18308 POST THIS CARD NEAR FRONT OF BUILDING
- PERMIT NUMBER
CITY OF CUPERTINO 1 $308
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS �" �4IVA01.47 UNIT# LOT# (/�{ � - [ {
rP•ERM1TEXPIRES IF WORK
• OWNER L CONTRACTORIS NOT STARTED WITHIN
INSPECTION DATE I INtPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU
FOUNDATION - ANCE OR 180 DAYS FROM
NOTE: �
UFER - ALL GRADING AND.DRAINAGE SHALL BE'INSTALLAST CALLED.INSPECTION.
LED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF 1 LI AIT VALIDAnoN
CUPERTINO STANDARDS. {//�
GARAGE SLABS - rw`�I.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL , ISSUANCE DATE
MECHANICAL B•uc ELECT PLG mECR.
• - El ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT -
INFORMATION
' WOOD FLOOR VALUATION
SIFT.
PLUMBING' N '''
MECHANICAL
ELECTRICAL /�'yn(AJPERmn ro
FRAMING I ' '—I STORIES TYPE corvsTR.
INSULATION
/-� OCC.GI+ORE RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED / /
sa IT.FLooR AREA TOTAL A<R ACE
ROOF NOTE:NO FINAL INSP,SHALL BXMADt BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID F�
BUILDING USE
• ROOF SHEATHING• dEs INn ' CON - PB 00—
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE .INSP. ❑ ❑ ❑ ❑
ASSESSORSPARCELNO
'ROUGH SAN.k - -
PLUMBING ELECT.ENERGY
rRncr Nu, PARCEL rvo.
' TUBS&SHOWER PAN , PLUMBING ENERGY - ,
MECHANICAL - MECH.ENERGY
ELECTRICAL ACC DATE ACC,FILE NO.
BUILDING ENERGY
FRAMING ELECT.FINAL TEST
ZONING ENG.SITE NO.
*INSULATION � PLUMBING -
' GAS TEST GAS
FIRE SPRINK 'ENERGY i:<
MECHANICAL "v N� v N�
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
: >> L.
EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ION[ U.C.v� 'RE-1I N❑
INTERIOR SHEAR - FIRE DEPT.
SHEETROCK - GRADE FEE SUMMARY
EXTERIOR LATH BUILDING BUILDING r1
INTERIOR LATH ; TEMPORARY APPROVALS•
SCRATCH COAT ELECTRIC PLAN CHECK
' GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE F (I
OCCUPANCY OF BUI LDING IS NOT PERMITTED UNTI L BUI LDING,FINAL IS SIGNED BY BUI LDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
1 O PLEASE GIVE JOB ADDRESS WHEN PHONING'.
III "dD Z SEE PERMIT FOR EXPIRATION DATE — MECHANICA 0'
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTA'C
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL-POINT PEN ONLY '
BU I LDING PROJECT I DENTIFICATI ON .PERMIT NUMBER
BUILDING APPLICATION & PERMIT 18308
ADDRESS
V
Se• In BUILDING-ELECTRICAL-PLUMBING-MECHANICAL ,i„
OWNER'S PLAN CHECK VALIDATION
NAME ,,/n� QTY. ELECTRIC PERMIT FEE
T v o
CONTRACT
NAUTLETS-SWITCHES-RECEP 10.00/1.00
ME
LIGHTING FIXTURES 10.00/1.00 1/11//i sZ
ADDRESS ons PPLIANCES-RESIDENTIAL 4,00
ADDRESS }jtJ �/
O �� /PRONE PANELS - 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO.
OR
ENGINEER
LIC.No. SIGNS TRANS. 3.00
ARCH.OR ENG. - - PERMIT VALIDATION
ADDHEES SPECIAL CIRCUIT 5.00
ZIP TEMP.METER OR POLE INS. 20.00
APPLICANTS MOTORS SEE FEE SCH.
ADDRESS V
SERVICE CHANGE 20.00
o0o LICENSIiD CONTRACTORS DECLARATION
u U I hereby affimt that 1 am licensed under provisions of Chapter 9 V ISSUANCE DATE
y s (commencing with Section 7000)of Division 3 of the Business and
w rl DG ELECT. PLG. MECH.
