14556 '♦ - +
POSTTHISCARD NEAR.FRONTOF BUILDING ۥ,.' iF MiTN MaEN
CITY:,DF CUPERTINO X555
f. INSPECTION DIVISION!-
JOBANSPECTION RECORD '
e^: r - - •• n °
PERMJT E�RI TION :
JO BSA D OR ESS —17 UNIT# ' LOT.#
r ° •PERMIT,EXPIRES:IF WORK„
y F"
OWNER ' .TN 2 ir'coNTRACro � x- 'E'C_ IS ,NOT-.STARTED WITHIN;
, :
INSPECTION. DATE INSPECTOR INSPECTION RECORD
- 180 DAVS'O F+PERMIT ISSU r'41
a ` FOUNDATION E. _ ANCE OR 180 DAVS_PRO,
M`` +
NOTEr -7' ; - - LASTCALLED INSPECTION
UFER: {� a ALL GRADING AND DRAINAGE SHALL!BE INSTALLED -
T TO COMPLY WITH THE APPROVE®lAIV9^iND CITY OF PLHMIT VArioATION
PR EGUNI E CUPERTINO STANDARDS •_^�N "
ti
GARAGE SLABS
P,OUR'NOCONCRETE UNTIL ABOVE HAS BEEN-SIGNED
3
.•UNDE.R.GROUND /SLAB,
' ,
' PLUMBING t L - * %7 Z rya . - *-. ' O OPe1tI0o' � s -,-
ELECTRICAL t }`. t. u .D"
_ ISSUANCE UA(E
MECHANICAL" BLOer. eLECT PLG i mECRe,.
00 NOT POUR FLOOR UNTI_L,ABOVE HAS-BEEN SIGNED * +; '' - 1 BUILDING PERMIT .
..''SA` •'WOOD FLOO R: PINFORMATION•
-3' PLUMBING .`�+ '• .e .. & "y rALuanoN. k _s/FT
.
. MECHANICAL
ELECTRICAL .. + �, PERM I TU,. .:
.FRAMING N e. .a: , it, e .H'�.t�•`6
INSULATION - ; t STORIES . ,TAPECONSTR
rr
4 i UOC GROUP RES UNITS -
rip
PLACE'NO SUBFLOOR'UNTIL`ABOVE HAS BEEN SIGNED
-ROOF" + NOTE:NOFINAL'INSP.SHALLBEMADEBEFORE AREA ,'TOTAL
_ sa rFLoaRA ACREAGE
F 7 DIAPHRA M :xy; THE CONSTRUCTION TAXJS PAID x' r _ •_T '
M1 r P BUIL UINC USE
ROOF SHEATHING' ''I+es' Irvo coN'.; Pn o
AP.P.L"Y',NOiR00F,ING UNTIL,ABOVE�HAS:BEEN SIGNED €A a,� FINALS T �„p, DATE° `4 t;INSP�x � � '� "�"❑ � "
nsssssor+s PARCEL No -
s ROUGH SAN.a
' "• PLUMBING "! * N ELECT.-ENERGY
_ TIF NO '.'PARCEL NOr
'r • TUBS&SHOWER PAN `'-- ,:_- ~' PLUMBING ENERGY - .r
% MECHANICAL ` ';::- MECH.-ENERGY _ • •�'
'EL^ECTRICAL" �, - ,NJ•} BUILDING ENERGY,
A FI
ACC.DATE'
CC LE NO
FRAMING + ° x .,� - , - ,ELECT:FINAL TEST _ ,�
! l .ZONING .ENG SITE NO.:
INSULATION +, PhUMBING- _ 1 _ .•s ',
r
GAS TEST_ {"� 'a=. '^ GAS,"u"•.: - + x i e
MECHANICAL FIRE SPH N za
K E ERGY T
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED- HEATING - _ ° ' ,y_. N�' ~Y N❑.
