15485 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT rvuti,eER
CITY OF CUPERTINO 15485
INSPECTION DIVISION
JOB INSPECTION RECORD
/1� PERMIT EXPIRATION
JOBADDRESS C�� �'�CM ,�S Tc�K. /'�V(_ UNIT# -LOT#j '
- PERMIT EXPIRES IF WORK tl
OWNER — 7 2,007-1,1 CONTE CTOa ,yca-, m, IS NOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSPECTION RECOIRD 180 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 i PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
• UNDERGROUND /SLAB
PLUMBING C '
ELECTRICALIssuANCE DATE ,
MECHANICALepi 1 LECT .PLy. - $+LCR
�1- ❑ El El
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING VALUATION SIFT.
MECHANICAL
ELECTRICAL PERMIT TO
FRAMING
INSULATION STORIES TYPECONST R.
- OCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
.'
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO,Fl FLOOR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
ROOF SHEATHING DEC INouaoi NOfrNJ USE
D..,,•, �
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE IN P. ❑ 0 ❑ ❑
ASSESSORS PARCEL NO
ROUGH SANA .
PLUMBING ELECT.ENERGY
TRACT NO PARCEL NO
TUBS B SHOWER PAN PLUMBING ENERGY -
MECHANICAL MECH.ENERGY "
PCC DATE ACC.FILE NO
ELECTRICAL BUILDING ENERGY. -
FRAMING 2, .ELECT.FINAL TEST
ZONING ENG,SITE NO.
INSULATION PLUMBING � .•
GAS TEST GAS - '
MECHANICAL` FIRE STRUCK ENERGY r.7a
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING .Y ❑ "0 ` ❑ "El
_ FLOOD ZONE A.L U C.
EXTERIOR SHEAR - ELECTRICAL-RELEASE -
INTERIOR SHEAR - FIRE,DEPT. Y ❑ N Y ❑ N❑
SHEETROCK GRADE, -- - FEE SUMMARY
EXTERIOR LATH BUILDING _
INTERIOR LATH TEMPORARY PPROVAL BUILDING
SCRATCH COAT _ ELECTRIC PLAN CHECK 7 '.
. GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY .SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED 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.Tnx
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. - TOTAL'
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
f I LD1 NG PROJECT I DENTI FICATI ON PERMIT NUMBER y
BuaDINc ; APPLICATION & PERMIT 15485 A p
r ADDREss - - - 15 4 0 Iq�l (YasBUILDING ELECTRICALPLUMBING MECHANICAL J
W
ONERS PLAN CHECK VALIDATION
NAME 1 J��� OTY ELECTRIC PERMIT FEE
.MEnA °Kars LCO 61 ' UTLETS-SWITCHES-RECEP 10.00/1.00
`^Ile 0(_ (ts� OCC NO. Z, LIGHTING FIXTURES 10.00/1.00
cONTRACTORs PPLIANCES-RESIDENTIAL 4.00
AOOREsi {�I ` -y
1L V` P•) NNr}E �Wf^ M C3 PANELS 10.00 DATE OF APPLICATION '
OgcRrrecr PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER
LIc.No. SIGNS TRANS. 3.00 '
ADDREss ENc' SPECIALCIRCUIT 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APsOCAr$
DORESs MOTORS SEE FEE SCH. _
A
SERVICE CHANGE 20.00
o 2
0
Foo LICENSED COMI'RACTORS DECLARATION -
a u u I hereby affimt that I an,licensed ands,provisions of Chapter 9 ISSUANCE DATE
Icommeneins illi Section 71X10)of Timm 3 f the Business and
rn ¢ ,^�, BLD .1-ELECT. PLG. MECH.
r N� Yrolessions Cal� p se is in(all for ////hhhhttt4{{yt�t�ss (�� 'L
O z u, D Littnu nLic.Numlier_� e
Le
m r Duro�� Coal rector- (_pS
SVUHING PERMIT
0 a D OWNER-BUILDER DECLARATION INFORMATION
w3: u _ I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
ia
H .. w 4 Law for the following reason.(Sec,7031.5,Business and Professions PERMIT ISSUANCE 1000 VALUATION 5/FT.
