15692 4 POST THIS CARD.NEARFRONT OFBUILDING
p - PFHMIT-NUMBER :.
f CITY. 'OF CUPERTINO ; <j .` 1569
INSPECTION DIVISION
JOB',INSPECTION RECORD
+,-PERM IT•E XPI RATION
JOB ADDRESS' '/, �'30 `='��EV�T�/`r �i�C'EK Ln`+11 # LOT# t
..
PERMIT-EXPIRES IF WORK ;
OWNER - /Z."Lcsit,i [/ , CONE ACTOR IS NOT STARTED WITHIN'
}- " INSPECTION DATE INSPECTOR - .INSPECTION RECORD - •180 DAYS OF PERMIT ISSU.
FOUNDATION - 7;,2 C` .NOTE: ' . - , . ANCE' OR 180 DAYS FROM
LAST CALLED INSPECTION:''
LIFER : x - " - ALL GRADING AND DRAINAGE-SHALL BE INSTALLED
PREGUNITE, _ Y. TO COMPLY WITH THE APPROVED PLANS AND CITY OF _ PERMIT VALIOATON
CUPERTINO STANDARDS
GARAGE SLABS - - • - '
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - D-./Y fr 'p I�f(� ,�M1ld(• ,!.C,, t �' c
'.`; UNDERGROUND'-/SLAB : ,/' -'► b „ '.( «
PLUMBING
•
ELECTRICAL + r, ISSUANCE.UAIE
- _
" 'dLJ6 [LF.CT., PLG MF.CH,� •'
MECHANICAL
00 NOT POUR FLOOR UNTIL ABOVE HAS,BEEN SIGNED ' - - BUILDING PERMIT
INFORMATION.
WOOD FLOOR .' vnwnnoN .slFr.
PLUMBING -
MECHANICAL'• - V ''•J I / _�'
ELECTRICAL ' PERrom r
FRAMING - - .. O
TVP[CONSTH. -
INSULATION. '-'•-'
OCc.GROUP, AES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED `
SO FT.FLOOH AREA TOTALACREAGE
• - : ROOF• .-NOTE:NO FINALINS" SHALL BE MADE BEFORE -
DIAPHRAGM - - - THE CONSTRUCTION TAX IS PAID -
BUILDING USE
ROOF SHEATHING __ r Rrs,,.INN CON Pd 0.,.:
APPLY NO ROOFING,UNTIL ABOVE HAS BEEN SIGNED. FINALS DATE , INSP. 0 10 D 11 �
ASSE550RSPARCEI.NO
ROUGH SAN.#'
PLUMBING - ELECT.ENERGY
_ THACT NO. ,. PAHCEL NO.
NUBS&SHOWER PAN . - PLUMBING ENERGY - -
MECHANICAL - a MECRENERGYnrm.On rE .Acc.FILE No,
ELECTRICAL- • 'BUILDING ENERGY
FRAMING /..2 - , QV. , ELECT,.•FINALTEST .. .T.-? zowrvc. f ENc.SITE No.
'INSULATION - _29_ (, 1 PLUMBING _
GAS TEST GAS -
'FIHESPRINK ENI RGY T IG
- MECHANICAL
N[:]COVER NOWORK UNTIL ABOVE HAS BEEN SIGNED ' HEATING _' ''❑ "D
EXTERIOR SHEAR• � ELECTRICAL RELEASE FLOOD ZONE A,L.u.C. I
^ffEt I tt� I -)3'S'
INTERIOR`SHEAR FIRE-DEPT. 7, ❑ ND. YL„',NEI
SHEETROCK ' „ - --ffFj'+, e` GRADE a . FEE SUMMARY
EXTERIOR'LATH' B iLD1N133-3-87CI
INTERIOR.'LATH, - ' 'TEMPORARY-APPROVALS BUILDING ' .
SCRATCH COAT - _ ELECTRIC • : PLAN CHECK T it
GAS rFEE.
NO TAPE OR PLASTER UNTIL ABOVE HAS:BEEN SIGNED OCCUPANCY . SEISMIC FEE 6Q '
OCCUPANCVOF BUILDING.ISNOTPERMITTEOUNTILBUILDING I F INALISSIGNED BY BUILDING,INSPECTOR. MICROFILM
uJ ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
o� ONE WORKING DAY BEFORE' REQUIRED INSPECTION. ,.;PLUMBING
PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z - _ MECHANICAL
SEE. PERMIT,FOR EXPIRATION DATE'—
IMPORTANT! covsr: TAX. p
PLEASE,READ REVERSE SIDE BEFORE °
CALLING FOR FINAL•INSPECTION. TOTAL �'�S+
OFFICE COPY;
^ A
/tPPLICANT;TOAFILL IN INFORM'ATION'WITHIN'.RED LINES; USE BALL POINT,PEN ONLY
8 t' « - - Y - -PERMIT NUMBER
'-' BUILDING PR03ECT 1 DENTI FICATION - ^.
