8785 POST THIS CARD NEAR FRONT OF BUILDING
PrRMIT N6MF HR
CITY OF CUPERTINO ��
' INSPECTION DIVISION
/
JOB INSPECTIO RECORD
- PERMIT EXPIRATION
•••���J// JOB ADORE /09&0 • kTT# PERMIT EXPIRES IF WORK
OWNER. UNIT#- ONTRACTOR IS NOT STARTED WITHIN
IN EC I N DATE I INSPECTOR - lwgmcrloN RECO D 180 DAYS OF PERMIT ISSU-
FOUNDATI ANCE OR 180 DAYS FROM
• UFER
LAST CALLED INSPECTION.
PREGUNITE
PERMIT VALIDATION
' � '
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING /
ELECTRICAL - IssuArvc pnrE
MECHANICAL BL G ELECT. PLG, MECR.
❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT '
INFORMATION
WOOD FLOOR VALUATION $IFT.
PLUMBING _ - ,
- MECHANICAL - -
ELECTRICAL - P9 Ir TO
FRAMING - - •'
INSULATION STORIES TYPE CONSTR,
OCC.GROUP . RES.UNITS ,
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF - SO.IT,FLOOR AREA TOTALACREAGE
DIAPHRAGM - - -
BU'
LOING USE
RES IND CONPB Oine'
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED E3 ❑ E) ❑
ASSESSORS PARCEL NO,
ROUGH;
PLUMBING }-
GAS TEST TRACT NO, PARCEL NO.
�_ -, _
MECHANICAL
ACC.DATE ACC.FILE NO,
ELECTRICAL IFINALS DATE INSP. -
FRAMING U SAN # -�
.4.ZUrvlNC ENG.SITE NO.
INSULATION - - PLUMBING
GAS
MECHANICAL - FIRESPRINK . ENERGY T 2 ,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y N� Y N[:]
-FLOOD ZONE A.L.U,C.
LATH—INTERIOR , ELECTRICAL
` LATH—EXTERIOR FIRE DEPT. - YF] No Y ❑ N❑
SHEETROCK _ GRADE FEE SUMMARY
SHEAR INTERIOR .BUILDING '
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING
FIREWALLS ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDINGINSPECTOR. -M ICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
H ONE WORKING DAY BEFORE';REQUIRED INSPECTION. PLUMBING
h .' 'z PLEASE GIVE JOB ADDRESS WHEN PHONING.
' MECHANICAL
—.SEE PERMIT FOR EXPIRATION DATE —
- - - - CONST.TAX
,IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE. r -
CALLING FOR FINAL INSPECTION. TOTAL
OFFICE COPY - -
_ _ _ - — '__— �— _. 'i-.' � _ —. .ter• __
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BU LDI NG PROJECT IDENTIFICATION . PERMIT NUMBER
BU0.PING APPLICATION & PERMIT
AOVRE55/�(���� 8785
_ BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
)NAME
,��` - PLAN CHECK VALIDATION
NAME V`r^'J� Q17 -TY. ELECTRICGPERMIT' FEE
PRIOR -lvlD
rvomERAc7oRs UTLETS-SWITCHES•RECEP 10.00/1.00 Q
J COP-P. uc.No. LIGHTING FIXTURES 10.00/1.00 0h -
CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00
A r PRONE �' PANELS 10.00 PATE OF APPLICATION
- •ORR nDECT' - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER
LIC,NO, SIGNS TRANS. 3.00
ARCM.OR ENG. PERMIT VALIDATION
ADDRESS SPECIAL CIRCUIT 5.00
ZIP EMP.METER OR POLE INS. 20.00 ,r
APPLICANT S
ADDRESS MOTORS SEE FEE SCH. �(\/
SERVICE CHANGE 2000. �J G�
woo LICENSED CONTRACTORS DECLARATION TEMP.POLE 38.00 No
< u w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE PATE
n a$ (commencing with Section 7000)of Division 3 of the Business and 1995
H N z Professions Code, A y license is in full fo5$p�(IQ rfjffy_4/ BL V In MECH.
z o m - License CI ss Lic.NumM1er
G = - Date �_g!5 D; mdnr - City of CuDe�ino
¢ y I J
5 rt w u OWNER-BUILDER DECLARATION BUILPERMIT
A.
0 LL y I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION
HLLO4 Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION $/FT.
Code:Any city or county which requiresa permit to coroUnct.alter, 11�
Mw ELEC.CONTR. LIC.NO.
rt ¢ o improve,demolish,or repair any structure,prior to its issuance,also ELEC.
so ii: C u requires the applicant for such permit tD file a signed statement that TEL
PERMIT TOQ
cam he is licensed pursuant to the provisions of the Contractor's License /b d JEL B•9-Ti�rt.0
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