16632 POST THIS CARD NEAR FRONT OF. BUILDING PERMIT NUMBER
CITY OF CUPERTINO 4
16632
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
y ,q ,
yJOB ADDRESS - v ��e' ��C �� UNIT#O _LOT#• `
'1 ( - PERMIT EXPIRES IF,WORK
GwrvER I?�Vw`�L �( S CONTRACTOR ,�lS IS NOT'STARTED WITHIN
INSPECTION DATE IN PECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATIONANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT vALNATION
CUPERTINO STANDARDS.
GARAGE SLABS
•3— .meq- 9
POUR NO CONCRETE UNTIL ABOVE HA BEEN SIG EO upD
UNDERGROUND /SLAB. - MAR-Ul _l9ba
PLUMBING tF
erw
ELECTRICAL - - Y14. ISSUANCE DATE
MECHANICAL DG eyICT I ,I G VCH
' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED • - BUILDINGPERMIT
INFORMATION
WOOD FLOOR -
PLUMBING VALUATION s/FT.
� � � '` JI
MECHANICAL
ELECTRICAL or PERIn('-I T/O
FRAMING
INSULATION sroare Tvve corvsrrv,
• , - - - - UCC, GHDUP IIHS UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
5Q Ei fIOOR PHF.A TOTAL ACREAGE
ROOF '
00 N NOTE:'
O E. 0 FINAL INSP.SHALL BE MADE BEFORE .�
DIAPHRAGM THE CONSTRUCTION TAX IS PAID , �� ,Sj�� •
ROOF SHEATHING JRES IND ILUCON usEPB DO— ,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS, DATE INSP. ❑ ❑ D ❑ ❑
I ROUGH ELECT.
3nSSESSORS PARCEL NO
8 . 57- �,
PLUMBING � ELECT.ENERGY c �
TUBS 8 SHOWER PANLs' PLUMBING ENERGY TRACT No. - PARCEL No
MECHANICAL -� MECH.ENERGY O�,P'. ACC DATE ACC PILE NO
ELECTRICAL -J BUILDING ENERGY
FRAMING 71 ELECT.FINAL TEST
ZONING 'ENG.SITE NO,
INSULATION PLUMBING
GAS TEST GAS' +
MECHANICAL FIRE SPRINK ENERGY T 2
-i' y ❑
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED � HEATING "` N.❑ V E) N❑
_ _ J-
F
EXTERIOR SHEAR ELECTRICAL RELEASE LOODZONE AL UC,
'INTERIOR SHEAR - 0 FIRE DEPT. v❑ N❑ ° ❑ N❑
SHEETROCK _S= 1,r7 GRADE / FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS BUILDING . UD
SCRATCH COAT. ELECTRIC PLAN CHECK
�� R U TIGAS + FEE
NO TAPE OR PLAS L ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
- OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUI LDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC E
g4=4
H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBINGqw IZ
1 PLEASE GIVE JOB ADDRESS WHEN PHONING.
MECHANICAL
- SEE PERMIT FOR EXPIRATION DATE -`- 0
I •-
IMPORTANT! CONST.TAX Q�`v
r'
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY.'
APPLICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALL POIJT P11 ONLY
- - / -PERMIT NUMBER
? c.. DING ING PROJECT IDENTIFICATION APPLICATION & PERMIT -'
BUILDING 16632'
10316'Chiertino. California> BUILDING- ELECTRICAL-PLUMBING-MECHANICAL
..=4T. OWNER'6
n s NAME Terry Brovm 'Constructs on/ PLAN CHECK VALIDATIONQTY. ELECTRIC PERMIT FEE
Jim Sisk Gevelo mentbo408-996-372
NAME CTORS,�!l y Dr OWnGO(I,struc'tl On OUTLETS-SWITCHES-RECEP 10.00/1.00
NAME
AM X71 `UiL LIC.N0.B352642 LIGHTING FIXTURES 10.00/1.00
CONTRACTOR-521721 Granada Ave;36"53 APPLIANCES-RESIDENTIAL 4,00
ADDRESS
Cupertino, CA 95014 ,408-996-3722 PANELS 10,00 DATE OF APPLICATION ^1
OORRCHITECT i C ar L. ee. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C:NO.
'. 6rrBM1GG�
LIC.NO.C16645 ISIGNS TRANS. 3.00
ARCH.Rg- 2409 Appley Way SPECIAL CIRCUIT - '5.00 PERMIT VALIDATION
ADDRESS
San Jose, CA 195124 TEMP. METER OR POLE INS. 20.00 J
APPLICANTS MM-Pasadena Avv MOTORS SEE FEE SCH. -1
ACupert1no, CA 95014 SERVICE CHANGE 20.00
o¢ ige r", ",
Foo LICENSI:D CON'1'RACfORS DECLARATION QO
a w I hereby affirm that 1 am licersed under provisions of Chapter 9 1
MAR 01 M jISSUANCE DATE
,HA a w (commencing with Section 70001 of Division 3 of the Ousiness and C. ELECT. PLG. MECH.
