18742 POST THIS CARD NEAR,FR,ONT OF BUILDING.
PERMIT NUMBER
CITY OF CUPERTINO 1 $?42
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS '(V LJ / !�L/ �' ' "�` UNIT# _LOT#"
/ PERMIT EXPIRES IF WORK
OWNER • /� CONTRnCTOR L�I'F / 1 1�;,NOTj STAit78b WITHIN
I SPECTION DATE INSPECTOR INSPECTIONRECORD 80 DAYS OF PERMIT ISSU-
FOUNDATION - - - ANCE OR 180 DAYS FROM
NOTE:
UFER � � ALL GRADING.AND DRAINAGE SHALL BE INSTALLED �� LASTCALLED INSPECTION.
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF •PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL ! ISSUA'NCE.DArr.
MECHANICAL BLDG. ELECT vLc. MECR.„
❑ ❑ ❑ ❑:
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR - INFORMATION
VALUATION SIFT.
PLUMBING
MECHANICAL -
ELECTRICAL ,� PERMIT TO
PAID:. . Ia L 1c r m;,, i
FRAMING '
INSULATION 51989 _ sraRlEs TYPE CorvsrR.
OCTV !`�' _ OCC.GROUP RES UNITS
City of Cupertino
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
• ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO.FT FLOOR AREA TOT AL.ACREAGE
DIAPHRAGM ,THE CONSTRUCTION TAX IS PAID,
BUILDING USE
ROOF SHEATHING RES ' IND CON BE O'E"
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED' FINALS - DATE INSP. ❑ E-1 ❑ 'F-1 ❑
ASSESSORS PARCEL NO
ROUGH SAN.N
PLUMBING ELECT.ENERGY
_
TUBS&SHOWER PTRACT NO AN PLUMBING ENERGY PARCEL NO
MECHANICALS MECR ENERGY - '
ELECTRICAL BUILDING ENERGY ACC DATE ACC FILE NO
FRAMING ELECT.FINAL TEST
INSULATION PLUMBING ZONING ENG,SITE NO.
' '
GAS TEST GAS
MECHANICAL FIRE SPRINK ENERGY T 24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING N[]
EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A .0 C"
INTERIOR SHEAR- _ FIRE DEPT. '
Y N� L-1 N�
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC . PLAN CHECK `
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BYBUILDING INSPECTOR. MICROFILM ,
V
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC !
F ONE WORKING-DAY BEFORE REQUIRED INSPECTION. PLUMBING
o PLEASE GIVE JOB ADDRESS WHEN PHONING:
Z 'MECHANICAL
- SEE PERMIT FOR EXPIRATION DATE -
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL �+
CALLING FOR FINAL' INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN,INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
IL DING PROJECT I DENT(FICATION PERMIT NUMBER
BUe,DING APPLICATION & PERMIT Q r] A
ADDaESs I,. O 1 4F
/ UILDING—ELECTRICAL—PLUMBING—MECHANICAL
O N 'S PLAN CHECK VALIDATION
r°M OTY. ELECTRIC PERMIT FEE
• 1DNE
CONTRACTORS p
NAM / OUTLETS=SWITCHES-RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
ICONTHACTOR�Sjf - APPLIANCES-'RESIDENTIAL 4.00
A
vHOrvE 3 J PANELS 10.00 �dDATE OF APPLICATION
ogcHlrecr PANELS (OVER 200 AMP) 20.00 I: PLANCHECKFEE P.C.NO.
ENGINEER
LIC.No. SIGNS TRANS. 3.00
AAn CH OR DDRESS ENG. SPECIAL CIRCUIT - 5.DD PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
AILIS
ADDRESS - MOTORS SEE FEE SCH:
GA
SERVICE CHANGE , 20.00 .
002 -LICENSED CONTRACTORS DECLARATION
a U U . I hereby affirm Ihal I in.licensed under provisions of Chapter 9 PAID
- ISSUANCE DATE
y¢ H (commencing with Section 70001 of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
H N z Professions Code,and my license is in full force and effect. -
0 Z w License Class Lin. ac Our CT r. 1989
FNH J Uatc Contractor
¢ s J - BUILDING PERMIT
, 2 ¢ OWNER-BUILDER DECLARATION
a G u,u INFORMATION
w ;W w I hereby atl'Irm that I um exempt from the Contractor's License MISC.— Ci FER TO ORD vALunnON
Fu0¢ Law for the following reason.(Sec.703L5,eusinessund Professions PERMIT ISSUANCE ,iGr66 .W...
