16446 1.
THISCARDJNEAR_FRO_NTOFBUI'LDING
PERMIT NUMBER'
•t CITY OF CUPERTINO 16446
INSPECTION DIVISION ! ='
-.JOB INSPECTION RECORD-.
PERMIT EXPIRATION
JOB ADDRESSY�� SJ L'S d_�_I�.f UNIT# 1 LOT#
'PERMIT EXPIRES IF;WORK '
D"E'R }�.J'6 cL�(S` + " ' CONTRACTOR'' .' `.'ISNOT STARTED WITHIN
INSPECTI N DATE - INSPECTOR - INSPECTION RECORD180DAYSOFPERMIT,ISSu-.-` '
ANCE OR,180 DAYS FROM:;
FOUNDATION,{ jGPS ,NOTE:' `
LAST CALLED INSPEC710N:
UFER ALL GRADING AND DRAINAGE.SHALLBEINSTALLED
PR EGUNITE 1 TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAI,IDATION
- CUPERTINO STANDARDS. -
GARAGE' �_SLABSr _ •I r+ .
i... -
.' POUR NO CONCRETE UNTIL ABOVE HAS-BEEN SIGNED` lJn. .® �
- UNDERGROUND /SLAB , , '` Pn I � �-��1 ' IfV�` ,t'� /�,•
PLUMBING .. r ¢ S/�'E`�' Iw+11 PAW 06'R':�_OA 0 4
ELECTRICAL, ISSUANCE UATE .
MECHANICAL. . - I RLU(l ELECT,I, PLP I MECR '
ctn
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED1-10-01 ap BUILDING PERMIT
.,Ep,�-E INFORMATION'
WOOD.FLOOR
`s1� 00T �m Of -lin 1? TION SIFT.
PLUMBING - - 8'I•fa '
.t ' ODDr
+ 'MECHANICAL ; 'S ,PERMn To
{ ELECTRICAL'., - �eLS(5
FRAMING '
INSULATION n- 'STOH IBS .T VPEC )NSTR.
NOV 21 1988
. OCC.CROUP RES UNITS
PLACE NO SU.BFLOOR UNTIL ABOVE HAS BEEN SIGNED Cjt .flf Cuperti00
r_ • SO TT.FLOOR AREA TOTAL ACR LAS'
ROOF, NOTE:NO FINAL INSP.SHALL BE MADE BEFORE - -
i
DIAPHRA ' - THE CONSTRUCTION TAX IS PAID
GM • 'T'
ROOF SHEATHING _ BUILDING use -
. _ Io-s• .2 cory RH D
- cl
APPLY NO ROOFING UNTIL-ABOVE HAS BEEWSIGNED FINALS , ,,,DATE' ,'INSP. -�
ASSESSORS PARCEL NO
ROUGH SAN.a,
PLUMBING _p -S, ELECT.ENERGY - '
" THACT No. PARCEL ND, ,
TUBS B SHOWER PANPLUMBING ENERGY
., MECHANICAL MECH.ENERGY'
ELECTRICAL '�,'Z BUILDING ENERGY _=1, - ACC DATE. ncc.FaE No
FRAMINGELECT.FINAL TEST
ZONING ENG.SITE NO,
. INSULATION. S=3 PLUMBING,'•
GAS TEST _ GAS'-
' FITRE SPRINK ' ENERGY T.24'.
MECHANICAL r.
COVER NO WORK UNTILABOVE HAS BEENSIGNED HEATING 'v ❑.' Nom. '• v0' N❑
FLOOD LONE 0.L.U.C. ,
EXTERIOR SHEAR, - ELECTRICALRELEASE ,
INTERIOR SHEAR ' 'F °�'.-NO r ❑ No
I
RE DEPT.
SHEETROCK (j-- .� T GRADE FEE SUMMARY
EXTERIOR .LATH " " — } BUILDING
INTERIOR LATH , BUILDING
' �i0"1 ' , � , TEMPORARY
- SCRATCH COAT. � ELECTRIC '
PLAN CHECK'.<
' .. r . GAS .
