15397 . .
PERMIT NumneR• 1
r ' POST.'THIS CARD NEAR`FRONT OF BUILDING
CITY OF uCUPERTINO 15397
INSPECTION DIVISION ';
JOB,INSPECTI.ON'RECORD
PERMIT EXPIRATION
JOB ADDRESS /°``s STE"I;e__V.0 OEa 24ANIT# _LOT.#' 4
n •'• - PERMIT EXPIRES IF, WORK ,
'OWNER-_ L'c:t `(J�-j c ,:-� cONTRnCTOR - CL9h' �i 'CDNd" AS .NOT-STARTED .WITHIN '
IN CTION DATE INSPECTOR ANSP.ECTI NRECORD:CA,/d-
180 Dgvs of PERMIT issu
1 FOUNDATION - NOTE: , ",' ANCE"OR .180,DAYS FROM INSPECTION:
L -LASTCALLED
UFER - �' ALL GRADING AND DRAINAGE SHALL BE INSTALLED
- - - - TO COMPLY',WITH THE APPROVED PLANS AND CITY OF PLH6SIT VALIDATION
PREG UNITE
CUPERTINO,STANDARDS-. 'I
GARAGE SLABS ' _ •� ,�
,•, POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDeL,�.�F;Q•( ,Y /`., �••• "T`G ``rf'^'`
'
UNDERGROUND /SLAB - `: i ,�_ -•, `
PLUMBING 'iq�� L ( •'r' il
ELECTRICAL " RLDc. .eiSEc rrveE'FELE ' MECH ^
MECHANICAL - -2-�•S" 2 �IV'- ❑: '❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED -20-S& A1Cw 9. ti BUILDING PERMIT
C .,0 ,�, bC, INFORMATION
. •i: WOOD FLOOR : VALUATION SIFT.
'y '• PLUMBING : 'F„'a. .+ ,} ;
P
MECHANICAL
ELECTRICAL - - c - PERMIT TO
7: i/- d /rte• �� ` i,l, ?��r z.;41•:: ir.�l: �
- FRAMING STORIES I CONSTR.:
+INSULATION - r/,>/2• /S / _.
+ - OCC.GROUP 'RES.UNIrs
PLACE NO SUBFLOOR UNTIL ABOVE'HAS BEEN SIGNED -
- SO.FT.FLOOR PHFA 'tO rAL ACRFAGL
'ROOF. - NOTE:NOFINALINSP,.SHALLBEMADE:BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID ••
.l ROOF SHEATHING '•V - O RUILDING USE -
.HES 'IND • CON PB-..'ON•,
APPLY NO,ROOFING.UNTIL• ABOVE HAS'BEEN.SIGNED,� ` 'FINALS' ""' `" •" DATE'"' ' "ANSP."•�' - ❑ ❑ . ❑ '? ❑• ❑
ASSESSORS PARCEL NO.
ROUGH ,SAN.# .
PLUMBING' ELECT.ENERGY 'y- - '
TRACT NO PARCEL NO.
TUBS 8 SHOWER PAN r - PLUMBING ENERGY'
MECHANICAL MECH.ENERGY - -
�. ELECTRICAL c �'T• • ` BUILDING ENERGY - ACC.,DATE ACC.FILE NO. ,
FRAMING - • '' ELECT.FINALTEST _ •�2' "I •-
INSULATION" �:'�. PLUMBING - - zoNlNceNc.slre-No.
GAS TEST, - ) _ GAS
. •�.•.. •� MECHANICAL •. �9 FIRE SPHINK ENERGY L2J
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED• HEATING • �,', 'i ❑ N❑ ' ' � N[]
_ -
11,00f)ZONE n.L,U,C,
EXTERIOR SHEAR ELECTRICACRELEASE Z '
N :
.. INTERIOR SHEAR - FIRE DEPT. ..' V❑ N.❑ V L7 El
% • SHEETROCK :>. - GRADE FEESUMMARY
a EXTERIOR.LATH , ' BUILDING
` INTERIOR-LATH - TEMPORARY APPROVALS - BUILDING �r.' : ,..
_ SCRATCH.COAT.•• " - -^ ELECTRIC- - 'PLAN CHECK
' - FEE'
GAS
NO'TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY. SEISMIC FEE.
