172880
POST THIS CARD NEAR FRONT OF BUILDING
:PERMIT NUMBER
��. CITY OF ,CUPERTINO
172$$
` INSPECTION DIVISION
JOB INSPECTION RECORD
•
PERMIT EXPIRATION
�1 _
JOB ADDRESS �a.303 �jR'�.12.i% Gi1�-G
UNIT# _LOT#
RC
PERMIT EXPIRES IF WORK
OWNER I��^'� CONTRACTOR 5�
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU-
OR 180 DAYS FROM
INSPECTION DATE INSPECTOR
INSPECTION RECORD
FOUNDATIONANCE
NOTE:'
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
LASTCALLED INSPECTION.
LIFER
PREGUNITE
PERMIT VALIDATION
CUPERTINO, STANDARDS.
GARAGE SLABS -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLABTO��
r/
ISSUANCE UA. TE
PLUMBING L J- ,2F
ELECTRICAL. -
MECHANICAL. -
BLDG ELECT
I.
PLG . MecM.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
-
•
BUILDING PERMIT
INFORMATION
WOOD FLOOR
VALUATION siy
PLUMBING
MECHANICAL
ELECTRICAL
-
�^ PERMIT TO
k:�7 iA LAKY)°' ,IL'ii
FRAMING
INSULATION
STORIES
TYPE CONSTR.
DEC GROUP
-•
RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
NOTE: NO FINAL INSP. SHALL BE MADE BEFORE
THE CONSTRUCTION TAXJS PAID
' -
sD.FT. FLOOR AREA
TOTAL ,ACREAGE
DIAPHRAGM
BUILDING USE I.
ROOF SHEATHING
-.
RES IND CON PB, ORI- 1
11 I] ❑ 1
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
FINALS DATE INSP.
ROUGH
SAN.#
AS ESSO R6 PARC E L NO
-
PLUMBING
ELECT_ENERGY '
TUBS&SHOWER PAN
PLUMBING ENERGY
TNACI NO
PARCEL NO:
� '
FRENO,-
MECHANICAL
MECH.ENERGY
ELECTRICAL
BUILDING ENERGY
ACC.DATE
ACC.
FRAMING'
ELECT. FINAL TESTi
INSULATION
PLUMBING
ZONING
5
ENG SITE -NO.
GAS TEST
GAS
MECHANICAL
EIRE SPRINK -
"E3
ENERGY T.24
NF]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING
EXTERIOR SHEAR'
ELECTRICAL RELEASE
FLOOD ZONE
Y El .` "El
A:L UC. '
Y L,, N❑
INTERIOR'SHEAR
FIRE DEPT.
SHEETROCK
GRADE
FEE SUMMARY
EXTERIOR LATH
BUILDING
BUILDING
E �/
INTERIOR •LATH G' �'�
TEMPORARY APPROVA S
SCRATCH COAT
ELECTRIC
PLAN CHECK
FEE -
1�r.
-
GAS '
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY
SEISMIC FEE
�6
OCCUPANCYOF BUILDING ISNOTPERMITTEO UNTIL'BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ELECTRIC
L71 JQ
F ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLUMBING
.
z PLEASE GIVE JOB ADDRESS WHEN PHONING.Z:00
MECHANICAL
2 '
= SEE PERMIT FOR EXPIRATION DATE—'
CONST. .
IMPORTANT!'
TOTAL
PLEASE READ REVERSE SIDE -BEFORE
CALLING FOR FINAL INSPECTION.
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OFFICE COPY ' '
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APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
8 ILDING PROJECT IDENTI FICATION
'APPLICATION&PERMIT
BUILDING —ELECTRICAL— PLUMBING —MECHANICAL
.vERMITNUMBER
� Q
1 U
17288
BVIEDC
pOR"`_2 j 3 Dei/ r je
O A/ C � N•
OWNERS , �
NAME
G- C.? _NL�`/6roi37
(
OTV. 'ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
,
DATE OF APPLICATION'
CONTRACTORS
ONTACTOR -
NAME
LIC, NO,
UTLETS-SWITCHES -AECEP 10.00/1.00' t
OX ILIGHTING FIXTURES 10.00/1.00 JLVOO
CONTRA
ADDRESS Ons
'"JBtZ e� PHONE 39S
PPLIANCES-RESIDENTIAL 4.00
PANELS - 10.00
ORRCHITECT
ENGINEER
LIC. NO,
PANELS(OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
ARCH. OR ENG.PERMIT
ADDRESS
SPECIAL CIRCUIT 5.00
VALIDATION .
