8288/ POSTTHISCARDNEAR FRONTOFBUILDING, PFRhuTNUMBER v
CITY OF CUPERTINO, ``
INSPECTION DIVISION
JOB INSPECTION RECORD Al _
PiERMIT,EXPIRA+��
L(j �(T!'Y 1
JOB ADDRESS_ UNIT# LOT# PERMIT EXPIRES IF WORK
OWNER CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATEp
INSPECTION RECORD 180 DAYS OF PERMIT ISSU. _
C� /��� p� ��iT�� ANCE OR 180 DAYS FROM
FOUNDATION �2S\ LAST CALLED INSPECTION.
UFER /_'0-li7 -Z(•5 /I-c 41F KLct L(
PREGUNITE PERMIT VALIDATION
:
POUR NO CONCRETE UNTIL ABOVE HAS a�rw� r :.� - c fT /
UNDERGROUND /S ABShe I✓aGL M4%L/
PLUMBING ELECTRICAL SIr , L - ICLov/t ISSUANCE DATE
MECHANICAL ELECT. PLG. MECH❑ ❑DO NOT POUR FLOOR UNTIL ABOVE HAS0-2 "� /5 t[T• BUILDING PERMIT
WOOD FLOOR (0 , Lw 0- INFORMATION
VA WATION $/FT.
PLUMBING
MECHANICAL ,J! 'I ? N'
ELECTRICAL �`- I vERNIn Tp
/0Yjl �, ld Y37 GL- 11
FRAMING �•r I
INSULATION l ISTOR177GS'4TYPE CONSTR.
OCC.6ROUP .RES'.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED I;z • -
ROOF SO,FT.FLOOR AREA TOTAL.CRETGE
DIAPHRAGM '-'/1 I
BUILDING USE
RES IND CON PB Olnrl
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED Q/ 0 El 0 El
ROUGH r . ASSESSORS PARCEL NO.
PLUMBING .7,t4c r I� � ( uzz
TRACT NO. PANC[L NO.
GAS TEST
MECHANICAL
ELECTRICAL Acc;DATE AC0.FIL__1N O
—.ZJ�Y' FINALS DATE INSP. I
FRAMING ftt.6 _ SAN u ZONING ENc.SITE No.
INSULATION PLUMBING
GAS
FIRE SPRINK ENERGY T 24
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y N❑ Y ❑ N❑
FLO D ONE A.L.0 G.
LATH-INTERIOR ELECTRICAL
LATH-EXTERIOR FIRE DEPT. Y❑ NE] Y ❑ N❑
SHEETROCK - I GRADE FEE SUMMARY
SHEAR INTERIOR BUILDING - -
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING
FIREWALLS ELECTRIC PLAN CHECK ''• `
FEE /^/ .r:•
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCY OF SU ILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM f I
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
0 PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE'—
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. • .� !„ ; '
OFFICE COPY
JEFFREY A. BARNETT
A PROFESSIONAL CORPORATION
B52 NORTH FIRST STREET, 3RD FLOOR
SAN JOSE, CALIFORNIA 95112
TELEPHONE 14081 9]I-9411
fII
-_ I
F ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE'
CITY OF CUPERTINO
19rN
#E To
Yoa are hereby aathoriz d to Connect electrical service for
E O-is�f/ZJ /ln�Lr�
'Owner or Tenant —7
At—
p
No.of Wires Size of Wires Size of Switch /dam
Motor Load Voltage Phase
Heating Load
K W Voltage
/ ( light 110__New Service Reconnect
Na,of Meters 11 Heot I20_—Three Wire More Service
Power / hree Phase Move Meter 1
No.of Add.Meters z�!
