15342 POST THIS CARD NEARFRONT OF BUILDING
- PERMIT NUMBER
; I
CITY OF CUPERTINO 15342 .
INSPECTION DIVISION
JOB INSPECTION RECORD
.� ..PERMIT EXPIRATION
JOB ADDRESS 10750 :-FARALLONE DRIVE- UNIT.# LOT#
PERMIT EXPIRES IF-WORK
' WEIGHT WESTW60D DESIGN
OWNER CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.
FOUNDATION - ANCE OR 180 DAYS," OM
NOTE: LASTCALLED INSPECTION.
LIFER ALL GRADING G AND DRAINAGE SHALL BE INSTALLED
PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMn VALID N
GARAGE SLABS
CUPERTINO STANDARDS: { !
' -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 3-1(o- hocl� IIc ex cep
UNDERGROUND /SLAB QeNdiN YOJct� o� ",A
fy + Q �Q;;: � y
PLUMBING -
ELECTRICAL - City Of PIInort SUANCE DATE
MECHANICAL BLDG ELECT PLG. NIECE
+' - ❑ ® ® -�
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
-WOOD FLOOR -
VALUATION SBFT.
PLUMBING., -
MECHANICAL -
ELECTRICAL II vERrI ro
FRAMING. .. LI1 !.I 'I
.INSULATION
- - SIORI S IYP.ECONSTR.
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS-BEEN SIGNED
SO FT FLOOII AREA TOTAL ACREAGE
- • ROOF' NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING us
ROOF SHEATHING - - I+es Irvu cCN PB OILY.
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE ' INSP. ❑ ❑ ❑ ❑ ❑
' ROUGH SAN.k
ASSESSORS PARCE L NO
_ � '•
PLUMBING ELECT. ENERGY _
TUBS&SHOWER PAN , - PLUMBING ENERGY TRACT No, PARCEL No
MECHANICAL MECK ENERGY '
• ELECTRICAL BUILDING ENERGY - ' HCC.DATE ACEFILE NO
FRAMING ELECT.FINAL TEST
ZONING ENG.SITE NO.
INSULATION � PLUMBING "
GAS TEST - GAS "
FIRE SPRINK ENERGY TQG
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y - "� ` ❑ "0
EXTERIOR SHEAR
ELECTRICAL RELEASE FLooD zarvEA.L u.c.
INTERIOR SHEAR FIRE DEPT. Y❑ "❑ ° ❑ "❑
SHEETROCK' - GRADE FEE SUMMARY
EXTERIOR LATH BUILDING oc
INTERIOR LATH -TEMPORARY APPROVAL BUILDING
SCRATCH COATELECTRIC PLAN CHECK
GAS
FEE
NO-TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE
OCC UPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL IS SIGNEDBY BUILDING INSPECTOR. MICROFILM
ELI ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC c5-
• ONE WORKING DAY BEFORE REQUIRED INSPECTION. /
PLUMBING
0 PLEASE GIVE JOB ADDRESS WHEN PHONING. _
1 Z
- SEE PERMIT MECHANICAL FOR EXPIRATION DATE -
IMPORTANT! oNST.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 LD1 NG PROJECT I DENT[FICATI ON .PERMIT NUMBER
BUILDING APPLICATION & PERMIT -
ADDRESS ' 15 3 4 2
[6*,s- rA-> �[,(O Al
BUILDING - ELECTRICAL-PLUMBING -MECHANICAL
OWNERS
NAME • , - PLAN CHECK VALIDATION
OTV. ELECTRIC PERMIT FEE
(,JY.f ONE
CONTRACTORS
'S
NAME [O UTLETS-SWITCHES-RECEP 10.00/1.00 '19
f - Yliszlli, LIGHTING FIXTURES 10.00/1.00 I.
DoRs
ADDRESS
PPLIANCES-RESIDENTIAL 4.00
ORE55
[(00 Zan PNONE 2 -,$]O PANELS 10.00 DATE OF APPLICATION
OORRCNITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE _C.NO.
ENGINEER
LIC.No. ISIGNS TRANS. 3.00
nooaEss cute. - SPECIAL CIRCUIT' 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00 1.AID
APPLICANTS MOTORS SEE FEE SCH. Y • CkMh��I
DOR E55
116,11) L.CWI �� �[ SERVICE CHANGE 20.00
o a LICENSED CONTRACTORS DECLARATION -
Q 5 u 1 hereby a0inn that I am licensed under provisions of Chapter 9 I CunArliMUANCE DATE
2 "' (commencing with Section 7000)of Division 3 of the Business and
res< N BLDG. E ECT. PLG. MECH.