4 aO,LO,rvG APPLICATION &I
ERMIT « "g
AnpRE _ 15 6 9 2
aYELECTRICAL-PLUMBING=..'MECHANICAL
a
' OWNER'S ';f F � � l+ "�� - „ t `.' 'y r,PLAN CHECK VALIDATION tS
R n 7 ',� I��t., QTY. rf' ;tELECTRIC'PERMIT " '. i ';FEE l '!1
(. l/ PHONE _ v w 'jv "* .r., .',:' 7 O(a 0 �\
CONTRACTOR s - OUTLETS`SWITCHES-,RECEP 10:00/100 .
NAME('.., 1 t
' ,:".+_: LIGHTING.FIXTURES
x,10:00/,1 00 ? -.
oos ss TORS. py '�V✓ :*'_. APPLIANCES-RESIDENTIAL.: -'r.� 400 „ #T+
rvE PAN ELS '� Yr.4 �q. +-]O OD ^.DATE'OF APPLICATION r
C'
ARCHITECT . / PLAN CHECK FEE P C,:NO,`
,PANELS (OVER+200 AMP),, , 2000
ENGINEER' y i // ` -
1oR a Vn0. u'l Noe/,.. _pJ'. SIGNS TRANS. ,. -,E' ry 'r•.300I i,t 'a • 'W s
ARCH.OR ENG. .1 - - PERMIT VALIDATION
-
AO
OR Ess ` 'r I SPECIAL CIRCUIT-r; _ 500 .I s
' J ...z,P EMP.METER OR POLE INS '2000,
APPLICANT'S•yr ! t
- AOOREssI 'T B ' MOTORS � ; .'rev SEE'FEE SCH ,
r - s' ' F- F SERVICE CHANGE ✓ ` 2000a-
0 0 01. .LICENSED CONTRACTORS Df CLARATION
N V
'Q
ca P: IdtePehy gfftnn tlullant licensed°under pro visions of Chgpl 9 b;,,+a 'I66UA CE DATE
yz w- (co nmencing illi"Se'iion 7000)of Diviami 3rofthc Busmen,.and -
aAU n 'BLDG." ELECT. ".PEG., MECH.>`.
t` r m• Professions Code, dim Ilwuse Is Io all torn A or' +i
i o ml icenaeC ' _Lie.'Number t ' -•��' �, -� '
Date- 1py] —Contra ,-: . e P
a a - • - '' x .' ^,, BUILDING PERMIT,'" e.
4�,
OWNER-BUILDER uecLAR ' y c' - A„INFORMATION
x'3-a vi � I hereby afNnn that I ran exempt from the Eonpractor's'LI ense 'MISC.'-,,q r REFER TO ,- VALUATION "$/FT. -
r'_ o'J Law for the lotto nig reasoa(Se 703L5;Risine sand Professions ,: PERMIT ISSUANCE r +n:'r -"10.00
Code Any city or county-whmh requiresa permit[o construct,al ter
QH ELEGCONTR + LIC NO-, 1 L..�
'a Improve,demolish or repair any shuchne,prior to Its is�uunce also ,x s T ECE ^ �{' -
ec o ¢ : regmies the appl can[for such pcnnit to file a signid UntemeN that _- t �',: P - F ., T PERMITT
X m.I` ' he is licensed pursuant to Olepr svivons of tlrc Contracmr's L¢ense - : 0. ''
Uzi' Law(Chaptar 9(commencingwith Sec0on 70001x[Division3of thel .0 '•' � v rte'" ' ' " - F%?B' MOl�Lp(�'7-/Q�f
4 o business and.Profeaelons Cod•)or thaLhe is e empt therefrom a d QTY, PLUMBING,PERMIT'/ p Y 0� x
¢ r� the busis.Cor the ullegud exemption.Any violation of Section 703 L5 -,-•. + ;,"" ., T `�V�}� -vrd• STORIES - TYPE CONSTR.