NO.TAPE OR PLASTER UNTIL ABOVEMAS BEEN SIGNED OCCUPANCY'' r' + 'SEISMIC FEE
OCCUPANCY.OFrBUILDING I S NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. 'MICROFILM +,
ARRANGE FOR INSPECT ION 'BY PHONING 252-4505, ELECTRIC
F_ ONE•WORKING DAY.BEFORE REQUIRED INSPECTION.- PLUMBING
Q�. PLEASE G_ IVE.JOB ADDRESS WHEN PHONING:
Z MECHANICAL
`= SEE PERMIT FOR EXPIRATION DATE=
.'IMPORTANT! CONST.TAXo x
PLEASE READ REVERSE SIDE BEFORE,'' TOTAL
•.CALLING'FOR FINAL INSPECTION'.
.APPLICANT TO FILL IN INFORMATION WITHIN RED LINES'- USE BALLPOINT PEN ONLY. t
��1 - ; - - '-PERMIT NUMBER
BIl!LUING I'. '
BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT .
' - -
ADDRESS - ..
/L� (� 7 d✓1�n� �� ! BUILDING-ELECTRICAL'-PLUMBING-,MECHANICAL '
OWNER'S - ;PLAN CHECK VALIDATION
IIIrp rvamE aa., �j y�J�JDTV. ELECTRIC PERMIT FEE Q •/y �^
L.'�rJ1lD�/�• •• 'PHON[L�"_-� - r "Jo V.� ,1
CONTRACTORS � I UTLETS:SWITCHES-RECEP 10.00/100NAME - t
l
LIC,No -` LIGHTING FIXTURES•. 10.0011-.00
DDRESCrORs
As - ..APPLIANCES:RESIDENTIAL 4.00,
OOREs
` PHONE I PANELS - .10.00 DATE OF APPLICATION
wre
ARccTM a �f3L PANELS (OVER 200 AMP) 20.00 •tPLAN.cHECK FEE 'P.c:No.
GR V,
EN I EER �,5_,fA Lie NO g00ZT SIGNS TRANS.' •' 3.00Y
ARCRESSH.OR ENG. c- r SPECIAL CIRCUIT 5,00 a PERMIT VALIDATION `
5 ' �P TEMP.METER OR POLE INS. 2000
nooeess Ts _ MOTORS - . v SEE FEESCH
SERVICE CHANGE 20 00 ..
o o LICENSED CONTRACTORS DECLARATION
QLaI
¢ U w I hereby affirm that I am licensed underprovisionsof Chapter9 •' ^ ISSUANCE DATE
z (commencing with Section 7000)of Division 3 of the Business and
¢ a rBLDG:"ELECT, H
PLG. MEC .
R N i Professions Code,and my license is it,full I rrce anJ effect
z
o License Class LieNumber
DData Contractor
i Y o, Cupedmo
UILDING
a m E r _ •B-INFORM PERMIT'
_ ¢¢
OWNER-BUILDER DECLARATION '
sm c U -- -INFORMATION
X ;LL w I hereby affirm that I am exempt from the Contractor's License MISC.- r ' REFER TO ORD" VALUATION ' $/FT,
e c o¢ Law for the following rcoson.(Sec.7031:5,Businessand Professions - PERMIT ISSUANCE +- :10.00
3 Code:Any city or county which reyuiresa permit to construct,alter, I OQ-v 1
w< improve,demolish,or repair n -Vuclure,prior to its issuance,also ELEC.CONTR. LIC.NO.
¢ ¢ ¢ O P P'mu any . ELEC. _ -
O u requires the Ilpplicnnt I'or such permit to.(ile u signed glatmnent[Imt ,TOTAL - PERMIT TO
w$ he is licensed poominl to the provisions of the Contractor's License
� zQ Law(Charter 9(commcneingwith Section 7000)of Division 3 ofOe - - ;A'0 � �7�'�/"
i a business unit Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE• t
a'I- the hoses for the alleged exemption.Any violation of Section 7031.5 - s' STORIES. TYPE CONSTR.
