18385 POST THIS CARD,NEAR FRONT OF BUILDING PERMIT NUMBER
CITY - OFP
CU ERTI
NO
18385
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS_ L I UNIT# LOT# pERM1T EXPIRES IF WORK
owNeq.• $ �c I CONTRACTOq G l C S NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 80 DAYS OF PERMIT ISSU.
-
FOUNDATION NOTE: ANCE OR 180 DAYS FROM
. � '
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PREGUNITE. TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLHVIT VALIDATION
CUPERTINO STANDARDS.' �
GARAGESLABS - Ps��D
> % ..
POUR NO CONCRETE'UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB. - _ _ ' JUL H 0 1989 I
PLUMBING � rp,'�M ✓fry ti IN
ELECTRICAL . � {
of�IVN! ISSUANCE DATE
MECHANICAL — BLDG, j ELECT.I PLc. &TECH.
,
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR - INFORMATION
VALUATION, ',_ij s
PLUMBING ,";'`51F T.
MECHANICAL
ELECTRICAL - PER;m
FRAMING T
INSULATION RIES'— TYPE CONSTR,
O
occ.cHDUP Hes.uNlrs
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
" ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 50 I L FLOOR AREA TOTAL ACREAGE
I"• DIAPHRAGM THE CONSTRUCTION TAX IS PAID. '
BUILDING USE
ROOF SHEATHINGHIES IND CON Re : Oen.
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 •0 0 0 0
ASSESSORS PARCEL NO.
ROUGH" SAN.#
PLUMBING; - ELECT.ENERGY ,
• THACT NO: PARCEL NO
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY '
' ELECTRICAL - .BUILDING ENERGY ACC.DATE ACC,FILE NO.
FRAMING ELECT,FINAL TEST
INSULATION _ zoNlNc
PLUMBING ENG.SITE NO,
GAS TEST GAS -
FIRESPRINK ENERGY T-24
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - T' 0 ND ` 0 NO
'
' EXTERIOR'SH EAR ELECTRICAC'RELEASE - FLOOD ZONE AL UC.M,.�,�-I
INTERIOR SHEAR FIRE DEPT. Y El !"❑ ❑- NEI
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 ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE.FOR.INSP ECTION BY PHONING 252-4505, ELECTRIC
o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. 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 3oE�
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
RUILDING . APPLICATION & PERMIT - !
ADOREss '_ 18385
Jam! G1LJ.Ick BUILDING - ELECTRICAL-PLUMBING-MECHANICAL
• OWNER'S PLAN CHECK VALIDATION
NAME
DTV. ELECTRIC PERMIT FEE
CONTRACTORS
- s I PROM - �2 2.
NOMERAcrona UTLETS-SWITCHES-RECEP 10.00/1.00
t�tAiE I{p6E'cR- I �Df'CL+c,ND 51IY LIGHTING FIXTURES 10.00/1.00 -
ADDHEacroR'E APPLIANCES-RESIDENTIAL " 4.00
CONTRACTOR
A '1
S/S• AcTV.w"mssr FHONE �lC)`0 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE P.C.NO.
on , PANELS (OVER 200 AMP) 20.00 _
ENOINEER
'ARCH OR LSA �, • uc.NiU L ' SIGNS TRANS. 3.00
AD EN SPECIAL CIRCUIT 5.00 'PERMIT VALIDATION
A. ZI EMP. METER OR POLE INS. - 20.00 7-
ADDRESPPLICANrFJ ' MOTORS SEE FEE SCH. L� /
SERVICE CHANGE 20.00
LICGNS _ Joy /
rOo
,
< ED COVE RACTORS DECLARATION
zaa
V I hereby altlmt that I am licensed under provisions of Chapter 9 JL11 2 d 1qA4 ISSUANCE DATE
G
(commencing with Section 7000)of Division 3 of the Business and¢ A BLDG. ELECT. PLG. MECH.
H m i Professions Codde and my license is in(all fo�cr (tecta ❑ ❑
Z o,a- License
Clpss�Lie Numhcr.?__0"1''-13
O v, H ac Dale J ContracI.<L UT&
a Y f BUILDING PERMIT
a
OWNER-BUILDER DECLARA'T'ION _
a a u t ' INFORMATION
w g LL R I hereby affirm that I am exempt from the Commctor's License MISC.- REFER TO ORD
u-0' Law for the following rcason.(See.7031.5.Busimzsind Profe.Uons PERMIT ISSUANCE 10.00 VALUATION S/FT.
