15341a ,
r POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
'CITY OF- CUPERTINO. 15341
INSPECTION DIVISION
JOB INSPECTION RECORD,
(• . ,'' - PERMIT EXPIRATION'
JOB ADDRESS 10056 -ORANGE UNIT# 1 _LOT#. - '
_ PERMIT EXPIRES IF WORK
OWNER DONALD ,DUNN' CUNTRACTOR ISNOT STARTED WITHIN I
INSPECTION I DATE JINSPECTOR INSPECTION,RECORD 180 DAYS OF PERMIT ISSU.
FOUNDATION NOTE: ,ANCE OR 180 DAYS.FROM
• T -
LAST CALLED INSPE
UFER � �' ALL GRADING AND'DRAINAGE SHALL BE-INSTALLED I i.
PREGUNITE TO COMPLY WITH'THE APPROVED PLANS AND CITY OF PERMIT VAI.IDA ION
CUPERTINO STANDARDS. .+ -
GARAGESLABS' •
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 717 ,;F� A• - i/c - �" � �=, �
UNDERGROUND /SLAB'
PLUMBING
ELECTRICAL'' p r G d'?LF 43•AfIAIIf, ,, - lg`�wi ISSUANCE unrE
MECHANICAL'• ELUL, PLO_ wcR.
City of (UrP. mLe• ❑ : ❑
DO NOT POUR FLOOR UNTIL-ABOVE HAS BEEN SIGNED - a ILDING P RMIT
' INFORMAi4ON
WOOD FLOOR".. ;, - VALUATION STP>•,
PLUMBING''.
MECHANICAL _
ELECTRICAL PERMIT TO
FRAMING - <. - I 1�-G• .
. INSULATION - - - STORIES TYPE CONSTH.
r oCC.,GHOUP "RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO.ii.FLOOn ARCA TOTAL ACREAGE
ROOF NOTE:NO FINAL]NSP.SHALL BE MADE BEFORE
• DIAPHRAGM - �� THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING - - Res,; IND CON PB On...
-APPLY NO ROOFING UNTIL•�ABOVE'HAS BEEN SIGNED, . FINALS , ` ,DATE INSP. ❑ El ❑ ❑
ASSESSORSPARCELNO,
'ROUGH SAN.p ' - �
PLUMBING' - 't'• ELECT.'ENERGY '
TRACT NO PARCEL No.
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL - MECH.ENERGY - s Acc.DATE' Acc.FaE rvo.
ELECTRICAL .'BUILDING ENERGY ,
FRAMING.-•' - " ELECT.FINAL TEST TONING ENG.SITE NO.
'INSULATION • " •- PLUMBING �.
GAS TEST' - GAS
FIRE SPRINK' ENERGY T.?A
MECHANICAL"
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED r•. HEATING - - - ° ❑ • N E) • NEI;
FLOODIONE ALuc.
EXTERIOR SHEAR ELECTRICALRELEASE - -
INTERIOR SHEAR' N❑ ❑
+, - FIRE DEPT.
❑. .�❑•
SHEETROCK • GRADE FEESUMMARY
EXTERIOR LATH _ - BUILDING A
INTERIOR LATH; - - TEMPORARY APPROVALS- BUILDING
SCRATCH COAT ELECTRIC PLAN CHECK ;
GAS FEE
NO TAPE OR PLASTER UNTILABOVE HASIBEEN SIGNED OCCUPANCY . . SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UN IT
IBUILD I NG FINALIS SIGNEDBY BUILDING INSPECTOR: .MICROFILM
UJ ARRANGE FOR INSPECTION BY PHONING 252'4505," ELECTRIC '
ONE WORKING DAY'BEFORE REQUIRED INSPECTION. PLUMBING
•' 00 `: PLEASE GIVE-JOB ADDRESS WHEN•PHONING. r
='SEE PERMIT•FOR'EXPI RATION DATE —. ;- MECHANICAL
IMPORTANT!
CONST.TAX
PLEASE READ.REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL' INSPECTION. . .
OFFICE COPY
• I
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
r (i, - ' PERMIT NUMBER
BUILDING PROJECT IDENTIFICATION
aIIILDINGAPPLICATION & PERMIT 15341
li ADDRESS -
.. BUILDING—ELECTRICAL—PLUMBING=MECHANICAL ,
0 ER'S - - - PLAN CHECK VALIDATION
N" ow mX TY. ELECTRIC PERMIT FEE 7 '
co oRs �u�G/ry
NA OUTLETS-SWITCHES!RECEP 10.00/1.00
r
uc.rvo. LIGHTING FIXTURES 10.00/1.00
DTRACTOns
ADDRESS PPLIANCES-RESIDENTIAL 4.00 `
AO
PRONE - PANELS y 10,00 7 DATE OF APPLICATION.
ARCHITECT
OR ' PANELS (OVER 200 AMP) . 20.00 'PLAN CHECK FEE , P,c.NO.
