14387 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
CITY OF CUPERTING 14367
INSPECTION DIVISION ' . .
JOB INSPECTION RECORD'
• PERMIT EXPIRATION
1'9462 ROSSMARI&PLACE
JOB ADDRESS UNIT# - _LOT'# PERMIT EXPIRES IF WORK .
OWNER BLUE CONTRACTOR JAMES E. MOORE IS NOT STARTED WITHIN •
INSPECTION DATE INSPECTOR - INSPECTION,RECORD 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED -
PREGUNITE - - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING - -
ELECTRICAL
ISS DANCE DATE
MECHANICAL - - 'u LOC. ' ELrcr. PLG. MECH
❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION SIFT.
PLUMBING .. -
MECHANICAL'
ELECTRICAL" PERMIT TD
• FRAMING `.'�• �. .
INSULATION L aa''' ult.SILMIDS TYPE CONSTR.
CM
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
• ROOF '• NOTE:NO FINAL NSP.SHALL BE MADE BEFORE sn.FT,aoDR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
R UI LDING USE
ROOF SHEATHING RES IND .CON PB OIC
'APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS. DATE , INSP.. ❑ ❑ ,❑ - ❑ 11
ASSESSORS PAHCF.L NO 1
ROUGH SAN.a
PLUMBING -- ELECT.ENERGY _ -
TUBS&SHOWER PAN PLUMBING ENERGY - TRACT No. PARCEL No
MECHANICAL MECH.ENERGY
ELECTRICAL - .BUILDING ENERGY - acc DATE AGO FILE No.
FRAMING - ELECT.FINAL TEST
',r•' ZONING ENG.SITE NO
INSULATION � PLUMBING � ,
GAS TEST GAS
MECHAN ICA �6� O FIRE SPRINK ENERGY T.24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING / NEI "�
,
EXTERIOR SHEAR � ELECTRICAL RELEASE � FLOOD20NE A,L UC.-
INTERIOR.SHEAR FIRE DEPT. - YE. 'IBE] __l "❑
SHEETROCK ` GRADE - FEE SUMMARY
EXTERIOR LATH IBUILDING d ,6,9
INTERIOR LATH - TEMPO
RARY'APPROVALS .BUILDING.
SCRATCH COAT ELECTRIC - PLAN CHECK -
GAS
FEE
_ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY - SEISMI&FEe�'"'
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM Y
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING'
• Z PLEASE GIVE JOB ADDRESS WHEN PHONING..
- SEE PERMIT FOR EXPIRATION DATE — MECHANICAL e• 5 1
IMPORTANT! CONST.TAX .
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION
.PERMIT NUMBER
BU I REN APPLICATION & PERMIT 14387
24 aoDREss �j�,,,,�� (-� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL I
Z
OWNER'S
70 TY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION
- "nm
PHONE � •
CONTRA OR'S
�( NAME OUTLETS-SWITCHES-RECEP 10,00/1.00
LIGHTING FIXTURES 10.00/1.00
CONTRACTOR' y-�S PPLIANCES-RESIDENTIAL 4.00
AD R_ESS AAL`�^. A`y♦_..
O /'V�� /.��.MONE �� PANELS 10,00 DATE OF APPLICATION
ARCHITECT - PLAN CHECK FEE P.C.NO,
OR PANELS (OVER 200 AMP) 20.00
ENGINEER
Uc.No. SIGNS TRANS. 3.00
ADDRESS CNG,
SPECIAL CIRCUIT 5,00, PERMIT VALIDATION
zm EMP.METER OR POLE INS. 20.00 n
aA :ESS MOTORS SEE FEE SCI{•) � de-(J'L(.��
AO RE55 •
3D A&DtL'Q 4L.AE SERVICE CHANGE 20.00 _ // I 7
woo LICENSED CON'[RACTORS DECLARATION \ (',^ �Q ✓/
Q u I hereby affirm that I am licensed under provisions of Chapter 9 `k)r Qe' ISSUANCE DATE
r z W (commencing with Section 7000)of Division 3 of the Business.nd
w Q H BLDG, ELECT. PLG. MECH.