EMP. METER OR POLE INS. - 20.00
zip
A-�
Tey n
-
APPLICANTS'
SdmQ�
MOTORS SEE FEE SCH.
SERVICE CHANGE ." - 20.00[—
' LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and
Professions Code; and my license isin full force and effect. .
ISSUANCE DATE
BLDG. ELECT.
PLG. MECH,
License Class Lie. Number
Date Contractor-
BUILDING PERMIT
INFORMATION
OWNER -BUILDER DECLARATION-
' I hereby athe ffirm that I so exempt from the mess Contractor's License
Law for nycit llorcoutywh(Sea 70r Lapersi[tocodProfessions
perm; loots issuance alter.
Code: Anymolish nor ntywhiny structure,
improve, demolish, or repair any strunure, prior to its issuance, also
MISC.— REFER TO ORD �Z e00
VALUATION
�8
L/ L�k/Q��
$/FT.
PERMIT ISSUANCE 10.00
ELEC. CONTR. - LIC. NO. ELEC. Bey+ �� (yam)
requires the applicant for such permit to file a signed statement that
he is licensed pursuant to the provisions of the Contractor's License,'
Law (Chapter 9(commencing with Section 70000of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
TOTAL I J l J
OTY. PLUMBING PERMIT FEEthe
PERMIT TO
n
�fl Q�{�I�E'•`\b y'
STORIES
TYPE CONSTR.
basis for the alleged exemption. Any violation of Section 7031.5
by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500)J:
ALTER -DRAIN -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 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
-
Code: The Contractor's License Law does not apply to an owner of
Property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improve
limits are not intended or offered for sale. If, however, the building
FIXTURES - PER TRAP 5.00
SQFT. FLOOR AREA
-TOTAL ACREAGE
GAS - EA. SYSTEM - i INC. 4 OUTLETS 6.00
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that he d
Elul not build or am-
pros for Purpose of sale.).
I, as owner of the properly, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code: "file Contractor's License Law does not apply
to an owner of property who builds or improves thereon, and who
GAS EASYSTEM -OVER 4 IEA) 200 -
- . ..
BUILDING USE
RES IND CON PB Omer ,
❑ ❑ ❑ ❑
ASSESSORS PARCEL NO.
INDUSTRIAL WASTE INTER. .30.00 '
_
LAWN SPRINKLERS- 1 INC 5 V.B. -• 6.00
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
contracts for such projects with a contractor(s) licensed pursuant to
the Contractor's License Law.
'SEWER -SANITARY -STORM EA. 200ft/10.00
TRACT NO.
PARCEL NO.
❑ I am exempt under Sec.., BAP.C. for this
reason
WATER HEATER W/VENT 6.00
Owner - Date
WATER SYSTEM 5.00
ACC. GATE
ACC. FILE NO.
' WORK ERS'COMPENSATION DECLARATION
- WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent to self -insure.
or a certificate of Workers' Compensation Insurance, or a certified
FEB
ZONING
ENG. SITE NO.
O IL
copy thereof (Sec. 3800, Lab.C.).
Policy No. Company
FIRESPRINK
V N
1:1 Cl
ENERGY T-24
V N
❑ ❑
❑ Certified copy isloactly furnished.
❑ Certified copy is filed with the city inspection division.
A IiCanl
- MISC. - D.
PERMIT ISSUANCE ,OO Cts
CERTIFICA'rF, OF EXEMPTION FROM WORKERS'
FLOOD ZONE
A.L.U.C.
PLG, CONTR. LIC. NO.
-
PLG. ^.�
TOTAL 0.y.Da
COMPENSATION INSURANC17
e permit is for one
(This action need not be completed if tile
Y ❑ N ❑
Y ❑ N❑
OTV MECHANICAL PERMIT FEE
-
FEE SUMMARY
Imndredd.dkRx(S100)o}less,) '-
I certify that in the performance of the work for which this per.
out is issued, I shall not employ any person in any manner so as o
become the Workels'C ens. io I'Calil'
Date APE can"
NOTICE; TO AI LICANT: 11, u} cr making this Ccrli a:ate of lix-
BUILDING
111 06
ALTER OR ADD TO MECH. 5.00 j
APPLIANCE - 5.00
PLAN CHECK
FEE
�y
trun ion, you should become subject to the Workers' Compensation
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT (TO 10=QF.IW 4.00
AIR HANDLING UNIT (OVER 10=C.P.M.) 6.00
SEISMIC FEE
P�
CONSTRUCDON LEND) NC AGENCY +
I hereby affirm that there is a construction lending agency for
EXHAUST HOOD (WITH DUCT) 5.00
..
e work for which this permit is issued (Sec.
the performance of tile
MICROFILM
HEATING UNIT (TO 100;000 B.T.U.) 6.00 '
Lender's Name -
Lender's Address
H EATING UNIT (OVER 100,000 T.U.)9.50
B.
