18313 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY .OF CUPERTINO 18313
INSPECTION DIVISION
JOB INSPECTION RECORD
�� ►� PERMIT EXPIRATION
Q
JOB ADDRESS�—(Z__.` --�JZj_ =�--y—UNIT# LOT# • PERMIT EXPIRES IF WORK
OWNERDC) J CONTRACTOR IS NOT STARTED WITHIN
INSPECTION - D E INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION - NOTE:
LAST CALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
GARAGE SLABS CUPERTINO STANDARDS. p 4F�
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED � 0
Y 7,,.,,• / � �
UNDERGROUND /SLAB .`.1011 101,
PLUMBING
ELECTRICAL - �1L�+wi1W ISSUANCE DATE "'W
MECHANICAL - - BLDG ELEcr PMI. MECHT;?
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
�f
' ' WOOD FLOOR INFORMATION
VALUATION .SIFT.
PLUMBING DO
MECHANICAL - OO�y
ELECTRICAL - KIT TL4
FRAMING' � l /�
INSULATION - STORIES TV ECONSTR.
OCC,GHDUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOFNOTE:NO FINAL INSP.SHALL BE MADE BEFORE �" rr."ooR AREA TOTAL ACREAGE -
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING use
ROOF SHEATHING RES 'IND CON PB On.,.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP, Cl El 0 11 0 `
ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING ELECT.ENERGY
TRAGI NO. PANCELNO
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ELECTRICAL BUILDING.ENERGY ACC DATE ACC.FILE NO.
FRAMING ELECT.FINAL TEST
ZONING ENG,SITE NO.
INSULATION PLUMBING '
GAS TEST GAS. '
MECHANICAL FIRE SPRINK ENERGY T-24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [:] NDI Y D IN
EXTERIOR SHEAR ELECTRICAL RELEASE `1.001)ZONE A.L U.C.
� -
INTERIOR SHEAR FIRE DEPT.' � `" ❑ No ° ❑ N❑
$HEETROCK GRADE FEE SUMMARY
EXTERIOR'LA TH BUILDING
INTERIOR LATH, TEMPO RARY'APP ROVALS BUILDING %,
SCRATCH COAT ELECTRIC PLAN CHECK -.L.yc�
- GAS FEE 1
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE n i
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
z° PLEASE GIVE JOB ADDRESS WHEN PHONING. .
— SEE PERMIT FOR EXPfRATION DATE — MECHANICAL
IMPORTANT! CONST.Tnx
PLEASE READ REVERSE SIDE BEFORE TOTAL 16F
CALLING FOR FINAL INSPECTION.
OFFICE COPY'.. .
APP-LI•CANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BU I LDING PROJECT IDENTIFICATION - PERMIT NUMBER
BUILD, G _ APPLICATION & PERMIT 1 $313
ADDRESS �p
- Z dl,•co�'B ✓E BUILDING-ELECTRICAL-PLUMBING-MECHANICAL .�
OWrvEWS �� / 0� - PLAN CHECK VALIDATION
NAME TN ��'f1 / OTY. ELECTRIC PERMIT FEE
/ills//'��'- Q PHONE-; -5
NAMER"cTORs UTLETS-SWITCHES-RECEP 10.00/1.00
Lie NO. LIGHTING FIXTURES - 10.00/1.00
CONTR ACTOR
ADDRESS PPLIANCES-RESIDENTIAL 4.00
ADDRE
PHONE PANELS 10.00 DATE OF APPLICATION
Rcmracr PANE LS.IOVER 200 AMP) .20.00 PLAN CHECK FEE P.C.NO.
OR
O
ENGINEER
LIC.No. ISIGNS TRANS.' 3.00
ADDRESS ENc. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. - 20.00 `7^
ADDH fss r$ MOTORS SEE FEE SCH. l
A
PPLI ESE
Q. (,!/� AId SERVICE CHANGE 0.00 I' /s
w o a LICIENSEk
D CONTRACTORS DECLARATION 0 YCC.
a ul� I hereby affirm.11al I am licensed under provisions of Chapter 9 ISSUANCE DATE
a, a a (commencing with Section 7000)of Division 3 of the Business and L U BLDG. ELECT. PLG. MECH-
_ 30 Professions Code,and my license is in full force and effect. v -- ❑ ❑ ❑
Z o a - License Class Lia Number
4 m r La Dule Contractor ^t
a u E d City of Comma - BUILDING PERMIT
¢ ¢o rt u OWNFR-BUILDER DECLARA'n ON - INFORMATION
w ;,� N 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
Imo ¢ Law for the l'ollowingressnn.(Sec.7031.5,Businessand Professions pERMIT ISSUANCE 10.00 VALUATION $/FT.