- Code:Any city or county it my Structure,
oor to construct,alter,
also
2 IS Q 0 improve,demolish,or repair any sUucmrc,prior to its 6SuancC else ELEC.CONTR. LIC.NO. ELEG '
u u requires the applicant for such permit to File a signed statement that - TOTAL
re w he is licensed pursuant to the provisions of the Contractor i LicenseLa
PERMIT TO
Rz � Law(ChmIcr 9 fmmmerving with Section 7000)ofl :vision 3 of the -
a Business.,,it Professions Code)or that be is exempt therefrom and OTY. PLUMBING PERMIT FEE
r the basis for the alleged exemption.An,violation of Section 7031.5 STORIES TYPE CONSTR.
a ; by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER MA.) 5.00
of not more than five hundred dollars(S500)J:
❑ I,as owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 ,
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
ns
intended or offered for sale (Sec. 7044, Husiness and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 .
Code The Contractor's License Law docs not apply to an owner of -
property who builds of impmvcs thricon,and who docs u,l,work F IXTUR FS,PER TRAP 5.00 Sa FT.FLOOR AREA TOTALACREAGE
t himself or through his own employees,provided that stock improve-
mentsarc not intended oroffered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM. 4(EA.) 2.00
builder will have the burden of proving that he did not build or im- - _ BUILDING USE
prove for purpose ofsale.). INDUSTRIAL WASTE INTER3000 RES IND CON PB Other
Ci . .
1,as owner of the property,am exclusively contracting with 0 ❑ -❑ ❑, El
licensed contractors to con.strttel the project(Sec 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. ' '6.00 ,ASSESSORS PARC EL NO.
and Professions Cade: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 contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contract.,',License Law. TRACT NO. PARCEL NO.
❑ Iamexemptunder Sec. ,B.&P.C.for this WATER HEATER W/VENT. 6.00
'x cavo.
Owner Dale WATER SYSTEM 5.00 ACC.DATE ACC.FILE.NO.
WORK ERS'CONPE NSA'r10N DECLARATION WATER TREATING EQUIP, 5.00
I hereby altirm that I have a certificate of consent to self-insure' ZONING ENG.SITE NO.
or a certificate of Workeri Compensation Insamnco ¢
e. r a rtinvc!
copy thereof(Sec.3800,Lab.CJ. -
Policy Nn. Company
O ❑ Cemilicd 'opy is hereby fumohed. FIRE SPRINK ENERGYT T4
Z Z CvtiI is y� with Ih aty stttlion division.
O ,(pplicant (r �/o - esn-�cn. MISC.- REFER TO ORD. Y E] NE] Y ❑ N�
CC y - PERMIT ISSUANCE 10.00
� - fliR'I'IEICATE OPGXGRIPI'INS PROMWORKGHS' FLOOD ZONE A.L.u.c.
IL > CONneed F.'t he oro INSURANCE PLG.CONTR. uC.NO. PLG. Y0 NE Y � NEI
� Z (This dollar, need col he completed if the permit n for one TOTAL
hundred dollars IS 1the or Ica.) -
U O I cerlily Thal in the performance of tire work for which this per- GTY. MECHANICAL PERMIT FEE FEE SUMMARY,
0 U mit is issued.1 tOndl o tie W employ any person in any manneror lie In
become subject to Oso Workers'Compensation laws of Calilomiu.
U do Date Applicant BUILDING
} W NOTICE: 'f0 APPLICANT'. If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00
F ? emption,you should become subject to the Workeri 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 I0=C.F.M) .4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE' '
I hereby affirm that Ihere'is a construction lending agency lin EXHAUST HOOD(WITH DUCT) 5.00 -
the perlomlxnce of the work lot which this permit is issued(Sec. MICROFILM.
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00Up
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I cerlily Ili,I have read Ihisapplicelion and stole thatthe above VENTILATION FAN (SINGLE) 4.00
moninmion is correct. I agree to comply with all city and county PLUMBING
ordinances and slate laws relating to building construction, unJ 601 LER-COMP 13 H:ROT 100,000B.T.U.) .6.00 , - ID
hereby authorize representatives of this city to enter upon the BOILER-COMP(Oxer 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes.
(We) agree tO save, indemnify and keep havn). the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any way ancme-against said City in consequence of the 2,CiD
raming of l�rtni. MECH.CONT. LIC.NO. MECH.
TOTAL��r D� TOTAL
Sre of Applicant/Contractor Date '
OFFICE COPY