18188POST THIS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO
INSPECTION DIVISION
JOB INSPECTION RECORD
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JOB ADDRESS �C .SS`O _ `•` IL' �/Y_L�LI `81LAIT4 _LOT#
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OWNER T� ,y NG CONTRACTOR SLkk 4--� 7u
PERMIT NUMBER
18188
'-PERMIT EXPIRATION
'r
PERMIT EXPIRES IF CNORK
ISI NPT STARTED WFTHIN
180 DAYS OF PERMITASSU.
ANCE OR. 180 DAYS FROM
LAST CALLED INSPECTION.
INSPECTION DATE JINSPECTOR
IINSPECTION RECORD
FOUNDATION
NOTE: -
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS. m
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- �
UFER
PREGUNITE ,
PERMIT VALIDATION
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SUANCE DATE
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
JUL 2 0 1989
UNDERGROUND/SLAB
PLUMBING
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ELECTRICAL -
MECHANICAL
8LD(Ilf ELECT.
PEG, MECH
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
BUILDING PERMIT
INFORMATION
WOOD FLOOR
PLUMBING
-
VALUATIONN� O
3U{(/jT
SIFT.
MECHANICAL
ELECTRICAL -
-
PERMIT To
FRAMING
INSULATION
..
STUDIES
TYPE CONSTR,
-
OCC. GROUP
RES'. UNITS
t
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
' ROOF
NOTE: NO FINAL INSP. SHALL BE MADE BEFORE
THE CONSTRUCTION TAX IS PAID
501'T F'.LOOR AREA
'70TAI.,ACRFAC.E
1' .
DIAPHRAGM' -
ROOF SHEATHING
NG US
PS 00—
-BUILDWE]'.[]
RE IN❑D CON ❑ O
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
FINALS DATE INSP.
ROUGH. -
,
SAN,#
ASSESSORSPARceL No.
-
PLUMBING -
ELECT. ENERGY
TUBS 8 SHOWER PAN
PLUMBING ENERGY
TRACT No.
PARCEL ND
MECHANICAL
MECH.,ENERGY
ELECTRICALBUILDING
ENERGY
ACC. DATE
Acc. FILE NO.
FRAMING
ELECT. FINAL TEST
INSULATION .-
PLUMBING
ZONING
ENG SITE No.
GAS TEST
GAS
MECHANICAL'
FIRE SPRINK
Y E] N[]
ENERGY LPA
Y D. NC]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING
EXTERIOR SHEAR
ELECTRICAL RELEASEI I
FLOODrorvE
Y ❑ N❑
ALUC.
Y Lam. �❑
INTERIOR SHEAR
FIRE DEPT.
SHEETROCK
GRADE
FEE SUMMARY
EXTERIOR LATH
BUILDING j ,y
.: U'D
INTERIOR LATH
TEM OR00tBUILDING
SCRATCH COAT
ELECTRIC
PLAN CHECKGASFEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCYSEISMIC
FEE
,
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
o�ONE WORKING DAY BEFORE REQUIRED INSPECTION.
z PLEASE GIVE JOB ADDRESS WHEN PHONING.
-SEE PERMIT FOR EXPIRATION DATE -
ELECTRIC
PLUMBING
MECHANICAL.
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE.
CALLING FOR FINAL INSPECTION.
TOTAL •
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OFFICE COPY.
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APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DENTIFICATI ON
APPLICATION & PERMIT
BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
PERMIT NUMBER _
y.,
BUILDING
ADDRESS
1 b5a ,AJC, awo
NAME 'S
NAME
6 P A mep ICA. PHONE
QTV. ELECTRIC PERMIT FEE
PLAjJC t/.Q D(�TJQ�
I/`'/V_l LI Il)(J1]
CONTHAGS(1G
NAME b7bD SHICu,f40Ja�OUTLETS
-SWITCHES-RECEP 10.00/1.00
i,M i 1.1 e,►LTlvt uc.N 1,5,* T✓-
LIGHTING FIXTURES 10.00/1.00
CONTRACTORS
ODR
ADDRESS
APPLIANCES - RESIDENTIAL 4.00
M 2Y 4 li"e b `j - ftog
PANELS 10.00
DATE OF APPLICATION
ARCHITECT
OR , Sp�„Isy,
ENGINEER
K,4i,�C uc.NQpl �%
PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. NO,
.
SIGNS TRANS. 3.00
ADDDRESS ENa
ilkCINM GLCL 17$ ALA)JW4 yz
SPECIALCIRCUIT 5.00
PERMIT VALIDATION
�7
C /
EMP. METER OR POLE INS. 20.00
APPucANrs -
ADDRESS
MOTORS S EE SCH-
'b4•Eakr< 4.�i �L4TISM--T
SERVICE CHANGE �- 20.00
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I um licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and
Professions Cod nd license is in full force nand effect.
License Class�Il_ Lie Number�t �y
jUL
SgUANCE DATE
BLDG. LECT.• PLG. MECH.
go, o' 1:1Date
Contractor _.5-F L
BUILDING PERMIT
INFORMATION
OWNER -BUILDER I mH Ser Hi DECLARATION
I hereby affirm that I um exempt from the Cons Ionil H License
Law for theityfollowing Professions
county
Code: Any city or county which requires a permit to construct, ulteq
requires a permit reconstruct,
MISC. - REFER TO ORD
PERMIT ISSUANCE
VALUATION
$/FT.
