15612 POST THIS.CARD NEAR FRONT OF BUILDING
-a •• PF:HMIT NUMBER
CITY OF CUPERTINO
15612
INSPECTION DIVISION
JOB INSPECTION RECORD
''•'is ,,,�PERMIT EXPIRATION
JOB ADDRESS ���_ ��.7a Z u IC- UNIT# _LOT#
' //ff �Q I- p PERMIT EXPIRES IF WORK
OWNER tom` - {J• r`0 CONTHACTOH� f` hS �D�NeS L IS NOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF-PERMIT ISSU. '.
FOUNDATION. - ANCE OR 180 DAYS FROM
NOTE: ,
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PR EGUNI.7E - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO RDS.
STANDA -
GARAGESLABS- - 2 PAID , (/
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB . APR 2 b 1989pPLUMBING QG + ' u` v<<..
ELECTRICAL. City of CgCrtiOD ISSUANCE DA rC
MECHANICAL . - - wwoLUc *,ICT I
PLG. MEGA
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED S - OCk d T::'IC5TBUIL
. WOOD FLOOR — �- Q- VALUATION
PLUMBING. 7 2evlA T--I co Q, �-2�-"'�j,�C�se�
MECHANICAL
ELECTRICAL - - - _ - vLRAUT TO
FRAMING O n
- STORPES TYPE CONSTR,
'INSULATION _ r
OCC.GROUP ♦RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
,�'
- ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFOREyy�r.cLgDR TOTALACREAGE,
DIAPHRAGM
- THE CONSTRUCTION TAX IS PAID
- " - BUILDING USE
H, .
ROOF SHEATHING 11fS IND CON PEI FT,...
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ n 0 o o
ROUGH SAN.q - oP_ SIS�I�s�sc�Rs ARC`
PLUMBING - ZZ0 ELECT.ENERGY 13✓"•
IHACTNO. PARCEL NO
TUBS&•SHOWER PAN • PLUMBING ENERGY
MECHANICAL - MECH.ENERGY-
- ELECTRICAL - - BUILDING ENERGY ACC DATE! ACC.FILE NO
FRAMINGi ELECT,FINAL TEST
ZONING ENG SITE NO.
INSULATION PLUMBING, -
- GAS TEST - GAS
MECHANICAL FRE SPRINY. ENERGY T 24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ NEl ` ❑ NF]
FLOOD ZONE A.L.uc-
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT. Y 0. NE' Y L NE]
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING.
INTERIOR LATH .TEMPORARY APPROVALS BUILDING
SCRATCH COAT - ELECTRIC PLAN CHECK
GAS . FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
I' LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 460,
I.- ONE WORKING DAY BEFORE REQUIRED INSPECTION. . PLUMBING
C)
PLEASE GIVE.JOB ADDRESS WHEN PHONING.
- SEE.PERMIT FOR EXPIRATION DATE = MECHANICAL �6
. IMPORTANT! . CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING
FOR,FINAL INSPECTION.
OFFICE COPY
T' . I - ' '" Itv uvr[,runN 1 IOIV VVI I I-IIN RLD LINES - USE BALL POINT PEN ONLY
^- 1 BUI CDING PROJECT IDENTIFICATION
ADDRESS tlU1LOEAPPLICATION & PERMIT PERMIT NUMBER
n
rD ) S Ra.e L �Lr h'(10 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 1561
iL �1SG
OWNER'S
/ NAME
T&CiE ' R, Fiore wy+o 26ZL1 Q
FNONI(e)4Dd as3'ocr QTY 'FEE
ELECTRIC PERMIT PLAN CHECK VALIDATIO
corvrRAcroR s
NgME
UTLETS-SWITCHES-RECEP 10.00/1.00 {10
foNrn ACTORS 5 uc.No. 3357 LIGHTING FIXTURES
ADDRESS 10.00/1.00 1 �V
O 3iNE PPLIANCES-RESIDENTIAL 4.00 i OD
.7u ARCHITECr _ PANELS 10.00
ENGINEER tRYIN I-AVON PANELS (OVER 200 AMP) DATE OF APPLICATION
H' S 20,00 PLAN CHECK FEE P.0
ARCH.DR ENc. L1°-NO' SIGNS TRANS.
