15347 POST THIS CARD NEAR FRONT OF BUILDING
.. / PERMIT NUMBER
CITY OF CUPERTINO 15347
INSPECTION DIVISION
rJOB INSPECTION,RECORD
- - _ . ' , PERMIT EXPIRATION
JOB,ADDR ESS 7SF)S Heathe'rwoofl Drive UNIT �_LOT# - '
; I ' - - PERMIT;EXPIRES IF WORK '.
'OWNER Jeff Peters CONTRACTOR - "IS-NOT STARTED'WITHIN .
INSPECTION" DATE " INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU
- FOUNDATION _ NOTE: - ANCE OR 180 DAYS FROM
'LASTCALLED INSPECTION. ,
LIFER d ALL GRADING AND DRAINAGE SHALL,BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVEDPLANSAND CITY OF. PERmiT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS :c
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED tf. /(, �...-'r./�A'►r
UNDERGROUND /SLAB Ir, �L2r1:,
PLUMBING' . -' f�• eIf, t
ELECTRICAL - ISSUANCE DATE
MECHANICAL - p,Pt».o BLOC. ELECT I PLG. ,. VECH,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR ` INFORMATION
i
PLUMBING' - fal'`vncunnoN. -�
Citi y�fy-
MECHANICAL
ELECTRICAL PEHMIT TO t
FRAMING
INSULATION ' - " STORIES . .TYPE CONSTR.
"e OCC GROUP RES UNITS
PLACENO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF SO FT FLOOR AREA TOTAL ACREAGE
• NOTE:NO FINAL'INSP.SHALL BE MADE BEFORE -
DIAPHRAGM . "- THE CONSTRUCTION TAX IS PAID
rvDBUILDING USE
' ROOF SHEATHING ' Res I ' 'CON PB OW"
❑ ❑ ,❑ '❑, 1:1
j
APPLY NO ROOFING UNTIL ABOVE-HAS BEEN SIGNED- ` FINALS �. DATE '~ 'INSP,� AssessoasaARCELNO.-
ROUGH SAN.# „
PLUMBING ELECT.ENERGY .
TUBS&SHOW ER PAN PLUMBING,ENERGY TRACT NO. -PARCEL NO
MECHANICAL }
,. � MECH.ENERGY
ELECTRICAL ' - O-°� BUILDING ENERGY '" ACC.DATE ACC.FILE NO.
FRAMING - 'ELECT.'FINAL TEST "
INSULATION - PLUMBING � — w ZONING ENC SITE NO
GAS TEST - GAS " - -
MECHANICAL - ' - FIRE SPRINK ENERGY T 2
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING '. Y ❑• N❑ Y ❑ N❑'
EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE A.L.U.C..
,INTERIOR SHEAR , FIRE DEPT. Y ❑ N❑ Y ❑ N❑
SHEETROCK GRADE FEESUMMARY,
EXTERIOR LATH BUILDING -
INTERIOR LATHTEMPORARYAPPROVALS'' BUILDING
SCRATCH COAT t '. ELECTRIC PLAN CHECK
. , . GAS _ FEE
'NO TAPE OR PLASTER UNTIL ABOVE;HAS BEEN SIGNED OCCUPANCY. I I SEISMIC FEE
OCCUPANCY OF BUILDING IS NOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. rMICROFILM
ARRANGE FOR INSPECTION BY PHONING 2524505;' ELECTRIC'.
o� ONE WORKING DAY BEFORE REQUIRED NSPECTION.,' � •' PLUMBING ~
PLEASE GIVE JOB ADDRESS WHEN PHONING.
—'SEE PERMIT FOR EXPIRATION DATE,_ MECHANICAL
IMPORTANT! CONST.TAX '
" PLEASE READ REVERSE SIDE BEFORE TOTAL, 1
CALLING FOR FINAL INSPECTION. �.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES ,— USE BALL.,POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER
i' BUILDING APPLICATION & PERM
IT, 15�IA
ADDRESS 15 '7
/t4rM rlle r+-oc+G BUILDING -ELECTRICAL-PLUMBING-MECHANICAL >^I
OWNER'S PLAN CHECK VALIDATION
"AME J // OTY.. ELECTRIC PERMIT FEE
�• ip`� PHONE dsy —,j 2?
CONTRACTOR'S
NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 Q�
LIC.rvo. LIGHTING FIXTURES 10.00/1.00
CONTRACTORS
ADDRESS APPLIANCES-RESIDENTIAL' . 4.00
PHONE' - PANELS 10.00 DATE OF APPLICAtION '.
ARCHITECT PANELS (OVER 200 AMP) 20.00 'PLAN CHECK FEE P-.c. o.
ENGINEER
uc.No - SIGNS TRANS. 3.00
ARCH.OR ENG. - PERMIT VALIDATION
ADDRESS SPECIAL CIRCUIT 5.00
ZIP TEMP.METER OR POLE INS. 20.00
APPLICANT'S MOTORS, SEE FEE SCH:
ADDRESS
SERVICE CHANGE 20.00
w o o LICENSED CONTRACTORS DECLARATION 3 -
a u LLe I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE
y 4 N (commencing with Section 7000)Of Division 3 o the Business and - BLDG. EL6CT.. PLG. MECN.
