14532 !POST THIS CARD NEAR FRONT OF BUILDING PFRMIT NUMBER
CITY OF CUPERTINO
INSPECTION DIVISION �� �
�l JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS /y6 o v U"�J� ~, UNIT# _LOT#--
PERMIT EXPIRES IF WORK
OWNER ITA-C CONTRACTOR Uri-• j XA IS NOT STARTED WITHIN
INSPECTION DATE ' `INSPEb 0 " INSPECTION RECORD IBO DAYS OF PERMIT ISSU
FOUNDATION _ �F',- ANCE OR 180 DAYS FROM
NOTE: LASTCA L LEO INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF "•"^^' •""+'�
PREGUNITE CUPERTINO STANDARDS.
GARAGESLABS
P ;N .. N ETE'UNTIL ABOVE
UNDERGROUND /SLAB A,1` o>
PLUMBING
ELECTRICAL '•`°"•'" 1d 1'
MECHANICAL ).GL Urb ` — , ': ' ":. 1 ^•r+.w
721 A Agq4.— — n-92 C�` ❑ LJ ❑ ❑
•,DTjfp,qRfIVOR%U11jTIL ABOVE H `B _ N j-3/-$% T c i"�MArltt/t �I 81RtkAnOfd
WOOD FLOOR sar
PLUMBING •� — �`'`
MECHANICAL
ELECTRICAL
FRAMING \
INSULATION ",II •
�•fC ',.no lr nsa.5
• G^ U 0 k' iSl DI
ROOF NOTE:NO FINAL INSP.STiALL BE MADE BEFORE •{
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
ttl.
ROOF SHEATHING un s �wa . ON � ��a I111-
APPLY10tR00FIIVG.UNTIOABOVE%HAS BEENISIGNED FINALS DATE INSP. r
ROUGH SAN.a
PLUMBING --3- �'C� ELECT.ENERGY '
fwaCe Nr, Pn w1 f1.`,�•
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECR ENERGY
.ct rv.n An Pau N"
ELECTRICAL BUILDING ENERGY
FRAMING —'s—V7 fC. ELECT. FINAL TEST ,r ' /i -�/
INSULATION PLUMBING
GAS TEST — GAS -
f NAE CHAN nC AL
COVER NO WORK UNTIL ABOVE MAS BEENISIGNED HEATING
EXTERIOR SMEAR El.'�Ef,:T1R11(:AI. IIE IIVIA,`B,•� r ..
INTERIOR SWEAR — —� PIFtE OEP11 'r •i^'I L-.I •,�
._..__._ _... _____..�.. .___._..__.._—..._.e.... .T_...�� -.- ..,_..,,.� ..
S.HEE TR OIC X. p('•�' _ y'' 1'.R',nLrol SEB tIUNMARY
EJ(TE�R10FI :Alr! 41UIIL 01IN6
_ —
uNTEHPOFI aATlti } 111:'.AllhOR',AIRW1AP+PIROVrA13 '
SGF--AIL r.!('A. 7rl - —II 11'IA!I �"- _ 1'I AWI';;HIL ICI
NO TAPE OR PLASTE L AL1011816El0EENI LIBAIE0 1tX 1r l In nw( + SEISMIC I i E
OCCUPANCY OF BUILDING IIS NOT PIIR'6tl11 IIE1011191`116 11014 01114I5'I EN,41. IS%1`61NE 0 OW BAALII11oyG 111SBLI 00114 AeCW5F LM f
ARRANGE FOR IINSPECTI101NI Bt V' PHIGNING 25'24'5051, ELECTRIC
-'� F ONEVPORKUN& D,A.Y BEFORE AEQUIRE0 1NSPIEC7109 PLUMBING
Oy . PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z MECHANICAL s 'L,
— SEE PERMIT FOR EXPIRATION DATE
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE TOTAL S
CALLING FOR FINAL INSPECTION.
