION BY PHONING 252-4505, ELECTRIC
Lu
ONE WORKING'DAY BEFORE REQUIRED INSPECTION. PLUMBING
o� PLEASE GIVE JOB ADDRESS WHEN PHONING.,
Z - MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
IMPORTANT!
CON ST.rnx
PLEASE READ REVERSE SIDE BEFORE TOTAL J
CALLING FOR FINAL INSPECTION.
OFFICECOPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DENTIFICATI ON PERMIT NUMBER
. MSoLDING _ APPLICATION & PERMIT
- aoORESS BUILDING-ELECTRICAL-PLUMBING -MECHANICAL
OWH''s PLAN CHECK VALIDATION
• "AME II [ OTY. ELECTRIC PERMIT FEE
7,-. (/ L PHONE ZS,J !)
CONTRACTORS
NAME UTLETS-SWITCHES-RECEP 10,00/1.00
NAME
J-gve LIC:NO. LIGHTING FIXTURES 10.00/1.00
CONTRACTORS
ADORE - PPLIANCES-RESIDENTIAL 4.00
(/
I g Q r-V PHONE '1 /7,JbPANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS(OVER 200 AMP) 20,00 PLAN CHECK FEE
on
ENGINEER
uc.NO. SIGNS TRANS. 3.00
ARCH.OR ENG. - PERM T,VALIDATION
ADDRESS
SPECIAL CIRCUIT 5.00
ZIP EMP.METER OR POLE INS. 20.00
APPLICANT'S
ADOREM
APPLICANT'S
1Y MOTORS SEE FEE SCH.
/
SERVICE CHANGE 20.00
w O o LICENSED CONTRACTORS DECLARATION i {"1��Cppe �Q 3
<u I hereby affirm that I am licensed under provisions of Chapter 9 rIM ISSUANCE DATE
< m (commencing with Section 7000)of Division 3 of the Business and
BLDG. ELECT. PLG. MECH.
F D. Professions Code,v my license is in full force end effect
z o�,- License Class Lic.Number ❑ ❑ ❑
o N D Dated,_�.p�y]__Contractor
Q y f j y "� ` BUILDING PERMIT
¢ ¢W a OWNER-B41LDER DECLARATI eN INFORMATION
MISC.- REFER TO ORD
`< 3 a H 1 hereby affirm Brill am exempt from the Contractor's License VALUATION $/FT.
w u O Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00
Ey Code:Any city or county which requires a permit to construct,alter,
a 2¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
A. -O BE requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License
ri> Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe
a Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE
ce $ the basis for the alleged exemption.Any violation of Section 7031.5 t STORIES TYPE CONSTR.
i ;- by any applicant for a permit Subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 .
of not more than five hundred dollars($500).):
❑ I,as owner of the properly,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
Cade:The Contractor's License Law does not apply to an owner of
. properly who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.06 So,FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-1 8.00
mems are net intended or offered for sale.If,however,the building
of improvement is sold within one year of completion,the owner GAS•EA.SYSTEM-OVER 4 (EA.) 2,00 BUILDING USE
builder will have the burden of proving that he did not build or im" RES IND CON PB Omer
prove for purpose of sale.). INDUSTRIAL WASTE'INTER. 30.00
❑ I,as owner of the property,am exclusively contracting with 11110 ❑ ❑
licensed 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 does not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO, PARCEL NO.
❑ l am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00
even
Owner Date WATER SYSTEM 5.00
ACC.DATE ACC.FILE N0.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that 1 have a certificate of consent to self-insure. ZONING ENG.SITE NO.
or a certifiewe of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.C.I `S �
Policy No. Company a �J-_nd
0 ❑ Certifiedcopy is hereby furnished. FIRE SPRINK ENERGY T 14
Z Z ❑ Certified filed with Ne ity inspection division. MISC.• REFER TO ORD.
O Applicant V ❑ N❑ V E] E]
~ rnPERMIT ISSUANCE 10.00 - FLOOD ZONE A.L.u.c.
CC CERTIFICATE 'XEMPT1ON FROM WORKERS'
LU _ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y❑ N❑ v E] N[]CL 0 (This section need not he completed if the permit is for one TOTAL
D Z hundred dollars(S 100)or less.)
0 O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mil is issued,I shall not employ any person in any manner so as to
O become subject to the Workers'Compensation Laws of Califomie.
0 W Date Applicant BUILDING �'Sa
a ALTER OR ADD TO MECH. 5.00
} w NOTICE pion,TO APPLICANT: If,after making this Workers'
Compensation
io
F Z 17
empision You should become subject to the Workers'Compensation gppLIANCE 5.00 PLAN CHECK
provisions io the Labor mit shall
you mus[ forthwith comply with FEE
U such provisions or this permit shall be deemed revoked.. AIR HANDLING UNIT(TO 10p00 C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10p00C.F.M.) 6.00 SEISMIC FEE of
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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ.C.l.
Lenders Name
Lender's Address HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I certify that I 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 BOILER-(XM4P 13 H.P.or 100,000 B.T.U.) 8.00 PLUMBING
ordinances and slate laws relating to building construction, and
hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,Oo0BTU)SEE FEESCH. MECHANICAL
above-mentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against Babilittes,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any way accrue against said City in consequence of the
Panting of this permit. MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL qO�
lure oA ;/CoSignaoD '
OFFICE COPY