14314 POST'THIS CARD NEAR FRONT OF BUILDING
+ - _ PERMIT NUMBER
CITY OF CUPERTINO
' 14314
' INSPECTION•DIVISION ;•
JOB-INSPECTION RECORD
r' PERMIT EXPIRATION
oBAoodess 201,1j'•.STEVENS 'CREEK unix#' 25U _LOT#
' PERMITEXPIRES'IF WORK,; ,
OWNER , -ATTORNEY' OFFICE CONFRACTOR -THOMAS PLUMBING- + IS NOT STARTED WITHIN ',
INSPECTION DATE INSPECTOR INSPECTION RECORD ,180 DAYS OFPERMPPIsBu. •I
' FOUNDAT.ION - - ANCE:OR 180 DAYS FROM � .•'
NOTE:.' -o "'R L'ASTCALLED INSPECTION.
LIFER - , t. •`• "ALL GRADINGANDDRAINAGE*.SHALL.BE INSTALLED
I
TO COMPLY WITHTHE APPROVED PLANS AND CIN OF. PERMIT VAI-IDATION.
' PREGUNITE "' CUPERTINO STANDARDS. •'' '" 'x "��
GARAGESLABS
POUR NO-CONCRETE UNTIL ABOVE HAS BEEN SIGNED
,, "'UNDERGROUND /.SLAB •' l^r ! t s' ,!•�t„
PLUMBING - ,. / 'Y�/`•1,,,i '.,j
IIx • ELECTRICAL, _ ;' ISSUANCE DATE
MECHANICAL, I - - .. tlLUG„ ELE;r. ,'PEG, MFCIL.
El
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
^ INFORMATION
• 'WOOD FLOOR vawan ON 5/ET.
e . ,
.,PLUMBING pyE' rtinn . .
MECHANICAL e ,{ :u'
ELECTRICAL
FRAMING + I'INSULATION' - _ STORIES, ",Tuve mNSTR,
UCC,GROUP, .RES UNITS
�'• . PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
-SO.FT,FLOOR nRLa tOiAL ACREAGE
• ' ROOF •NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
.� DIAPHRAGM I THE CONSTRUCTION TAX IS PAID.: _
BUILDING USE.
ROOF SHEATHING - 'I RES IND CON ,',vBOm„
El 0in El
;-;APPLY,NO ROOFING UNTIL-ABOVE,HAS,BEEN SIGNED., �,'.I• _; FINALS.',<".«..., ,%,DATE"....'. INSP.. . '�' ✓
ASSESSORS PAHCfI.NO. .
• ROUGH" 'SAN.N '' p
PLUMBING aj./6.09 -ELECT.ENERGY. 1
" - TRACT NO., PARCEL NO
TUBS&SHOWER PAN - PLUMBING ENERGY T
MECHANICALP,2 Ab dM : MECH.ENERGY "
ELECTRICAL - '—J � 'BUILDING ENERGY- - - ACC.DATE -ACC.FILE NO
FRAMING ECECT.FINAL.TEST
ZONING ,ENG SITE.ND,
INSULATION - - PLUMBING
tl`
GAS TEST 4 Y GAS
- ' MECHANICAL-.A. FIRE,SPRINK, ENERGY 1 71 11
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING.,' ' '° N❑ • .,❑ NC]
EXTERIOR SHEAR. - ELECTRICAL RELEASE - '< -,2 7 FLOOD ZONE A,LLLC. r
INTERIOR SHEAR _ .T•~ • I 'FIRE DEPT.
SHEETROCKy .�0. GRADE FEE SUMMARY
EXTERIOR LATH' " : - BUILDING P,', 7 —
E - INTERIDRLATH --, - 'TEMPORARY APPROVALS .: DING.,
SCRATCH COAT - ELECTRIC -PLAN CHECK
I GAS_ .'.FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY 'SEISMIC FEE
' OCCUPANCV'OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR.