APPLICANTS POSTING COPY
ADRUCANTUTO FILL IN INFORMATION WITHIN.RED LINES - USE BALL POINT PEN ONLY
BUILDING-OROJECT IDENTIFICATION PERMIT NUMBERAPPLICATION IBt PERMIT
AD
' ewcoirvG;. � "
DRES$ O s�: � - - 145.32
i )Y� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S l u ' - PLAN CHECK VALIDATION
"AME1
�� ,f CITY. ELECTRIC PERMIT FEE '
"4I r b�✓ LN. �Q� of S
Y/�•- PHONE .,
CONTRACTOR'S -
NAME 311
=SWITCHES-RECEP 10.00/1.00
LJLGwr6 LIGHTING FIXTURES 10,00/1.00 S� "
ADDRESS
PPLIANCES-RESIDENTIAL
1 RESR
LNPHONE 'SR-JIU PANELS' a " 10.00 H'-'� • DATE OF APPLICATION _
V ARCHITECT •PLAN CHECK FEE P.C.NO.
oR 1f{h �/ j(1� � Ck ./�y PANELS (OVER 200 AMPI20.00
ENGINEER �sbt� kj ZQ t 1• 1 L lZ , .
uc.No, . SIGNS TRANS. 3.00
ARC H.OR ENG, - •PERMIT VALIDATION
ADDRESS LaS'Cr4.�'La SPECIALCIRCUIT 5.00
101 C ' ^^'w� P o'j' EMP. METER OR POLE INS. 20.00
AKrs
ADORDOREsS MOTORS SEE FEE'SCH.
- - C71r.r`f bl.yl-`(A•L.L�.�.
D ¢ z SERVICE CHANGE 20.00 C •.
o o -
F LICENSED CONTRACTORS DECLARATION (,- v �o /.'ys� 1
¢w - (((
-I hereby affirm that I n licensed undo provisions It Chapter 9 - ISSUANCE DATE
a �" Professions g with Seddon 70001 Of Division 3 it the Business and BLOC_ PLG. MECH.
C)z Professions Code,anti my license is in full for e n fleet. �(] TL
le JJJ �IVTJI`. /
z o m Lice"a Class Lic.Number_ ,
9 m r-� Dale 8�17-fI1C Coalructor O�
Q y f J , ����hI+ ING PERMIT
¢ o a
OWNER-BUILDER DELL ATION - FORMATION
E: w 1 hereby affirm that I am exempt Iron the Contractor's License MISC.-; ,REFER TO ORD �
LLO j', Law for the fallowing reason.(See.
7031.5,Business and Professions PERMIT ISSUANCE �� VALUATION . ' $/FT.
- Code:Any city or county which requiresit permit to conslrt¢q:,ler, l
" ¢ K Q•� impnive,demolish;or repair any sUuctum Pprior lu its issuance,also ELEC.CONTR. LIC.N0. - ,LEC. ` ,l/Q••(/ '���
n�isO.LL requires the applicant for such Permit to file a signed statement that , TOTAL T PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License _ -
Hir
Las(Chapter 9(commencing witliScelion7000)OI'Division 3oLtbe ' AY)4
4
at Business and Professions Code)or that he is exempt therefrom andQTY. PLUMBING PERMIT FEE .� >
I- o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
by any applicant TO,a perntil subjects the applicant to a civil Penalty a ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars(55000.):
1 ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00
their Sole mmlpensal inn,will do the work,and the shuel are 1s not OCC.GROUP RES.UNITS
Intended! or after,, for sale (Sec 1044, Business and I'ro1'essinns 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 thercon,and who does such work FIXTURES-PER TRAP -6,00 pl SO.F,T.FLOOR AREA TOTALACREAGE
himself or through his own employees,provided Ibdsuth imp....c" -
identsare Get mundedoroffered for sale.If,however,the building - GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00
or,Improvement is sold with in one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA'.1 2.00
6uiWcr will have the burden of Proving that he did not build or ins _ BUILDING USE
t prove for Purpose of sale.). INDUSTRIAL WASTE INTER30.00 RES IND CON PB Other
(
ED 1,as own .er of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
- licensed contractors to construct,the project(See.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 of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00
ebntruets,fo,such projects with u contractor(s)licensed pursuant to -
The Contractor's License Law. SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO, PARCEL NO.
