C 8127 POST THIS CARD-NEAR FRONT OF BUILDING ,
PFRNIR NUYIRER '
:CITY OF, CUPERTINO Q1
r I ~ 'INSPECTION DIVISION' " ( ' LJ I � ,
JOB INSPECTION RECORD
PERMIT EXPIRATION
.JOB ADDRESS 22-+ UNIT4 _LOT# '
ti
PERMIT+EXPIRES IF WORK
OWNER CONTRACTOR r IS NOT STARTED-WITHIN
INSPECTION ATE INSPECTOR INSPECTION RECORD. 18oDAYS OFPERMIT ISSU-"
FOUNDATION - - •ANCE OR:180 DAYS FROM
UFER -
+.LASTCA '
LLEDINSPECTION.'�' '
PREGUNITE
PERMIT VALIDATION.
- � � _ - � � � '
ar
. 'POUR NO C NCRETE UNTIL ABOVE HAS BEEN SIGNEDt. e'
UNDERGROUND /SLAB
PLUMBING ,.
ELECTRICAL - -
ISSUANCE MECHANICAL' - �. RL c fELECT. PLc, ECR.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
-- INFORMATION,
.PLUMBING WOOD FLOOR 'VALUATION' -s/FT
4 IJ•.
MECHANICAL- . -
ELECTRICAL , •. kk
. 'PERMIT • i,
FRAMING - '
S ` E ONSTR.
,INSUL•ATION - `
- Dec.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN•SIGNEO ^:
+ ROOF . SG,IT.'I.00RPREA TOTALACREAG! i
��. DIAPHRAGM ; ••`
' RUI LOING USE
x + IND . •CON . PB o"t-C ..
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED Eh 11 0-
4'bLU PARCEL No. `
ROUGH
PLUMBING - - }• s. '
GAS TEST
TRACT NO. - PARCEL NO,
' � � - - - -
r 's
•
MECHANICAL
ACC.DATE ACC RLE NO
ELECTRICAL' FINALS DATE INSP.
FRAMING • - ' ' SAN
ZONING.' ENG.SITE NO..
' INSULATION ' PLUMBING , ' � � - +
GAS'
MECHANICAL „ FIRE'SPRINK,M1 'ENERGY T 24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' °' "E
- . LATH—INTERIOR ELECTRICAL FLOOD-ZONE, A.L.LLC.- „�
LATH-EXTERIOR N Y N
FIRE ., N Q r
SHEETROCK GRADE - '.'FEE SUMMARY
.i SHEAR INTERIOR - - BUILDING _ !•�
BUILDING
SHEAR EXTERIOR TEMPORARY•APP ROVA I R „J .
''. FIREWALLS' ELECTRIC ' - PLAN CHECK 'J
. + GAS ' FEE' r
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY .SEISMIC FEE,
OCCUPANCYOF BUILDING ISNOTPERMITTEDUNTILBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR: - - '
. MICROFILM
ARRANGE FOR INSPECTION BY PMONING.252-4505; . "o,, .. ELECTRIC , „ r
o� ONE WORKING DAY BEFORE REQUIRED INSPECTION PLUMBING
PLEASE GIVE'JOB-ADDRESS WHEN PHONING.
Z — SEE PERMIT EXPIRATION DATE, S jMECHANICAL
IMPORTANT!
PLEASE READ REVERSE-SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION:,"':
OFFICE COPY, T".r
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-- USE BALL POINT PEN ONLY
BU LDI NGPROJECT.I DENTI FICATION 1
PERMIT NUMBER
BUILcf �- APPLICATION & PERMIT ., f}''(� 1 //')7
ADD' r ` �J 1 LE 1
BUILDING,- ELECTRICAL-PLUMBING=MECHANICAL
OWNER'S - PLAN CHECK VALIDATION
NAME CITY. - ELECTRIC PERMIT FEE
yawsAONE
enN r CTOR SUTL ETS-SWITCHES-RECEP 10.00/1.00
/YdD c.No, LIGHTING FIXTURES 10.00/1.00
ADN Ac*o R's
ADDRESS ceuZ /^ APPLIANCES-RESIDENTIAL ' 4.00
PHON\ AC'rf..x{
8 PANELS 10,00 DATE OF APPLICATION
ARCHITECT .PLAN CHECK FEE NO.
OR C�71Mk. 'eCVOCS��AO�+� PANELS (OVER 200 AMP) 20.00 F.C.,
ENGINEER
I"(C'IAL�. uc.ND.'• ' SIGNS TRANS, - 3.00
ARC
ADDRESS ENG. • a SPECIAL CIRCUIT. 5.00 PERMIT VALIDATION-
Ii
EMP.METER OR POLE INS. - 20.00
APPucnrvrs . - MOTORS SEE FEE SCH.