TMICROFILM {�
w ARRANrGE�FO,R INSPECTION BY PHONING 252-4505,
ELECTRIC
I ONEWORKING DAY BEFORE REQUI:RfQ INSPECTION:' PLUMBING
zo�. PLEASEfGIVE JOB ADDRESS WHEN PHONING. "
=,SEE PERMIT,FOR EXPIRATION DATE;- MECHANICAL
IMPORTANT! .k CONST.TAX q
PLEASE READ REVERSE SIDE BEFORE..., I: . . . TOTAL
CALLING FOR FIN'AL'INSPECTION
OFFICE.COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED-LINES — USE BALLPOINT PEN ONLY.`
• BUI CDI NG PROJECT I DENTI FICATION - PERMIT NUMBER
AOiaOINC, wI. a APPLICATION &.PERMIT - ' : :1431
�.4a
np9R ,
0 ve n Cee BUILDING-ELECTRICAL-PLUMBING-MECHANICAL -
OWNER'S - - "• PLAN CHECK VALIDATION
rvnME. j ZORN OCL r1
PTY. - , ELECTRIC PERMIT - - FEE -�
..,� 0..N _ '/ e d - '• a =:, - '
' CONTRACTOR'S' ,
AMEOUTLETS-SWITCHES-RECEP. 10.00/1 00
ucrN a LIGHTING FIXTURES •, .10.00/1.00
-oernncro ' / { PPLIANCES-'RESIDENTIAL x.4.00
' AODR Ess . 5 � ,
PANELS E, 't 10.00 DATE OF APPLICATION
OR IrecT PANELS (OVER 200 AMP) _. 20.00 PLAN CHECK FEEP.C.NO.
ENGINEER ,,I,
I.E.No. SI GINS TRANS.. - 3.00 -
ADDRESS ENG. SPECIALCIRCUIT. ' '5;001 - PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS:' . 20.00
APDRESS,PLICANs - MOTORS SEE FEE SCH.
ADORES$, '-,
SERVICE CHANGE 2000 f
w o o LICENSED CONI RACTORS DECLARATION
or
ib
I hereby of firm that I am licenua ander provisions of Chapter 9 ISSUANCE DATE r
(commencing with Section 7000)of Division 3 of the Busmess and'
_ BLDG. ELECT.' PLG. MECH,
r m z Profesr om Code, d nse ue In full fort and y - - _
z
0. - License Class ./�Lie, Number
r w Uatc____A�AOL— Co uraular� -
rc ¢ ¢ OWNER RUILDLR DECLARATION - - BUILDING PERMIT
.INFORMATION'
K
;LL w I:hereby affirm Bmt 1 am exempt from the Contractors License MISC.- - >' REFER TO ORD VALUATION SIFT.
LL o ¢ Law for the following reason.(Sec.7031.5,Business and Professions
� -0 � Code:Any cityorcounty which requiresa permit loconstomralter, PERMIT ISSUANCE' 10.00
I '¢> ELEC.CONTR.. LIC.NO.
¢ ¢ ¢ p improve,he applicant repair any structure,prior to its iateme e,\that ELEC. - \
n
¢ requires the applicant for such permit to file a signed statement that TOTAL
w m" hh:¢
e Is licensed pursuant to the provisions of the Conlar PERMIT TO
s License 'p
s- Law(Chapter 9(commencing with Section 7000)of Division 3 of the
s o Business and Professions Code)m,thm he is exempt therefrom and OTY. PLUMBING PERMIT FEE
¢ m the basis for the alleged exemption.Any violation of Section 7031.$ - - STORIES TYPE CONSTR.
by any applicant for a permit Subjects the applicant to a civil penalty '
of not more than five hundred dollars($5000.) - ALTER-DRAIN&,VENT-WATER (EA.) 5.00 ' p
0 1,as owner of the property,or my employees with wages as BACK FLOW
their sole conmensation,will do the work,and the structure is not PROTECT.DEVICE 4.00 DCC.GROUP RES.UNITS- ,
intended of offered for sale (Sec. 7044, Business and Prafessions DRAINS-FLOOR,ROOF,AR EA;GON D. 5.00
Code:The Contractor's License haw does not apply to an owner of
property who builds or improves thereon,and who does such work / FIXTURES-PER TRAP 5.00 sit Fr.FLOOR AREA TOTAL ACREAGE
. hir,SvILor though his own employees,provided that such improve- ,
ments are not intended or offered for sale,If.however,the building GAS-EA.SYSTEM-11NC.4,OUTLETS 6'.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER (EA.) ..2.00
- builder will have the burden of proving that he didhnot build or sin- - -BUILDING USE
prove for purpose of Sulo.). . INDUSTRIAL WASTE INTER. 30.00 RES' IND CON PB Omer
111,as owner of the properly,am exclusively contracting with - 1:1- ❑ ❑ ❑ ,- ❑
licensed contractorstoconstruct the project(See. 7044,Business LAWN SPRINKLERS=1 INC 5 V.B. 600 _ ASSESSORS PARCEL N0.
