148781-0
•
POST THIS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO'
INSPECTION DIVISION
JOB INSPECTION RECORD
G'PERMIT
JOB ADDRESS f / 7 O ALL CT. UNIT# LOT#
OWNER /,p�,�q�Iff- ,L TQ ja 7X, CONTRACTOR -7Zt
PERMIT NUMBER
14878
EXPIRATION
PERMIT EXPIRES IF WORK ,
IS NOT STARTED WITHIN
180DAVSOFPER MITISSU-
ANCE OR 180 DAYS FROM
LASTCALLED INSPECTION."
,INSPECTION :i�;.::.-� ?,.DATE;: INSPECTOR
-tJ I,,,•i'i;.—, 1NSPECTION, R ECO RD �;;,'a,:., %+'.5
FOUNDATION
NOTE:
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS.
UFER
PREGUNI?E
PERMIT VALIDATION
--•^'
C
e ISSUANCE DATE
GARAGE SLABS
POUR NO CONCRETE'UNTIL;ABOVEjHASMENSIGNEDA
81'a6128 fl0l, e
—wCJ 88 Tv"n ok
UNDERGROUND/SLAB
PLUMBING
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ELECTRICAL
MECHANICAL
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ELECT.
PLG. ,- MECR-"
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DONOT.ROUR;F.LOOK;UNTIL'eABOVESHAS.BEEN'SIGNED
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BU�CDINcVERMIrA.
AINFORMAT,ION,. -
WOOD FLOOR
VALUATION
/
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PLUMBING
MECHANICAL ��
ELECTRICAL
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FRAMING -a'
INSULATION
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STORIES
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TjY�P,ECO/N�STR..�.,I
u,6e,
OCC.GROUP
;R,I UNITS
•PLACE'.NOSUBFLOORUNTILVABOVE; AS,BEEN'.SIGNEO"
ROOF'
NOTE: NO FINAL INSP. SHALL BE DE BEFORE,..'
THE CONSTRUCTION TAX IS PAID
. - ;y .,
,fi. FLODR AREP
a
TOTAL ACREAGE :.
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DIAPHRAGM
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'RES IND CON PB j OM ,'
�" S a'� ❑
ROOF SHEATHIN I Q!
TC
TAPPLY,NO ROOFING'.UNTILTABOVEMASIBEEKSIGNED�
�y-.01NALS`0" 7 A DATE .i� INSF'
ASSESSORS PARCEL N O t
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ROUGH
SAN.p S
PLUMBING
ELECT. ENERGY
TRACTNO.
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PARCEL' NO.,. y,.,
ur..
TUBS &SHOWER PAN —3o-
PLUMBING ENERGY
MECHANICALMECH.ENERGY
.'".x'
ACCD. GATE
ACC -FILE NO.
'ENG.
ELECTRICAL -j
BUILDING ENERGY
FRAMING
ELECT. FINAL TEST
ZONING
SITE NO.
,�'.•' '"
INSULATION
PLUMBING
GAS TEST
GAS
FIRESPRINK
c]N�
ENERGVT;]<;i%
�='�N❑
MECHANICAL
COVER NO WORK UNT LA OVf HAS BEEN SIGNED 4''$,
HEATING
FLOOD ZONE
vo•"NO-"::�7�,r+Q''
A,LU,C�y
•.%"i '
EXTERIOR SHEA @.
ELECTRICAL RELEASE
INTERIOR SHEAR
SHEETROCK
FIRE DEPT.
GRADE
,EFS
.. , L
EXTERIOR LATH
BUILDING
BUILDING
•. ,Q,'}�?3�
INTERIOR LATH
TEMPORARY APPROVALS
SCRATCH COAT p- /
ELECTRICPLAN
CHECK
FEE
- '�"`'•
GAS
SEISMIC FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED,
OCCUPANCY
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL ISSIGNED BY BUI LDING INSPECTOR.
MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252.4505,
ONE WORKING DAY BEFORE REQUIRED INSPECTION.PLUMBING
z PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE -
ELECTRIC
(P"
6 T3
MECHANICAL7
6 , yt
CON
ST.TAXPLEASE
IMPORTANT!
READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
TOTAL
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OFFICE COPY
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APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PFN OM x/ -
BUILDING. PROJECTIDENTI FICATIONC'r
APPLICATION &PERMIT
BUILDING - ELECTRICAL- PLUMBING -MECHANICAL
PERMIT NUMBER -
4 S 7 S
.o°ss ,.,�
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Zq9zo..
OWNER'S 1
E ✓T ' f�� �m
✓ T\ O
F / _ PRONE q
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_ _
OTY- ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
DATE OF APPLICATION
PLAN CHECK fEE P.C. NO.
C NTRgCTORS
"AxsEOUTLETS
RlL.EX LIC. N(3_4//-_7
-SWITCHES -RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S
ADDRESS 1700 Thf- /li&GqMF_0
N 3 CS ILi SI?JjINE 2 -0
f OgCXrtECT
ENGINEER
PPLIANCES- RESIDENTIAL 4.00
PANELS 10.00
PANELS (OVER 200 AMP) 20.00
SIGNS TRANS. 3.00
LIC. NO. 14ox
aRCX.OR ENG.'�^
syr y
v' aDDRE55 G.�y S S7yNS ('(2
SPECIALCIRCUIT 5.00
PERMIT VALIDATION
r LA o OI zlv
TEMP. METER OR POLE INS. 20.00
APPLICANT'S
AOPLICA
MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chaplet 9
(commencing with Section 7000) Of Division 3 of the Business and
Professions Codc,JdbPdmY license is in full force n e Cr
License Cie _ Cum, tuber_
Date Contractor 1 (�@71C
ISSUANCE DATE
ELECT.
PLG. MECH.
p�
L6x
OWNER -BUILDER DECLARATION
I hereby . m ffuthat I am exempt from the Contractor '& License
Law for The following reason. ch requiresa permit to andcon Professions
Code: r theAnycily orcountyles which c. 7031. Businoconslro a alter,sions
improve, demolish, or repair any structure, prior to its issuance. also
requires the applicant for such permit to rile a signed statement that
he is licensed pursuant to the provisions of the Contractor's License
Law(Cbapm'9(Commenciu e' th Section US ekcmfDivision3ofrhe
Business and Professions Code) or that he is exempt Therefrom and
The basis for the alleged exemption. Any violation of Section 703 L5
by any applicant (or a perrnir subjects The applicant loo civil penalty
of not more than five hundred dol1.rs(5500).):
❑ I, as owner Of the property or my employees with wages as
their sole compensation, will do the work, and the structure rs not
intended or offered for sale (Ste. 7044, and
and Professions
Code: The Contractor's License Law don not apply to an owner of
property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improve-
an are no mon "dad or Offered for sale. If, however, The building
or unprwill h lis sold within one year of completion, the at-
builder will have the burden of proving that he did not build or im-
prove for purpose of Sale.).
❑ d as owner of the property, em exclusively contracting with
licensed contractors to construct the project (See. 7044, Business
and Professions Code: The Contractor's License Law does not apply
to an owner of property who builds or improves thereon. and who
contracts for such projects with a contnetods) licensed pursuant to
the Can License Law.
reason am exempt under Sec. ,BAP.C. for this
son
ING PERMIT
rl . ;; ' b
INFORMATION',,'
MISC. - REFER TO ORD
PERMIT ISSUANCE 10
_ V^
FS/`Typ{Y V f' x+
ELEC. CONTR. LIC. NO. .
SLED.