EcoAt Code:Anycilyorcounlywhichrequiresapermittoconstruct,alter, �Bt
¢ ¢Q O improve,demolish,or repair any stfuctnro,prior to its issuance,also ELEC.CONTR. LIC.6uT ELEC.
D¢ requires the applicant for such permit to file a signed statement that TOTAL
So
m'• he is licensed pursuant to the provisions of the Contractor's License PERMIT TO
= zat
Law(Chapter 9(commencing with Section 7000)of Division 3 Oflhe
4 D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE 111 1
T F $ the basis for the alleged exemption.Any violation of Seepo07031-.5 _ ' STORIES TYM CONSTR.
a � by any applicant for a permit subjects the applicant too civil...natry ALTER-DRAIN -WATER (EA.) 5.00
of not more titan five hundred dollars(55000.):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 400
their sole compensation,will do the work,and the structure is not . .
OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner or
property who builds or improves thereon and who does such work FIXTURES-'PER TRAP S.00 SD.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such rt, e-
mentsarenotintendedorofferedforsale.If,however,the building GAS-EA.SYSTEM-i INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4 (EA.) 2.00
builder will have tire - . - .
e burden of proving that he did not build or im- BUILDING USE
pros for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB outs,
I,as owner of the property,am exclusively contracting with
li • sed contractors to construct the project(Sec.7044,BusinessLAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law docs not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA-) 1.00
contracts liar such projects with a conlraclon s)licensed pursuant Io
the Contractor's License Law. _SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ I at exempt under Sec. ,B.&PC.for this WATER HEATER W/VENT 6.00
reason
Owner - Date - _ WATER SYSTEM 5.00
ACC.DATE ACC,FILE NO.
WORK ERS'COMPENSA-1 TECLARATION ' WATER TREATING EQUIP. 5.00
1 hereby atirm that I hove a certificate W onsinl In selfmiisr e, ,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy Ihereoi'(See,3800,Lab.C.).
Policy No. Company
0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T24
Z 2 C1Certified copy is filed with the city inspection division.
O_ Applicant MISC.- REFER TO ORD. YEj No v ❑ - N❑
T CERI1 FICA'FE OF EXEMPTION FROM WORK 17 RS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. _
D. 0 (This sectidn need not he completed if the permit Is for one TOTAL Y NF] Y[:] N�
hundred dollars IS 100)or less.)
V O 1 certify that in me performance of the work COT
which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL b- mitis issued,I shall not employ any person in:toy manner sn as In.
O U become subject to Lite Workers'Compensation Laws of California.
Q. Dmlc Applicant ALTER OR ADD TO MECH. 5.00 BUILDING UV
>_ Go NOTICE TO APPLICANT: If,after making this Certificate W Ex-
F_ Z eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK �''•
provisions of the Labor Code, you must forthwith comply with FEE �•l
U such provisions or this permit shall be desired revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 �7
CONSTR UCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.EM.) 6.00 . SEISMIC FEE - SV
1 hereby affirm that titers is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance of lite work lot which this permit is issued(Sec! MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's NamAdd H EATI N G U N IT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I salify that I lave read this application and state ty and lovecounty VENTILATION FAN (SINGLE) 4.00
information is State l I agree to comply with all city and county PLUMBING
ordinances and state laws relating t0 building construction, and BOILER-cOMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes.
(We) agree to save, indemnify and keep.hannlesa the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which' PERMIT ISSUANCE 10.00 CONST.TAX
may in any way accrue against said City in consequence of the
S2
gof this permit MECH.CONT. LIC.NO. MECH.
LrL G TOTAL TOTAL 6 S
.r Signature o pplicant/Contras ate O -
OFFICE COPY