17648 POST THIS'CARD.NEAR FRONT,OF BUILDING
PERMIT NUMBER
" CITY .OF''"CUPERTINO : ' ;
INSPECTION DIVISION 17648'
JOB INSPECTION RECORD :
I j D .. PERMIT EXPIRATION •
!OB ADDRESS'_ .' �Z2 •/`e�ILLfl-lls k d. UNIT# _LOT# PERMIT EXPIRES IF WORK
OWNER TzCONTRACTOR IS NOT STARTED WITHIN .
,INSPECTOW DATE " INSPECTOR INSPECTION RECORD ,'.180 DAYS OF PERMIT ISSU; '
FOUNDATION i ^' - LANCE OR 180 DAYS FROM
NOTE: - LASTCALLED INSPECTION. '
LIFER - ' ALL GRADING.AND DRAINAGE SHALL BE INSTALLED I
T . :PREGUNITE ' - - TO COMPLY WITH THE APPROVED PLANS AND CITY OF I r2HMn VALIDATION .
CUPERTINO STANDARDS.
GARAGE SLABS - ` c_ ,Ch, 1 S/.. •y
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ( cT
UNDERGROUND /SLAB
PLUMBING - " . �U P �'F NA
ELECTRICAL
Issunmce unrE
•
MECHANICAL , `
• BLDG. ELECT PLO. ME'H
EC '
DO NOT POUR,FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT
s ., WOOD FLOOR - INFORMATION
'PL 'MBIN - ,• �vnLUATiGN,_ 5/FT,
U G
. MECHANICALrp
• � �" ��
MIT TO
ELECTRICAL
FRAMING
INSULATION ,°'•1. •( STORICS TYPC CONSTR.
`- - OCC.GROUP RES.UNITS
''PLACE NO;SUBFLOOR UNTILABOVE HAS BEEN SIGNED
SO ET FLOOR AH[4 TOT wL nCREwGE
C. ROOF . NOTE:NO FINAL INSP:SHALL BE MADE BEFORE
DIAPHRAGM '0" '• THE CONSTRUCTION TAX IS PAID
BUILDING use
ROOF"SHEATHING HES IND CON PB O
111,;,APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED, . r FINALS 9 DATE . INSP. ❑ ❑ '❑ ❑ ❑
ASSESSORS PARCEONO..,
k
I. ROUGH SAN. • +i
PLUMBING •-" , ELECT.ENERGY
TUBS&SHOWER PANPLUMOING ENERGY„;
•. - TRACT NO. PARCEL NO.
^ .r
MECHANICAL ' MEGR ENERGY, '
ELECTRICAL -
BUILDING ENERGY ACC DATE acc.FILE No
FRAMING:' '...a ELECT.FINAL TEST ' -
�TT,...._ - INSULATION ;' PLUMBING ' WFEE
ENC, No.
_ GAS TEST, - GAS - NK. '' ENERGY T.24 .MECHANICAL.COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 'HEATING "❑- ° ❑ "❑EXTERIOR SHEAR,^ " ELECTRICAL RELEASE NE , n.L.0 C.INTERIOR SHEARFIRE DEP.T. . "❑. ° ❑r' N❑SHEETROCK. ; T.. GRADEE SUMMARYEXTERIOR LATH ';r a BUILDING ,
INTERIOR' LATH TEMPORARY APPROVALS • 3� .�'Q SCRATCH COAT _ ELECTRIC. - ECKGAS - / :
NO TAPE'OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY.; - "SEISMIC FEE,,.
OCCUPANCY OF:BU I LDI NG IS NOT PERMITTED UNTI L BU I LDINGF I NAL IS SI GNED BY BUILDING INSPECTOR.
MICROFILM
W C ARRANGE-FOR INSPECTION BY PHONI'NG,252:4505, ELECTRIC .E ,Iry
H� ONE WORKING DAY BEFORE REQUIRED INSPECTION
PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING cg?0 D;D
zr k ;+ MECHANICAL
=''SEE PERMIT• FOR EXPIRATION DATE '- �.
i
? CONST.CONST:TAX _
PLIMPORTANT!