H m z Professions Co 41 an t cense is in full fur'•'n •�
License Class Lic.Number ❑ ❑ ❑
m - Date Contractor�J�
m BUILDING PERMIT
¢ ¢ w OWNER-BUILDER UEC. TION
-
MISC.- REFER TO ORD INFORMATION
w a- I hereby affirm tlwt 1 um cacmpt fr the Contract.,',License _
as a- Law for the following reason.(Sec.7031.5,Bminessand Professions PERMIT ISSUANCE ' VALUATION $/FT.
Ew0 Code:Any city or county which requires a permit to Construct,alleD 10.00
¢ ¢ ¢0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. ,.LIC.NO. ELEC.
o¢ requires the applicant for such permit to file a signed statement that TOTAL
w " he is licensed pursuant to the provisions of the Contractor's License PERMIT O
Law(Chapo,9(commeneingwith Seclinn 7000 m(Divislon3ofth,
a Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE
¢ r D the basis for the alleged exemption,An violation of Section 7031.5
g p Y STORIES TYPE CONSTR.
d3 $ by any applicant for opemre dollars tile($500b.):
toacivil penalty ALTER-DRAIN -WATER (EA.) 5.00
of no[more than five hundred dollars(5500).):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITSt heir sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:'Che Contractor's License Law does not apply to an owner m,
property who builds or improves 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-
neons are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4 IEA) 2.00
builder will have the burden of proving that h - . - .
e did not build or im- BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30,00 RES IND. CON PB Omer
❑ I,as owner of the property,am exclusively contracting will ❑ ❑ 0 0 ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not apply
to an owner of property who builds or improves thereon,unit who LAWN SPRINKLERS-OVER 5(EA.) 1.00
Contracts for such projects with u emumcbms)licensed pursuant o SEWER-SANITARY-STORM EA.200ft/10.00
the Contractors License Law. TRACT NO. PARCEL NO.
❑ I ata exempt under Sec. ,BARC.for this WATER HEATER W/VENT 6.00
reason
Owner Dole WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
- WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of comenl to self-insure.
or a,erlificale of Workers'Compens: ton Insurance,or a certified ZONING ENG.SITE NO.
Copy thereof(Sec.3800,Lab.C.)
Policy No. Cmelomy
Q r
tified copy is hereby furnished. FIRE SPR INK ENERGY T-24
Z Z.�/ d y Is filed wn the city ins •,tion division.
a
2_4 _ 1. . _ MISC.- REFER TO ORD. Y 0 No .Y D N�
w PERMIT ISSUANCE 10.00
LU IPICCOI OPEKEhON INS FROM WORKERS' vaooD zorvE A.L.u.c.
W � COMPENSATION INSURANCE PLG.CONTE. LIC.NO. -. PLG.
CL <Clitin need not he completed i(the permit is for one TOTAL V N� Y N� '
Z hunda(idollars($100).r I,ss.)
U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- mit is issued,1 shall riot employ any person in any manner so as to
O L) become subject to(lie Workers'Conspmhsation Laws of California.
OL Date Applicant BUILDING
} W NOTICE TO APPLICANT: If,after making this Certificate of fix- ALTER OR ADD TO MECH. 5.00
Z emption,you should become subject to the Worker,'Connpmssotion APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked, AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRuCIION LENDING AGENCY AIR HANDLING UNIT IOVER 10)=C.F.M.) 6.00 SEISMIC FEE
1 hereby al'Orm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance of h w k far which this permit is issued(Sec. MICROFILM
3097,Civft.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name H EATI NG U N IT(OVER 100,000 B.T.U.)9.50 `
Lender's Address ELECTRIC
I certify tbaf l hove read this application and stale that file above VENTILATION FAN (SINGLE) 4.00
. information is correct. I agree to comply with all city and county PLUMBING
ordinances and star, laws relating to building construction, and 130ILER-COMP(3H.P.Or100,000B.T.U.) 6.00
hereby above-mentioned
representatives
ec This city m enter upon Ito BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for insp of
purposes.
(We) agree to save, Indemnify and keep harmless the City of MISC.- - REFER TO ORD. -
Cupertino against liabilities,judgments, Costs and expenses which CONST.TAX
may in any way accrue against said City in Consequence of the PERMIT ISSUANCE 10.00
•r' this permit. MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL '
7Ci ng utas of AppilearRiCobtalkdatr Date
OFFICE COPY