R o z Pron tsions Code,and my license is in full force and effect. I I
o m- License Class Lic.Number
9 Date Contractor
x, y E BUILDING PERMIT
a Ic o OWNER-BUILDER DECLARATION 'INFORMATION
w0 1 hereby affirm that I am exempt from the COniractor's License MISC.- REFER TO ORD
iso Law torthe following reason.(See.7031.5,BUSItle'SmldProfCs90ns PERMIT ISSUANCE 10.00 VALUATION SIFT.
I - Code.Any city or county which requires a permit m construct,alter, �)
at Q st improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. /Root)
- LL requires the aermit to Gk a sined statement that TOTAL y�
pplicant for such pgERMIT TO
whe is licensed pursuant to the provisions of the Contractor's License ,_l
ai
Law(Chapter 9(commencing with Section 7000)ofDivision 3 of the e e
a Business and 1'rufcssions Codc)or that he L exempt themtrom'and QTY. PLUMBING PERMIT - FEE W 111 ve
R I$ 11¢haus for the alleged exemplion.Any violation of Section 703 L5 STORES TYPE CONSTR.
w. by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than Five hundred d.II rs(S500).):
❑ 1,as owner of the property.or my employees with.,is as BACK FLOW PROTECT.DEVICE 4.00 OCD.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
inlunded or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law dos not apply to an owner of
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP - 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
• himself or through his own em Ploytts,provided that such improve- -
ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvemem is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not huild or in,-
prove for purpose of sale.). INDUSTRIAL WASTE.INTER. REl ES IND CON PB Omar 30.00 RES IND
I,as owner of the property,am exclusively contracting with
licensed contractors to comtmct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESS(DRSPARCELNO.
and Professions Code:The Contractor's License Law does not apply
to an owner of property who builds or intprovLs thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a mntra,t000 license pursuant le ,
the Contractor's License Law, SEW ER-SANITARY-STO RM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exempt under Sec. ,B.&RC.for this WATER HEATER W/VENT 6.00
reason
Owner- Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO.
WORKERS'COMPENSATiON DECLARATION WATER TREATING EQUIP. 5.00
I hereby dfrm that 1 have a certificateof censcmt toself-insure', ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.CI.
Policy No. Company
O ❑ CeRitic d copA hc'cby famished. FIRESPRINK ENERGY T 24
❑ Certifwc filed he n division. MISC.- REFER TO ORD.
Z
O Applicant Y ❑ N� Y N�
Fy - PERMIT ISSUANCE 10.00 FLOOD zoIN A.L.U.C.
2 CER P EONEAfI N NS RONWORAIiRS'
LL �_ COMPENSATION INSURANCE PLG.CONTR. LIC.N0. PLG.
1 Y❑ NE] Y E3 N�
O hundred
-act trio aced not be complcicd if the (xnnit is for one TOTAL
� 2 hundred dollen IS 100)or Icss.l
U O 1 cerOfy that in the Performance of the work for which this per- QTY- MECHANICAL PERMIT FEE FEE SUMMARY
LL F mitis issued,I shall not employ any Person in any manner so as to
U become subject to the Workcn'Compensation Laws of Cxlifomia.
U a Dare Applicant ALTER OR ADD TO MECH. 5.00 BUILDING II _-
- m NOTICE TO APPLICANT': If,after nwkk g this Certificate of Ex-
♦- cmpIlun,yoddmuld become etIhjc,t to(he Workers'Cmin,nsation 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=CF.M,) 4.00 kr
CONSTRUCTION LENDING AGENCY . AIR HANDLING UNTT(OVER 10MCF.M.) 6.00 ,SEISMIC FEE /b
I herchy affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
- the performancc of the work for hich this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,OD0 B.T.U.) 8.00
Lender's Name
Lender's AdHEATI NG UN IT(OV E R 100,000 B.T.U.)9.50 ELECTRIC
dress
L cerldy that I have rc d th is application and stale that the obo4 VENTILATION FAN (SINGLE) 4.00
in onnxtion is correct. 1 agree to comply with all city and county PLUMBING
ordinances and stale laws relating to building construction. and BOILER-COUP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorite representatives of this city to enter upon the
above-mentioned property for inspection purposes. BOILER-COMP(Oxer 100,000 BTU)SEE FEE SCH. MECHANICAL
(We) agree to save, indemnify and keep hannles the City of MISC.- REFER TO ORD. -
upertin, against liabilities,judgments, costs and exlwness which PERMIT ISSUANCE 10.00 CONST.TAX
Nay in Bway ac� Hast said City in consequence of the
MECH.CONT, LIGNO. MECH.
7 TOTAL TOT
lis icon[/ actor Date
OFFICE COPY