ELEC. CONTE. LIC N0. ELEC.
C.
TOTAL
-
DTV. - PLUMBING PERMIT FEE
t structure, Prior to its iatement also
improve, demolish, or repair any permit
requires ole applicant for such permit m file a signed statement that
of the )ofDisnlr s License
he is licensed pursuant to the phis Section
Law (Chapter 9 (commencing with Section 7000) of Division 3 oC the
Business and Professions Code) or that he is exempt therefrom and
PERMIT TO
5�
the basis for the alleged exemption, Any violation of Section malty
by Pat th,a forapcmtit Millets theapplicam toacivil penalty
of not more than five hundred A011ars 155001.1:
-BTO 5
TYPE CONSTR.
ALTER-DRAIN-WATER(EA.) 5.00
❑ I, as owner of the property, or my employees with wages as
their sole compensation, will do the work, and the structure is not
BACK FLOW PROTECT. DEVICE 4.00
OCC. GROUP
RES. UNITS
DRAINS.FLOOR, ROOF, AR EA, COND. 5.00
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractor's License Law docs not apply to an owner of
'
FIXTURES - PER TRAP 5.00
GAS-EA.SYSTEM-11NC.4OUTLETS 6.00
property who builds Or Improves thereon, and who docs such work
himself or through his own employees, provided that such improve.
mems are not intended or ofl'emd for sale. It, however, the building
SG. FT. FLOOR AREA
TOTAL ACREAGE
or improvement is sold within one year of completion, the owner
builder will have the burden of proving that h mi e did not build or
prove for purpose of sale.).
❑ I, as owner of the property, am exclusively contracting with
. ..
GAS - EASYSTEM -OVER 4 IEA) 200
BUILDING U
RES IND CONSE B Other
11 D
INDUSTRIAL WASTE INTER. 30.00
licensed contractors to conslruel the project (Sac. 7044, business
and Professions Code; [he Contractor's License Law docs not apply
to an owner of property who builds or improves thereon, and who
LAWN SPRINKLERS- 1 INC 5 V.B. 600
.
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
ASSESSORS PARCEL NO.
conlructs for such projects with a contractorls) licensed.pursuant U
the Contractor's License Law.
❑ lam exempt under Sea. ,B.&I'.C. Ii.. thi"
reason
SEWER-SANITARY-STORMEA. 200ft/10.00
TRACTNO,
PARCEL NO.
WATER HEATER W/VENT 6.00
Owner Date
WATER SYSTEM - 5.00
ACC. DATE
ACC. FILE NO.
WORKERS'COMPF:NSATION DECLARATION
WATER TREATING EQUIP. 5.00
'
I hereby affirm (hal I have a certificate of consent to selGinsure,
or u cenificate of Workers' Compensation Insumnee, ora certified
ZONING
ENO. SITE NO.
copy thereof(Scc. 3800, Lab.CJ.
Policy No. Company
❑ Certified copy isltcreby funtished.
FYT'enifed fp(,y�i`lled h the yet"y inspection division.
Applicant ,[��GL✓
FIRE SPRINK
y[:] N�
ENERGY TQ4
yE] N�
..
MISC.- REFER TO OflD.
CERTIFICATE OF EXEMPTION FROM WORKERS'
(70417NSATION INSURANCE '
('Phis Section need not be completed if the permit is for one
PERMIT ISSUANCE 10.00
FLOOD ZONE
VE] N�
A.L.U.C.
Y ❑ NEl
PLG. CONTE. - LIC. NO.
PLC.
TOTAL
hundred dollars IS 100) or I.S.)
I Certify that in the performance of the work for which This Per
mil is issued, I shall not employ uny person in any manner so as to
QTY.MECHANICAL PERMIT FEE
FEE SUMMARY
BUILDING
�OO
become subject Io lire Workeri Cnmpmtsu tion Laws of California.
Dale Applicant
NOTICE 1'0 APPLICANT': If, utter making this Certificate of Ex-
ALTER OR ADD TO MECH. 5.00
APPLIANCE 5.00
AIR HANDLING UNIT (TO 10,000C.F.M.) 4.00
PLAN CHECK
FEE
emption, you should become subject in the Workers' Compensation
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT (OVER 10100DC.F.M.) 6.00
SEISMIC FEE
CONST RUC IION LENDING AGENCY
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.
3097, CN.CJ,
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Name
Lender's Address -
HEATING UNIT (OVER 100,000 B.T.U.)
ELECTRIC
I certify that l have read this applicationand state that the above
VENTILATION FAN(SINGLE) 4,00
information is correct. I agree to comply with all city and county
oodha nces and stat, laws refuting to building conatruction, anA
PLUMBING
BOILER-COMP(3 H.P. or 100,000 B.T.U.) 6,00
hereby oulhoriae represemalives of this city to enter upon tire
above-mentioned property for inspection purposes.
BOILER -COMP (Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
(We) agree to save, indemnify and keep harmless the City of
MISC. - REFER TO ORD.
Cupertino against liabilities, judgments, costs and expenses which
may in any way accrue against said City in consequence of the
taming of permit. // y
/%/• .�/AA1 ��f
Sign ure of Applicant/Contractor Date /-
PERMIT ISSUANCE •10.00
CONST. TAX
MECH. CONT. LIC. NO.
MECH.
TOTAL
-
TOTAL
OFFICE COPY