16596 POST THIS CARD NEAR FRONT OF BUILDING
.. - PER NI 1T N U NIS E R'
CITY OF CUPERTINO 16596 .
INSPECTION DIVISION
JOB INSPECTION RECORD `
'(��( PERMIT EXPIRATION
JOB ADDRESS �a� /OA-1 LrS7��}'/� ' la' UNIT# '_LOT#
• - - PERMIT EXPIRES IF WORK
OWNER CONTRACTOR - IS .NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.
FOUNDATION MA ANCE OR 180 DAYS FROM
NOTE:
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF -e!'ERMIT vn Llunn ON
CUPERTINO STANDARDS.
GARAGE SLABS !ki
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB `�` �• ' � � ��
PLUMBING
ELECTRICAL ISSUANCE DATE
MECHANICAL BLDG ELECT PLG. MECH
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED _ BUILDING PERMIT
WOOD FLOOR O$MA ION
51 )_VA ATION T SIFT,
PLUMBING
MECHANICAL
3Wp
ELECTRICAL ut PER^"T TO
FRAMING _ Hda�L.
INSULATION - - - STORIES TYPE CONSTR,
DCC GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOFNOTE:NO FINAL INSP,SHALL BE MADE BEFORE sO.FT.PLooII AIIen TOTAL neREAr,E
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING .� Res IND CON PB 00",
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
ROUGH SANA nssessuRS PARCEL NO.
PLUMBING ELECT.ENERGY
TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO
MECHANICAL: MECH.ENERGY
ELECTRICAL BUILDING ENERGY Acc DATE Acc FILE NO
FRAMING -�- ELECT.FINAL TEST
INSULATION _ •q. PLUMBING ZONING ENG.SIT ENO.
GAS TEST GAS
MECHANICAL' FIRE SPRINK ENERGY T 7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N ❑ N
EXTERIOR SHEAR ELECTRICAL RELEASE ., ,FLOOD ZONE .ATL UC.
INTERIOR SHEAR FIRE DEPT, Y❑ NO Y ❑ N❑
SHEETROCK GRADE _ FEE SUMMARY
EXTERIOR LATH IBUILDING
INTERIOR 'LATH TEMPORARY APPROVALS I BUILDING Q 7 ..,�.
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY,
SEISMICFEE �.
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED'BY BUILDING INSPECTOR.
MICROFILM
t
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
I- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
Z PLEASE GIVE JOB-ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL.
IMPORTANT! coNST.TAz
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
-PERMIT NUMBER
,BUILOWG PROJECT IDENTIFICATION APPLICATION Sl PERMIT 16596
'
euaolrvc
.�( A;- ss BUILDING—ELECTRICAL—PLUMBING—MECHANICAL
c�� 0 6,src ..
OWNERSPLAN CHECK VALWATION
NAM_ C y�Q� 7 OTV. ELECTRIC PERMIT FEE /7-
L ! oNEz
NOMERAcroRs UTLETS-SWITCHES-RECEP 10.00/1.00 v
LIC.NO. LIGHTING FIXTURES - 10.00/1.00
Oooness sons PPLIANCES-RESIDENTIAL 4.00
PHONE PANELS - 10.00 DATE OF APPLICATION. u
ARCHITECT JA PLAN CHECK FEE P.C.INO.
on `!t-/T -+/ � / PANELS (OVER 200 AMP) 20.00
ENGINEER /
SIGNS TRANS. 3.00
ADDRESS Ervc' SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
�crLrXo:✓rv.�
�Ir1 l B zIP EMP.METER OR POLE INS. 20.00APPLI CANTS
ADDRESS �� MOTORS
�)a SEE FEE SCH.
/S"'/'n� SERVICE CHANGE 20.00
C¢ i
,00 LIC-ENSIiU CONTRACTORS DECLARATION
<v E, 1 hereby affirm Thal 1 am licensed under provisions of Chapter 9
P,a m (commencing with Section 7000)of Division 3 of the Business and ISSUANCE DATE,
r D a Professions Code,and Imy license is in full force and effect. DG. ELECT. PLG. MECH.
Z 0m o License Class Lic.Number ,LZ7
P,H a, Date Contract.,
¢ w a OWNER-BUILDER DECLARATION \{V BUILDING PE MIT
INFORMATION
w 3 u I hereby affirm that I nm exempt from the Contractors License MISC.— 'REFER TO OR O
F LL o j Low for the following reason.(Sec.7031.5,Businessznd Professions / VALUATION $/FT.
