13483 POST THIS CARD NEAR FRONT OF BUILDING
PFRM1tIt NUMBER
CITY OF CUPERTINO 13483
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS 10029 oakleaf place UNIT# LOT#
PERMIT EXPIRES IF WORK
OWNER Linda Weiss CONTRACTOR SKYCRAFT IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION LASTCALLED INSPECTION.
UFER
PERMIT VALIDATION
PREGUNITE
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL SSUA DATE
MECHANICALQE Dc ELECT, PLc. MECH.
❑ rL�f11 D❑. _ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED "EUILDING PERMIT
INFORMATION
WOOD FLOOR
VALUATION S/FT,
PLUMBING
MECHANICAL
PENMIT TO
ELECTRICAL C� 4"cl HT
FRAMING J
$TORI TYPE CONSTR.
INSULATION
OCC,GROUP RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO.FL.FLOOR ANEA TOTAL ACREAGE
ROOF
DIAPHRAGM
BUILOING USE
HES IND CON PB 00-
El
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED I ElElEL
ASSESSORS PARCEL NO
ROUGH
PLUMBING
TRACT NO. PARCEL NO.
GAS TEST
MECHANICAL
ACC.DATE ACC.FILE NO,
ELECTRICAL FINALS DATE INSP.
FRAMING SAN #
ZONING ENG,SITE NO.
INSULATION PLUMBING
GAS
F IRE SPRINK ENERGYT24
MECHANICAL N� NE]NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD ZONE A,L.UC.
LATH-INTERIOR ELECTRICAL
LATH-EXTERIOR FIRE DEPT. `'❑ N� v I] N❑
SHEETROCK GRADE I ICA FEE SUMMARY
SHEAR INTERIOR BUILDING
SHEAR EXTERIOR TEMPO RARYAPPRO LS BUILDING j
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE ,}
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
� F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
. z PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
CONST.TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
AJPPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BU LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER
BUILDING APPLICATION & PERMIT
ADDRESSQD� BUILDING - ELECTRICAL-PLUMBING -MECHANICAL 3
OWNER'S PLAN CHECK VALIDATION
C` '^ E OTY. ELECTRIC PERMIT FEE t2.S PRONE 5 D
CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00
IL NAM 7 y
Cr No. 7.zaG LIGHTING FIXTURES 10.00/1.00
CONTRACTs APPLIANCES-RESIDENTIAL 4.00
ADDRESS
PHOry /S PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS(OVER 200 AMP) 20,66 PLAN CHECK FEE P.C.NO.
OR
ENGINEER
LIC.NO. ISIGNS TRANS. 3.00
AENG. 566 PERMIT VALIDATION
ADDRESSDDRESS SPECIAL CIRCUIT .
ZIP EMP.METER OR POLE INS. 20.00
APPLICANT'. MOTORS SEE FEE SCH. AID
LJ
ADDIR s 1, IR
4_ SERVICE CHANGE 20.00 S
o O LICE ' CONTRALTO S UEC ARATION
¢U U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE ATE
z w (commencing with Section 7000)of Division 3 of the Bus, ess and
y" Professions Co , sd y license is in full fn qq BLDG. ELECT. PLG. MECH.
z O�- License Class� �(_�Lic.Number`'9y(A V1 t [u�1e ti�
Q y 4 Uale Contractor
m ¢ ¢ OWNER-BUILDFiR UECLARATI N BUILDING PERMIT
ao>ca MISC.- REFER TO ORD INFORMATION
X 3 ¢ r 1 hereby affirm that I am exempt from the Contractor's License VALUATION $/FT.
LL o 4 Lawlor the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00
r - Code:Any city Or County which requiresa permit to construct,alter, /DD
QQ ¢Q improve,demolish,or repair any structure,prior In its issuance,also ELEC.CONTR. LIC.NO. ELEC.
D ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
wm" he,s licensed pursuant to the provisions of the Contractor's License
t z i
Law(Chapter 9(Commencing with Section 7000)of Division 3 ofthe
¢ Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE
¢F p the basis for the alleged exemption.Any violation of Section 7031.5 STORI TYPE CONSTR.
n ; m mi
by any applicant for a pert subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not more than five hundred dollars(S5000.):
❑ 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 Jo 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
�(t` property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SQ.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such inspleve-
mentsarenetintendedorofferedforsale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will hove the burden of proving that he did not build Cron-
RES IND CON PB ower
vP^u prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ 1,as owner of the property,am exclusively Contracting with ❑ ❑ ❑ ❑ ❑
licensed Contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law docs 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 contractorts)licensed pursuant to
the Contract.,',License Law, SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
Pe❑ I am exempt under SCC.-,B.&P.C.I'or this WATER HEATER W/VENT 6.00
on
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKIi RS'COMPI!NSA'TION DI(CLARAT'ION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent loself-insure. ZONING ENG.SITE NO.
or a Certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.C.). ��('7�:� _
Policy No. Company
Q \1, ❑ Cc'
ied copy is sherebyfdc( forms til FIRE SPRINK ENERGY T 24
Z ZI\ Cerili• o y s tiler ith the 'y in ect'r divisor. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑
O JJJ J PP cant v N v N
Fm '�� PERMIT ISSUANCE 10.00 FLOODZONE AL.uc.
UJ CERTIFIC MPENSA IONINSURAMPTIONFRA KfiR"
W _ COMPENSATION INSU RA C PLG CONTR. LIC.NO. PLG. Y[:] N❑ Y❑ N❑
1 O (This section need not be completed it the permit is for one TOTAL
Z) Z hundred dollars IS 100)or less,) 1
U O 1 certify that io the performance of the work for which this per- DTV. MECHANICAL PERMLT FEE FEE SUMMARY
LL F ..sit s issued,I shall not employ any person in any manner so as to 111
O w become subject to the Workers'Compensation Laws of California.
n. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} N NOTICE TO APPLICANT: 11,after making this Certificate of Ex-
F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must lorthwilh comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=CF.M.) 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
3097,Civ CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
Lender's Address
-� I certify that I have read this application and slate that the aboveVENTILATION 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 100,000B.T.U.) 6.00
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 ve, inm
denify and keep harmless the City of MISC.- REFER TO ORD.
C.Pcrtl m
ast abilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
mu any acerae a st a' it in nsequence of the
anting lis permit. - N ECH.CONT. LIC.NO. MECH.
EIS TOTAL TOTAL
e o pplicant/Contractor Date v
OFFICE COPY