15216_ POST THIS CARD NEAR FRONT OF'BUILID ING
CITY`.OF CUPERTINO
INSPECTION DIVISION
JOB INSPECTION RECORD
JOB ADDRESS 10991, North De Anza Blvd. UNIT# _LOT#
•
OWNER Mariani Develo ment CONTRACTOR
PERMIT NUMBER -
521
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
IS NOT STARTED 'WITHIN
180 DAYS OF PERMIT ISSU- '
OR 180 DAYS FROM
LASTCALLED INSPECTION.
+
INSPECTION DATE INSPECTOR
INSPECTION RECORD
FOUNDATIONANCE
NOTE:
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS.
- - •
LIFER -
PR EGUNITE
J Pr. RMIT nLmpnON
;V JlY^f'- -•",, _ ! •.
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-
ISSUANCEUATE
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
- -
' UNDERGROUND/SLAB
PLUMBING
ELECTRICAL
MECHANICAL
BLDG ELECT: I PLG. MECH.
El 1:1❑ '
BUILDING PERMIT
INFORMATION
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
�``�
6t
WOOD FLOOR
ALUA TION
y
SIFT.
PLUMBING
MECHANICAL•
ELECTRICALA.
PERMIT TO
.%•"%✓LT`f ay,�, �,.4%J(-•A
FRAMING
INSULATION -
STORIES
TYPE CONSTR.
-
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
OCCGROUPRES
UNITS
ROOF
NOTE'. NO FINAL INSP. SHALL BE MADE BEFORE
THE CONSTRUCTION TAX IS PAID
-
SO FT FLOORAREA
TOTAL ACREAGE ,
DIAPHRAGM,
ROOF SHEATHING
BU'ry oUSE
RES IND Q PB on..•,
❑ ❑' El If i
❑
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
FINALS DATE INSP.
nssessoas PARCEL No.
ROUGH
SANA
PLUMBING
ELECT. ENERGY
TRACT NO
PARCEL NO
I ,
TUBS & SHOWER PAN
PLUMBING ENERGY
MECHANICAL
MECH.ENERGY-
ELECTRICAL -
BUILDING ENERGY
ACC.OATE
ACC. FILF.'NO
FRAMING
ELECT. FINAL TEST
zoNlrvc-
ENc. SITE No.
INSULATION
PLUMBING
GAS TEST - -
GAS -
FIRESPRINK
Y ❑ N❑
ENERGY T 2
Y ❑ NQ
'-
MECHANICAL 2
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING
FLOOD ZONE
.Y ❑ N❑
A.L u.a.
Y ❑ N❑
EXTERIOR SHEAR _
ELECTRICAL RELEASE
INTERIOR SHEAR
FIRE DEPT.
SHEETROCK -
GRADE
FEESUMMARY
EXTERIOR LATH
BUILDING
BUILDING
,? ;
INTERIOR' LATH
TEMPORARY APPROVALS,
SCRATCH COAT
ELECTRIC
PLAN CHECK.
•
GAS
SEISMIC FEE
r' 4
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY
OCCUPANCYOF BUILDING IS NOT PERMITTED'UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
MICROFILM
ARRANGE,FOR'INSPECTION BY'PHONING 252-4505,
11 ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z
—SEE PERMIT FOR EXPIRATION DATE -
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE.
CALLING FORTINAL INSPECTION.
TOTAL
OFFICE COPY
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APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
ILOI NO PROJECT IDENTIFICATION
-
APPLICATION &PERMIT
BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
PERMIT NUMBER _.
q [ L+.
I J �J
ADDRES -
AOORF55
OWNER'S
NAME
COKIP PHONE y/�•
OTY. ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
NAM,ERAcroRs
OUTLETS -SWITCHES -RECEP 10.00/1.00
ILIGHTING FIXTURES 10,00/1.00
Vr N uc. No.q3_7QAJL
DATE OF APPLICATION
CONTRACTORre -
AOOREss
. t1J4r%IftN PHONE
PPLIANCES-RESIDENTIAL 4.00
PANELS 10.00
ARCHITECT
OR
ENGINEER
LIC. No.
PAN ELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P. C. NO.
^/
SIGNS TRANS. 3.00
ADDDRESS Ervc' _
zlv
SPECIAL CIRCUIT 5.00
PERMIT V LI'' ,I,ON
L� y
EMP. METER OR POLE INS. 20.00
APPLICANT'S
ADDRESS-
MOTORS SEE FEE S.C.H.
SERVICE CHANGE 20.00
'
LICENSED CON'T'RACTORS DECLARATION
'
I hereby affirm that 1 am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and
Professions Code, anq my license is in full lorce�'Iy e t.
License Class.Q l Lie. Number. 7
ISSUANCE DATE
BLDG.
ELECT.
1
PLG. MECH. ,
❑
S Date 0" Contractor.
-
I NG PERMIT
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OWNER -BUILDER DECLARATION
1 hereby ctire ollo That 1 apt exempt 031.5 the ices, Contractor's License
Law fornycit followingreason.h.ch re quires a permit tocnd Professions
Code: Any miry or county which sequiture permit to construct, issuance, aeq
requires, he applic Or fop arc any rmit tole,e. si n T1saemnt talsohat
requires the applicant for such permit to file a signed statement that
he is licensed pursuant to the provisions of the Contractor's Licenser'77r4-�
Law (Chapter 9(commencing with Section 7000) of Division 3 ofthe
Business and Professions Code) or that he is exempt therefrom and
ORMAT10N
MISC.- REFER TO ORD
PERMIT ISSUANCE 10.00
VALUATION
r
$/FT.