aooRess [�'' 3,00
n I s
. Morrion pQ , ,�a.vN3D.�e SPECIAL CIRCO IT 5.00 PERM IT VALIDATION
APPLICANT'$ zIP�SI,�.(, EMP,METER OR POLE INS. 20.00
ADDRESS MOTORS
SEE FEE CH. �- Z
D¢ z SERVICE CHANGE .20.00
o O Ll('IiN$IiD('ONl'k ACTUkS UC('LARA'fION � v p
ri w I hereby arinn dmt 1 and licensed under Provisions of Chapter 9 + Q C.� �'� �L
H HI e (con",mus C will,Section 7000)of Uiv inion 3 of 111,Bo'lue.+s and
2 Professions Code,a my license is in lull ISSUANCE DATE
' 0
W Liccluc Alas r'+f Lic.Numb /`1�"� BLDG. ELECT. PLG. M
H are-- •3--0-Fs-�Cnlllr'Jcl
n ¢w a 0 OWNIi k-BUILUtilt Uli[ ARA PIONAIX of CuRafto
u
m 3 n H 1 hereby ull'ino 11ta" I am exempt front IhC('°ntramori LicenxC MISC.- BUILDING PERMIT
' FuOj Law for lite following nawn.(Sec,701L5,'Businessund Rul'essions REFER TO ORD INFORMATION
E '^i� Code:Any citymcoumy whieh relabel a permit ln,,.a,, m.alteq PERMIT ISSUANCE
¢ ¢a O improve,denmlish,or repair any SH"Co"'prior:o its iswtanca,also ELEC.':oil 1H. 1 Q.QQ (�� VALUATION $/p-
¢ requires the applicant Ibr such permit to file a signed s,aLL•men:111x1 LIC.NO. f✓ D M
e ta a" he is licensed Puralann inghe Provisions of the Conhhctor i License ELEG, V
r z ¢ Law lChand Prommmcncingwith SIC 1 R70001 n1'Uivisir S Louise TOTAL 6a ` D
kusiness and Prot Code)or Ill h,iv exnnpl Immo rim and QTY. PERMIT'u
w o the basis li+r the alleged exemplioll.Any violin on ol'Seclion 707 LE PLUMBING PERMIT d1),'
,
a 3 m by any EPplicam Ibr a FEE 4`� 1)/7i-U�
'Do'more Ihwl five hundred 1 EEDDT)Ic'ulll m a civil Penally
ALTER-DRAIN$ VENT-WATER (EA.) 5.00 STORIES .TYPE CONST
❑ I,as owner of the will do
or my emploYies will, wages as 0D
I ten sole r Offered
l r' will(S lite work,and lite slruclure is not BACK FLOW PROTECT. DEVICE
intended or offerN 1'or sale (Sec. 7044, Business and Rnc,Ajons 4.00
Code;l'he Contractor License Law do es not Epply to En owner of DRAINS-FLOOR, ROOF,ARE OCC.GROUP RES.UNITS
Properly who builds or improves thamon,and :hal
such work A.GOND. 5.00
•� himselfre through his own Cmpl°yces',Provided:hal suchimprove- FIXTUfl ES-PER TRAP -
.1items are not intended D io(fere)(or sole.If,however,Il,,.building 5.00 so.FT.FLOOR a�
nrlde, iemcm is sole within one GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 77 TOTATACREAt
builder will have the burden°I'pruvluyrklal`hodid not huild°Ille ."C'
Prove for purpose of wle.L GAS-EA.SYSTEM-OVER 4 IEA.) 2.00
❑ 1,as owner of Ibe Property,um exclusively conlrac"ing with INDUSTRIAL WASTE INTER. BUILDING USE
licensed cuntraClon lO c°nstmCl (hC proy'c11Sec 7044,business 3Q,QQ RES IND CON PB 0111
and Pro(essiuns 1"' The IT
-lor's License Law does on apply LAWN SPRINKLERS-1 INC 5 V.B. ❑ ❑ ❑ ❑
to Contra
owner of Irto r, who builds or improves .'"'and who 6.00
contracts l'or such projects withuconlrupolys)IiccnxJ LAWN SPRINKLERS-OVER 5IEA.) 10Q ASSESSORS PARCELNO.
