13927 POST THIS CARD NEAR FRONT OF BUILDING. �t ti PFRMIT NUMBER
CITY OF CUPERTINO
13927
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB
.' ADDRESS ESS 22606 POPPY DRIVE UNIT# LOT#
PERMIT EXPIRES IF WORK
OWNER AHT,.qTRnm CONTRACTOR ANTHONY PQnTA IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OFPERMIT I#SU-
FOUNDATION ANCE OR 180 DAYS FROM
LASTCALLED INSPECTION.
UFER
r
PR EGUNITE PERMI�VALIDATION
- / _ lq_ Q . L��„
UR NVdO 0 ftRETt UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING - _ `f C G.�1C '•'.; f
ELECTRICAL &-/FlryISSUANCE DATE T
MECHANICAL BLDG. ELECT.I PLG, MECH.
o El
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
VALUATION $/FT.
PLUMBING • -/ ,y ,//Iii
MECHANICAL /1/ •�6L.+
ELECTRICAL h.�U/�E�IrT 00.E
FRAMING
STORIES TYPE CONSTR.
INSULATION
OCC.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF SO Fi LOOHARE TOTAL ACREAGE
DIAPHRAGM - Al
BUILDING USE
RES IND CON PS Omni
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED E] [:] 0 0 1
ASSESSORS PARCEL NO.
ROUGH
PLUMBING ( '+ /
TRACT NO, PARCEL NO.
GAS TEST
MECHANICAL
ACC.DATE ACC FILE NO.
ELECTRICAL FINALS DATE INSP. `
FRAMING SAN #
INSULATION IPLUMBINGZONING ENO.SITE NO,
GAS O�
MECHANICAL FIRE SPRINN ENERGY T:44'
Y El
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING NE] NF]LATH-INTERIOR ELECTRICALFLOOD ZONE A.L.U.C.
LATH-EXTERIOR FIRE DEPT. V NE] Y 0' NE]
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR BUILDING p
SHEAR EXTERIOR - TEMPORARY APPROVALS/ BUILDING l �'
FIREWALLS ELECTRIC - PLAN CHECK
GAS - FEE �'.•:
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �,
o ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
PLEASE GIVE JOB ADDRESS WHEN PHONING. ��'
� z 70X
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL �(�.
CALLING FOR FINAL INSPECTION.
I
OFFICECOPV
CITY OF CUPERTINO
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
Date ....... ...........CY................. Building Permit No. -.........The Building Located at .....2_2,24.a
..........pjp�pY .....Q.
N..................
Ownedby ........ ....................................... ...........
Has Be ( am let I
4�
here )�ior Use As: ....................................
.........................................................................I...........................I..............................I.............
............................................................... .....................I...........................................................
.............................. ...........I............................I........................................................................
PD-7 .......
DING INSPECTOR
..............
ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE
CITY OF CUPERTINO
To
You ore hereby authorized to Connect electrical service for
Owner a,Tenant ekAJ?41 C1,1 7 lltti!,4ia..— JJj
:,No.of Wires Size of Wires Size of Switch
Motor Load Voltage . Phase
Heating Load K.W. Voltage
No.of Meters Ughl�l I O�New Service Recon,ect-
Heat.1 20.Three Wire More Service_
No.of Add,Meters Power Three Phase�Move Meter.
M ELECTRICAL INSPECTOR
I
! BUILDING INSPECTOR'S OFFICE Bldg.Dept
CITY OF CUPERTINO office Copy
❑ Backflow Device . Son tory'Permit No.
I
❑ Sewer Connection Plumbing Permit No. 2 &yam
� Plumbing Final Q ' / > Lot No.
Owner or Tenant -/ f �f��•'� �pT-� �">'��"'•
At 'Z
Tract .
- Y . n -
r
Date Connected 19—Date Final �"• f� 19�
0" ;1/41/ PLUMBING INSPECTOR
• i
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
r BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
aultiu.G APPLICATION & PERMIT
.. ADDRESS n
BUILDING—ELECTRICAL—PLUMBING—MECHANICAL
13927
r OWNERS PLAN CHECK VALIDATION
NAMEa.Jo2 CITY. ELECTRIC PERMIT FEE
//L T
NNnMl! crow's AQP/,' UTLETS-SWITCHES-RECEP 10,00/1.04
4LZc.No. �7 LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S - pPLIANCES-RESIDENTIAL 4.00
ADD s �)
N� PANELS 1000 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 2000 PLAN CHECK FEE P.C.NO.
OR .
ENGINEER
LIc.NO. ISIGNS TRANS. 3.00
ARCH.OR ENG. PERMIT VALIDATION
ADDRESS SPECIAL CIRCUIT 5.00 t,
IIP EMP.METER OR POLE INS, 20.00 L r ' 1
APPLICANT'S MOTORS SEE FEE SCH.