F y Z Professions C.dequBil my license ,in
frit fart n •f'• L ,�
Z o m- License Cla Lie.Nmnher,
L 4 N F B Date Contractor _ �Siitr cu")
¢ 'c ¢ a ZUZ 6h OBDILDIiR DGCLA�s82f� V V BUILDING RMATIOPERMIT
w gw U INFORMATION
,- 1 here y xf it In 1 am exempt from tl o actor's License MISC.- REFER TO ORD
Fro J Law for the followiogreasm.lSec.7031.5,tlusinessanJ Professions pEflMIT ISSUANCE 1000 -VALUATION $/FT.
Code:Any city or county which requires a pcnnit io construct,shag 24 0
z i Q FO improve,demolish,or repair any struchve,prior to ifs issuance,also $LEC.CONTR. LIC.NO. $LEC. 9/' '37D n
w O LL requires the applicant for such permit to file a signed stated ent that TOTAL , (� PERMIT TO
A w m he is licensed pursuant(commencing the provisions of the Cont ivision License
}.
FZrt Law(Chand Prosion, ode)lir Section is coulDivision3of lite
z o Business'and Professions Come)or that he is exempt therefrom and OTY. PLUMBING PERMIT _ FEE
thebasis for thea ora exemption.Any violation
ca of Section malty STORIES TYPE CONSTR.
by any applicant fore permit subjects the applicant toaeivil penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred dollars(5500).):
❑ 1,as owner of toe property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 DCO,GROUP RES.UNITS
their sole compensation,will Jo tru
ie work,and the stcture Ls not
intclided or offered Gtr sale(See 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
„ Code:The Contractor's License Law does not apply to an owner of
.r AlL property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
Inents am through his own employees,provided that such improve- 30 �� l
stents are not inWndcJ or ofl'crcd for sola.if,however,the huilding GAS-EA.SYSTEM-1INC.4OUTLETS 6,00 S CY
or improvement is sold within one year of completion,tie owner.
ft builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 1 BUILDING USE
- prove for purpose nfsale.). RES IND CON PB Other
❑ I,as owner of the properly,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 11 ❑ ❑
lEl 1:1
icensed cantramare m constnv;t the project(Sec. 7044,Business LAWN SPRINKLERS-i INC 5 V.B. 6.00 ASSESSORS PARCEL N0.
and Professions Code:The Contractor's License Law docs not apply Q
„
to an owner of property who Builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 a rl
contracts for such projects with contraetosl licensed pursuant to 35^I_ Ob
- / PS-Q0
tasm,he Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT No. PARCEL NO.
' I ❑ tum exempt tinder Sec. ilii&I'.C.for this WATER HEATER W/VENT 6.00
i Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO.
S,Clip�. sypTpto•/N nPbc•ARA'fION WATER TR EATI NG EQUIP. 5.00
1 arca fISIt T11at I Mu �clrftltulc onsant to self-insure,
ora tifimate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy th of(Seo.38Co LpapYLr=E+�z�
Policy No. Compan -f- P[.1- _
0 .PL❑�/ Cerlifiedeopyisherebylumished' FIRE SPRINK ENERGY T 24
z Z Certi ' espy is filed will, the city inspection division.
H O APPlicant_1/ MISC.- REFER TO ORD. Y N� y No
,( PERMIT ISSUANCE 10,00
cc: CIiRTI h F '.XIiMPTI G1\VGRKCRS' FLOOD ZONE A.L.U.O.
.LU COl zI rlSA'I'ION INSURANCE PLG.CONTR. LIC.NO. PLG. rx
EL O (This section need not he completed if the pit m.it Is for one TOTAL p } Y-❑_ N Y'[] NE]
7) Z hundred dollars($100)or less I
U O I certil)+that in the perfornsnce of lire work for which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued,I shall not employ any peann in any.lamer so ns to
O W become suhject to the Workers'Compensation Laws of California.
n Das Applicant ALTER OR ADD TO MECH. 5.00 BUILDING OD
>_ W NOT CE T'O APPLICANT; If,after..,.king till Certificate of Ex- \
F Z ereptIon,you should become subject m the Workers Compensation APPLIANCE 5.00 PLAN CHEC \
provisions of the Labor Code, you Bull forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00
CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.FM.) 6.00 SEISMIC FEE (6f
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
- Lender's Name
Lender's Address HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC D/y D -
I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 --, G
information corrycL I agree to comply with all city and county BOILER-COMP13 H.P.or 100,000 B.T.U.) 6.00 PLUM�I G O l 9
ordinances and orale laws rebating t0 building construction, and
hereby authorize representatives of this city to enter upon the I D
kabopurtyfor
ovmm�tioned proinspection purposes. BOILER-COMP (Ovar 100,000 BTU)SEE FEE SCH. MECHANICAL
S71z' ) agree to save, Inde roily and ke Itarmless the I , MISC.- REFER TO ORD.
upert o against lir TiNes )uJlpnents, c is and L A NST.TAX_ 7t.3
a - ea auenc o PERMIT ISSUANCE 10.00
'
this pcnnit, - M H.CONT. LIC.NO. MECH
5'
Si sure of App cant/Comractor ate
OFFICE COPY