@ r ELECTRICAL INSPECTOR
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ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTORS NOTICE-
CITY
OTICECITY OF CUPERTINO
a _ oZd , 19�' —
V To i C/
Yoa are hereby aathonz d to Connect electrical service for
Jr-
.. 'Owner or Tenant
At /v 3S �1 tiC//1 1N1 lP OvUOT
No.of Wires Size of Wires
Size of Switch X6-0
Motor Load
Voltage Phase
K W Voltage
Heating load
Light �— '�[/
/ 110New Service ' ` Reconnect
No.of Meters Heat
120-1hree Wire More Servrce
Move Meter
No.of Add.Meters Power
three Phase f
Qw ELECTRICAL INSPECTOR
ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE-
/,n�(�� CITY OF CUPERTINO .f
d To V "A- `;' 9'_ �7� "— o�V , 19
You are hereby authorized to Connect electrical service for
p 'Owner or Tenant
f At //s:3—,
tqq
No.of Wires Size of Wires Size of$witch /dam 1'f
Motor Load Voltage Phase
Heating Load K.W. Voltage`I(/
/
Light-1
No.of Meters Light 110New Service ` ` Reconnect
Hent 120 Three Wire More Service
No.of Add.Meters Power / �T ee Ph'ose�, s ' Move Meter
ELECTRICAL INSPECTOR ( ^ It �s�^�'^"""c __"
0
ELECTRIC SERVICE NOTICE OFFICE COPY
w e wA 4
BUILDING INSPECTOR'S NOTICE•
1 CITY OF CUPERTINO c
pl r — e2O , 19 O 6
To / {(
You are hereby outh ized to Connect electrical ervice for
Owner or Tenant
At
No.of Wires
p Size of Wires Size of Switch
Motor Load Voltage Phase
Healing Load K.W. Voltage
/ Lig __
ht 110New Service X . Reconnect
No.of Meters I Heat 120_Three Wire Mme Service
ll Power Three Phase Move Meter
No.of Add.Meters
Qr w ELECTRICAL INSPECTOR -/
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a ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE"
CITY OF CUPERTINO
i 19
To
You ore hereby authorized to Connect
_electrical
/service,fo
0 9 'Owner or Tenant_ (X-�I`-Il.1z'�•�/�— Zo .e(,r
No.of Wires Size of Wires Size of Switch J�d
Motor Load Voltage Phase
Healing Load K.W. Voltage I
/No.of Meters Light I10New Service Reconnect
Heat—1 20—Three Wire More Service
No.of Add.Meters Power. �fryt ee Phase Move Motor
ELECTRICAL INSPECTOR
- e
e 0 ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE
CITY OF CUPERTINO /
tG4f �" T ;F. ;Z- 1Z / 19 LO
To
You are hereby authorized to Connect electrical service for
r 'Owner or Tenant
At /O x-27 `ryL.a�-c �L. z�`-01•
No.of Wires Size of Wires Size of Switch
Motor Load Voltage Phase
Heating Load K.W. Voltage
(/
No.of Meters
Llghi 110_New Servlcev Reconnect
Hoot 120 Three Wire More Service
No.of Add.Meters Power. Three chose Move Meter
0" ELECTRICAL INSPECTOR ` t
U
z _ , ELECTRIC SERVICE NOTICE
OFFICE COPY
BUILDING INSPECTORS NOTICE,
/�--�s E. CITY OF CUPERTINO
To �cJ c�
You are hereby authorized to Connect electrical service for
'Owner ar Tenant
No.of Wires Size of Wiresy Size of Switch o-0
Motor Load Voltage Phase
Heating Load K.W. Voltage
/ Light -I l eNew Service kZ Reconnect
No.04 Meters Hew-120- Three Wire More Service
No.of Add.Meters Power- ` /1(/�✓,__\hree Phase � � � Move Meter
�Z
@r" ELECTRICAL INSPECTOR (-n - -�- r
itr �rl
ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE-
CITY OF CUPERTINO
19
To p
You are hereby authorized to Connect electrical
service for
r 'Owner ar Tenant r�f-�
y
No.of Wires Size of WiresSize of Switch
Motor Load Voltage Phase
Heating Load K.W. Voltage
/ Light I10New Service Reconnect
No.of Meters Meat 120Three Wire More Service
No.of Add.Meters Power Thr a Phase Move Meter
ELECTRICAL INSPECTOR (
U I
• k�BU_ ILDING INSPECTOR'S OFFICE :" . ' '• ' r
j CITY OF, pOflicCUPERTINO i hf effic of e(.o 01. .- *.
�f i
' '4. + .. 1.•� "•.r�l -FY••'•A,S ' j•!•f r-..�NY R., 1�.. IM Hy•:%•• .•I'!i�"• � 6,•:r '
0 .Brickflow Dev-ice ':"' + "` `� r.Sanitary PermiY;'No:'f
R_
Connect'io'n 4 Plumliing.Perrnit No; '
t .
.0 Plumbing Final ' Lot No.
. fI.