ea
m
e, by any applicant fora permit subjecls themlplicunt tox civil penally ALTER-DRAIN -WATER.(EA.) 5.00
of.not more than five hundred dollars(S504): - -
❑ I,as owner of the".Party,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP ^RES.UNITS
their sole compensation,will Bothe work,and the It
Is riot
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:,The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work- 7 FIXTURES-PER TRAP 5.60 10.00 50.FT.FLOOR AREA TOTAL ACREAGE
Gimselfor Got
hde ownemployees,to,
provided to halsuch improve- GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 :
mems ore not intended or offered year o If,however,the bolding 0 0 -
or improvement issoldb within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden off,roving that he did mil built or im, BUILDING USE ,
prrfor purpose ofsale.). INDUSTRIAL'WASTE INTER. 30.00 RES IND CON' PB ' omar
. L'as owner of the property,am exclusively contracting with -❑ ❑ ❑ ❑ ❑,
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V,B. , 6.00 ASSESSORS PARCEL NO.
and Professions Code:*1'lie Contractor's License Law does not apply
to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
'animals fit,such projects with a nmlractrlfs)licensed pursuant It
t the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 - TRACT NO. PARCEL NO.
❑ I am exempt under Sac.-,BAP.C.for this WATER HEATER W/VENT '6.00 - d
onvo11
Owner Date WATER SYSTEM 5.00 -
' ACC.DATE ACC,FILE N0.
•WORKIi RS'COMP1iNSA'IION DECLARATION WATER TREATING EQUIP. '5.00
I hereby affirm Ihnl I have a curlificate of consent to self-insure, ZONING
or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO.
copy thereof(Sec.3800,Lub.C.L -
Policy No. Company
Q ❑ Candied copy is hereby furnished. - FIRESPRINK :ENERGY T 24
Z Z ❑ Certified copy is filed with the city inspection division. MISC. REFER TO ORD.,'
O Applicant 'V❑ N❑ V ❑ No
� y CERTIFICATE 01'EXEN1PI'[ON PROM WORKERS' PERMIT ISSUANCE 10.00 X 90 FLOOD ZONE A.L.u.C.
Lu COMPENSATION INSURANCE PLG.CONTR.- LIC.NO. PLG. O
d O t'fIn, section need not be completed if ilia pennil is for one ,TOTAL 2 10 V❑ N❑ V ❑.. N
mn ❑-
Z h undd dollel$100 ,tlea.)
U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
U_ I- mit is issued, I shall not employ any person in any manner so us to
U become subject to the Workers Compensation Laws of California.
O i Date Applicant -- ALTER OR ADD TO MECH. 5.00 BUILDING
>_ far NOTICE TO APPLICANT': If,after making this Certificate of Ex- " _
F.z emption,you should become subject to the Workers'Compensation - APPLIANCE 5.00 ` PLAN CHECK -
provisions of,the Labor Code, you must forthwith comply with FEE
U such provisions or this,permit shall bu deemed revoked. AIR HANDLING UNIT(TO'10,000GF.M.) 4.00 7
CONSTRUCTION LENDING AGENCY -' AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC.FLE
- 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. MICROFILM
3097,Civ.C.). _ / HEATING UNIT'ITO 100,000 B.T.U.) ' 8.00 -O
Lender's Name HEATING UNIT IOVER 100,000 B.T.U.)9.50 ELECTRIC,
Lenders Address -
1 certify trot 1 have read this application and stale that the above I VENTILATION FAN (SINGLE)' 4.00 . 0 -
�, information is correct. I agree to comply with all city and county - PLUMBING
ordinances unit stale laws relining to building construc'tiol and BOILER H.BOf100,000B.T.U.) 6.00 �--/1
hereby authorize representatives of this city to enter upon the BOILER-COMP'loser 100,000 BTU)SEE FEE SEH. MECHANICAL �.� ✓.^
above-mentioned property for inspection purposes. .]
(We) agree to save, indemnify and keep harmless the City of - MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which -0ONST:TAX
may in any way accrue against said City in
consequence of the PERMIT ISSUANCE 10.00 -
grantingOf Ibis pennif, - - MECH.CONT. LIC.NO. MECH.
DTA . Tj I
5itmature of Applicant/Contractor Data �TOTAL 10.37
'
OFFICE COPY