and Professions Code'I'he mno
Contractor's'Lieee Law d6csl apply, .-
ro as owner of property whit builds(ir improves thereme.and who LAWN SPRINKLERS-OVER 5(EA.) - 1.00 J
contracts for such,prq,ets with a.eontractois)licensed Pursuant tO - - -
theContractor'sLicenseLaw. I SEWER-SANITARY-STORMEA:200tt/10.00 TRACT NO. PARCEL NO.
0 Iamexempfunders", ,B.&BC.for this ' WATER HEATER W/V ? ' 6:00
` reason '
- Owner - Dee WATER SYSTEM - 5.00 . Ace.DATE Ace,FILE NO.
WORKERS'COMPENSATION DECLARATION ' ' WATER TREATING EQUIP. '5.00 ,
I hereby affirm that I have a certificate of co6rnt to sell-insure,
' aLa certifmxle of Workers'Compensation Insurance,or a certified ZONING ENG.SITEr NO.
copy thereof ISe 3800,Lab.C)
Policy No_ Company�
O ❑ Certified yrs here fum¢Ihtgy FIRE$PRINK ENERGY T-24
mw
Z Z -F�Nfied py ecu city inspection div
F p Applicant_ REFERTO,ORD.
'Y ❑ N❑ ,Y ❑ N❑
-
CC w CIiRI'IIICA'I'I:OP EXEMPTION PROM WOR Kfk S' PERMIT ISSUANCE 10.00 — FLOOD ZONE A.L.u,c.
W > COMPENSATION INSURANCE - PLG.CONTR. LIC.NO. _ PLG. _
(This section need,nnt he completed if the permit is for one TOTAL ,2 v❑ N❑ v C:] NC]
hundred doll.is(S 100)or less,)
1f U 4, certify that in the Pedontanct,ul-the work fin which this per-. QTY MECHANICAL PERMIT FEE'' FEE SUMMARY, -
ILL . an
issued,I shall not employ any person in;my mannerso us to
O w Appl
becomen-subject to the Workers'CompensatioLaws of California. ^" e
,U1 Data ' icant BUILDING
>; to NOI ICI.TO APPLICANT: If aft making thus Certificate of Ex ALTER OR ADD TO MECH.
Z emptier,you should become subject to the Workers Compensation - APPLIANCE _ '1-5.00 PLAN CHECK -
provisions of the Labar.-Code, you muit'forthwith comply with FEE
U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 1Op00 C.F:M.1 X4.00
- 'CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.).6.00 SEISMIC FEE
1 hereby affirm that there is a cotutruction lending agency for EXHAUST HOOD(WITH DUCT) - 5.00
-+ tiro-performance of,the work for Which this permit is issued(Sec. MICROFILM
3097,Civ.C.L - HEATING UNIT(TO 100,000 B.T.U.) 8.00 _.
Lender's Name' HEATING UNIT 100,000B.T.U.)9.50
- Lender's Address " (ELECTRIC - -
I certify that 1 have read this Application and state that the above VENTILATION FAN (SINGLE) • 4.00 -
-
information n correct I agree to comply with all city,and county BOILER=COMP(3.H.P.or 100000,B.T.U.)' 6.00 -PLUMBING
ordininfor alioces unit stere'lows rcletmg to comply
with co sty an and
hereby authorize representatives of this city to enter upon the
abovenedtimied Property for inspection purposes. BOILER-COMP (Over 100.000'BTUI SEE FEE SCMECHANICAL
(We) agree to save, indemnify and keep harmless the City of M.
MISC.- - REFER TO ORD. -
Cupertino against liabilities,judgments, costs and expenses whicli+ PERMIT ISSUANCE 10.00 . CONST.TAX'
=/Umflorena,
rne against Said,City in consequence f theMECH.CONT. LIC:NO. MECH.
TOTAL
Dirty -'TOTAL,.
OFFICE,COPY , ,