a ; _ by any applicam fora pertnit objects theapplicanttowcivilpetatty "A.. ALTER`DRAIN&'VENT-WATER (EA),500 '
of not morn than Crve huvdreJ Uollnrs(5500).1' ,' _
- ❑ •1,es owner ol'the propcily m Ihy'cmployees wuh wage s -y BACK'F.LOW PROTECT.•DEVICEAI. '4:00
their sole compensation,will Jo[he work;and'lhe structure n not ” - - DDD.GROUP- a RES.UNITS,
Intended or offeixd 0>r sole(Sec 7044"-Ruane,, .,,it Professors "�. DRAINS-FLOOR,ROOF',AR EA,COND. 5.00
Code:The Contractor's LIUi:e La docs not apt ly t n of
9• property who b Ids Or improves th r n and h does s c h wok '_ FIXTURES"'PER'TRAP' 1 �',. 5.00 60.FT.FLOOR AREA TOTAL ACREAGE
himself or through h s own employ Provided 11 it 'unh"rip o -
meritsarenotintnddoro0celmsl Il howee til building "x GAS''EA'.SYSTEM-11NC_40UTLETS 6.00 ' .I'JSD A07) .- .
® or Improvement is sold within O y r f comp) t mi the owe r GAS-.EA.SYSTEM-OVER 4(EA.) -.2 00 ' \. - ,
budder will have the hu dun of prying that lie did n t,bl ild'r Imo _ - .. BUILDING USE
prove for purp a of sale). "' 'RES IND CON PB" 'Other
❑ I,as owner of the "' �`6: INDUSTRIAL WASTE INTER s `^4 301.00 propertY he project
7 44,Ing col Hl W - K - - : ❑h .,.� .i '
licensed contractors t o The
projec[,(,2 7044 rot dippls °' LAWN'SPRINKLERS-1,INC5 V.B.e 600 '.ASSESSORS PARCEL NO."
" and nProfession,nen Code The Contra tors License Law do s nut apply - ,
to an owner ofroopcHy.w1u,b Id unpro thcrcen and who a _ LAWN,SPRINKLERS OV ER'5,IEA.1. 1 00 _ 3 6'�p
057
contracts for r' h projects nw. a c ntie w, i hienseJ pursuanA,te SEWER'-SANITARY-STORM EA,200ft/10 00
the 1rancexe License Law. - " ' ! - % - WATER HEATER W/VENT`' 600 ' ,TRACT No ;PARCEL ND�
❑ I am exempt under Sec 'R.NcP.G.for Hos r
reason
- ,( 'Owner x Date " •. WATER SYSTEM "5.00 5.00'• - - - ACC:DATE.t, ACC FILE NO.;
WORKI RS'COMPENSATION DECLARATION' 4 %' WATER TREATING-EQUIP 5.00
I hereby affirmsthal'Ihoveacc,hIiCkcHfern'cnl.ir sclfinsua w, s. s -•- e-
oma certifirme of Workers'Compensation'Insurance, r a cc ii
d + ZONING I ,'ENG SITE NO.
copy thereof(Sec.-38 OrL,gjy�.
Policy
O Certified copy is herell FIRE~SPRINK ENERGY T-24 -«
°Z,2 ❑ Cerlific a inspec iiviva°. MISC - '.. J REFER TO ORD ,'y'O� N '.SiY ❑"�(N�
Applicant
CC. tri- PERMIT-ISSUANCE - ' +. .; '['10.00 b '
� CI;RTIEICATI OP IiXI MPTION ORKERS � -' FLOOD ZONE �•A.L U.C. '
ED > COMPENSATION INSURANCE PLG.CONTR.- LIC.NO. '"PLG s '"I
CLO
(This section need not-he eo nPlcLvd "C th permit (or ovc • § TOTAL Y _ N�, VL�v.-•N�
0.2- h u n died dolls E($100)'.,less.) s rs
C 10, 1 cerfify4hat in the performance Of the work for which this per Q.(Y I `` � - . 'FEE SUMMARY.