•^ OCCOPANCYOF BUILDINGdSNOT,PERMITTED'UNTILBUILD ING FINALISSIGNEDBY BUILDING INSPECTOR. 'MICROFILM '
r
ARRANGE FOR ,INSP.ECTION.BY PHONING 252-4505, ELECTRIC
H ONE WORKING DAY BEFORE REQUIRED INSPECTION Y" PLUMBING
0� PLEASE GI'VE•9 'BA'DDRESS.WHEN,PHONING.
;SEE PERMN`
IT FOR-EXPIRATIODATE — " MECHANICAL
:IMP.ORTANTI. CONST. TAX
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. ' TOTAL
'
OFFICECOPY ,
APPLIC ANT,TO FILL IN INFORMATION WITHIN'RED LINES USE BALL'POINTPEN ONLY
• `, "BUI LDI NG PROJECT I DENTIFICATION. + t .PERMITNUMBER
aG, D,rvG APPLICATION.& PERMIT '15397,` 'T noon s 'MI
' E � 'r_// BUILDING mELECTRICAL—PLUMBING— ECHANICAL
OWNER'$. - •• Gam'—
N _ ,_ PLAN CHECK VALIDATION
AME
AP LE �MPI%7z oNE QTY. ELECTRIC PERMIT . FEE
CONTRACTORS UTLETS-SWITCHES'-RECEP 10.00/1'.00 z;
' LIGHTING FIXTURES v 10.00/1.00 "
CONTRACTOR - , APPLIANCES:RESIDENTIAL• '4.00,
" T �/ �/J/ PHONE 4r-Fl�// - ' PANELS W.00 { DATE OF APPLICATION
ARCRITE T PLAN CHECK FEE P.C]NO.
OR � �A9/�,- - PANELS (OVER 200 AMP) 20.00
Ery Irve
LIc.NO: -771' SIGNS TRANS. - 3,00
CH,OR ENG. PERMIT VALIDATION
ADDRESS nn SPECIAL CIRCUIT. 5.00 .
7• ZIP EMP.METER.OR'POLE INS. -- - 20.00
Ar5 MOTORS SEE�FEE SCH.
ADDRESS OOREss. -
^ SERVICE CHANGE _ 20.00 1
w0 o LICENSED D CONTRACTORS DECLARATION
<v u 1 hereby alt rm.lhat 1 am licemed,under provisions of Chapter V' .. '� ISSUANCE GATE
I- Z w (commencing th Section 7000)of Division 3 of the Business and
Q �� - ,BLDG. ELECT. PLG. - MECH.
H �'i Professions Co m I my li"a is In full for i fe�t
,-0 m kens P s Lin Numhery LEE
�'
/D z F - Uate COM to, -
a BUILDING'PERMIT.
¢ ¢ a QWNI R-BUILDER DEC[. ATION
o a u INFORMATION
F
0 n U 1 hereby affirm Ihm I am exempt frim the Contractor's License MISC.—" REFER TO ORD
.F a_ v, Law for the following reason. 703.1.5,Business and Professions PERMIT ISSUANCE ,. 90.00 VALUATION $/FT.
Code:Any city or county which requires a permit In conslracl,alle'; l
r¢-a, ¢ o, improve,demolish,or repair any Stnctknc.prior to its issuance,also ELEC.CONTE. LIC.N0. ELEC. J - _
D¢ req vires fisc tppheanl(or such punnll h file o slgnW 9lalemenl shut TOTAL ''" PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License
� zQ3
Law(Chapter 9(commencing with S tint 7000)ni'Drvson 3 ofthc '
E 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE 1
w H$ the hasi,for the alleged exemio
plion.Any vmialr of Section 7031.5 - - /• STORIES TYPE CONSTR.