ENGINEER' '
' uc:No. SIGNS TRANS. 3.00 -
ARCHE55 ENG. SPECIALCIRCUIT S.00 G - PERMIT VALIDATION
ZIP EMP.METER OR POLE INS. 20.00
AMOTORS r SEE FEE SCH. '
ESS ADDADR EESS
p SERVICECHANGE 20.00 ID I I
y
o o LICENSED CONTRACTORS DECLARATION /� 'J� I ~
< it u I hereby affirm that I am licensed under provisions of Chapter 9 � IMnnISSUANCE DATE
y a vpAi (commencing with Section 7000)of Division 3 of the Business and BLDG. E EC PLG.' MECH.
D z Professions Code,and my license is in full force and effect. t- I`—,,I'
Z o= — License Class Lia Number CIty,OI I17�t1 'O �'
Q o, au Date Contractor
a r � . ' BUILDING PERMIT
a w 4 (OWNER-BUILDER DECLARATION INFORMATION
o a. D - MISC.— REFER TO ORD
F.
3 U- , 1 hereby affirnt that 1 am axempt from the Contractor's License -.
.. 0 4 Law for the following reason.(Sec 7031.5,Busimessand Professions PERMIT ISSUANCE 10.00 .VALUATION $/FT.
— NJ Code:Any city or county which requires a permit to construct,alter, �d
aa
p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTFL LIC.NO. TT LEC.
0 u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
w8 he is licensed pursuant to the provisions of the Contractor's License
I z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe
— 4 Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
R F D the basis for tire Alleged exemption.Any violation of Sccti,,n 7031.5 1 STORIES TYPE CONSTR.
5_; any applicant lin a fiction sum,,I,the applicant to a civil penally ALTER-DRAIN -WATER IEA.) 5.00 '
of not more than five hundred dollar,($500)J:
❑ 1,as owner of the properly,or my employees with wages as BACK FLOW PROTECT.DEVICE ' .4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP REB.UNITS
intended or offered for sale (Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Convactor's License Law does not apply to an owner of
property who builds or improves thereon,and who Joe,such work FIXTURES-PER TRAP. 5,00 so.FT.FLOOR AREA TOTAL ACREAGE
himself or through his awn employees,provided that act,imprerve-
paentsareotintended or offered for sale ll',however.the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00
n
or improvement is sold within one year of completion, the owner- GAS EASYSTEM-OVER 4 IEA) 200 BUILDING USE
builder will have the burden of proving that h - . . .
u did not build or int' 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
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 thereon.and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00
contracts for Such projects with a contmetot(s)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCELNO.
❑ l am exempt under Sec. ,BAP.C.lot this WATER HEATER W/VENT r 6.00
axon
Owncr Date - WATER SYSTEM' 5.00
• - ACG GATE ACC.FILE NO,
WORKERS'COMPP-N'SATION DECLARATION WATER TREATING EQUIP. d - 5.00
1 hereby affirm that I have a certificate of consent to,,H-insu,c, ZONING ENG.SITE N0.
or a certificate of Workers'Compensation Insurance,or cerlificA
copy Ihereof(Sec. 00, C.). -
Policy No. Co a -
❑ Cerit led r un s d. FIRE SPR INK ENERGY T-04
ZZ /y1L.Tce o it • J 't eh• nspeclion'divisinn. MISC.- REFER•TO ORD.
O Npltraant n y.❑ N❑ Y ❑ N❑
w
CER'I'[FICA'11;01:EXEMPTION FROM WORKERS' PERMIT ISSUANCE - 10.00 FLOOD ZONE A.L.U.C.
LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
(L 0 (This section need not be compl_eled if the.perinit is for one TOTAL Y❑ N❑ Y❑ N❑
Z) Z hundred dollars IS 100)or less.)
U O I certify that in the performance of the work for which this per- QTY. > MECHANICAL PERMIT FEE FEE SUMMARY
LL 1— iry nor is issued,I shall not employ aperson rany mapper so as to - -
O W become subject to the Workers Compensation Laws of California BUILDING
Uatc Applicant ALTER OR ADD TO MECH. 5.00
} 2NOT ICE this Certificate of Ex- -
m cippajor.TO shoo) decor 1s after ata king,
♦— ? mnption,you should bor Co e, you i the W'orker,d Co piply with
APPLIANCE 1 .r 5.00 PLAN CHECK
provisions io the Labor mit shall
ripe meet fi revoked.
h comply with FEE -
U such provisions or this permit shall be decried revoked. . _ AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000GEM.) 6.00 SEISMIC FEE '
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance o1the work for which this permit is issued(Sec. - HEATING UNIT TO 100,000 B.T.U.) 8.00 MICROFILM -
3097,Cre.C.), L
Lender's Name HEATING UNIT IO VER 100,000 B.T.U.)9.50 ELECTRIC S40
Lender's Address
I certify that I have read Ilia appllcalip,and ,are that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
ordinances and slate laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the r BOILER-COMP(Over 100,000 STU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes.
(We) agree to save, Inde ify and keep Ilarntess the City of MISC.- REFER TO ORD. - --
upertino ogai tliahi' ,ju gments, crisis and expenses which' PERMIT ISSUANCE 10.00 CONST..TAX
may in any ay uc ai t City in consequence of the -
ranfing0 C MECH.CONT. LIG.NO: r MECH.
t
`) TOTAL /
- � TOTAL S 00
rigia fAp lie I/Co ractor Date s ' -
OFFICE COPY
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