18275 w POST THIS CARD NEAR FRONT OF BUILDING
• PE:RNIr Nun��Yi99
CITY OF CUPERTINO 18275 '
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS STC. �UNIT4 _LOT# - '
PERMIT EXPIRES IF WORK
OWNER cu i�LN coNrRAcroR QUIti IS NOT STARTED WITHIN
INSPECTION _ DATE INSPECTOR INSPECTION RECORD ' 180 DAYS OF PERMIT ISSU-
FOUNDATION •ANCE OR 180 DAYS FROM
NOTE: LAST CALLED INSPECTION.
UFER . 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 7
l
' ; UNDERGROUND /SLAB
4nonAPLUMBING
ELECTRICAL. .ISSUANCE DATE
MECHANICAL dLoc. ELECT PLG. m CR
El ❑ ❑.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING - - vALunnoN S/F r.
MECHANICAL
ELECTRICAL - - PERM I TO
FRAMING - - eL
INSULATION STORIES TYPE CONSTR.
Gl IDUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
+ A SO,FT,FI.00R ANCA TOTAL DCIII AGE
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE'
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUI LDING USE
ROOF SHEATHING Res mo CON Pe om.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP, ❑ ❑ ❑ ❑ ❑
ROUGH SAN.k A SSESSORS PAR CE L NO
PLUMBING ELECT.ENERGY
TRACI NO, PARCEL NO
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
FIRESPRINK ,ENERGY TQE
MECHANICAL NQ'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED . HEATING
EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZCNE, A.L.U.0
INTERIOR SHEAR FIRE DEPT. Y❑ N❑ v ❑ N❑
SHEETROCK _ GRADE FEE SUMMARY * (I
EXTERIOR LATH IBUILOING I
INTERIOR LATH TEMPORARY APPROVALS BUILDING �.
SCRATCH COAT ELECTRIC PLAN CHECK ,
GAS FEE 1177
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY, SEISMIC FEE �!
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. , MICROFILM /
ARRANGE FOR INSPECTION BY PHONING 252-4505„ ELECTRIC
Lu
I.- WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
o PLEASE GIVE JOB ADDRESS WHEN PHONING.
z - SEE'PERMIT FOR EXPIRATION DATE - 4ECHANICAL
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 #649
PERMIT NUMBER
BUILDING PROJECT IDENTIFICATION APPLICATION PERMIT" 1•
ADD.EA 8l 18 2 7 5
AD30B185 North Stelling Road BUILDING.ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
. "AME QTY. ELECTRIC PERMIT FEE
Cit of Cupertino PHON1973-0969
ONTR TORS 1�� /�
NA � lR'e til OUTLETS-SWITCHES-RECEP 10.00/1.00
LID.No. 99257. LIGHTING FIXTURES 10.00/1.00
f, BTRACDTORs
O
CONTRACTOR
APPLIANCES-RESIDENTIAL 4.00
C
565 Laurelwood Rd yHONE988=4200 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 26.00 PLAN CHECK FEE P.C.NO.
OR
ENSTbInberg Group uc.No. SIGNS TRANS. 3.00
ARCH,OR ENG. PERMIT VALIDATION
ADORESS SPECIALCIRCUIT 5.00
60 Pierce Avenue 9511() EMP.METER OR POLE INS. 20.00 ���
APPLICANTS MOTORS SEE FEE SCH.
ADDRESS
2943 Daylight Way, SJ 95111 SERVICE CHANGE Inin 0. 20.00 � I /1` �u
�
Co LICENSED CON TRACTORS DECLARATION -4,4vt70 V"--t
r i W I hereby affrrm that I am licensed under provisions of Chapter 9 -Q-1 `1 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Business andJUL BLDG. ELECT. PLG. ME H.
iort Professions Code, d license in in full force yyryuW�ppfj(��W3 +
License Ckuss � Lic.NumberA�X-_Wee �.
N w Uate LL Commctor_bL FA1_�NV�I�Cha.nl al - ci1u w{(��t�e,��
It w a OWNER-BUILDER DECLARATION 1L�l'�L1w1�� BUILDING PERMIT
- o A D INFORMATION
wet ¢ H I hereby affirm that I am exempt from Lha Contractor's License MISC.- REFER TO ORD
r iA
0< Law for the following mason.(See.703 1.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION $/FT.
Code:Any city or county which requires u permit to construct,alter,
ce a ¢o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR.' LIC.NO. ETEC.
DLL requires the applicant for such permit to file a signed statement that TOTAL ,
e w 9 he is licensed pursuant to the provisions of Ota Contr actor's License PERMIT TO.
F z i Law(Chapter 9(commencing with Section 7000)of Division 3 of the pp '
g 4 Ar, Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE C-.
¢ H m the basis for the alleged exemption.Any violation of Section 7031.5 - STORIES TYPE CONSTR.
e. 3 _ by onyapplicanl lora pennit auhp,eta theupplicant to a civil penalty
of not more than five hundred dollars($500),): ALTER-DRAIN&VENT-WATER (EA.) 5.00
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the Structure is not
intended or Offered for stile(Sec 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA;COND. 5.00
af'^ Code:The Contractor's License Law does not apply to an owner of
i,t= 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
k meats are not intended proffered lir sale.If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00
or improvement is wild within one year of completion,the owner GAS-EA.SYSTEM-OVER 4 IEA.) 2.00
builder will have the burden of proving that he did not build or int. BUILDING USE
Prove for purpose of sale.), INDUSTRIAL WASTE INTER, 3000 ARES IND CON Pe Omer
.