ELEQ CONTR. LIC. NO.
ELEC.
TOTAL ��
PERMIT r0
S ✓C.a%
OTY, PLUMBING PERMIT FEE
STORIES
TYPE CONSTR.
the basis for the alleged exemption. Any violation of5ection 7031.5
. by any applicant for a Permit subjects the applicant too civil penalty
of not more than five hundred dollars (S500f):
ALTER-DRAIN&VENT-WATER , (EA.) 5.00
❑ I, as owner of the property, or my employees with wages as
their sole compensation, will do the work, and the structure is not
BACK F LOW PROTECT. DEVICE 4.00
DCC. GROUP
REB. UNITS
DRAINS -FLOOR, ROOF, AR EA, COND. 5,00
intended or offered for sale (Sec. 7044, Business and Professions
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
SO. FT. FLOOR AREA
TOTAL ACREAGE
himself or through his own employees, provided that such improve-
meats are not intended Or offered for sale. if, however, the building
GAS-EA.SVSTEM-11NC.40UTLETS fi.00
or improvement is sold within one year Of completion, the own
builder will have the burden of proving flint he did not build or i.
prove for purpose of sole.).
O as owner of the property, am exclusively contracting with
GAS - EA. SYSTEM - OVER 4 IEA.) 2.00
BUILDING USE
RES IND 'Cory PB Oder
ElEl❑,_ 11 1:1licensedd
INDUSTRIAL WASTE INTER. 30.00
LAWN SPRINKLERS -I INC 5 V.B. 6.00
LAWN SPRINKLERS -OVER 5 (EA.) 1.00
ASSESSORS PARCEL NO.
contractors to construct the project (Sec. 7044, Business
and Professions Code: The Contractor's License Law does not apply
In an owner of property who builds or improves thereon. and who
contracts for such projects with a contractoos) licensed pursuant to
lire Contractors License Law.
S EWER -SAN ITAR V -STORM EA. 200ft/10.00
TRACT NO.'
PARCEL NO.
WATER HEATER W/VENT 6.00
❑ I am exempt under SED., B.&P,C, for this
reason
Owner Date
WATER SYSTEM 5.00
ACC. DATE
ACC. FILE NO,
WORK ERS'COMPENSATION DECLARATION
WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of Consent to self -insure,
or a certificate of Workers' Compensation Insurance, or a certified
ZONING
-ENG. SITE N0.
.
-
copy tire��egql1.���ef{'',�3j1QQQr I.A.C.l. (IIT �N
PnllcyNAyU9LL7`YJ 1pany01
-
FIRE SPRINK
ENERGY T -I4
v ❑ N❑
❑ Cerlilied copy is rereby furnished.
§p Certified Sop I fle��jth }h' e't rspo' io Wslml.
/ Applicant_,j''!%[lMijJ00.'d�"BL$�-B➢YL't'D IMrTif.
MISC. - REFER TO ORD.
CERI'1171CATI: OF EXEMPTION FROM WORKERS'
PERMIT ISSUANCE 10.00
' A.L.u.C. '
PLG. CONTR. LIC. NO.
PLG.
TOTAL
COMPENSATION INSURANCE
0 his section need not be completed if the permit Is for one
❑
Y N❑
CITY. MECHANICAL PERMIT FEESUMMARY
-
hundred dollars f 8100) or less.)
1 certify that in the performance of the work for which this per.
mit is issued, 1 shut not employ any person in any manner So as to
MBUILDING
o
(�Date
become subject to the Workers' Compensation Laws of Calitornia.
Applicant
ALTER OR ADD TO MECH. 5.00NOTICE
TO APPLICANT: If, after making this Certificate.of fix-
emplion, you should become subject to the Workers' Compensation
APPLIANCE 5.00
Kprovisions
of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
AIR HANDLING UNIT (TO 10=C.F.M.) 4.00
AIR HANDLING UNIT(OVER I0=C.F.M.) 6.00
EI
EXHAUST HOOD (WITH DUCT) 5.00
HEATING UNIT (TO 100,000 B.T.U.) 8.00
M
hereby affirm that there is aconstruction lending agency for
the performance of rhe work far which this permit is issued (See.
3097, Civ C.).
HEATING UNIT (OVER 100,000 B.T.U.)9.50
ELECTRIC
Lender's Name
Lender's Address
I certify that I have read this application and stale that the above
information is correct. I agree to comply with all city and county
ordinances and state laws relating to building Construction, and
VENTILATION FAN (SINGLE) 4.00
PLUMBING
BOILER- COW 13. H.P. or 100,000 B.T.U.) 6.00
BOILER -COMP love, 100.000STU) SEE FEE SCH.
MECHANICAL
hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes. -
(We) agree to save, indemnify and keep harmless the City of
Cupertino against liabilities, judgments, costs and expenses which
may in any way accrue against said City in monsequenc of [he
rantingof this permit
i/ ��
MISC. - REFER TO ORD. .
CONST. TAX
TOTAL
p
c// (�
PERMIT ISSUANCE 10.00
MECH.CONT. ', LIC. NO. MECH.
TOTAL
Signature o Applicant Cmllraclor Dater-
OFFICE COPY