EASE READ REVERSE SIDE BEFORE
I CALLING..FOR FINAL.INSPECTION TOTAL
OFFICE COPY
•
APPLICANT TO FILL IN'INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLYI `
BUILDING PROJECT I DENTIFICATI ON .1 - PERMIT NUMBER .
BUILDING -APPLICATION & PERMITADDRESS . " 1.7648 7 nQ
BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
OWNER', - - PLAN CHECK VALIDATION
NAME
DTV. - ELECTRIC PERMIT FEE
.�i.r�2v . G. ,1'ARtsy�DNE1SS-8�9�-
CONTRACTORS UTLETS-SWITCHES-RECER 10.00/1,TW650'
_ ':S�LF• LIC.NO. - ,3 LIGHTING FIXTURES 10.00/1.00 �
F CONTRACTOR'S
aooREss - APPLIANCES-RESIDENTIAL „4.00
PHONE" PANELS r -- 10.00
DATE OF APPLICATION
OORRCHITECT PANELS (OVER 200 AMP) 20:Q0
PLAN CHECK FEE P.C." NO.
ENGINEER
LIC.NO, SIGNS TRANS.,,,, 3.00
ARCH.ON ADDRESS`ENG SPECIALCIRCUIT 5.00 PERMIT.VALIOATION
-
ZIP EMP:METER OR POLE.I NS. 20.00
APPLICANT s .�. MOTORS' SEE FEE SCH. �r /
$ARE SERVICE CHANGE - �_ 1'2 .00,
Foo LICENSED CONTRACT OkS DECLARATION � � •�e `- t ! O'` .
w
r i G 1 hereby affirm that l Con liccnxed wader provisionsof Chapter? 7
ISSUANCE GATE .
G (commencing with Section 7000)of Division 3 of the Business and B - "
H Proessions Code,aril my license is in full 1'arec anJ effect. `
LDG• ELECT. PLG. MECH.
z
00. - Date
Class Lie rector Clty of Cupertmu
y - D Dato Contractor - Y O
¢_ ¢ w a OWNER-BUILDER DEc1.nknnON � � BUILDING PERMIT ,
o a - INFORMATION
Is ; y 1 hereby aflinn that I am exempt from the Contractor's License MISC._ - ' REFER'TO ORD -
P_ Law far the following reason.(Sec.7031.$,Buslncssand Professions •10.00 'VALUATION O $/FT.
L - J PERMIT ISSUANCE d 0
Cod¢A,demolish,
County Yp.G.ny requires,permi toots nslmat,.alsolter, ZIOD -
e, ¢ FD improve,demolish or repwr any,tractate,pons to Its Issuance,also ELEC.CONTIi. .LIC.NO. ELEC.
D , requires the applicant for such 1 e n t In file a signed sf tenrent that TOTAL F-�� .PERMIT TO
a ce m he Is licensed pursuant m IhC provisions a thi Contractor's License f' - - I
r Z a
Law(Chafer 9(eommcn,ing with Section 70001 fDiNki .13offhc - K%
¢ O Business and Professions Code)or that he Isexempt therefrom and DTV. PLUMBING PERMIT FEE 1 \l� �e'.
¢ r the basis for IIB alleged exemption.Any vichllon of Section 7031.$
- �. STORIES TYPE CONSTR.
a 3 � by any applicant fora undoe,uo Cats $500)ire plicant toacivil penalty ALTER-DRAIN&VENT-WATER IEA.) 5.00 X101'
of not more than five hundreA dollars(5500).): `
❑ I,its owner of the Property,or my employees with wages as BACK FLOW PROTECT.DEVICE, • 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the sl oletme is not
t intended nr offered In, sale(See. 7044. Business and Professions DRAIN$-FLOOR,ROOF,AREA;COND. 5.00
-
Code:The Contractor's License law does not apply to an owner of 2 •Q -
propi-Ty who builds or unproves thereon,and who does such work FIXTURES-,PER TRAP 5.00 SO,FT,FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided That such improve.