TOTAL L�
OTY. PLUMBING PERMIT 'FEE 1
- -
ALTER -DRAIN & VENT -WATER (EA.) 5.00
PE MIT TO
V V
STORIES
TYPE, tC�ON�S/Tp�
�E C S
'V
BACK FLOW PROTECT. DEVICE 4.00
OCC. GROUP
RES. UNITS
DRAINS -FLOOR, ROOF, AREA, CON D. 5.00
FIXTURES -PER TRAP 5.00
GAS-EA.SYSTEM-11NC.40UTLETS 8.00
GAS - EA. SYSTEM - OVER 4 (EA.) 2.00
sa FT. FLOOR AREA
`x/
s
TOTAL ACREAGE
BUILDING USE
Rg TIN CO ,� DO
M.�,
INDUSTRIAL WASTEINTER. 30.00
LAWN SPRINKLERS- 1 INC 5 V.B. 6.00
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
ASSESSORS PARCEL INO.
9 C _6�' C/d
O ! /,
SEWERSAN ITAR Y -STORM EA. 2008/10.00
WATER HEATER W/VENT`
6.00
TRACT NO,
PARCEL NO.
-
- %
Owner
O're
WATER SYSTEM 5.00
WORKERS'COMPENSATION DECLARATION
1 hereby affirm that 1 have a certificate ofconwnt to self -insure.
or a certificate of Workers Compensation Insurance, or a terrified
copy thereof (Sec. 3900, Lab .CI
Policy No. Company! • /NJ /.
ACC. DATE
ACC. FILE NO.
WATER TREATING EQUIP. 5.00
ZONING
,
ENG. SITE NO.
.o
❑ Certified copy shereby famished.
�aCenified Ile with the y spec) wislon.
- A icanl �
FIRE SPRINK
Yo N[]
FLOOD ZONE
V N�
ENERGYT-24
YE] NM
A.L.U.C.
V 0 NEI
MISC. - REFER TO ORD.
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one
hundred doll.. IS 100) or less.)
PERMIT ISSUANCE MUO
.
PLGCONTR. LIC. NO.
PLG.
TOTAL
OTY MECHANICAL PERMIT FEE
- FEE SUMMARY',`<; _
I certify that in the performance of the work for which this per-
mit is issued, I shall not employ any person in any manner so as to
become subject to the Workers Com pensa l ion Laws of Ca lifornia.
Dale Applicant
NOTICE TO APPLICANT: If, after making this of
BUILDING
,�-G
v /
ALTER OR ADD TO MECH. 5.00
emption.ion you should become subject to the Wothwit Compensation
rst' Compensation
ion
provisions io the Lobar Code. you must forthwith comply with
such provisions or this permit shall be deemed revoked.
APPLIANCE 5.00
AIR HANDLING UNIT (TO 10,00DCF.M.) 4.00
PLAN CHECK
FEE
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
the performance of the work 1' or which this permit is issued ISec.
Lend, 0,C).G1.
Lender's Name Le-'_L I�T ++
- AI art IG
AIR HANDLING UNIT (OVER 100MC.F.M.) 6.00
SEISMIC FEE
!� "
EXHAUST HOOD (WITH DUCT) 500
.
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Addle- -,
HEATING UNIT (OVER 100,000 B.T.U.)9.50
ELECTRIC
9�
I certify that 11-1c,i.d this application and Sta to that the above
information is correct I agree ro complY with all city and county
ordinances and slate laws relining ro building construction, and
hen by authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
(We) agree to save, indemnify and k It the City of
upertino against liabilities, judgment ,costs and %pens which
may in n_rt . City i conxs Il•
m g6f tbrs enmt.
l' col,\pplicantlContracror D.n
VENTILATION FAN (SINGLE) 4.00
BOILER -CO VP(3H.P.Orl00,0006.T.U.) 6.00
PLUMBING
6 93
BOILER -COMP (Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
C
6 /,
MISC. - REFER TO ORD,
PERMIT ISSUANCE -49:64 a --
CONST. TAX
L`�
O
ECH. ONT. LIC. NO.
'
fj(
/i�`�
MECH.
TOTAL 7 4 93
TOTAL
is o F54Signat
OFFICE COPY