;❑ Ium exempt under See.• ,B.&P,C.for this WATER HEATER W/VENT
Rasnn •
0wni`r Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
T s WORKS RS'COMPENSA'II DECLARATION - WATER TREATING EQUIP. 5.00 . _
'I hereby affirm that I have a certificate of-consent to self-insure, ZONING
or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO.
- j espy Ihereof(Sec.3800,Lah.C.). �,�
Policy No. Company
❑ Cetlil'icl coP rcbyf n ctl. '�"/ FIRE SPRINK ' 'ENERGY T44
Z Z ❑ Certified y Ill, at in: on•division. MISC.- REFER TO ORD: '
O ix
Applicant Y❑ N❑ V ❑ NO
~ ran RK 7 - PERMIT ISSUANCE lAA9
C I.R' P CA'I'N OP E%EMPI'ION FROM WORKERS' Isal,�' FLOOD ZONE L A.L.u.C.
Eu COMPENSATION INSURANCE PLG.CONTR. - LIC.NO. PLG.
(L 0 I (1[,1, seclair need not be completed if the permit is for One - TOTAL' YF] N❑ Y ❑ N❑
D 2 hun,reddollurs(SI0()orl,ss.) - -
U O' I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
U- F- mit is issued;1 shall not employ:my.p,rson,in any rumour so as 1.
UW became subject to the Workers'Cnmpensul inn Luws of Cnlifomia.
d Data Applicata f �• BUILDING
} 0 NOTICE TO APPLICANT'. If,atter making this Certificate Of Ex ALTER OR ADD TO MECH. 5.00
F ?, ,rptlon,you should become sullied to Iho Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with, 'FEE
- U Such provisions or this pe nn it Shull be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4,00 , '
CONSTR UCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 'SEISMIC FEE � 03'
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 -
ttic performance of file work for which this permit is Issued(Sed MICROFILM
3097,Cis.CJ. " HEATING UNIT ITO 100,000 B.T.U.) '8.00
Lender's Nmne .HEATING UNIT(OVER 100,000 B.T.U:)9.50
Lender's Address - - - ELECTRIC ' 6CO
- I certify that I have read this application and state that the ahove VENTILATION FAN (SINGLE) -4-90
information is correct. 1 agree to comply with all city and county PLUMBING 3 60
ordinances and state laws relating to'building construction, and BOILER COMP(3 H.P.or 100,000 B.T.U.) 6.00 - I.
hereby authorise representatives of this city «s enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEESCH. MECHANICAL So
abovamentioned property for inspection purposely BOILER J
)I(We)'agree it, Saveindemnify and keep harmless the City of MISC.- "REFER TO ORD.
Cupertino against lit hilitics,judgments, costs .,,it expenses which use PERMIT ISSUANCE F;,yq;6g CONST.TAX
may m any ay accu" said,Ci ty in consuµronce of the
ranting o! 5 1niT. MECH.CONT. LIC.NO: ' MECH. ..
- rorAL. TOTAL
-\ Sign' re of Applidant/Ccfitractor Ute ,'I -
OFFICE COPY - '
POST-THIS'CARD NEA•R,FRONT OF, BUIL'D'ING
_ PERMIT,NUMBEH A'
-t. :CITy., 0F._•CUPERTIN0. i
INSPECTION DIVISION,
1:4532 .