F 3 z Professions Codyy,a�nd qqry license ism full fort d�fje - ❑
2 0 2 - License Class Y.GM Lie.Number- JC7
O Z F° Dmc Col..mclor. rIl
¢ y E
¢ ¢ ¢ OWNER-BUILDER DECLARATION BUILDING PERMIT
a o a U INFORMATION
X
3: LL H 1 hereby affirm that 1 am exempt from (lie Contractor's LicenseMISC.- REFER TO ORD
I Loa Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATIONr S/FT.
Code:Any city or county which reyuirna permit toconslnml,alter,
a ¢¢ 0 improve,demolish,or repair any structure prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
0 ¢ requires the applicant fur such permit to file a signed statement That TOTAL
6 w m LL he It 111nzed IIUrNlant to die proiisions Oftlle Contractor's License 'PERMIT TO
Law(Chapter 9(commencing with Section 7000)of Division 3 of the 1Ei'� �IC/11
a Business and Professions Code)or that he is exemprtherefrom and QTY. PLUMBING PERMIT FEE II 4-L.� N1�{�
¢ = $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
a ; by any applicant far.'unlit subjects the applicwlt wacivil penally ALTER-DRAIN -WATER IEA.) 5.00
of not more than Live hundred dollars(55000.):
❑ I,a.owner of the property,or my employees with wagesas BACK FLOW PROTECT. DEVICE 4.00 OCG GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or uttered for sale(Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code: The Contractors License law don not apply to an owner of .
property who builds or improves thereon.and who does such work FIXTURES-PER TRAP 5.00 Ll 5O.FT FLOOR AREA TOTALACREAGE
himself or through his own employees,provided that such improve-
memsara not iolcuded or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC,40UTLETS 6.00 •t
or improvement d'Vdd 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 purpox,ofsaleJ. INDUSTRIAL WASTE INTER3000 RES IND CON PB Other
. .
❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ - ❑
licenwd contractors In construct (lie project(Sec.7044,Business LAWN SPRINKLERS-11 INC 5 V.B. 6.00 ASSESSORS PARCEL NO, f
and Profecriots 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
contracts for such projects with a contractariso licensed purnenl to A
the Cot tractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exempt under Sec. ,B.&P.Cforthis WATER HEATER W/VENT 6.00
teasers
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO,
WORKERS'COMPENSA'I ION DECIARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate ofconsent to self-insure,
or a certificate of Workcri Compcnmtion Insurance,or a certified ZONING ENG.SITE NO,
copy thereof(Sec.3800,Lah.CJ,
Policy No. Company
Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24
Z Z ❑ Certified copy is Bled with the city inspection divisimt. MISC.- REFER TO ORD.
O Applicant Y❑ N❑ Y ❑ N❑
CC
y CERTI FICATE 017 EXENIP PION FROM WORKERS' PERMIT ISSUANCE 10.00 •� FLOOD ZONE A,L.U.C.
LL > . ' COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL O (This Kction need nut he conyrleted if the pennh is for un4 TOTAL �L7 V E] NE] V❑ NE]
�•Z hundred dollars(SI00)orless.)
U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
H
It is issued, 1 shall not employ any 'arson in any moaner su as to
0U Nconm subject to the Wnrkera'Com,cuidiun LawsotMc
'Carniu.
n Date Applicant - ALTER OR ADD TO MECH. 5.00VE
} w NOTICE TO APPLICANT: If,eHcr making this Certificate of lix-
F = cardion,you should become subject to the Workers'Compensation -0 APPLIANCE 5.00
provisions of IIIc labor Code, you most forthwith comply with
U such provisions or this'crmit shall be deemed revoked. AIR HANDLING UNIT(TO 10AOOC.F.NL) 4.00
CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10 OOC.F.M.) 6.00I lenity_affirm that there is a constitution lending agency 1ot EXHAUST HOOD (WITH DUCT) 5.00the performance of the work for which this permit is issued(See.3097,Civ.0 u HEATING UNIT(TO100,000 B.T.U.) 8.00
Lenders Name HEATING UNIT(OVER 100,000 B.T.U.)9.50Lender's AIf �`�
( certify that lhave read this application and state that the above VENTILATION FAN (SINGLE) 4.00
.
information n correct, I s rel to comply with all construction,
city and county BOILER-CCINW(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING
ordinances ar and state laws relating to building const r u on and
hereby mentioned
roperty tar fives of this city es enter upon tire BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
abovo-mentioneJ property for inspection purposes.
(We) agree to save, indemnify and keep arless me City
of misc.- REFER TO ORD.
on y liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 -CONST.TAX
nayy in anyy way accrue against said City In consequence of the
.ling of this permit MECH.CONT. LIC.NO. MECH. '
Ems.•/a.v1 /7 t> 3-9-8P TOTAL TOTAL
Ignature of Applicant/Contractor - Date
��
OFFICE COPY