15916 POST THIS CARD NEAR FRONT OF BUILDING li�/) PERMITNUMBER
CITY OF CUPERTINO
INSPECTION DIVISION - �� 15916
JOB INSPECTION RECORD
( 11) PERMIT EXPIRATION
JOB ADDRESS UNIT# _L
��^ ' PERMIT EXPIRES IF WORK
'OWNER ( y�/./'rU Ices' CONTRnCTOR i,,rcL .L,+� V \IS NOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSPE TION RECORD180 DAYS OF PERMIT ISSU
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VAI.R)ATTON
PREGUNITE CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED '=z ""'� z •�
UNDERGROUND /SLAB /-
PLUMBING Fj�L�f CSGJ /
ELECTRICAL ISSUANCE DATE
tlLUG. ELECT PL(i. MF.CR
MECHANICAL O
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUnTIDN SiFT.
PLUMBING j1.yg- - 3, "-0
MECHANICAL a-g—
vERNtn ro
ELECTRICAL
FRAMING - -'� .Q
STORIES TYPE CONSTH.
INSULATION A 1A \p,
UCC GRpUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO IT.FLooH AREA TOTAL ACRIIACE .
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM -\ _ u THE CONSTRUCTION TAX IS PAID X733
BUILDING USE
ROOF SHEATHING Res IND LON PB anr,
E El El El El
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.
ASSESSORSPARCeL NO
ROUGH SAN.p / (0.2
PLUMBING -Zr. - ELECT.ENERGY 'L
TACT NO PARCEL NO
TUBS&SHOWER AN .2-zcj-sf PLUMBING ENERGY -
MECHANICAL 2-ay MECH.ENERGY
ncc FILE No
ELECTRICAL BUILDING ENERGY �C� ncc onrE
FRAMING ELECT.FINAL TEST.' -
INSULATION - PLUMBING ZONING ENG.SITE NO.
��- T
GAS TEST (n— 6- GAS
FIRE SPRINK ENERGY i.]G
- MECHANICAL 1 - v 0 N[D v 0 •N�
COVER NO WORK UNTIL,ABOVE HAS BEEN SIGNED HEATING �/
FLOW LONE n L U G.
FIRE DEPT.
EXTERIOR SHEAR \�}.-\ - •� ELECTRICAL RELEASE
SHEAR _� Q `" ❑ N� L
INTERIOR
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH - BUILDING 2 BUILDING
INTERIOR LATH TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC PLAN CHECK
FEE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MIC90FILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �Q
u' ONE WORKING DAY BEFORE REQUIRED INSPECTION.
o� PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING pay
Z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
IMPORTANT! CONST.TAX G �/
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. TQTAL
OFFICE COPY
t,�PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
' - BUI L01 Nd PROJECT I DENTI FICATION PERMIT NUMBER -.
AUILmNG APPLICATION & PERMIT 15916
AU
OGRESS'
O� N e A BUILDING - ELECTRICAL-PLUMBING-MECHANICAL
WrvER'S PLANCHECK VALIDATION
JC
NAME QTY. ELECTRIC PERMIT FEE
2378K- vn- rE<rsie -4E PRGry - .
CONTRACTORS IUTLETS-SWITCHES-RECEP 10.0011.00
NAME
AME DEV• LIC,NOS 132(0 LIGHTING FIXTURES 10.00/1.00
.oNTRACTORS f� L APPLIANCES-RESIDENTIAL 4.00
DDR Ess �'J
.IIK J{�� � PHONC,�J%,/// PANELS 10.00 DATE OF APPLICATION
ARCHITECT - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE
R
t ENGINEER 'l LIC NO. SIGNS TRANS. 3.00
ARCH.OR ENG. $PEDIAL GIRDUIT S.DD PERMIT VALIDATION
A"o 43 ,.rO ko
Y l P zIP TEMP.METER OR POLE INS. 20.00
APPLICANT 5 MOTORS SEE FEE SCH. -
ADDRESS
�(� SERVICE CHANGE 20.00
CI tom//
Diez O LICENSED CONTRACTORS DECLARATION r
Q ewa w 1 harehy:iffurll Hurt I am licensed under provisions of Chapter 9 ISSUANCE DATE
y, w Cotnmm�emg with S etlon 7000)of Division 3.f the Business and BLDG. ELECT. PLG. MECH.
F w z Professions Cr a my license is in full fu WNJ4
z o m, Linens lass Lic.Numbs Q F w 14
Uatc ContraclorfOWNER-BUILDER DECL J BUILDING PERMIT
_ ¢w INFORMATION
U REFER TO ORD
w 3 LL'I- I hereby affirm that I am exempt from the Contractor's License MISC.- vq LUATION $/FT.