Code:An cit or count - PERMIT ISSUANCE _W.45
f a, Y Y Y it any structureP prior
cnnsuance,also �U
¢ ¢ QQ improve,Demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO, ELEC. 3o Sa �O
o LL et uires the applicant licant fur such
n w m {p permd no of t a signed statement that TOTAL J PERMIT TO
he is(Chapter
9(commencing
pursuant In the provision of the Contractor's License '^
Hz¢ LawLChandProcosionsCde) thSectionisexemfttherefion oofthe �l'-Ga�w7r`'L
T i o Business and lie alleged eComo)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE /\
¢ r the basis for the alleged exemption.Any violation of Section 7031.5STORIES TYPE CONSTR.
malty
a3 $ by any applicant lbra permit subjects applicant toacivil penalty
of not more than live hundred dollars 1myem): ALTER-DRAIN& VENT-WATER (EA.) 5.00 '
❑ Las owner of the property,or my employees with wagon as BACK F LOW PROTECT. DEVICE 4.00
intended
sole r offered
for
will(S the 044,work,Business
the structure is not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business ato n Professions DRAINS-FLOOR,ROOF,AR EA,CON D. 5.00
Cole:The h Contractor's r License Law does not apply to an owner of
•
property who builds or improv,thereon,vid who does such work FIXTURE$-PER TRAP 5DD sO.FT.FLOORAREA TOTALACREAGE
himselforthrough his own employees, lenIf,hothat
r,tSuch improve-
orimprovemeletnnleodedwithinoffered
neyearlolfhowecegthebuilding GAS-EA.SYSTEM-1INC.4OUTLETS 6.00
or improvement is sold within one year(hat
athe dill,ion,[he owner-
builder will have the burden of proving thug he did nm hhild or int- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
it far purpose of the.l. INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB one,
loss owner of the property,um lot,,,(Se contracting Wien ❑ ❑ 13 0
licensed contractors to le Contract.,',
ontra tie project La 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00
and Professions Cole:The Con hactai s License Law Jaen not apply ASSESSORS PARCEL NO.
to antr owner of pmperl who builds to improves teetam,,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such pr L wish a contmmods) icmued pursuant In
the Connector's LI .sPe - SEWER-SANITARY-STORM EA.2001t/10.00 TRACT NO PARCEL No.
❑ lam ext n C. B.&P.C.fur this WATER HEATER W/VENT
�! ma neer 6,00
Owner Data WATER SYSTEM
5.00 ACC.DATE ACC FILE NO.
KF S'COMPENSATION DECLARATION WATER TREATING EQUIP. � 5.00
1 hereby afh . that I have a certificate of consent io self-insure
or a certificate of Worker'Compensation Insurance,or a certified ZONING ENG SITE NO.
copy thereof(Sec.3800,Lab.C.).
Policy No. Company -
O O Certified copy is hereby furnished.
ZZ ❑ Certified copy is filed will, the city' inspection division. FIRESPRINK ENERGY T 24
FO Applicant MISC.- REFER TO ORD. v� N� - YE] NJ_]W CER'I'IFICA'TEOP IiXEMPTION FROM WORKERS' PERMIT ISSUANCE
_ C.
W COMPENSATION INSURANCE FLOOD ZONE A.L.0
PLG.CONTR. uC.NO. PLG.
D hundred
section ted not be c mpleted if Int pernlil is for one TOTAL Y[] N Y� N�
U O hundrtJ dollars 15100)or less.) a -/
1 certify eat h the to mploynce of person
work for which this per- OTY MECHANICAL PERMIT FEE SUMMARY
0 H mit is issued,1 shag not employ any ensaon in any moaner so is to FEE
Q w become subject to the Workers'Compensation Laws ofCalifornia, Iy
W0. Dalt APPLICANT:
ALTER OR ADD TO MECH. BUILDING 4c,I
} res NOTICE: TO shout become
If,after making Ihia Certificate of fix- 5.00 a
Z enlption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of enc Luber Code, you marl forthwith comply with
U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10=11F.NL) 4.00 - FEE
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE oQ{�
I hereby affirm ilial there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 J
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
Lender's Address HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ' ELECTRIC OS°
1 certify that I have read this application and stale that the above ,VENTILATION FAN (SINGLE) 4.00
information is correct. 1 agree to comply with all city and county
ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING
hereby authorize representatives of this city to enter upon tins
above-mentioned property forinspection purposes. BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL
(We) agree to c, indemnify d keep harmless the City of MISC.- REFER TO ORD.
upertino ag ' is t Iles,juan
dgments, c s and expenses which CONST.TAX
may in an r e a•ai t sac i\consequence of the PERMIT ISSUANCE 10.00
rantim MECH.CONT.
LIC.NO. MECH.
TOTAL TOTAL
gn ouant/Conlritem, Uate
OFFICE COPY