❑ 1,as owner of the property,am exclusively contracting with 0 0 0 0 0
licensed contractors to construct the project(See. 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,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts forsuch projects with a contractors)licensed pursuant In SEWER-SANITARY-STORM EA.200h/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑ l ue exempt under Sec.-.11&P.C.I'or this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ACC.GATE ACC.FILE NO.
WORK_RS'COM PENSA'If ON UHCLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have acenificancodeensent toself-insure, ZONING
or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO.
Pcopy there f `'3(�pO Lub.C.l.
olicy _44So.LigC)a 2 '
O ❑ ertifiad opy u h• urn ishe
Z Z . Cc nific ji IU)y m ity inspection division. FIRE SPRINK ENERGY T-ZO
O App t MISC.- REFER TO ORD. Y E] NY ❑ N[]
cc ai RTIFICATE 017 EX_MPT PROM WORKERS, PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.II.C.
QJ 1 COMPENSA770 IIRANCE PLG.CONTR. LIC.NO. ALG. V� N� Y�
Z (This section need not be con "Id if the permit is for one TOTAL N
CL hundred dollars IS 100)or Icss.)
U O 1 cattily that in me perl'ormanec of the work 1'or which this per. QTY MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- mit is issued,I shut]not employ tiny person in any mannerse,as In
Q U become subject to the Workers Compensation Laws(if California.
a
Date.Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} m NOTICE TO APPIACAN'f'. If,after making this Certificate of_x-
2 emgmn,you should become subject to the Workers'Compensation APPLIANCE 5,00 PLAN CHECK
provisions of lire Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. 5 AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 2
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IO,000C.F.M.) 6.00 SEISMICFEE 'b
I hamhy affirm that llbam 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 HEATING UNIT 100,000 B.T.U.)9.50
Lender Address - ELECTRIC
-� 1 certify that 1 have read this application and slate that the above 11 VENTILATION FAN (SINGLE) 4.00 4 Q
information is tate correct.l 1 agree to comply with all city and county PLUMBING
ordinances and late relating to building cunstnmtion, and BOILER-COMP(3 H.P.of 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTO)SEE FEESCH. MECHANICAL �-
above mentioned properly for inspection purposes.
(We) agree to save, indemnify and keep harmless ilia City of MISC.- - REFER TO ORD.
Cupertino against liabilities,judgm tits, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
on any way ace agains id City in consequence of Lhc .00
an[i • if this pc MECH.CONT. . , LIG NO. MECH.
' nN
areo phcant/Cool a Ito AEA Mechanical 206933 TOTAL $ 2.00 TOTAL
OFFICE COPY
` POST THIS CARD NEAR FRONT OF BUILDING
A CITY OF CUPERTINO 9
INSPECTION DIVISION
JOB INSPECTION RECORD
JOB ADDRESS !O' 6 S _ .�-STC.f NG—�. UNIT tf_ _LOT tt PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
o,vaeR G�` a COKERACTOR ti 4P C- IS NOT STARTED WITHIN
_ I_NSPE+CTION---llt-- [OATE_ INSPECTOR INSPECTION RECORD -- 180 DAYS OF PERMIT ISSU.
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LAST CAL LED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERVIT VAI IDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
MOyu
PLUBI
NG _ .. _._.._ Q4/.IJ �J� 2ND `•.I
ELECTRICALCu ISSUANCE UArE
MECHANICAL "MWw BLOC EtFcr vLe meCH
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMI
WOOD FLOOR INFORMATION _
._.__.... ._ V4LVAn014 SIFT,
PLUAI GING
MECHANICAL.
ELECTRICAL CN`i l - PEE+n+n ro
1 . .�YY• C e t�
FRAMING __ _
INSULATION Ce✓f` cw f/Q`�P C�rA,I TiG $+DRIES Trui coN51R
-- _ —--- /2C ly7e.!y C) OCC LROUP— RES UNITS
e*x a T-6s.c
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn IT
roon aaea TRIAL Ateur.E
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
RUII DINE USE
ROOF SHEATHING I I HES IND CON Pa Ov-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. - ❑ ❑ El 0
ASSESSORS PARCEL NO
ROUGH SANA
PLUMBING ELECT.ENERGY
TUBS d SHOWER PAN PLUMBING ENERGY TRACE NO PARCEL NO
MECHANICAL �Tfj-9,0 „� MECH.ENERGY
ELECTRICAL Act DATE ACC FILE NO
BUILDING ENERGY
FRAMING ELECT.FINAL TEST
2011IN0 EAC. SITE N'0
INSULATION PLUMBING
GAS TEST GAS
---� FIRE SPRINK ENERGY T N
MECHANICAL 1 Y ❑ N❑ Y [] NE]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED' HEATING
EXTERIOR SHEAR EI.ECTRICAL RELEASE FLODO PONEALUC.
INTERIOR SHEAR - FIRE DEPT. Y [:] N0 Y 0 N[]
SHEETROCK GRADE FEESUMMAIRY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS BUILDING V
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGN Eqj OCCUPANCY SEISMIC FEE O
OCCUPANCY OF BUILDING I$NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252.4505a ELECTRIC
F ONE WORKING DAY BEFORE REQUIRED INSPECTIPLUMBING
z PLEASE GIVE JOB ADDRESS WHEN PHONING.S£E PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST,TAX
PLEASE READ REVERSE SIDE BEFOREIOTA
CALLING FOR FINAL INSPECTION.
APPLICANTS POSTING COPY