meals are not intended or offered for sale.If,however.the building I IGAS-EA.SYSTEM-11TIC.4 OUTLETS 6.00 ��. .,
or improvement is sold within one year of completiou,the owner- - -
ry builder will have the burden of proving that he did not billion ins, GAS-EA.SV$T EM-OVER 4 (EA.) .2.00 BUILDING USE
prw for purpose Of sale.,. INDUSTRIAL WASTE INTER. 30.00ES IND CON PB Other
I as owner of the property,am exclusively contracting with 'Cl' El El El E]c ed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
:mdProfessions Coda:The Contractor's License Law docs Int Ilpply
to an owner of property who huilds or improves thereo),and who LAWN SPRINKLERS-'OVER 5 (EA.) 1.00
contratheC.cisl'orsuchprnjeLSEWER-SANITARY-STORM EA
withuamtranurl sl licensed pursumlt to, .200H/10.00 '
the Contractor's License Law. TRACT NO. '- PARCEL NO.
reason
❑ lent exempt under sec. ,B.&P.C.for alis WATER HEATER W/VENT 6.00
_ -
°te WATER SYSTEM - 5.00
ACC.GATE ACC.FILE N0.
•.W'ORKIi RS'COMPIINSA'FIONDECI.ARATION WATER TREATING'EGUIP. 5.00 .
I bcrcby'In'timr that I have a certificate.1 consent to sClf-insure,
or a"Gificale of Workers'Compensation Insurance,or it certified ZONING ENG.SITE NO.
Copy thereof(Set.3800,Lab.C.).
Policy Nn. Company
O 0 Cenified copy is hereby furnished FIRE$PRINK ENERGY T-14
Z Z ❑ Certified copy is filed with ,he-city inspection division. � �Y ❑' N4
FO Applicant - MISC.- REFER TO ORD. y N
CC m CliRlgl'ICATI:OF F-XI!MI'PION PROM WORKI?RS' PERMIT ISSUANCE 10.00
LU �- COMPENSATION INSURANCE PLG.COrvTR. - DO FLOOo'ZONE A.L.U.C.'
CL O- LIC.NO. PLG. ^�'•11 D -
Z• (TINS.Seerilin need not be completed if tire permit Is for one ,TOTAL pLB•C YE]. -N ;V.� IN r
hundred dlllImS(S l oa)Or less] I -
U O I Cindy that in the performance of the work for which This per- DTV - MECHANICAL PERMIT •FEE FEE SUMMARY _
LL- H mil is issued,I shall not employ any person In any manner so as Io _ j
Q w, becoole subject to the Workers'Compensation Laws of Calif ostia. -
a Date Applicant ALTER OR ADD TO MECH. 5.00 'BUILDING 3 3 n�
} m NOTICE'TO APPLICANT: If,after nuking this Certificate of fix-
♦- Z emption,you should become subject to the Workers'Compensaliun' APPLIANCE _ 5.00 PLAN CHECK
s; provisions om
f the Labor Cnde, you ust EHt ivoth complyish w
C„1. such provisions or this per 'FEEmit sha11 be deemed revoked. - AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 -
's�- ' CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10p00C-F.M.16.00 SEISMIC FEE
y, I hereby affirm that there is a constructionifiisernot ng agency for EXHAUST HOOD (WITH DUCT) 5.00
sD • Seel,
the performance of the work Corwhich'Ihi,Reimi, is issued(Sec. MICROFILM'
3097,r'sNa . HEATING UNIT(TO 100,000 B.T.U.) 8.00 -
Lender's Name
Lender's Address - HEATING UNIT(OVER 100,000 B.T.U.)9.!J0 •ELECTRIC' 2(eJ V
- I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct.1 agree to Comply With all city and county PLUMBING
or dinonccs.und;stme laws rioting to building em,slraclinn, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6,00
.'fi. hereby,authorizc representatives forties of tori, city to hams upon the BOILER_-COMP(Over 100,000 BTU)SEE FEESCH. MECHANICAL S'D
abo by am[ioncd prepresentorinsp of this
oil purposes.to -
(We)�agreo to save, indenmify and keep Imrmless the City of MISC.- REFER TO ORD.„ -
Cupertino against liabilities,judgments, cosls'and expenses which' - - CONST.TAX.
;ay�".'
aywayacrue again,, sal, City in Consequence of"the PERMIT ISSUANCE 1000 100nti Illy wape miTOTAL t ,a ppit ant/Contractor r/�
OFFICE COPY