12995 POST THIS CARD NEAR FRONT OF BUILDING
i
CITY OF CUPERTINO reRMlr NUMBER12995
INSPECTION DIVISION
JOB INSPECTION RECORD
' - PERMIT EXPIRATION
JOB ADDRESS_10577 '& 10585 S. Foothill UNIT# LOT#
_ - - PERMIT EXPIRES IF WORK
OWNER Kinst Ct. Partnershir, CONTRACTOR Terry Brown Construction IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
LIFER LAST CALLED INSPECTION.
•
PREGUNITE PERMIT VALIDATION J
1 rl ��` Il
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED � ',•• "
UNDERGROUND /SLAB - r
PLUMBING �,I• V��
`1 ELECTRICAL - ISSUANCE DATE
BLDG. ELECT, PLG. MECH,
I MECHANICAL ❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED AuILDINc PERMIT
INFORMATION
WOOD FLOOR L euoN d �S/FT.
PLUMBING
MECHANICAL •
ELECTRICAL PERMIT TO /
FRAMING u c'«! :-�'- i"7-•�
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 IND CON PB Omn
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ E) El
ROUGH ASSESSORS PARCEL NO.
PLUMBING
GAS TEST TRACT NO. PARCEL NO
MECHANICAL
ACC.OATE ACG FILE NO.
ELECTRICAL FINALS DATE INSP. -
FRAMING SAN #
INSULATION PLUMBING ZONING ENG.SITE NO.
GAS
MECHANICAL FIRE SPRINK ENERGY T"24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - YE] . NE3 Y ❑ "❑
.
- LATH—INTERIOR ELECTRICAL FLOOD ZONE AL.U.C.
LATH—EXTERIOR FIRE DEPT. Y ❑ NEI Y0 N
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR BUILDING
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING
FIREWALLS ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE u
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
j� 0� PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
i IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL 7'
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
ADDREBE O Sri rl $OsATH ort CU-
f BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 12995
OWNER'SK �/ PLAN CHECK VALIDATION NAME �` �/ T Y. ELECTRIC PERMIT FEE
Klni 6T CT eT1f J
CONTRACTORS
NAME OUTLETS-SWITCHES-RECEP 10.00/1.00
12aAJ tj Ct1 IC.No.3J.Z(o LIGHTING FIXTURES 10.00/1.00
CONTRACTOFfS
AODRES APPLIANCES-RESIDENTIAL 4.00
,;W1_11 alzA dl/E PNpNE9 PANELS 10.00 DATE OF APPLICATION
RCHIrecT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEEP.C.NO.
OR
O
ENGINEER
uc.NoSIGNS TRANS. 3.00
goo ESS ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
Zlp` TEMP. METER OR POLE INS. 20.00
APPUCANT9 MOTORS SEE FEE SCH. 3
KA
A PUCA
DRESS
SERVICE CHANGE 20.00 A1 •
W o LICENSED CONTRACTORS DECLARATION
v I herebyaffirm that I am licensed under provisions of Chapter 9 lEg! NCE DATE
maw (commencing with Section 7000)of Division 3 of the Business and D T. PLG. MECH.
F 0 z Professions Code"nd my license u in fall fmi�p a feet.
oi`� W License CIaR Lic.Number J.J
v,F Date 5 1-7-8-r)_Co arceir
a y.3 J CI I NG PERMIT
at Ica OWNER-BUILDER DECLARATION
o a v INFORMATION
E
; N m I hereby affirm that I am exempt from the Contractors Licenue MISC.- REFER TO ORD
F LL 0 a Law for the following reason.(Sec 7031.5,Busie..Rd Professions PERMIT ISSUANCE 10.00 VALUATION
S/FT.
Code:Any city or county which requires a permit to construct,alter, O
ac aa Q 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. ��6V
0 ac requires the applicant for such pemdt to file a signed statement that TOTAL PERMIT TO
wLa u � ��q�
he is licensed pursuant to the provisimof the Contractor's License ./�Law(Chapter 9(commencing with Section 7000)of Division 3 ofthc �.2, //'
a Businea and Profession Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
$ the basis for the alleged exemption.Any violation of Section 1031.5 STORIES TYPE CONSTR.
A , by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER IEA.) 5.00
of not more than Five hundred dollars(5500).):
❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEV ICE 4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
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
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SC_FT,FLOOR AREA TOTAL ACREAGE
_ himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-11NC.40UTLETS 6.00
ments are not intended or offered for sale.If,however,the building
or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM OVER 4 (EA) 200
budder will have the burden of proving that he d - . .
int
id not build or - BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Dm«
❑ 1,as owner of the property.am exclusively contracting with 0 ❑ ❑ D ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:'fine 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 contrachms)licensed pursuant to
the Contractors License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
rcason❑ lam exempt under Sea ,B.&P.C.fur this WATER HEATER W/VENT 6.00
Owner Date WATER SYSTEM 5.00
ACC.DATE ACC.FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby atOrn that 1 have a certificate ill-emovel to set&insure,
or a certificate of Workers'Compen, Insurance,or a ccrtif,d ZONING ENG.SITE NO.
copy thereof f5ec.3800,fab.C.l./}T-�N A
Policy No. Company(AG.�v_L[Cdr]42L.1 -�(�.
❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY L24
z = .❑ -Certified copy is filed wqh the city inspection division. MISC. REFER TO ORD. 0
Q APPicani�-'(�j/jg4F-A� Y N Y N
CC va PERMIT ISSUANCE 10.00
LU - CCRTI FICATMPFNEX SAiION PTI FROM WOR KERS' FLOOD ZONE A.L.U.C.
CL 7 need not be co N INSURANCE ifthe PLG.CONTR. LIC.NO. PLGCL ❑ ❑ ❑ ❑
Z (This do llarn need not be completed it the permit u for one TOTAL Y N Y N
hundmd dollars(S 100)or less.)
U O 1 certify that in the Performance of the work for which this per- QTy. MECHANICAL PERMIT FEE FEE SUMMARY
UL I- mit is issued,I shall not employ any person in any manner so as to
Q L) s become subject to the WorkerCompensation Laws of California --_
y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} w NOTICE TO APPLICANT: If,after making this Certificate of Ex-
2 emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you most forthwith comply with FEE
U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10)OCIOGF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10)JOOC-F.M.) 6.00 SEISMIC FEE J_b
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.f H EATI NG UN IT(TO 100,000 B.T.U.) 8.00
Lender's Name
H EATI NG UNIT(OVER 100,000 B.T.U.)9.50
Lender's Name ELECTRIC
I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00
information is Correct.I agree to Comply with all city and county PLUMBING
ordinances and slate laws relating to building const ruction, and BOILER-CDMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives ins ec this city es 'enter upon the BOILER-COMP (Over 100,"BTUI SEE FEE SCH. MECHANICAL
above hereby aut mentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, crisis and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
ra
may in any way acee,against said City in consequence of the
gaming of this permit MECH.CONT. LIC.NO. MECH.
N
x TOTAL TOTAL 3�
Signare of Applicant/Comnctor Date
OFFICE COPY