EX. ELECTRICAL RELEASE FLoou zorvE - ALuc. '
"P .`
INTERIOR SHEAR n t FIRE DEPT. . .i�. �;;; Y� IN Y ❑ N0_
SH EETROCK •`.y GRADE.' FEE'SUMMARY'
EXTERIOWLATH ' BUILDING.,
.INTERIOR LATH lk TEMPORARY APPROVALS ,
' BUILDwG =•� , ,r,L
.� : SCRATCH COAT a"
ELECTRIC PLAN"CHECK'.< 4;
r;r. GAS FEE', :,•t .@
NO TAPE OR PLASTER UNTIL ABOVE HASiBEEN SIGNED OCCUPANCY„ '• SEIPMIC^FEE
OCCUPANCY OF.BUILDING IS NOT PERMITTED UNTIL BUILDING F INAL ISSIGNEDBY BUILDING INSPECTOR �MIICR0 6L .1" + '
ARRANGE FOR INSPECTION BY PHONING 252-4505 E ecrRlc
"' ONE WQ,RKING DAY;BEFORE REQUIRED. INSPECTION'.' PLUMBING > ;
0 '. PLEASE GIVE JOB ADDRESS'WHEN PHONING
Z e ,.c- "' ' MECHANICA
r
SEE PERMITF-OR EXPI':RATION DATE —
'.IMPORTANT! � `' consT tAx,. r+
, +
PLEASE READ REVERSE SIDE BEFORE b ° TOTAL
;CALLING:FOR FINAL INSPECTION ^ /
OFFICE COPY
APPLICANTTO FILL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY
• 'BUILDING PROJECT IDENTIFICATION- - - PERMIT-NUMBER (r
iIILDING , APPLICATION &PERMIT � 1 4'556 -
ADDRESS
BUILDING-'ELECTRICAL-PLUMBING -MECHANICAL
OwNEI+' \-�Gt -4,'v a • PLAN CHECK VALIDATION I
• "" ,t-• QTY. e' ELECTRIC PERMIT FEE
T. (1 VA1D PHONE
NOMTRADTDRs - C, ") OUTLETS-SWITCHES-RECEP '10.0--7--T0/1,00 •7 •./��7^ '
rlD L
uc.NO LIGHTING FIXTURES 10.00/1..00
r,DN ACT 's "! PPLIANCES-RESIDENTIAL ,4:00
+ ' -
AnaRE5544 _ A/ // r• fv
L�� vL PHONE I yt 6 PANELS - 10100 ' DATE OF APPLICATION?--
ARCHITECT PANELS (OVER 200 AMP) 20.00
-'37045' +. PLAN CHECK FEE
` _I ENGINEE ':. S ,n .
IDI I �a3ZA uc.No. SIGNS TRANS. "� -', 3.00 ' � ' ''"
4 A ARCH.OR ENG SPECIAL CIRCUI T' 5,00 PERMIT VALIDATION
ADDRESS ((//,,��''
�4 2.0�3 OL.O; bVl ICV18- 11L TEMP.METER OR POLE INS. 20.00 - - -"
APPLICANTS .N MOTORS SEE FEE SCH.37-0 - r
Ao.R Ess -
3 392<7 , SERVICE CHANGE - P 0 -
o o LICENSED CON'FR ACTORS IIECLARATION - '
a U` - I hereby Infirm that I :im licensed under provisions of Chapter 9 .ISSUANCE GATE
AB
'H, m H, iiinencing with Section 7000)of Division 3 of the Business In
H.y d d - RLOG. PLO. MECH-
z Professions Code,and my license is in full force v effect - ❑ ❑ ❑
Z,z w o License Class_jCL__Lie.Number -
Y
r O.H j Date 10- 4 Contractor-WKtlsq E '�".e. , try-Of Cuperti to _ -
5 y E I BUILDING PERMIT
¢ ¢a OWNER-BUILDER DECLARATION '
M i v - 'INFORMATION
IL
; ,1 hereby all irm that I um exempt'fnnn the Contractor's Liccase MISC.- REFER TO ORD -
I. a¢ La or the following reason.(Sec,7031.5,Businessand Professions I PERMIT ISSUANCE 10 00 Zt -VALUATION• $/FT.
Code', Hy city or county which recµclmsa permitmeonsimm,ultaq - '
¢ ¢ Q improve, amolish,or repair any structure,prior to its Issuance,also ELE CONTR. LIC.NO.�yl.p ELEC. /
n w m'LL requires[h plicant for inch permit to file a signed slnicmmr that Vt O� Z�607 TOTAL PERMIT TO '
he is licensod rsu;un to rhe provisions of the'Cnntmcnor's License I- l / I '•
rzi
Law(Chapter') 'ommencingwit h Section 7000)nf Division of the +
4 o Business and Prole. ions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE, 1111
¢'I- m the basis for the alley exemption.Any violation of Section 7031.5 STORIES TYPE CONS R,
pg � by any applicant l'orap snit'subjects the applicant tolcivil penalty ALTER-0DRAIN -WATER (EA.) 5.00
1 '
of not more than five her d dollars($500).):
❑ I,as owner of the pro •rty,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP RES.UNITS
their sole colnpensmion;will dr he work,anJ the structure memre is not -
intended or of
for sale fSec. 044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:.The Contractor's License Law es not apply In an owner of _
property who builds or improves thereo and who docs such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE
himself or through his own employees,pro ed that such improve-
in -
' ents are not intended or offered for saic.I , oweveq the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 -
�/ or intprovmnmtt is sold within one year of mI +tattoo,the owner GAS-'EA.SYSTEM-OVER 4 (EA.) 2.00 --BuaDINc IBE -
builder will have the hurden of proving that he t not build or im- -
p
rove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30'.00 ' RES ' IND CDN' PB Othar
- ❑ I,as owner T-1 the property,am exclusively contacting with , Q ' �.
