14837 POST THIS CARD NEAR FRONT OF BUILDING Ye
Im f RM IT NUMBERF -
., CITY OF CUPERTINO
INSPECTION'DIVISION , 14837
JOB INSPECTION RECORD
22399 Janice Avenue PERMIT EXPIRATION
JOB ADDRESS UNIT.# LOT#' 4 `
• PERMIT EXPIRES+IF WORK
04ES Gd nes , CONTRACTOR • - I r,IS�NOT�STARtEDj,WITHIN.J
" INSPECTION - DATE INSPECTOR INSPECTION RECORD' '1.•;780 DAYS OFTERMITISSU_
FOUNDATION - ' '•. - q-ANCE-.0R,5180,11AYS,FROM',
NOTE: LAST CALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TOLCOMPLY WITH THE APPROVED PLANS AND CITY OF IPERMIT VAI IDArION
PREGUNITE CUPERTINO STANDARDS: - I
,GARAGE SLABS - g4iI P
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
-
UNDERGROUND /SLAB
PLUMBING , _ -� •/�i f G
ELECTRICAL - ,+. - ISSUANCE UAIE
. PLG.' MECH.
MECHANICAL BLDG.BLDG. ELECT '
DO NOT POUR FLOOR UNTIL ABOVE
HAS BEEN SIGNEDED BUILDINGDINGPERMIT
_
WOOD FLOOR + ' ' INFORMATION
VALUATION '$IETI
' - PLUMBING � • ' - � '
MECHANICAL' .
ELECTRICAL - - PERMIT TO
FRAMING _ - i'
STORIES TvvE corvsTR.
INSULATION
. •�� Dro.GHOulrvl RES UNITS-
' PLACE NO SUBFLOOR UNTIL ABOVEMAS BEEN.SIGNED
` SO'ET,FLOOR AREA TOTAL ACiEAGF .*
ROOF, _ NOTE NO FINAL INSP.SHALL BE MADE BEFORE
THE CONSTRUCTION TAX'IS PAID
DIAPHRAGM"
' BUILDING USE `
' ROOF SHEATHING ' - 'VIES - IND CON PH Oma• .
APPLY NO ROOFING UNTIL ABOVE HAS'BEEN SIGNED =FINALSDATE INSP. ❑ ' ❑ ❑ - ❑ ❑; ,i
' IHAN.N - ASSESSORS PARCEL NF>.�
-ROUGH
PLUMBING,. •• ELECT:ENERGY TRACT NO. •PARCEL NO
TUBS&SHOWER PAN PLUMBING ENERGY - r
MECHANICAL, - MECH.ENERGY
u4:' ACC.DATE; w^:4lj&jOgi-I. ..NC
ELECTRICAL -BUILDINGENERGY � +•f1� ,
FRAMING'` ' ELECT.'FINAL TEST J- - . : ...,y..:.n'1,• "
INSULATION PLUMBING i ,: ZONING E:•NG:•
,SITE NO.
"
_. GAS TEST GAS
FIRE SPRINIK .'ENERGY T 24
COVER NO WO" `
- - MECHANICAL '
RK UNTIL ABOVE HAS BEEN SIGNED•. HEATING � , y ❑ ^❑ -�°�❑� "❑
-n.E.0
- 'EXTERIOR'SH EAR - FLOOD ZONE C.
ELECTRICAL RELEASE � '- '-
'.INTERIOR.SHEAR - FIRE DEPT:
SHEETROCK - GRADE - - "FEE SUMMARYs
EXTERIOR LATH '' , BUILDING N
INTERIOR .LATE TEMPORARY APPROVALS BUILDING
SCRATCH COAT - ELECTRIC - PLAN CHECK -.
' GAS FEE
o'
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF,BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNEDBY.'BUI LDING INSPECTOR. MICROFILM -
ARRANGE FOR-INSPECTION BY PHONING 252-4505, EL�crRlc
ONE'WO'RKING.DAY BEFORE REQUIRED:INSPECTION: PL6MBiNG
o PLEASE GIVE JOB ADDRESS.WHEN PHONING.
z — SEE PERMIT FOR EXPIRATION DATE MECHANICAL71 .
IMPORTANT! coNST.TAx;
PLEASE READ REVERSE SIDE BEFORE TOTAL
-CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN.REDLINES - USE BALL POINT PEN ONLY _
BUILDING PROJECT I DENT[FICATI ON PERMIT NUMBER
.."LGINC APPLICATION & PERMIT - 14837
ADDRESS - r
, 22399 Janice Avenue BUILDING-ELECTRICAL-PLUMBING-MECHANICAL'
OWNERS
} PLAN CHECK VALIDATION
NAME
Ga S .,. PHONE 255-7799 QTY. ELECTRIC PERMIT - FEE
NAME ACTo�a se - OUTLETS-SWITCHES-RECEP. _10.00/1.00
DIAL ONE Buffalow lsL,L.No, 233558 LIGHTING FIXTURES 10.00/1.00 '
ADDRESS
CONTRACTORS PPLIANCES-RESIDENTIAL. 4.00
1245 Space Park Way PHONE 961-7550PANELS 10.00 PATE OF APPLICATION
ogcHrrecr PANELS (OVER 200 AMP) 20.00 - PLAN CHECK FEEP.C.No.