AOOREss
Z 007- SERVICE CHANGE 20.00 .lU
w o
LICENSED CONTRACTORS UGCLARATION TEMP.POLE 30.00 :J
a v U I hereby affirm that I am licensed under provisions Of Ch.pter 9 -
w a N (contn ecein8 with Suction 7000)of Division 3 of the Business and - '
MECH.
H D Prol'Cssions Cn am my license is in full fore• ❑ ❑
o Z_W Licenss����Cla;; Lia Numh�(
F m E J Date_5�1 - I Contractor j os- ,.
e _ rc w u . OWNER-BUILDER DECI`.JA'�RAA9'alo1N BUILDING PERMIT
wi,n H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION
.. Law J Law for the following reason.(Sec.7031.5,Business..d Professions VALUATION $/FT.
Code:Any City or county which,climresn pe nu it tocatistruct,alter, PERMIT ISSUANCE 10.00 {�f,
IS
¢ G p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR: LIC.NO. ELEC.
K m ES requires the applicant for such permit to file a signed statement that TOTAL
IL w he is licensed pursuant to the provisions of the Contractor's License PERMIT TO
Hir
Law fChapter9(commenciog with Section 7000)of Division 3 of the
a Business and Professions Code)or that h i is exempt therefrom and DTV. PLUMBING PERMIT FEE
¢_$ the basis far the alleged tion.An violation ofSectioh 703L5
8 p il STORIES TYPE CONSTR.
i` by any applicant meIlora permit subjects lheopplicant loativil Penalty ALTER-DRAIN -WATER'(EA.) 5.00
of not more owner
five hundred dollars($50100�amp . -
❑ Las owner of the properly,or my employees with mis not
canoBACK F LOW PROTECT. DEVICE 4.00 OCC GROUP RES.UNITS
their sole compensation,will Jo the work,and the structure rs not
intended or offered for sale (Sec. 7044, Business anti Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 -
Codc' 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 SG.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
- .
menrs are not intended or offered for sale.IL lowever;the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or int. GAS-EA.SYSTEM-OVER 4 (EA.)' 2.00 BUILDING USE
Prrwe for purpose of sole.). E IND CON PB Other
❑ I,as owner of the property,and exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ,
licensed contractors to construct the project(Sec, 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00ASSESS OHS PARCEL N0.
and Professions Code:The Contractor's License Law does not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.)• 1.00
contracts for neh projects will,n ,unn ctury)licensed purauanl to
the Contractor's License Law, SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exempt under Sec..,BAP.C.for this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKF?RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm tlmt I have o certificate of consent to sal Ginsurc, '
or a certificate of Workers'C,,n e,or o ce rlificd ZONING ENG.SITE NO.
copy thereof(S c.3800,Lab.C.).
Policy No. (, mpunvtp
❑ Certifier c pyi� serol hc,
Z ❑ Certifi,, d city inspection ivisiom FIRE BPgINK ENERGY T-24
FO Applicant_ MISC.- REFER TO ORD. Y 13 N0 Y IN
OC y CF RTI PKAT Ola F:XIiMI'I'ION 17 ROM WORK 1:RS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. M
W CO IPENSATIO..INSURANCE PLG.CONTR. LIC.NO. PLO, ❑ ❑ `�-�,-,
CL a ('this section need not be completediethe a is for TOTAL Y N Y LJ IN
U O hundred dollars(S 100)or ICx,.) Ls -
I certify that in the performunc of II •wor FEE SUMMARY
U_ H mit is issued,1 shall not employ Pe on'n s to DTV. MECHANICAL PERMIT FEE
Wbean su t e Workers'C Yo lis ia.
CL Date__ pplicant BUILDING
} U) NOTICEICE T�ANT: If,after n n nix. - ALTER OR ADD TO MECH. 5.00
F Z emption,you should become subject N the Wor crs Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith Comply with - AIRC,1 such provisions or this permit shall he beetled revoked. AIR HANDLING UNIT(TO 10,000OF.M.) 4.00
CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000 C.EM.16.00 SEISMIC FEE AIL
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) - 5.00
the perfornlunce of Ole work for which this permit is issued(Sec. - MICROFILM
3097,Cie,C.). H EATING UN IT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC.
I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city a I Country PLUMBING
ordinances and state I s relating to building c.nortiZ
on, Still BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
he -by authorize repr s•ntativ of this city to enter upon the BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL
a a-mentioned op or it pection purposes.
C) ree to v emn fy and keep harmless the City of MISC.- REFER TO ORD.
a1 'rIiI^ against a e , to gnlents, costa and expenses which PERMIT ISSUANCE 10.00
CONST.TAX
y way - at 'id City in consequence of the
9 ,s p ..' ECH.CONT. LIC.NO. MECH.
p
TOTAL TOTAL "1
S lar of i ant ntracto Dale M
OFFICE COPY