u 3 by any applicant for a Permit subjects the applicant to a civil penally
of not more ihanaivi:,hundred doll, ALTER
ALTER-DRAIN -WATER (EA.) 5.00 -
❑ 1,as owner of the property,or my employees with wages is 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 sale (Sec. 7044, Business and Professions
DRAINS-FLOOR,'ROOF,AR EA;CON D._, 5.00
Code:The Contractor's License Law does not apply to an owner of '
pivpmty who builds or improve,thereon,and all...docs such work FIXTURES-PER TRAP 5.00 - 50.FT.FLOOR AREA •.TOTALACREAGE
a himself or through his Own employees,provided that such improve
mems are not intended or offered for sola It,however,The building GAS-EA.SYSTEM-TINC.4 OUTLETS 6.00
or improvement is sold within one year of completion, the owner- G'AS-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 ortale.). - - INDUSTRIAL WASTE INTER: - -30.00 - RES IND:ICON Pa Orher
❑ 1,as owner of the property,'am exclusively contracting with
licensed contractors to construct Use project(Sec. 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 ulprnpcny�whn builds or improves Thereon,and who LAWN-SPRINKLERS-OVER 5(EA.). 1.00 -
contracts for such projects with a contractions)licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00
the Contractor's 1-iceose Law. I ' TRACT NO. PARCEL NO.
❑' I am exempt under.Sec. - ,B.&P.C.ter this WATER HEATER W/VENT 6.00 '
reason
Owncr - Dale WATER SYSTEM 5.00 _ ACC.DATE ACC.FILE NO,
WORKERS'COMPENSA'NON DECLARATION WATER TREATING EQUIP. 'r 5.00 " , -
I hereby-affrm that I have a certificate of consent to self-insure, _ -
or acertificate of Workers'CompensaTon Insurance,or a certified - ZONING +'ENG.SITE NO,
copy they of ISe .3800,Lab.0 /
col ler mVm,y tG� , ,
"Q ❑ er -ed copy U ni ted. - FIRE SPRINK 'ENERGY T-24
ZZ P CCr f• bpy is G J"wit An
city ecu ion division. MISC.- REFER TO ORD:
Q, Applicant _ V 0' N❑, Y. J N� '
PERMIT ISSUANCE
cc CHRT'IFICATE 017 EXEMPTION FROM WORKERS' FLOOD ZONE t A.L.U.C.'
W 7 ( COMPISNSAT'ION INSURANCE PLG.CONTE. LIC.NO., PLG. V ClIN V C] q O
d 0 ('Diss section need not be completed if the permit is for one TOTAL it'.
• Z hundred dollars($100)or less.)
U O 1 certify that in the performance of The work for which this per- OT Y. - MECHANICAL-PERMIT IFEE FEE SUMMARY'
LL U asst is issued,I Shull net employ any.person in any butane,so as to - - -
becomesubjecttotheWorkersCornpensationLawsof'California. - " -
Dide Applicant BUILDING
O 0- ALTER OR ADD.TO MECH. 5.00 ,.'' 1&
} w NOa'ICI:"f0�APPLICAN'f: If,alter making this Cerldicute OF],x-
F Z o enlption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK.
I— provisions.of the Labor Code;You must rothwillrcunildy will - - FEE-- '
U such provisions Or this permit shall be deemed revoked. AIR HANDLING UNIT ITO 10000C.F.11A)" 4.00 '
• CONSTR UCTION-LENDING AGENCY AIR HANDLING UNIT(OVER'10=C.F.M.) 6.00 SEISMIC FEE'. i
I hereby affna thus there is a constnmlion lending agency fur', EXHAUST HOOD(WITH DUCT) -5.00
the performance of the work for which this permit is issued(See.' - MICROFILM
3097,CiaC.), - HEATING UNIT(TO 100,000 B.T:U.) ' 8.00 -
LeadersNa..c - HEATING UNIT 100,000 B.T.U.)9.50
Lender's Address 'ELECTRIC
I certify that 1 ha ad lhis4ppliedlion and state"n,The above VENTILATION FAN (SINGLE) 4.001
mlormation is correct. I agree to comply with all city and county. PLUMBING
ordinances and site laws relating to building construction and BOILER-COMP(3H.P.or100,000B.T.U.) 600
hereby author o, representatives of this city to emu upon the BOILER-COMP (Over 100,000 BTU)BEE FEE SC MECHANICAL
above-mentioned property for inspection purposes.
c to,save i t7gn
nd keep hurndess the City of. MISC.- . REFER TO ORD.
m po'ninanagaw 'ies S, costs ' 'expenses whicli a. PERMIT.ISSUANCE 10.00 CONST.TAX
Y y y.a a d it ico equence of'the -
r ting of ,mil. ' MECH.CONT. ,LIG NO. MECH. - • -
TOTAL ' TOTAL:
Si alure of Applicant/Confructor Dale- r
OFFICE COPY