17463 POST THIS CARD NEAR FRONTOFBUILDING
PERMIT NUMBER
CITY OF CUPERTINO 17463
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS I V Co NIT# _LOT tk
' PERMIT EXPIRES IF WORK
OWNER CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LAST CALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE'SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS _ I
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB V
PLUMBING
ELECTRICAL ISSUANCE DATE
MECHANICAL - BLDG ELECT PLG. MECH.
E] E] ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBINGMAF( U„VtALUAJION
MECHANICAL ` :,I ES/
ELECTRICAL - Pea Mlr To
FRAMING - - �,• zf U'I tli k1 Ll .
INSULATION STORIES TYPE CONSTR.
OCC.GHOUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF• NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn Fr.aooR AREA TOTAL ACREAGE
DIAPHRAGM - THE CONSTRUCTION TAX IS PAID
d UI1.DI uSE
ROOF SHEATHING I RES IND CON PB •oma,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑-
ASSESSORS PARCEL NO
ROUGH SAN.H
PLUMBING �/- ELECT.ENERGY
TUBS&SHOWE AN PLUMBING ENERGY TRACT No PARCEL No
MECHANICAL MECH.ENERGY
ACC DATE ncc PILE No
ELECTRICAL BUILDING ENERGY
FRAMING ELECT.FINAL TEST zoNlNc ENG.SITE No.
INSULATION' PLUMBING
GAS TEST GAS
FIRE SPRINK ENERGY TQ9
MECHANICAL v 0 N❑ v ElN❑
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
EXTERIOR SHEAR ELECTRICAL RELEASE - FLOOD ZONE A.L.0 c.
INTERIOR SHEAR FIRE DEPT.'
.l YE] N❑ � ❑ NO
SHEETROCK - GRADE FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS BUILDING I. ...-
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE ^—
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE
OCCUFANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED,BY BUILDING INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC „• 'CO
. LU ONE WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST,TAX
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION: TOTAL
OFFICE COPY
,C NT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
PERMIT NUMBER
BUILDING PROJECT IDENTIFICATION
BUILDING APPLICATION & PERMIT 17463
ADDRESSni( �-J
f rf�l� UILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S _ � �=7� PLAN CHECK VALIDATION
nOTY. ELECTRIC PERMIT FEE
omm> PHONE
,NAE CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 8.6(:3
i uD.ry 73 LIGHTING FIXTURES 10.00/1.00
CONTRACTORS APPLIANCES-RESIDENTIAL 4.00
ADDRESS
F ON PANELS 10.00 DATE OF APPLICATION
ARCHITECT -,r``4"L PLAN CHECK FEE P,Q NO.
O
DR n11V V PANELS (OVER 200 AMP) 20.00
ENGINEER
LIC.NO. ISIGNS TRANS. 3.00
ARCH OR
ADDRESS ENG. +^ SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
- . , ZIP TEMP.METER OR POLE INS. 20.00 �^1 1N, may.
APPOCANTS MOTORS SEE FEE SCH. • sal �UCCI1
ADDRESS
m5& D SERVICE CHANGE 20.00 - ,cl j ry-y
r02 LICENSED CONTRACTORS DECLARATION
Q o w 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
H (commenting with Section 7000)of Division 3 of the Business and
.y ¢ n BLDG. ELECT. PLG. MECH.
r N i Professions Cole, ad my license is lx full fore I�ill(G 3_ evx+.. ❑ ❑ ❑ ❑
0 z m o License Class Lic.Number_ rfS�r..��
r �F J IJalc _ConUuctn r
¢ m ¢ ¢ OWNER-BUILDER DECLARATION � 1R Ml p{111V BUILDING PERMIT
ci
E
; v INFORMATION
w u I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
r u o J Law for the following reason.(Sec.7031.5,Buslnessund Professions pERMIT ISSUANCE . 1^' ^VALUATION� $/FT.
Code:Any city or county which requires a permit to corlstruct,:dteq s"(
Q Q ¢ 0 improve,demolish,Or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEQ I�
O ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
u w m he is licensed 9(copursuant In the provisions of the Contractor's License s � � )
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