Code:Any city or county whichrequiresapemiittoc.r MCt,alter,
R < p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. /
e w
- O a, requires the applicant for such permit to file a signed statement that TOTAL ^ PERMIT TO
he is licensed m1nudat to the provisions of the Contmclor's License /,�) qq
Fzi Law(Chapter 9(comnencing with Section 7100)of Division 3 ofthe {f- Lo lA VL-Ir ,
f 4 o Business and Professions Cale)or that he i,sexempt therefrom and OTY. PLUMBING PERMIT FEE
Q the hasis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
u ; _ by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars(S500)J: ALTER-DRAIN& VENT-WATER (EA.) 5.00
❑ 1,as owner of the Poitiers,or an,employees with wages BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS
their sol,comper.1mr,will do the work,and the struetum is not
intended or offered for sale (Sec. 7044, Business and Profsssi ao DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code The Contractor's License Law does not apply to an owner of
Property who builds or ingrr.ves thereon,amd won docs such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACIREAGE
himself or through his own employees.provided that such miloov,-
mentsare not intended or offered for sak.If,however,the building GAS-EA.SYSTEM-11NC.4 OUTLETS 6.00
or improvement is told within one year ol-completion,the owner- GAS EASYSTEM OVER 4 (EA) 200
builder will have the burden of proving that he did not build or air- - . - . 2.
GO USE
RES IND CON PB Omer
Prove 1,aso nee of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑
❑ I,as owner of the prupery,sen exclusively contracting with
licensed contract., m construct the pmj«I(Sec. 7044,Business AWN 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
contmas for such projects with a cnntractor(sl licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00
the Contractors License Law. TRACT NO. PARCEL NO.
❑ l am exempt under Sec.-,B.&P.C.for this WATER HEATER WNENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ACG DATE -ACC.FILE NO.
WORKERS'COM PENSAI'ION IN'CLARATIOS WATER TREATING EQUIP. 5.00
I hereby otfirm Ihal I have a crl,ieatc of,on.nt In Mt&inure. ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
�t copy thereof(Sec.3800.Lab.C.).
/ Policy No.-Company
O ❑ Certified copy is herehy Cur shed. FIRE SPRINK ENERGYT-24
Z_ Z ❑ Certifie op n Oled i 1 the , -nspection division. MISC.- REFER TO OR D.
O Applicant- Y ❑ N❑ Y ❑ N❑'
CC
L v_a PERMIT ISSUANCE 10.00 CI7R'1'I FICA'1'E EXEMPTION'FROM WORKERS' PERMIT ZONE A.L.u.C.
W > COMPENSATION INSURANCE PLG.CONTR., LIG NO. PLG.
CL O ('Phis scetiun nccd not be completed if the per it is lin one TOTAL Y❑ N❑ Y❑ 'N❑
:D Z hundred dollars IS 100)or less.)
U O 1 certify that in the performance of the work fo w ich this FEE SUMMARY
W I- mit is issued, I shall not empl any peruse in any to ncr s.a TY. MECHANICAL PERMIT FEE
U Dail 1i�T the Workcn m unvtiun Law. Tumi .
y Dat` 1 AI'pl"a"t 1 ALTER OR ADD TO MECH. 5.00 BUILDING -SZ
} to `1071 E TO APPLICs\NT: If,at making this Ccr Icatc o Ex-
F- ? emptu m,you slruuld beconm subject to the worker✓Compensation APPLIANCE 5.00 'PLAN CHECK
provisions of the Labor Code, you must lorthwith comply with FEE j�
deemed U such provisions or this permit shall be revoked. AIR HANDLING UNIT(TO 10,000C.F.ML) 4.00
CON SrFRUCI'ION LENDING AGENCY AIR HANDLING UNIT(OVER 1O=CF.K0 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(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,01x1 B.T.U.) 8.00
Lender's Name HEATING UNIT 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I certify that 1 hove read this application amt state Hlat Inc above VENTILATION FAN (SINGLE) 4.00
information is correct. 1 agree to comply with all city and county PLUMBING
ordinances and stat, laws relating to building construction, and BOILER-CDMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorise re ,es,"tmives e-1' this city to enter upon the BOILER-COMP(Over t10,10o BTU)SEE FEE SCH. MECHANICAL
e� above-mentioned property for inspection purposos
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against Ilpbilities,jud meals, cods and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
in way accrue agai s said Cil n <ons,q uence of dm
mg of tie permit �( �/� MECH.CONT. LIC.NO. MECH,
l s�IM1L_Y11y_ TOTAL TOTAL d 7
igna fApplicant/Contras r Dale
OFFICE COPY