14448 I _
POST THIS CARD NEAR' FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO 14448
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS / S^�E'y�-f 7EPC �'Y �L UNIT# '_LOT#
PERMIT EXPIRES IF WORK
OWNER �} '/}-K CONTRACTOR /,f L� 0_0A/f� IS NOT STARTED WITHIN
INSPECTION DATE JINSPECTOR INSOECTION RECOR
D 180 DAYS16F PERMIT ISSU-
FOUNDATION - ANCE.OR 180 DAYS FROM
NOTE: LASTCALLEDINSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS. .
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PAID,
UNDERGROUND /SLAB
PLUMBING 1^^ 1991`
ELECTRICAL - ,'F1 ;'ISSUANCF u_" E
MECHANICAL eLOc PLG. MECR.
❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING VALUATION SIFT.
'
MECHANICAL -
ELECTRICAL - PERMIT TO
FRAMING �""��
INSULATION, STORIES TYPE CONSTN
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa.Fr FL«w AREA To7AL AoaACE
.� DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING Res IND CON PB 0111-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El ❑ ❑ ❑
ASSESSORS PARCEL NO
_ ROUGH SAN.p
PLUMBING ELECT,ENERGY
IRACI NO. PARCEL NO
TUBS&SHOWER PAN PLUMBING ENERGY '
MECHANICAL ' MECH.ENERGY -
.
' ELECTRICAL BUILDING ENERGY ACC DATE ACCFILE NO
FRAMING ELECT.FINAL TEST
ZONING ENG.SITE NO.
INSULATION PLUMBING
GAS TEST . ' GAS
MECHANICAL
FIRE SPRINK ENERGY T-24
' '
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ ' N❑
A.L .
EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE UC.
INTERIOR SHEAR FIRE DEPT. ' Y N❑ r ❑ N❑
SHEETROCK GRADE - FEESUMMARY
EXTERIOR LATH BUILDING -
INTERIOR LATH TEMPORARY APPROVALS - BUILDING
SCRATCH COAT - ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY, SEISMIC FEE
OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL'BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505 ELECTRIC
F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE,- MECHANICAL
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
•" .BUILDING PROJECT IDENTIFICATION . PERMIT NUMBER --
BUILDING APPLICATION & PERMIT 14448_
noon Ess
O 2wt BUILDING-
ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
"AME TY. ELECTRIC PERMIT FEE
CONTRACTOR S
�( NAM x 1 UTLETS-SWITCHES-RECEP 10.00/1.00
( // Lm.No. 8� LIGHTING FIXTURES 10.00/1.00
ADNTR DRESS oRS PPLIANCES-RESIDENTIAL 4.00
//46 PANELS 10.00 DATE OF APPLICATION
ORRCRITECi PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.N0.
O
ENGINEER ^' A
F ,7 tic.No. SIGNS TRANS. 3.00
ARCH on ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP EMP.METER OR POLE INS. 20.00 �I
APPLICANT NS MOTORS _ftE FEE SCH.
ADDRESS
EA
oSERVICE CHANGE 20.00
0
0
Foo LICIiNSIiU CON]'RACI'ORS UI?CLARA'fION '
a v I hereby affirm that I am licensed under provisions of Chapler 9NXA ISSUAry CE GATE
Nay (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
r 2 License
s my license is in mbefull fort
9 r ❑ ❑ ❑
0 o v` - LiccnClass Lic.Nur o Date Contractor-�
x BUILDING PERMIT
w s OWNI?R-BUILDER DECLARATION
w ;LL N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD - INFORMATION
F u o Kr Law for the following reason.(Sec,7031.5,Businessand Professions PERMIT ISSUANCE 1000 VALUATION S/FT.
Code:Any city or county which requires a permit to construct,alter, �0
QM 0 improve,demolish,or repair any structure;prior to its issuance,also ELEC.DONTR, LIC.NO. ELEC. �(f)p12
O u rT.irm the applicant for such permit to file a sip�Ied statement that TOTAL ri`O `_ PERMIT TO
K
bis is licensed pursuant to the Provisions of the Conmlmor s License _
Hit
Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe
4 o Business and Prof zsions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
BE the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
by any applicant for a pernit subjects the applicant too civil penalty ,ALTER-DRAIN -WATER (EA.) 5.00
of not more than live hundred dollars(550().):
❑ 1,as owner of the prolverty,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 __TCC.GROUP RES.UNITS
sole compensation,will do the work,and the structure is not
intended or offemd for sale (Sec. 7044, Husine% and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractors License law does not apply to an owner of
property who builds oefmproves thereon,and who does such work FIXTURES-PER TRAP 5.00. SO.PT.PLOCR AREA TOTAL ACREAGE himself or through his employees,provided that such improve- .
menu Ge not intended or oltered for sale.IL however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00
or imovement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 IEA.1 2.00
builprder will have the burden of proving that he did not build or im- BUILDING USE
prove for na,ose of sale.). RES IND CON PB Other
❑ I,ca owner of the pro Petty,am exclusively contracting with INDUSTRIAL WASTE-INTER. 30.00 ❑ ❑ ❑ D -O
licensed commemrs to construct the project(Sec.71344,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
It(]professions Codc:The Contractor's Licensetaw docs 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 analm,wrio licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.,
O l an exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE Ata FILE NO.
WORAERS'COMPBNSA'1'ION DECLARA'I']ON WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate o1 consent to self-insure.
or a certificate of Workers'Compensalion Insurance,or a certified ZONING ENG.SITE NO.
copy thereol'(Sec.3800,had,C:. .
Policy No. Company MAla4?9's'ai`eeA-
O ❑ is py
CerlilieJ hcebyhmnishc
rd. RE SPRINK ENERGY T-24
Z Z ❑ Ceoifud/v1 Bled Ih the ity inspection division.
l- O Appfi,Ce i'T ,�, '� v MISC.- REFER TO ORD. Y � NEI , v N�
CC D CIi RR�C\I'Ii OP EXEMPI' , FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C,
LU > COMPFNSArm INSURANCE PLG.CONTR. LIC.NO. PLG.
CL a (This section deed not be completed if the permit is for one TOTAL Y❑ N ElY ry
hundred dollars(S I O0)or lex.)
U O 1 certify ural In the ped)nlnance of the work for which this pct- GTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued,1 shall not employ any person in any manner so as to
O W become subject to the ate
Com,,a martion laws of California.
Dme nppnea"t ALTER OR ADD TO MECH. 5,00 BUILDING
} H NOTICE: TO APPLICANT', If,aIter'making this Certificate til Ex-
F ? emplion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the labor Code, you must forthwilh comply with FEE
U such Provisions or this pcmlh shun be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.R) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IO)OODC.EM.) 6.00 _SEISMIC FEE
Thereby affirm that theta is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
lire performance of the work for which this Permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
Lender's Address HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I certify that l have read this application and state that the at.0 VENTILATION FAN (SINGLE) 4.00 -
information is correct.1 agree tU comply with all city and county PLUMBING
ordinances and stat, laws relating to building construction, and. BOILER-COXdP(3 H.P.or 100,ODO B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU(SEE FEE SCH.
above-mentioned property for inspection purposes. MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
apeton against liabilities,judglnenis, costs and expenses which pERMIT ISSUANCE 1000 CONST.TAX
ay In �Iy way accrue against said City in comaquence of the
garar n14§, is permit . MECH.CONT. LIC.NO. MECH.
- /._ _8 . . TOTAL TOTAL
ignat of Applicant/Co it for Date
OFFICE COPY