Ilse COnlraCt°ri License-Law. Punuunt lu �j� !^
❑ lam exempt under Sec SEWER-SANITARY-STORMEA.200ft/10.00 T 07- aD3
reason .B.&P.C.for this TRACT NO. PARCEL NO,
Owner WATER HEATER W/VENT 6.00
Date WATER SYSTEM
WORKERS'COMPENSATION DECLARATION 5.00
I hereby affirm HIS,I Imve a certificule of eonsenl t-self-insure. WATER TREATING EQUIP. ACC.DATE ACC.FILE NO.
or a ccrlifc4le o1'Workers'CroupenutC' 5.00
COPY the r• foo (Sea 3ypp,I. alt sur 01 a cneu
'olicyN (.1 ,^I ZONING O ENG.SITE NO.
CerliHed Py Is hereby banished.
z Z ❑ Cvr' ' ol'Y/is Ailed with Ihr it
O Applicun: A �f Y 11 "1 Aivision.
MISC.- FIRE SPRINK ENERGY T29
LU W CIiRTIFICATE OE EXEMPTION FROM W RKEPERMIT ISSUANCE REFER TO ORD.
LU C Y 1:3N❑
COMPENSATION INSURANCE Y❑ N�
d O PLG.CONTE. 10'00 lOD FLOOOZONE Z (This section need not ,, completed if the pennit is for one LIC.NO. PLG, A.L.u.C.
U O hu1 ceir dollar[ IT 1001 Pert... TOTAL t (1 D Y❑ N❑ Y❑
1 is issued,
Iitat b :he Purlbrmanca nl'the work liv which this per. N�
0 U b,c 1s issued, I shall no,c'nPloy any Parson in any mann,.,so as b1 QTY. MECHANICAL P
Q to become subjeal m the\Vorken'ComPemation Laws of C'alilRrR. ERMIT FEE FEE SUMMARY
Iy HEC- APPIicuRl_
Fin NOTICE TO APPLICANT: If,al'"cr nlnkio' ALTER OR ADD TO MECH. 7r�0 BUILDING
? e.,isio,You should become subject to the Workers rC'om ,ul'fix 5.00 �C-i1 b
C..1 provisions of DIC Labor Code, you as, forthwith comply"711" APPLIANCE VV tt!/
such provisions or Ihis Penni'shall be deemed revoked. 5.00 PLAN CHECK
AIR HANDLING UNIT ITO 1000C.F,M.) 4,00 FEE
CONSTRUCTION LENDING AGENCY
1 hereby affirm "hat there is a Construction ICndin AIR HANDLING UNIT IOVER IO
the h agency 1'or AODD.EM.) 6.00 SEISMIC FEE a U 6
PcrfonnancC of Il,•work I'or which this PenI1i1 is issued ISea EXHAUST I100D(WITH DUCT) 5.00
3097,is N J. s-Ir,
Leader's Nunlc HEATING UNIT IT0100,000 B.T.U.) 8.00 V MICROFILM
Lcnderi Address HEATING UNIT(OVER 100,000B.T.U.)9.50
I eeflllY l laI I II:IYC"ad'InG.PPheaholn and State llml 1110 al)°Ve ELECTRIC /
• ordina ordinances
is correct. I agree to Comply will,all city and cowl"y VENTILATION FAN ISINGLEI 6t ��
hereby
ncCs and slate Wws relating to binding cOR,rGC ion, and BOILER• 4,00
hereby 0u"hori.. I.incscu"atives of this cit lu CoMP13 H P•or 100,000 B.T.U.) 6.00 PLUMBING 3�. D
above-men tinned propcltytor inspection y Einer upon "he
(We) a• PI',Pususr BOILER-COMP IOva1100,000 BTUI SEE FEE SCH.
lags to save, indemnify End keep harndcss the City of MISC.- MECHANICAL lA
Im,Cupertino against liabilities,judgments, costs and expenses which REFER TO ORD. P
ay in any way accrue against said City R couse,luence Df the PERMIT ISSUANCE
rantin8 of this pernli", i10.00 0 CONST.TAX
MECH.CONT. LIC.NO. M
giECH,
Analufc of ApPlicanll('on:raq-ur ` --- TOTAL
-- ''n`• TOTAL 1
OFFICE COPY