F..
0 < Law for the(allowing reason.(Sec.7031.5.Business anJ Professions PERMIT ISSUANCE ._
Code:Any city or county which requires a permit to construct,alter, /
arQ0
A w improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. S1083
or
-D c, requires the applicant for spelt permit to file a signed statement that TaOTAL PERMIT TO
$ he is licensed pursuant to the provisions of the Contractor's Lice use
zi
Law(Chapter 9(commencingwith Section 7000)of Division 3 of tile
a Business and Professions Code)or that he is c4r,t therefrom and QTY. PLUMBING PERMIT FEE
¢ o the basis for the alleged exmnption.Any violation of Section 7031.5 1STORIES TYPE by
i : m by any applicant fora permit subjects the applicunuoacivil penalty
ALTER-DRAIN&VENT-WATER MA.) 5.00 �/vwr�
of not more than five hundred dollars($500).):
❑ Las owner of the property,n,my employees with wages as BACK FLOW PROTECT.DEVICE 4.00
their Solt,compensation,will do the work,and the nmfture is nut DCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 �-3
Code:The Contract.,',License Law does not apply to an owner of
property who builds or improves thereon,air,who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mems are not intended or offered forsale.If.however,the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 oZ 733
or imro
pvement is sold within one year (. completion, tireo
wner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or im- RES IND CON PB Omer
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ I,as owner of the property,am exclusively contracting with 2R 0
licensed contractors m in
construct the project(Sec.7044,Busess I LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORBPARCELNO.
and Professions Code:The Cpmmetor's License Law does not apply
to an owner of pmperry who builds or improve,mere,",and who LAWN SPRINKLERS-OV ER 5(EA.) 1.00 36,Z,)-d.3 '-03F
contracts for such projects with a emitructod s)licensed prioam l to h
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ laorexcmpuurder Suc. ,B,&P.C.I.r OR, WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORK ERS'COMPENSATION LFCLARA'1'ION WATER TREATING EQUIP. 5.00
1 hereby:dorm that I have a certificate of consent la self-inmm, ZONING ENG.SITE NO.
or u certificate of Workers'Conrp nsation lusuruncp,.r a certified
-N ropy thereof(See.3800,Lab.C.l.
Policy No. CompunY ) 3
Q ❑ CCrtil'icd ' ryis hereby to fished FIRE SPH INK ENERGY hl4
Z Ce o is 1 C ci inspection division. MISC.- REFER TO ORD.
��p leant yO NO YO NO
W CISRI'I JCA'I'1-OP BXEM TION ROM WORKERS' PERMIT ISSUANCE FLOOD ZONE A.L.U.C.
LL COh1PISNSATION INS RANCE PLG.CONTR. LIC.NO. PLG.
d O his section need not be completed if the permit is for one TOTAL �O d3 y ry V N
Z hundred dollars IS 100)or less.)
U O 1 certify that in the perfurmunce of the work nor which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued,I shall not nn ploy any pe non in any manner so as to
U become subject to the Workers'Compensation Laws of California. BUILDING Qr-10
U w Dare-Applicant ALTER OR ADD TO MECH. 5.00
>- N NOl'IC1?TO APPLICANT: if,after making this Certificate ul -I-
F ? eruption,you should becunmsubject to the Workers'Compen,atnio APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U suchro
provisions o,this permit Shull be deemed revoked, AIR HANDLING UNIT(TO 10=CF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 91-
1 hereby affirm that there is a construction Icpdiag agency for EXHAUST HOOD (WITH DUCT) 5.00
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 p
Lender's Name
Lander',Address BHEATING UNIT(OVER 100,000 .T.U.)9.50 ELECTRIC
1 certify that I huve read this application and nate that the above VENTILATION FAN (SINGLE) 4.00
infnrccorrect. I agree m comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING -;�
ordinanance,es and state Taws ,eluting m building construction. and
hereby call. ire representatives in, of this city to enter upon the BOILER-COMP (Over t00,000BTU)SEE FEE SCH. MECHANICAL .�
abovrmentio property for inspection carona
(We) a• a save, indemnify a keep harmless the City'of MISC.- REFER TO ORD.
,ICupertm uga liab nice, ul t,, is and expenses which M CONST.TAX
may ia aC e a m C' in consequence of the PERMIT ISSUANCE -10.00.
rant' pn MECH.CONT. LIC.NO. METAH
Oi 3g
TOTAL 5 � /
Sat of of App cunt/Con actor Datc
OFFICE COPY /