licensed conlracto6 to construct the traject(Sec. 7044,Business LAWN SPRINKLERS 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
_ and Professions Code:The Contractors License Law docs not apply
to On owner of prlperty,who builds or improves thercud,and who LAWN SPRINKLERS-OVER 5 IEA,) 1.00 -
contracts for such projects with a contructolis)licensed pursuant to SEWER-SANITARY-STORM EA.200f1 1
the Contractors'License Law. / 0.00 TRACT NO. PARCEL•NO.
❑ lam<xempp under Sec. ,tl.&P.C.for thle
reason . WATER HEATER W/VENT • 6.00
o
Owner
One - WATER SYSTEM'. - 5,00 ACC.DATE ACC.FILE NO.
WORKERS'COMPENSA'TION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a cerni0cate ofconsent to self-insum,.
or u certiliculclof Workers'Compensation Insurance,or a ccilified ZONING - ENG.SITE NO.
copy themof(See 3 09,J�;Ib.C.). - _
Policy No.Ped py s tercpny'r'r�(its
0 Cl Certll'icJr�py i5 beech nishcd.. ' FIRE BPRINK ENERGY T-24
Z Z /'Cert ificd/cop is wiI1�the city inspection division.
♦- O Applicant- V. KNy �(Fc L' MISC.- REFER TO ORD. Y N I] Y 'No
w ' 10.00
-
CER'I'IFlCCONi EXEMI'I'IFROhf WORK IiRS' PERMIT ISSUANCE FLOOD ZONE ''A.L.u.c.
'.Lu , CO\1PHNSAT'ION INSURANCE PLG.CONTE. .LIC.N0. - PLO. - -
O II' i'.s c11on need not be e nlplU d'If thepermit is Icor ono - _ TOTAL Y-[:] N[ Y �; N�-
� Z
U'O hundre o 'or less)
' I e reify that in the R once of Oe work for whi h this per CITY MECHANICAL PERMIT 'FEE - 'FEE SUMMARY
U nil Is issued',I shall not nlplcy a xlm in any income,so as to
beunne subject to the Workers'Compcnsal ws +I'California. '
0
ELI Date APR... - BUILDING
} to NOTICE 1'0'APPIJCAN'1': D,sa mgnhis
olakilCertilicalc of Ex- ALTER OR ADD TO MECH. 5.00
F ? emption,you should become subject to Ole Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisionsof the Labor Code, you must forthwith comply with FEE
U such Provisions.'thispermit shall be deemed revoked:- AIR HANDLING UNIT 10=11F.M.) 4.00
` AIR HANDLING UNIT 10=1 F.M.) 6.00 SEISMIC FEE,
•e ,.'I
• - "`CONSTRUCTION 1-ENDING ACIiNCY ,
I hereby aITirurare is a conkktn¢tion IcnJing Iyency Icor EXHAUST HOOD(WITH DUCT) 5.00 r
the performance of the woe hieli'Ihis permit is issued(Sec. MICROFILM -. -
3097,Civ.C.). ' ,' HEATINGUNIT(TO 100;000 B.T.U.) 8.00
Lender's Nmme • ' HEATING UN IT 100,000 B.T.U.)9.50 ( Q
Lender's Address- - ELECTRIC
I certify phut l have-read tliis appli state'tit the above VENTILATION FAN (SINGLE) _ 4.00 ,
information is correct:I ayree o ply with Ilscity and county PLUMBING -
ordinances 3" spate laws utin to buildit onstruction, anJ BOILER-IX3MP13 H.P.or 100,000 B.T.U.) 6.00
hereby'authorize repre' natives f cit to •iter rhe BOILER-COMP,Over 100,000 BTU)SEE FEE SCH. MECHANICAL •'`
above-mentioned Pro ty for in coon p I
(We) as RVA to e, ind fy and the Cily of MISC.- REFER TO ORD. -
Cuper urns imhilit ',j dpm sand pe es whi CONST.TAX s
may I -ant w acct ag' .aid ply in core ala ce of o PERMIT'ISSUANCE 10:00
' rant MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL
` Si airme o Appli nt/ tea Dale - t
OFFICE COPY ` .