13432 POST THIS CARD NEAR FRONT OF BUILDING
PFRMIT NUMBER
CITY OF CUPERTINO
INSPECTION DIVISION 13432
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDR ESS 7645 DUMAS UNIT# LOT#
PERMIT EXPIRES IF WORK
DWNER KRIS WANG CONTRACTOR STEVE ZANKICH IS NOT STARTED WITHIN
INSPECTION DATE INSP TOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM..
FOUNDATION D- LASTCALLED INSPECTION
UFER
PREGUNITE PERVVALIDATION ;
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ ?W:-,
UNDERGROUND /SLABPLUMBING y Cgoert4r�D P//
ELECTRICAL ISSUANCE CAW
O(((
MECHANICAL BLD ELECT. PLG. MECH.
7 ❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR vnwnnoN S/FT.
PLUMBING r - �
MECHANICAL /
PERMIT TO
ELECTRICAL
FRAMING femu`11 wt,
INSULATION STORIES - TYPE CONSTR.
OCC.GROUP RES,UNITS
` PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ;
ROOF SO FT.FLOOR AREA TOTAL ACREAGE
DIAPHRAGM
'BUILDING USE
..�" RES INC CON PB Olne.
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ 1:1 E]
ASSESSORS PARCEL NO.
ROUGH
PLUMBING
_
GAS TEST TRACT NO. PARCEL NO.
MECHANICAL
ELECTRICAL FINALS DATE INSP. ACC.DATE ACC.FILE N0.
FRAMING SAN #
ZONING
PLUMBING ENG.SITE NO
GAS
FIRE SPRINK ENERGY T 24
MECHANICAL Y ❑ NEJ Y [:] NE:]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD ZONE A.L.U.C.
LATH-INTERIOR ELECTRICAL
LATH-EXTERIOR FIRE DEPT. Y❑ NEl Y o N❑
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR BUILDING D"( BUILDING
SHEAR EXTERIOR TEMPORARY APPROVALS '
FIREWALLS ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE _
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM
i
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
7 O PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
CONST.ONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL -
CALLING FOR FINAL INSPECTION. ,
OFFICE CDPV
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
eUILDING APPLICATION & PERMIT 13432
ADDRESS
DU h4 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
76 L/5 D.N ER'S PLAN CHECK VALIDATION
IWO, QTY. ELECTRIC PERMIT FEE
"$ PHove
CONTRACTORS
NAME f UTLETS-SWITCHES-RECEP 10.00/1.00
s"1�'O'-'C Z.a ,V.•C uc.v0. LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'9
APPLIANCES 4.00
ADEDEEss
I p 4 PHONE 9 S,1 56 PANELS 10.00 DATE OF APPLICATION
OARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEEP.C.NO.
ENGINEER
uc.No. SIGNS TRANS. 3.00
ARCH,
OR
ENG. SPECIAL CIRCUIT 5.00 PER MIT VALI DATION
AD ZIP TEMP.METER OR POLE INS. 20.00 q�D
Ars
ADDRESS MOTORS SEE FEE SCH.
DREss
SERVICE CHANGE 20.00 A J
U (`
wo o LICENSED CONTRACTORS DECLARATION /r� `
A v rs 1 hereby affirm that I am licensed under provisions of Chaple,9 Il O/p x198 NCE DATE
yz "' (commencing with Section 7000)of Division 3 of the Business and
¢ BLD EL PLG. MECH.
H o z License Lice.ProfessionsCode, my license is in full tome and effect. ❑ ❑ ❑
S, o Class 11
Lia 44 -L
Number , ?.6$�
9 r Date Contractor
a r A BUILDING PERMIT
or a ¢ OWNER-tl UILUER DECLARAT
e- oa U INFORMATION
W I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD
0 rri / VALUATION $/FT.
HuOj Code:Any city owingrtawhihec.703L5,Buait tocnstruct,mons PERMIT ISSUANCE 10.00
Cade:Any city or coumy which requires a permit to construct,eller,
rt ¢ < improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
- G ¢ requires the applicant for Such permit to rile a signed statement that TOTAL PERMIT TO
X $ he is licensed pursuant to the provisions of the Contractor's License
H z i
Law(Chapter 9(conummeing with Section 7000)of Division 3 ofthe
¢ Business and Professions Code)or that he is exempt ihertfrom and OTY. PLUMBING PERMIT FEE
It = the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TYPE CONSTR.
a ; _ by any applicant for a Permit subjects the applicant Ina civil penalty
of not mon than five hundred dollars(551X1).): ALTER-DRAIN&VENT-WATER (EA.) 5.00
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, firmness and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00
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 sa FT.ELOOR AREA TOTAL ACREAGE
mento m through his own emred fors,Provided that such improve-
ments
mmselfo through
ot or empldfor Sale.If. that Suhe building GAS-EA.SYSTEM-1INC.4OUTLETS 8.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00
builder will have the burden of proving that he did not build or im- BUILDING USE
prove for purpose ofmle.). INDUSTRIAL WASTE INTER30.00 RES IND CON PB Omar
❑ 1,as owner of the property,am exclusively contracting with . ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN 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 1.00
conthe tracts for such projects with a contmaorts)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
the Contractor's h Proje Law.
❑ I am exempt under Sec.-,B&P.C.for this WATER HEATER W/VENT 6.00
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 sell-insure. ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
1 copy thereof(Sec.3800,Lab.C./. S f alt rU r
-�- Policy No. Company T'w IFL,
O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY TQe
Z Z ❑ Certified s file with p city inspection division. MISC.- REFER TO ORD.
Q Applicant Y ❑ N❑ Y ❑ N❑
~ Irl PERMIT ISSUANCE 10.00
LU -) CERTIFICATE F EXEMPTION FROM WORKERS' FLOOD ZONE A.L.U.C.
W > COMPENSATION INSURANCE PLG.covTR. LIC.NO. PLG.
This section need not he completed if the permit is for one TOTAL Y❑ N❑ Y❑ N❑
hundred dollars IS 100)or less.)
U O 1 certify that in the performance of the work for which this per- OTY MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued. I shall not employ any person in any manner so as to
U become subject to the Workers Compensation Laws of California.
0. Date Applicant BUILDING S�
} to NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 �� v__
FZ emption,you should berome subject to the Workin'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10XDC.F.M.) 6.00 SEISMIC FEE S-V
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.). a HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Ann
ddo HEATING UN IT ER 100,000 B.T.U.)9.50
Lender's AJJress ELECTRIC
1 certify that I have read this application andstate that the above VENTILATION FAN (SINGLE) 4.00
information is comet. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING
ordminm and State laws relating m building construction, and
hereby euthmhm representetivs of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes. -
(We) age" to save, indemnify and keep harmlm the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which
may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10,00 CONST.TAX
Wanting of this Permit MECH.CONT. LIC.NO. MECH.
Z TOTAL TOTAL le"T
Signature of Ap t/Co tm for Dat
OFFICE COPY