15162 JUkf'I_WkkiV 1 10 1-ILL IN INi-UII:YIA I iUN VVI I I-I IN IiEU LINES — US BALL PUINTHEN ONLY
BUILDING PROJECT I DENT[FICATI ON PERMIT NUMBER
wno,NG APPLICATION & PERMIT
A°°"Eos 1516 2
BUILDING —ELECTRICAL—PLUMBING —MECHANICAL
OWNER'S
NAME PLAN CHECK VALIDATION
'•
ONE
'� OTY. ELECTRIC PERMIT FEE
N G I,. PRC a
COTN C C7 S `
NA UTLETS-SWITCHES•RECEP 10.00/1.00
C✓1 c 0 _s..No, LIGHTING FIXTURES 10.00/1.00
19
CONTRACTORS
ADDRESS ' PPLIANCES-RESIDENTIAL 4.00 �I
- ` �J sk HONE Zi C- PANELS 18.00 12, DATE OF APPLICATION
LH TELT
ORPANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE
ENGINEER
LIC,NO SIGNS TRANS. 3.00
ARCH
RR.SS .
ADDESPECIAL CIRCUIT 5.00
PERMIT VALIDATION
?IP TEMP.METER OR POLE INS. 20.00 NTS �" •7( m •�-
ADDRESSS MOTORS SEE FEE SCH. /T� "p''��` `Q"�q�`
SERVICE CHANGE 20.00
woo LICENSED CONTRACTORS ULCLARA'fION
r2 U I hereby affirm thatI am licensed under pnlvieions of Charlie,1) ISSUANCE DATE
¢ n
('.an Lacing with Section 7000)of Divisimr 3 01 the Business and BLDG. ELECT. PLG. MECH.
r D= Prohn,sions Code�yuI m license is in lull force' 11'ecf.
Q z h W Li cense Class Lic.Number. Q! ,f{I!ETyI ❑
,A I_ Dale Contractor L�
¢ y F J
a a w u
OWNER-BUILDER DECLARATION BUILDING PERMIT
F.
;LL N 1 hereby affirm that I un,exempl Bom the Contra lot's License MISC.— REFER TO ORD ^ INFORMATION
LLoj Law forlbe following reason.(Sec.703 1.5,Businessand Professions PERMIT ISSUANCE IU! VALUATION $/FT.
v, to Code:Any city o r Loamy which requires a permit In conuruc•I,alter,
QQ ¢D IlnprUVC,JemOIHII,orrepalr:,IlY sIruclure,prior to its lKnune,,also ELE0.CONTR. LIC.NO. ELEC
a �OOo
E a requires the applicant for suet.permit m file a signed sWlaneat thud TOTAL 2�,�
w m he is licensed pursuaml to the.PP,trdonS d dire Cmdur'ori Lic,Io, PERMIT TO /
HZQLaw Chapter 9(con,mencing with Section 7000)ef Division 3 of dile �,s,s
>: o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE �) W ql" BD
M L� the basis for the alleged exenliumn.Any violation of Section 7031.5 STORIES TYPE CONSTR.
nim by any applicant for a permit subjects the uppliu,mtle a civil penalty
of not more Ilan live hundred dollars 155001.1: ALTER-DRAIN& VENT-WATER (EA.) 5.00
❑ I,as owimr of Idle[',.Perryor...Y elriployets with wages al BACK FLOW PROTECT.DEVICE 4.00
their sole compensation,will Jo die work,and the structure is not OCC.GROUP RES.UNITS
intended or uttered for sale (Sec. 7044, Business and Professions DRAINS•FLOORROOFAREACON D. 5.00
Code:The Contractors
License Law dues lot apply IO am owner of , , ,
property who builds or improves Ihereon,and who does such work FIXTURES-PER TRAP 5.08 SO.FT,FLOOR AREA TOTAL ACREAGE
himself or through his ownemployee
ns,provided that such improve-
mus an, imendad or.ficle•J let sale.If,Imwevvr.the building GAS-EA.SYSTEM-1 INC.4 OUTLETS-6.00 ,Q
or improvement is sold within one year of completion,the owner-
builder
wnerbuilder will have tie burden of proving that he did trot build or air. GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
Clove mr Purpose of the'1' INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB oma,
V ❑ d as owner of the pwperly,con ExclusivelyrojeSt contracting704 , u with 11
licensed contra Cod In a Contractor's
rhe Project(Sec. 7099,business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00
and Professions Cole:'rhe Conlructor s License Law Jots nod apply AS5E5SLNS PARCEL NO.
to an owner of property who builds or improves ti,con.and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
cnnlrams mr such proi•cts with a comructur(S)Iieenad Pursuant do
tic Contra "s
Lien SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ 1 um cxe pd I B.AP.C.for this
reason_ -h e WATER HEATER W/VENT 6,00
Owner_ r Ume WATER SYSTEM 5.00
WC/IZ�4 �, ACL.GATE ACC FILE NO.
WORKIiR 'CDA P:N \TION UfCLA HA'P10N WATER TREATING EQUIP, 5.00
I hereby ul firm mnl 1 have a certificate ofemiScat mself-inxuc,
or certificate of Workers'Compensation lasurunec.ur a certified ZONING ENG.SITE NO.
'up ,cut(See.3H00,Lub.C.).A.4tnt9AJRf„ L(AJlc9aJ
Policy C _��
O 11 Certified copy is hereby fu m Iv
Z Z ;✓Certified y led w' the city inspection iivisim.. FIRESPRINK ENERGY T 24
O APPlicuf� MISC.- REFER TO ORD. Y❑ 913 Y ❑ .N❑'
LU to CERT I('ATIi F SA 'ION FROM WORKERS' PERMIT ISSUANCE -10:60 I FLOOD ZONE A.L.U.C.