i MECHANICAL PERMIT •FEE :, a �
LL,H. mit is issued,I shelf not employ any person n any manner so as t0 P F
" U become subject to Lire Workers C mpensation La s sb Calil'or I "' >•
0 y Date '+" ti -Applicam - ALTER-OR'ADD TO;MECH:" � _sy s 500 - BUILDING ,•/��
} to NOTICE TO'APPLICANT: If,after making this Certificate of Ex- - - _ -
'F_ Z emption,you should hecnme subject to the Work s Compensation APPLIANCE,1 -s.s 1' '5.00
, PLAN CHECK
provisions,of the Labor Code, you must forthwith 'mu'ly with '
U such.provisfons'or this permit shall he deemed revoked AIR HANDLING UNIT-(TO IOJ p CAW 4.00 FEE
AIR HANDLING UNIT 10 C.F.M.) 6.00 SEISMIC FEE
CONSTRUCTION LENDING AGENCY � - .�
I I hereby'aRiinl Ihai there is a construction Icnding'uguncy for EXHAUST HOOD(WITH DUCT) 5.00 -
the performance 6LHIiii work for which thisrpermil is issued,(Sen. - - _ - 'MICROFILM_
3097,Civ C) ±s ., HEATING-UNIT(TO 100,000 B.TiU'.) 6.00 - x3
• Lenders T -
HEATING UNITIOVER 100,000 B.T.U:19.50 " ' r.'.
LenJe,s Address ''' -_.. - ! _. '• ELECTRIC..
1 certify that I have ieod this application and stututhat the aboveVENTILATION FAN (SINGLE 4.0.0
rfrnnation is correct I'agree to eonll ly.wlth all city and county PLUMBING ^s;
ordinarces'und state laws relating to building construction`fand BOILER-COW(3HP.Of 100,000 B:T.U.)"6.00
hereby authorvre-representatives of this city to enter upon the BOILER-COMP.IOver,t00,000 BTU)SEE FEE SCH. MECHANICAL'
above mentioned property for inspection se
purpos, J _ - - " - �•
(We) agree to seve, indemnify and"keep;hannless the'City or + MISC. ,'. REFER TOIORD. - 5. �yx
' Cupertino against i oets,and expenses win h 'PERMIT ISSUANCE 10.001k
CONST.TAX .O ..7 D
may t said y'In consequence of the 10 00
�' i •' MECH.CONT / LIC NO MECH .k i
TOTAL TOTAL �S
t Signature o Pp,cant on rector . 'Da
.. .. .,
qsOFFICE`COPY
_ :./
POST THIS CARD NEAR FR(;AA'. OF BUILDING
' ITY OF CUPL171NO
1: INSPECTION DIVISION
,,' JOB INSPECTION RECORD
1� ~J JOB ADDRESS _L71 J `S I` Vt_-�iJ l � /� I�M11TT# _LOT#
PE
OWNER [__Z.�•( �., CONTRACTOR IS
INSPECTION DATE' INSPECTOR - INSPECTION RECORD 181
FOUNDATION INCITE APS
LA
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CIN OF
PREGUNI'FE CUPERTINO STANDARDS.
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB 'io or ;, -' • : • ` �!
PLUMBINGd- '� I C--��—�7 Yt •3l(x=L-V�L'�•y
ELECTRICAL -q' ni,:cV, =<<:. i y
MECHANICAL ri
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED I=,,, :,' 4+%'� r
WOOD FLOOR
PLUMBING M•
MECHANICAL NAIL N FQw-4a f%- lagG'7S CL's
ELECTRICAL (1
FRAMING L �
INSULATION l��CppiLe's-Teo✓}.+ LVA
i'.t-•rib,.!!-2`7-tS$'! '.c.�
itc c1.tAvosL3puFE �Cck+-Q <��
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED �( 2odc—O� U d8C
]J
ROOF O FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
�k ROOF SHEATHING 1°
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.
ROUGH SANA
PLUMBING ELECT.ENERGY i
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECK ENERGY
ELECTRICAL BUILDING ENERGY
FRAMING ELECT.FINAL TEST
INSULATION PLUMBING
'GAS TEST GAS
r.
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
EXTERIOR SHEAR - •-}Li I V ELECTRICAL RELEASE
INTERIOR SHEAR _ .. � '� F-IRE,DEPT.
SHEETROCK I t; GRADE
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS Bu
SCRATCH COAT ELECTRIC PL.
FE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MI
ARRANGE FOR INSPECTION BY PHONING 252-4505, C 1
EL
o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. ,' PL
® Z PLEASE GIVE JOB ADDRESS WHEN PHONING.'. II; ME
— SEE PERMIT FOR EXPIRATION DATE —
IMPORTANT! ! cc
ii�I II� a� it (t� Iq:�} x'23
PLEASE READ REVERSE SIDE BEFOREgf���4!, au i i�7
CALLING FOR FINAL INSPECTION.
AFPLIC�,jllTS POSTING C:PV