1 JOB INSPECTION RECORD �._
MI
+< • • "+/ - .PERMIT EXPIRATION
'JOB ADDRESS UNIT# LOT#
PERMIT EXPIRES•IF WORK s;
owNER /� CONTRACTOR D nI C,fC�` IS NOT-STARTED.WITHIN I
I - INSPECTION - DATE INSPECTOR INSPECTION RECORD 1BU DAYS OFPERMIT ISSU-'.;
ANCE OR 180 DAYS FROM
FOUNDATION - Ci':•� NOTE:,
' UFER . 'r,� LAST CALLED INSPECTION.
.ALL GRADING AND DRAINAGE SHALL BE
PREGUNITE ..•/ o TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAULATION
,.,- _ CUPERTINO STANDARDS. - +;
GARAGESLABS. - -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ,�pq�y`-Qj- -t�q1S -
OL.-
UNDERGROUND /SLAB ' U 1
PLUMBING' <,•. - J
'r T
ELECTRICAL ISSUANCE LATE
MECHANICALt uLLG. ELIC,. PLC. Rif CH.of c1�o rx r�I��. , s Elq ,Q
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT
'• - 'WOOD FLOOR WkINFORMATION
ALUATION gIFT,
PLUMBING — — 1h4 STS: ,.�-r
MECHANICAL - -
ELECTRICAL , q P�eynHT To / -
RRAMI NG. .. _ r'ifX�!T1 cl
' 'INSULATION STORIES TYPE CONSTRr•,
�• [� Occ,GROUP- RES UNITS .y
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
- so ET.n.UoinnBa iorAL ACREArP.
I ROOF NOTE:NO FI AL INSP.SHALL BE M DE BEFORE
blAPRRAGM - THE CONSTRUCTION TAXIS PAID . '
• _ ' BLILDING.USE
�1 r ROOF SHEATHING:, ' - ! HEi NO CON PB 00111
;.APPLY NO ROOFII UNTIL'ABOVE'HAS"BEEN"SIGNED FINALS DATE 'INSP." E 1:1ASSESSORSPARCEL NO
ROUGH SAN.a
PLUMBING ELECT.ENERGY - "
PARCEL NO.
TRACT NO.
NUBS&SHOWERPAN '. �> - PLUMBING ENERGY
MECHANICAL '�Q -V ` MECH,ENERGYE ACC DATE ACC,FILE NO
• 'ELECTRICAL, - BUILDING'ENERGY
FRAMING — ( ELECT.FINAL TEST - 'ZONING ENC.SITE No.
INSULATIO ' PLUMBING ;
I'
GAS TEST GAS• - +
MECHANICAL FIRE SPRINK y EN[RGY T 24
COVERNOWORK UNTIL ABOVE,HASBEEN SIGNED HEATING" ,Y [D -NO' . ❑ NO,
EXTERIOR-SHEAR. - ELECTRICAL RELEASE PIDDo zoNe„ ' ILL u.c.
•� INTERIOR SHEAR _ • FIRE DEPT. �' >• Y[ N� � '.'JL N�
+tt SHEETROCK. 0; .) . GRADE _ - FEE SUMMARY
y r EXTERIOR LATH` _ ! '/. BUILDING ..
INTERIOR ,LATH TEMPORARY APPROVALS BUILDING
.'� SCRATCH,COAT ' ELECTRIC - PLAN CHECK
° FEE
' t� � •:,+. � . .. GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE. v
le � ',• OCCUP_ANCYOF BUILDINGISNOTPERMITTED UNTIL BUILDING"FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ...—
ARRANGE-FOR INSPECTION BY. PHONING 252-4505 ELECTRIC 4?'
�? o� ONE WORKING DAY BEFORE'REOU,IRED INSPECTION 11. PLumewc: ��`
PLEASE GIVE JOB ADDRESS.WHEN PHONING '
— SEE PERMIT FOR-EXPIRATION DATE--
CONST.
HANICA L.
CONST.TAX
\ IMPORTANT. .
�. PLEASE READ REVERSE SIDE BEFORE w
CALLING FOR FINAL INSPECTION.' .' TOTAL
OFFICE COPY.' r