Z1- D z Professions Code,and my license is in full force and effect. - . .n� I ❑
o i= W License Class Lic.Number
,A H Datc Contractor - -
< Y BUILDINGIPERMIT
c, 0 i o OWNER-BUILDER DECLARATION I INFORMATION
wg u_ w 1 hereby affirm that 1 am exempt from the Contractor's License MISC.— REFER TO ORD
u o¢ Law for the following reason.(Sec.7031.5,Businessand Professions VALUATION $/FT.
- g PERMIT ISSUANCE 10.00 V' CnpE din,.
Ew> Cade:Any city Orcounly which requires a permit to construct,alter,
— M
¢ ¢ 4 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. O GU IOW
i w m¢ requires the applicant for such permit to file a signed statement that TOTAL' PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License
Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe —
a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
¢ =$ the basis for the alleged exemption.Any violation of$ection 7031.5 STORIES- TYPE CONSTR.
e- by any applicant for a permit subjects the applicant to a civil penalty - ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars(8500).1:
❑ I,as owner of the property,Or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 - ace.caouP BEs.UNITS
their solo compeneatioq will do tire work,and [he etrucRoe is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code',The Contractor's License Law does not apply to an owner of - - -
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 So.PT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
ments are not intended or offered for sale.If,however,the building GAS-EA.SVSTEM-I1NC.40UTLETS6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00
builder will have the burden of proving that he did not build or im- BUILDING USE
prove for purpose of sale.: INDUSTRIAL WASTE INTER30.00, " RES -IND CDN PB .ocher
.
❑ 1,as owner of the property,am exclusively contracting with _ El El ❑ '❑ Ellicensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLER$- 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.) '.1.00
contracts for such projects'with a coutraetoo(OLlicensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 - TRACTNO. PARCEL NO.
❑ 1um' xem er ,BAP.C.run this WATER HEATER WIVENT , 6.00
reason
.� Owner Date WATER SYSTEM 5.00r
ACG DATE ACC.FILE NO.
RKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 '
1 hereby affirm that I have a certificate of consent to self-insure,
Or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. t
copy thereof(Sec.3800,Lab.C.). ...
Policy No. Company
❑ Certified copy is hereby furnished. FIRE SPRINK. ENERGY LY4e
Z Z ❑ Certified copy is filed with the it, inspection division. -
O Applicant MISC.- REFER TO ORD:' y ❑ N❑ v ❑ N❑
CC CE RTI FICAT E OF Ir X EM PT ION F ROM WORKERS' PERMIT ISSUANCE 10.00 :FLOOD ZONE _ A.C,U.C. :.
11J >
COPENSd not bATdO1NPIIN3URfANCEpennit is for One PLG.CONTE- LIC.NO, TOTAL Y E] ry❑
(This sermon nee - Y [3N❑
D Z hundred dollars($100)or less)
U O . 1 certify that in the performance of the work for which this per, QTY MECHANICAL PERMIT FEE 'FEE SUMMARY
LL 1— mil Is issued,1 shall not employ any person in any manner so as to
O W become subject to the Workers'Compensation Laws of Cul iforn into
It, Date Applicant BUILDING. .-
ALTER OR ADD TO MECN. 5.00
} to- NOTICE TO APPLICANT': If,after making this Certificate of Ex- IJV I
Z emption,you should become subject to the WOrkeri Compensation APPLIANCE - 5.00 •PLAN CHECK
provisions of the Labor Code, you most forthwith comply with FEE
V such provisions or this permit shall he deemed revoked AIR HANDLING UNIT(TO 10AMC.F.M.) 400 I'
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT,(OVER 10=C.EM.) 6.00 SEISMIC FEE ,0-0
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work lot which this permit is issued(Sec. MICROFILM
3097,Civ.C.L HEATING UNIT(TO 100,000 B.T.U.) 8.00 -
Lender'sName HEATI NG UNIT 100,000 B.T.U.)9.50 ao dT.
Lender's Address ELECTRIC _
1 certify that I.have read this application and state that the above VENTILATION FAN (SINGLE) .4.00 - ,
information is correct. 1 agree to comply with all city and county PLUMBING.
ordinances and stale laws relating m MP
building construction, and BOILER- H.P.or 100,000'B.T.U.)16.00
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. •MECHANICAL
above-mentioned property for inspection purposes.
(We) agree,to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. - ..
upertlno against liabilities,judgme ts, costs and expenses vihidl PERMIT ISSUANCE 10.00 CONST.TAX-
' may in any ay a c against Id City in consequence of the
rant gof sp MECH.CONT. LIC.NO. NIECE.
TOTAL, u TOTAL
p//
i an[/Contractor Date
OFFICE COPY