� O COAII'IiNSA1'ION INSURANCE PLG.CONTFl. LIC.NO, PLG Y1/-�
CL 0 (This section need nut be completed if lire permit is for one TOTAL IJ(V••moi- Y E—) N� V NC]
O hundred dollars l$100)of les,,) .. . ... ..
1 ttnily Ihm in ac crfunnance of the work fo which this Ilsr OT,. MECHANICAL PERMIT FEE SUMMARY
LL U mit is issued,I shall I employ any person in any nhaamer se.,to
FEE
become subjec 1 ,kers Compensation Laws of Cnhifurnia.
W Dm, I NI. I ALTER OR ADD TO MECH. 5.00 BUILDING D a CO
} In NO ICF TU AI LICANT: If,ulcer making Ibis Cert it.coil•ul'IGx-
I— Z elliptic,,,you should become subject to the Workers C'onlpensatiun APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10X0GF.M.) 4.00 FEE
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.FM.) 6.00 SEISMIC FEE s D
I hereby affirm that there is a construe IOur Latin,agency for EXHAUST.HOOD (WITH DUCT) 5.00
to p,d.rnence of the wor for which this permit is issued(Sec.
3097,nder's .m � � HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
Lender's Name
Lender's Address ' HEATINGUNIT(O VER100,000B.T,U.)9.50 ELECTRIC
s. I certify that I have read this upphicatum and Sate that rhe above VENTILATION FAN (SINGLE) 4,00 h 1
information is correct I agree Io comply with all city and county PLUMBINGIIM
ordinances and Idea Uws relaling to building c.RSr,,Um, and BOILER•COMP(3 H.P.Or 100,000 B.T.U.) 6.00 v lel t
It authorise n•presenalive, of this city to ender upon le �^
above-mentioned property for inspection purposes. BOI LER-COMP(Ove 100,000 BTU)SEE FEE SCH. IL MECHANICALW
(We) agree to save, indemnify and keep Ihannless lire City of MISC.- REFER TO ORD.
up,in a against Iimbilitics,judgment,,misend costs :u a m[penses wilier CONST.TAX
may in any way ;moue against sail City i,, euuscyucne,of the PERMIT ISSUANCE
` ranling�s�lis'p,fn.il.�- . MECHTA
.CONT. LIC.NO. OTL
Date fD
-- — Sr — JO TOTAL 261
Sign dare ul'AppliemD/C'ol mel r mc
OFFICE COPY
POST THIS'CARD NEAR FRONT OF BUILDING PERM IT NUMBER
CITY OF CUPERTINO 15162
`INSPECTION DIVISION
JOB INSPECTION RECORD
' //�-7 7 ' PE MIT EXPIR'A'�1'ION
.JOB.ADDRESS I O�Q lA--�'�.A�SO�'✓ 2 —UNIT# _LOT#'- Pdr ! � /
r —PERMIT EXPIRES F WORK
'.
OWNER CONTRACTOR � - - � � IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD . 180 DAYS OF PERMIT ISSU-'
FOUNDATIONJJpN - l' NOTE: ANCE OR 180 DAYS FROM
-
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
' TO COMPLY WITH THE APPROVED PLANS AND CIN OF Prnnni vALlon noN
PREGUNITE - CUPERTINO STANDARDS. -
GARAGE SLABS ` <<` .,•Vi�'
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED r•�I ,�, . ���+++•••:::_
_ UNDERGROUND /SLAB
PLUMBING JAN _ . 1989 !
ELECTRICAL ISSUANCE DAr[:
MECHANICAL + uuy of U(°BLDG
ELECT PLG, MECR
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUIL DING PERMIT
.. ,IN'PO RNIATION
WOOD FLOOR 1AL11TroN - $IFT.
PLUMBING
MECHANICAL - f
PERMIT TO"
ELECTRICAL - _ ,C•r �1 .,'�t't, �,
FRAMING _ J
INSULATION .. _STORIES T YPE CONSTR.
/LOV rU' 47-W .BCG GIIOUP RES UNITS
,PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
A '.ROOF - NOTE NO FINAL INSP:SHALL BE MADE BEFORE so rr irocrr m,EA TOTAL ncacncP
I� DIAPHRAGM THE CONSTRUCTION TAXIS PAID ,
Bm LOIrvN USE
ROOF SHEATHING Res IND CON PB oln.,
AAPPLYINO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE . INSP. . 0 ❑ 0 ED 0
ASSESSORS PARCEL NO,
ROUGH SAN.p
PLUMBING' ELECT.ENERGY
TR ACT NO. PARCEL NO
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ELECTRICAL BUILDING ENERGY - ACC DATE - ACc.FILO.NO
FRAMING ELECT.FINAL TEST ZONINGENG SITE NO. -
INSULATION - - PLUMBING
GAS TEST GAS
FIRE BPHINK ENERGY L24
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING NE r NF]
ZONE AL. u.c. �
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR. FIRE DEPT. NO V ❑ - No
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH - BUILDING
. INTERIOR LATH TEMPORARY APPROVAL
SCRATCH
�r, ,y><T
SCRATCH COAT ELECTRIC FEE CHECK
GAS
NO TAPE OR.PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE III. t1 v
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
w ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC {r,
ONE WORKING DAY BEFORE REQUIRED INSPECTION. ` PLurnBwc
o� "PLEASE GIVE JOB ADDRESS WHEN PHONING. • �l';.i"
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! >CONST.TAX,+
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. _r
OFFICE COPY•