ELECTRIC
/+ Sys
`7L,7 �+
I certify that 1 have read this application and state that the above
information is correct. 1 agree, to comply with all city and county
ordinances and stale laws relating to building construction, andBOILER-
VENTILATION FAN (SINGLE) 4.00
PLUMBING
q
2vLA�
DOW (3 H.P. of 100,000 B.T.U.) 6.00
BOI LER-COMP (Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
hereby authorize representatives of this city to enter upon the
above-nsentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of
uperlino against liabilitie judgments, costs and expenses which'
may in y way ace e � abot said City in consequence of the
i of this per i .
2 G3
MISC. REFER TO ORD. eC70
'CONST. TAX
PERMIT ISSUANCE 10:00 Moo
MECH. CONT. LIC. NO. - MECH.
TOTAL �. i�
� �
TOTAL
^1 ,u�
aLO%Jrl.(D1
' nature of Applicant/Can actor Uale
OFFICE COPY
i
CITY OF COLKI-1Vt'.j
INSPECTION DIVISIG,J
JOB INSPECTION RECORD
PERMIT EXPIRATION
•2P G2tLGl.r UNIT tt _LOT# PERMIT EXPIRES IF WORK
�B ADDRESS —1=�—P�
Ai'�� IS NOT STARTED WITHIN
wNER G . RPI; Utr2 CONTRA CTOR 180 DAYS OF PERMIT ISSU-
INSPECTION:' . , DATE INSPECTOR INSPECTION RECORD- ANCE OR 180 DAYS FROM
FOUNDATION NOTE: LAST CALLED INSPECTION.
LIFER TO
GRADING AND DRAINAGE SHALL BE INSTALLED rl unu, vni mn uUN
TO COMPLY WITH THE APPROVED PLANS AND CIN OF
PREGUNITE C ERTINOSTANDAR S-J.-'rA j
GARAGE SLABS L L.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 22
uNInFRGROUND/SLAB
ELECTRICAL
YJI
W
MECHANICAL
-BUILDING PERMIT
ABOtlE HAS BEEN SIGNED
INFORMATION .
-00 NOT POUR'FLUORUNTIL
WOOD FLOOR
sfE T.
E^VAL.UAnUN
PLUMBING�-J-
PU+NRt 10
MECHANICAL
ELECTRICAL
s, auEs ,vrl l:ON5t1+
FRAMING
INSULATION
ufG GROUT REs UNITS
A111 R t.L ACI FACE
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
S„ „ n.a°"
NOTE: NO FINAL INSP. SHALL BE MADE BEFORE
ROOF
THE CONSTRUCTION TAX IS PAID
DIAPHRAGM
B,,,ENING USE
Nts No CON PR Uw.•
El 13
ROOF SHEATHING INSP.
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE
A55ESSOHSPAnCkI NO
ROUGH SAN .#
Z ELECT. ENERGY
m<u NU PARctE No
PLUMBING
PLUMBING ENERGY
TUBS & SHOWER PAN
MECH.ENERGY
Acc nnTt ncc EnE. No
MECHANICAL
ELECTRICAL BUILDING ENERGY
ELECT.FINALTEST
zON�NG EN(: SITE NO
FRAMING
- -•� PLUMBING
INSULATION--
GAS TEST GAS
FINE SrHINR ENERGY" E-]<
MECHANICAL
❑ N❑ v ❑ N❑
WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
,uxnvuNE A. Uc
COVER NO
EXTERIOR SHEA JELECIHECAL RELEASE
❑ N❑ . ❑ N❑
INTERIOR SHEAR FIRE DEPT.
FEE SUMMARY
GRADE
SHEETROCK �=
EXTERIOR LATH BUILDING
INTERIOR LATH 'r Fi- . .TEMPORARY APPROVALS
BUILDING
PLAN CHECK C
ELECTRIC
SCRATCH COAT'
FEE I l
GAS
SEISMIC FEE L
CJ
NO TAPE DR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY
1
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
MICROFILM
ELECTRIC
ARRANGE FOR INSPECTION BY PHONING 252-4505,
PLUMBING 7,00
w
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
00 PLEASE GIVE JOB ADDRESS WHEN PHONING.
MECHANICAL Z ,o0
z - SEE PERMIT FOR EXPIRATION DATE -
CONST.TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
TOTAL OLfij�
CALLING FOR FINAL INSPECTION.
APPLICANTS POSTING COPY