18595 POST THIS CARD NEAR FRONT OF BUILDING vERnuT NUMBER'
CITY OF CUPERTINO
8595
INSPECTION DIVISION,
JOB 1PISPECTION RECORD
(\ PERMIT EXPIRATION
JOB AD DR ESS `�. - LOT# PERMIT EXPIRES IF WORK
OWNER 1 CONTRACTOR ,. - IS NOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSP ION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION AWE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER ,ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE AP OVED PLANS AND CITY OF PLHMN VALIDATION
CUPERTINO STANDARDS�A
.. GARAGE SLABS wA.
_1(a' I • .
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL '
65UANCEAAIE
MECHANICAL .. BLDG ELEc r LG. MEC..
❑ d PILE.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - Buaowc PERMIT
WOOD FLOOR INFORMATION
PLUMBING VALUATION SIFT.
'
MECHANICAL -
ELECTRICAL PER&IITyTO1r
FRAMING kt� I ` II ,I
INSULATION -sTORI`s TYPE CDrysTR.
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
.
ROOF' NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SOf T FI,OOII SIll TUTAL ACR[AGL
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHINGI RES IND CON PB Oli—
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑'
ASSESSORS PARCEL NO
ROUGH SAN.N
PLUMBING - ELECT.ENERGY
TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO
MECHANICAL MECH.ENERGY
ELECTRICAL' BUILDING ENERGY ACc.DATE . ACc FILE NO
'
FRAMING ELECT.FINAL TEST
INSULATION ONING ENC,SITE NO.
PLUMBING T ,
GAS TEST - GAS
MECHANICAL FIRE SPRINK ENERGY T-?a
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ NL] ` ❑ NE-
I
EXTERIOR SHEAR ELECTRICAL.RELEASE . FLOOD ZONE ALUC.
INTERIOR SHEAR FIRE DEPT. Y❑ N❑ vL No
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
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, .. ELECTRICLU
~� ONE WORKING DAY BEFORE REQUIRED INSPECTION. .' rF'
PLUMBING
z PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TAX
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
BU LDI NG PROJECT 1 DENTI FICATI ON I PERMIT NUMBER
BUILDING APPLICATION & PERMIT q �C �C
A�$a�j'js •��[,o,�,a E BUILDING - ELECTRICAL-PLUMBING -MECHANICAL I J J
OWNERRS
NA�+Y PLAN CHECK VALIDATION
CITY, ELECTRIC PERMIT FEE
15i0"WIrL PHON? Tl •`8
CONTRALTO
N E I ') OUTLETS-SWITCHES-RECEP 10.00/1.00
,J ✓. Co. LIC,3 /2_" LIGHTING FIXTURES .10.00/1.00
IGONTFLACTORS
ADDDRESS
p'/ O� (,s� N C• APPLIANCES-RESIDENTIAL 4.00
Gi/j)7T�Yn70M'It/6 PHONE JAIL PANELS 10.00 - DATE OF APPLICATION
ARCHITECTon PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER OCA/1`1t^_
sec.No. SIG TRANS. 3.00
ARCH.OR ENG. PER MIT VALI N
ADDREss ECIAL CIRCUIT 5.00
➢P EMP.METER OR POLE INS. �0
APPLICANTS- MOTORS SEE FEE SCH.
DRESa U 1`
AD
SERVICE CHANGE 20.00 •�\
o¢ i JFoo LICIiNS1iU CON'1'RAC'I'ORS DECLARATION
rt
Z , I hereby off rm that I am licensed under provisions of Chapter 9 PAZ
ISSUANCE E
¢ t.- fromnmennpg with Section 7000)of Division 3 of�the�Bs�t},loess and BLDG. ELECT PLG. MECH.
H m z Professions Codt9pJ mY liecnm is in full 4 �I Lf 1"fes ❑ ❑ ❑
z o m- License Class_pp �_Lic.NIfot __QJt_I_
m
IS w a 1 OWNER-BUILDER DECLAR,1FfION 15 1989
BUILDING PERMIT
A o a " INFORMATION
w LL I I hereby affirm that I am cxempl from the Contractor's License MISC.- EFER TO ORD
HL0< Low for the following razsor.(See.7031.5,Busincssand Professions PERMIT ISSUANCE 10.00 VALUATION $/FT.
improve,
d city or county which sti Lctesa permit its
i slnm6ahcq
ec ¢ o ilnpmve,demolish,or repair any sb'uclura,prior to its ismuncc,also ELEC.CONTR. LIG.N0. ELEC.