Code:Any city or county which requires a permit to construct,alter, -
Ny
2 ¢ ¢ o' improve,Demolish,or repair any structure,prior to its issuance, CONTR. LIC.NO.
uncc,also ELEC. fG
D t< requires the applicant for such permit to file a signed statement that TOTAL L•-.411 PERMITTO
u w
As he is licensed pursuant To the provisionsof The Contractor's License '
Law(Chapter 9(commencing with Section 7000)of Division 3 oft he
— ¢ Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT - FEE.
¢ t the basis for the alleged exemption.Any violation ol'Section 7031.5 STORIES TYPE CONSTR.
a. by any applicant fora permit dollarsthe licant ton civil penally ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred
op Dollars($500).):emp
❑ Las owner at the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
their sale compensation,will(S the work,and the structure is not
intended or offered for Luce(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,GOND. 5.00
Cade:The Contractor's License Law not apply t0 an owner of
properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 sa PT.FLOOR AREA TOTAL ACREAGE
.
himselforthroughintends ownemployees,for
provided that such the
improve- GAS-EA.SVSTEM-1 6.00
mems are not intended Or offered for sale.If,however,[he building
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not buil)or int- RES IND CON PB' ' Other
prove for purpose of saleJ. INDUSTRIAL WASTE INTER.. 30.00
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ . ❑
licensed Contractors 10 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(hereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1,00 f
contracts for such projects with a contractorts)licensed pursuant Io SEWER-SANITARY-STORM EA.200tt/10.00 '
The Contractors License law. TRACT NO. PARCEL NO.
❑ I am exempt under Sea ,BAP.C.lir this WATER HEATER W/VENT 6.00
reason
Owner Dale WATER SYSTEM 5.00
ALG DATE ACC,FILE NO.
WORK ERS'COM PENSATION DECLARATION WATER TREATING EQUIP, ) 5.00
I hereby affirm that I have a certificate of consent to sel Pinsure.
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.L
Policy No. Company
Q ❑ Certified Copy is hereby furnished. 'FIRE SPRINK ENERGY T 24
Z ZO Cl Certified 4/'/n fl with t y inspection division. MISC.- REFER TO ORD. - ❑ ❑ ❑ ❑
Applicant_r_,p_-,� V N Y N
~ va NIPERMIT ISSUANCE 10.00
Lr — CIiR'fI PICA'I'E OE IiXF.M ION FROM WORKERS' FLOOD ZONE A.L.U.C.
W �_ COMPIiNSATION INSURANCE PLG.CONTE. - LIC.NO. PLG. y❑ N❑ v ❑ N❑
CL O (This section need not be completed if The permit is for one TOTAL
0 Z hundred dollars IS 100)or less.)
L) O I certify that in The performance of the work for which this per- DTV. MECHANICAL PERMIT - FEE FEE SUMMARY
LL I— mit is issued,I Shull not employ any person in any manner so as to
Ow become subject to the Workers'Compensation Laws of California. BUILDING
IL Date Appl'cart ALTER.OR ADD TO MECH. 5.00 .
} 0 NOTICE TO APPLICANT: If,after making this Cerlificati of Ex-
F Z emptier,you should become subjecl To the Workers'Compensation APPLIANCE .5.00 PLAN CHECK
provisions al' the Labor Code, you must forthwith comply with FEE
CJ such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDINGAGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE -
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(See. MICROFILM
3097,Civ.C.L I HEATING UNIT(TO 100,000 B.T.U.) .8.00
Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50es
Lender's Address ELECTRIC
1 certify but I have read this application and state tlTat the above VENTILATION FAN (SINGLE) 4.00
. information is correct. I agree to comply with all city and county BOILER H.P.or 100,000 B.T.U.) 6.00 PLUMBING
ordinances and stale laws relating to building construction, and
hereby authorize representatives of this city to cit er.upon the BOILER-COMP (Over 100,000 BTU)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 - PERMIT ISSUANCE '1D.00 CONST.TAX
may in any way cerate against said City In consequence of the
rantingofthisp mil MECH.CONT. LIC.NO. MECH.
I ,d2� TOTAL TOTAL ��•
Signature of Applicant/Cont clor Date I '
OFFICE COPY