ADDRESS ; 1L
SERVICE CHANGE 20.00 ° �?'-ono,• _
r M o LICENSED CONTRACTORS DECLARATION ' O ll/l(/�'W//Y"'7VVVJI1t
Q U w I hereby affirm Iltal I am licensed under provisions o(Chap[er 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Business and
BLDG ELECT. PLG. MECH.
r m i Professions Cod- andsn 'cense is in full lure . d Cff`L9 ❑ ❑
o z w W License ass Lic.NumM1e
Date Contracto " ��
a Y E /�pryx�0 BUILDING PERMIT
= a w a OWNER-BUILDPR DECLARATION INFORMATION
Oaca
a'xI ; LL t- I hereby affirm that I am exempt from the Contractor's License MISC.— REFER TO ORD
u 0¢ Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 vALUATlO E/FT.
F W y J Code:Any cilyorcounty which requires a permit to construct,alter,
'Q a:Q Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. L'V
DLL requires the applicant I'Orsuch perinit to file a Signed statement that TOTAL p MIT T
wm m he is licensed pursuant to the provisions of the Contractor's License
ria
Law(Chapter 9(commencing,wilh Section 7000)of Division 3 ofthe
a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE
¢ r m the basis for the alleged exemption.Any violation of-Section 7031.5 STORIES TYPE CONSTR.
c ; _ by any applicant for a permit subjects the applicant Ion civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not more than five hundred dollars(S500)J:
0 I,as owner of the property,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 RES.UNITB
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,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 FIXTURES-PER TRAP 5.00 SO,FT.,FLOOR AR TOTAL ACREAGE
himself or through his own employees,provided that such improve- GAS•EA.SYSTEM-1 INCA OUTLETS 6.00
ments are not intended or offered for sale.11,however,Ilse building
t or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
le
builder will have RIe burden of proving that he did not build or int-
P purpose INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Oma,
M rave for ur ner of sale J. ❑ ❑ ❑ ❑ ❑
❑ 'd as owner rs the properly,am exclusively contracting with
licensed contractors construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code::The who
buildsContractor's License Law docs not apply
to tr owner of h proproperty who bailds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts forsuchceneLwimaeonlractorls)license lam to SEWER-SANITARY-STORM EA.2001t/10.00
IF,Contractois License Law. TRACT NO, PARCEL N0.
❑ I ant exempt under Sec , WATER HEATER W/VENT 6.00
Nhi on i
OwnerDute WATER SYSTEM 5.00 1 ACC.DATE ACC.FILE NO.
Wo KERS'COMP17NSATION DECLARATION IWATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate ,I consent to self-insure, l ZONING
ora certificate of Workers'Com eon tign Insulanee,o 1 ce rl ified ENG.SITE NO.
wS copy there f(Sec.3R0ut Lab. )•[J,/
Rod Cut CompanyY i_sT•`c
(] ❑ Certllled copy is hereby furnis to FIRE SPRINK ENERGY T-24
Z Z 0 Certified copy is Bled with the city inspec Ion division. MISC.- REFER TO ORD.
f"
0 Applicant Y NNCO] Y El N[]
lcc: y CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 / PLOOOZONE A.L.U.C.
W COMPENSATION INSURANCE. PLG.CONTE. LIC.NO. PLG,
CL O (This section need not be completed if the permit is for one TOTAL .Or Y E) N0 Y El NO c
D Z hundred dollars(S 100)or less.)
U O 1 certify that in the performance of the work for which this pery CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued,I shall not employ any person in any manner so as la
O become subject to the Workers'Com +lifornia.
U y Date— Ap I' ALTER OR ADD TO MECH. 500 BUILDING C7
} m NOTICE.T 'I':If,after making this Certificate of Ex- . O
? emplion,you should became subject to the Workers'Compensalion APPLIANCE 5.00 PLANCHECt'�7 Sa
provisions of the Labor Code, you must forthwith comply with FEE d- 3
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 14000 Q F.M.) 4,00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=11F.M.) 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 emit is issued(Sec. MICROFILM
3097,Civ.C.). A HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Nam
Addres f� HEATING UNIT(OVER 100,000B.T.U.0.50 ELECTRIC 0
Lender's y ttuo s�. .--_ L
I certify Ilial I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00
information n correct. I agree to comply with all city and county BOILER•COMP13 H.P.Or 1 0,000 B.T.U.) 6.00 PLUMBING
ordinances and stale laws relating to building construction, and
hereby authorize representatives' of this city to enter upon the BOILER-COMP IOve, 0 OB U EE FEESCH, /0— MECHANICAL
above-mentioned property for inspection purposes. PWrr (�
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. '
Cu ertine against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10,00 CONST.TAX
y y y accrue,ag is said City in consequence of the
gra lin of[Itis permit MECH.CONT. LIC.NO. MECH. ,
1 TOTAL QD TOTAL l94 6T
Signature of App mem/C ractor Date
OFFICE COPY