O LL retluires the applicant fur such permit to file a signed statement that TOTAL
A w m he is licensed pursuant to the provisions of the Contractor's License PERM TO
H z i
Law(Chapter 9(commencing with Section 7000)of Division 3 of the tc
E x o Business and I'roressions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE
w I o the basis for the alleged exemption.Any violation of Section 7031.5 TORI PPE CO $TR.
e. 3m by arty applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN -WATER (EA.) 5:00
ol'not more than five hundred dollars(b5001.)'.
ID 1,
as owner of the Property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP AES.UNITS
their sole compensation,will do the work,and the Orrefors is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of
prnpefly who builds or mprove,thereon,and who docs such work FIXTURES-PER TRAP 5.00 So.FT FLOOR AREA TOTALACREAGE
himself or through his own employees,provided Ilia(such intpmve-
Inept,are not intended orofl'umd torsale.IL however,the building. GAS-EA.SVSTEM-11NC.4OUTLETS 6.00
or intprovement is sold within one year of completion, fire owner- GAS-EA.SYSTEM-OVER 4 IEA.1 2.00
builder will have the burden of proving that he did not build or ire- BUILDING USE
prove for purpose of ale.). INDUSTRIAL WASTE INTER. 3000 RES IND CON PB other
❑ 1,as owner of the property,am exclusively con .
tracling with ❑ ❑ ❑ ❑ 0
licensed contractors to construct the project(See. 7044.Business LAWN SPRINKLERS-1 INC 5 W.B. 6.00 ASSESSORS PARCEL No.
and Professions Code the Contractors License Law does not apply
to an owner of property who builds or improves thereon,and who LAWN SPR INKLERS-OVER 5(EA.) 1.00
contracts for such projects with a c'nnlraetogs)licensed puouanl to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 " TRACT NO. PARCEL NO.
❑ 1 am exempt under Sec..,BAP,C.for Ihlx WATER HEATER W/VENT 6.00
noon.
Owner Date WATER SYSTEM 5.00 ACCDATE ACC.FILE NO.
1V0RKI!RS'C0MPENSA'1 ION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that 1 have a certificate ofconsent toself-insure,
u 1 o1ptn_su/mme,or jrrtiilii'dd ZONING ENG.SITE NO.
yCc�jI� 4�� Lab.Cm
coprC mpanY- y
policy No.
Q ❑ CeFified[Copy til fu it, FIRESPRINK ENERGY T.24
Z Z LY1:ertified copy filed 'Ih t• tl inspec lion division.
O Applicant- 4 /. 1� MISC.- REFER TO ORD. Y N v N�
y CERTI PICA'I'1>Of ialiMl'"PION 17ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0C.
LL > COMPIiNSATION INSURANCE PLG.CONTR. LIC.NO. PLG. .
CL 0
('Phis section eed not be completed if the permit i, for ons - TOTAL v N Y N
hundred dollars IS 100)ar less.)
U O_ 1 certify that in the performance of the work for which filix per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued.I shall nor employ'any Person in any manner an as to
O U become subject to Bre Workers'Cmnpensation Laws of Gdifontia.ED -
0. Dale APPhcwtt ALTER OR ADD TO MECH. 500 BUILDING
to
} NOI'ICl?TO APPLICANT'' H.aver nt akin,this C,HifiLatc of . .
lis- -
F>Z
,,option,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with U FEE such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MOC.EM.) 6.00 SEISMIC FEE
I hereby affirm that mere is a construction lending agency ter - EXHAUST HOOD (WITH DUCT) 5.00
the performance fhc wok Ior tiyll this JJJJ/T'''''' iI is issued(Sec. MICROFILM TO
3097.Civ.C.). w/I xl# HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name • HEATI NG UNIT 100,000 B.T.U.)9.50
Lsndcr',Address_.(y )7;7 D_ � - ELECTRIC
Iccrtify thwlhuve rand las upplicolion and alum rhm meubuvc VENTILATION FAN (SINGLE) 4.00
i«l(rmalion is correct. 1 agree to comply with sell coy and couNy PLUMBING
I ordinances and Oats laws relating to buildi1, construction, send BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby/fth,,"
flee representatives of this city to en to upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH.
above- red properly for inspection purposes. MECHANICAL
(Weto save, Indenumify and keep It; I ess the Cily of misc.- REFER TO ORD. '
upertiinsl Iia biline jt di, is, costs and cx peaks which CONST.TAX
nay inway accrue gal t d City in cunscyuence of the PERMIT ISSUANCE 10.00 ��-
rantins permit' / MECH.CONT. LIC.NO. MECH.
i_+//` 913�➢ TOTAL TOTAL
Signature fAp is nt/ ontractor Uulc
OFFICE COPY