ENGINEER '
- LIC.No. SIGNS TRANS. 3.00
ARCH.OR ENG. -E PERMIT'VALIOATION
ADDRESS - SPECIALCIRCUIT' 5.00
ZIP TEMP.METER OR POLE INS. - 20.00
APPLICANT - MOTORS ' SEE FEE SCH. "
ADDRESS
SERVICE CHANGE 20.00 p{�
/
F ' Od
"O{o o `LICENSED CONTRACTORS DECLARATION ,
¢U w I hereby affnn that I ran licensed under provisions of Chapter 9 - ISSUANCE DATE '
Naw (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
H m z Professions Code a it my license is in fu9ATION
p eL ❑ ❑ ❑ MEC
H.
0 ,n - License Clas Lie,Num0 Datca f a BUILDING PERMIT
OWNIER-BUILDIiR DBC
¢ o n 0. - - INFORMATION
w ;e-w 1 hereby affirm that I am exempt from the Con ractor's License MISC.- - REFER TO ORD
r u 0 j. Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION S/FT.
� Code:Any city orcoomy whiehrequiresopennil loc'onsl mcLuller,
¢au a improve,demolish,mr repair any structure,prior to its issuance,also ELEC.CONTR., LIC.NO. ELEC.
n w m¢i requires the applicant for slick permit ns file a signed statementstatementthat t TOTAL PERM TO -
he is licensed pursuant to the provisions of the 6tora License
F z Law(Chapter9(commencing with Section 7000)of of Division of the -
4 o Business and Professions Code)or that he is exempt therefrom,and CITY. PLUMBING PERMIT FEE
¢ H $ the basis for lire alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN$VENT-WATER (EA.) 5.00
of not more than five llur
hundred doS(5500).):
❑ I,as owner of the property,or try employees with wages as BACK FLOW PROTECT.'DEVICE 4.00 OCC.GROUP RES:UNITS
their sole contpensulion,will do the work,and the structure is not ,,
.. intended or offered for sale (Sec. 7044, Business and Professions
Code: ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of -
propertywhobuildsVrruprOvesthereon,and who does such work . F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE
himself or through his own employees,provided that such improve.
.cuts tremor intended or offered for sale.If,however,the building GAS-EA.SYSTEM-I 1NC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS,EA.SYSTEM-OVER 4 (EA.) 2.00
builder will have'fhe burden of proving that he did not build or im- BUILDING USE-
RES IND CON PB Other
prove foes purpose of safe.). INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ . ❑
❑ I,as owner of the property,um exclusively cool rooting with
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-I 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 Ihereun,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 I.
contracts Contraorsuchprnje Lwitltacontracturts)licenced purivanl to SEWER-SANITARY-STORM EA.200ft/10.00
lire COIamCexeS License Lace. - TRACT NO. - PARCEL N0.
❑ tum exempt see. ,B.&P.C.I'or Ibis
reason WATER HEATER W/VENT 6.00
Owner Date WATER SYSTEM - .5.00 -
t - ACC.DATE ACC.F ILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I.hereby affirm that I have a certificate of consent to scl insure,
or a certificate of Workers'Compensation Insurance,or eerlified ZONING ENG.SITE NO.
copy Ills�ypj��p y 0,I.A.C.). •'
Policy r`�L.:,LUtB?amp:my_Pac•_O'CY11p• -
0 O Certilied copy is hereby furnished. " FIRE SPRINK ENERGY T 2
Z Z ❑ Certified copy is tiled with the city inspection division. MISC.- REFER TO ORD.
0 APPlieml Y ❑.. i N❑ .❑ N❑
cc:~ In PERMIT ISSUANCE 10.00
Lu CER'TIFICCOMPE ISATION INS PRANCE . 61iRS' FLOOD ZONE A.L.U.L:
' W � COMPENSATION INSURANCE PLG.CONTE. LIC.No. ;,PLG.
(This section need mol' be completed if the per is for oneL Y❑ „ N C] V F1N❑
Z -
handout dollars(S 100)or less.)
U 0 1'certify that in the performance of the work for which this per- QTY. 'MECHANICAL PERMIT FEE f' FEE SUMMARY
•LL 1- mil is issued.I shall mol employ any person in any irromerso as to
O W become subject to the Workers'Compensation Laws of California. '
Date - Applicant BUILDIN
ALTER OR ADD TO MEC 5. G
d -
} to NO'1'IC1: l'O APPLICAN'T: If,after making this Certificate of Fx- 00 '.
cmption,you should became subject to the Workers'Compensation APPLIANCE' PLAN CHECK -
provisions of the Labor Code, you must forthwith comply with Crli .FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10 .1 4.00
CONS"TRUCHONLIENDINOAGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE
-1 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
309,7,Ow CS.. • HEATING UNIT(TO 100,000 B.T.U.) ;8.00
Lender's Name HEATING UNIT 100,000 B.T.U.)9.50
Lender's Address- ELECTRIC -
I certify'Oiut I have read this application anJstate that rhe above VENTILATION FAN (SINGLE) 4.00
information b.correct.I agree to comply with all city and county PLUMBING
ordinances and suite laws relating to building.construetion, and BOILER-COMP(3 H.P.or 100,000 B.T.U.( 6.00
hereby amli be represerllatives of this city-to enter upon the alsove-mentituBOILER-COMP'IOver 100,000 BTU)SEE FEE SCH. MECHANICAL
a-
ned property for inspection purpoxs.
(We) agree t save, indemnify and keep hnnniess the City of MISC.- REFER TO ORD. . _
upertino ago st lialS ities,judgnte is, costs and expenses which PERMIT ISSUANCE 10.00 1Q:QQ CONST.TAX
may in ny ay' a agai i it in consequence of the
ranlin of Is , - MECH.CONT. LIC. MECH: -
TOTAL TOTAL
S" nater o Imo o met Da 1-988- 24•00I
OFFICE COPY :.