Owner or Tenor.. '�+r–�•1J
At ' l hA .//,/Ik "•'i >/3rd( • '
�-Tract
Date Connected ` 19 Date Final `'I 1- 19
O- PLUMBING INSPECTOR
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDIN PROJECT IDENTIFICATION PERMIT) MBER
BUILDING APPLICATION & PERMIT
f' ADDRESS
IW,27-It)
;^1 O 0
/Y,� 1/21Ua� BUILDING - ELECTRICAL-PLUMBING-MECHANICAL Z(idle-
OWNER'S VOR 739--3779V qN CHECK VALIDATION
NAME OTY. ELECTRIC PERMIT FEE f
. i WNCFNTf>s FA
NAMER cross UTLETS-SWITCHES-RECEP 10.00/1.00 ✓Yi ,JY
LIC.NO. LIGHTING FIXTURES 10.00/1.00
CONTRACTOR oxs
ADDRESS
APPLIANCES-RESIDENTIAL 4.00
C
PHONE PANELS 10.00 DATE OF APPLICATION
ARCHITECTPLAN CHECK FEE P.C.NO.
OR 5�iy { 5$oc.I-+•/T�z-� PANELS (OVER 200 AMP) 20.00
ENCINEE III-r SIGNS TRANS. 3.00
LIC.NO.
ADDRESS ENG. SAQA'TD Lr SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
75. .SA(RP EMP.METER OR POLE INS. 20.00
ADDRESS is 130% S_ Amy MOTORS SEE FEE SCH.
ADDRESS (/
S.,YL U CAL 9s-08 C, SERVICE CHANGE 20.00
00 LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00
a u U I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE GATE
w < v6i (commencing with Section 7000)of Division 3 of the Business and B G. ELECT. PLG. MECH.
H w z Professions Code,and my license is in full force and effect. ❑ ❑ ❑
o i m W License Class Lia Number
-
,z
w
Date Contractor
¢ y E J BUILDING PERMIT
¢ m it ¢ OWNER-BUILDER DECLARATION INFORMATION
MISC.- REFER TO ORD
w 3 u m I hereby affirm Thal I am exempt from the Contractor i License VALUATION $/FT.
F LL m j Law for the(allowing reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00
Code:Any city or county which requires a permit to construct,alter,
re ta Q o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC.
O u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
a w m he is licensed pursuant to the provisions of the Contractor's License
F z a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe O VN'
E i o Hasiness and Profexsions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
a H pN the basis for the alleged exemption.Any violation of Section 7031.5 STOP TYPE CONSTR.
La by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.0(
of not more than five hundred dollars(5500).):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure 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 F IXTUR ES-PER TRAP 5.00 SD,FT.FLooR AREA To ACREAGE
• himself or through his own employees,provided that such improve
mems are not intended or offered for sale.It,however,the building GAS-EA.SYSTEM-11NC.4 OUTLETS 6.00
or hnprovement Is sold within one year of completion,the owner- lk000
GAS-EASYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or I.,- .- /I
Pr for purpose of sale.). INDUSTRIALWASTE INTER. 30.00 Sht IND CON PB oma, 1
I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑
licensed contractors to construct the project(See.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSOR S 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 ILAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a cmltructoos)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ 1am exempt under ec. BA P.C.for this WATER HEATER W/VENT 6.00
reason
owner Dale WATER SYSTEM 5.00
A .DATEI ACG FILE N0.
WORE:I;RS' MPI:NSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that l have acertifican,of Consent loself-insure, ZONING ENG.SITE NO.
or a certificate of Workers Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.CJ.
Policy No. Company
Q ❑ Certified copy is hereby furnished FIR SPRINK ENERGY T 24
Z Z O Certified copy is filed with the city inspection division. MISC.- REFER TO ORD.
O Applicant Y N❑ Y ❑ N❑
CC CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 PL OD ZONE A.L.u.C.
W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
0- Z (This suction need not be completed if the pe rn [:]it is for one TOTAL Y NE] Y C] E)N
hundred dollars IS 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 H i s issued,I shall not employ any person in any manner so as to
U object to the Workers'Com Compensation Laws of Cali torma.
O w mesa j pe BUILDING i �J
0. Dal Applicant ALTER OR ADD TO MECH. 5.00
} to ICE TO APPLICANT: If,after making this Certificate of Es.
F Z coalition,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
• CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER IOAOOC.F.K) 6.00 SEISMIC FEE ,
I 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
3097,Ci,CJ. ��jj //JJ HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Adders 'AL e5� nCJE IC"t'NY HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
Lenders Address ;S'A�7 � G'x�.$�P /1]1�,LeLL
1 certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00
• information is correct. I agree to comply with all city and county PLUMBING
ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authori e representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned properly for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,I. d meals, is an pen which PERMIT ISSUANCE 10.00 CONST.TAX Iq
ma any wa cme Aga' s;' .i ns' u of the
o Penni{. MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL
ignature of App ant/Contrattoor Date
OFFICE COPY