16900 POST THIS CARD NEAR FRONT".OF BUILDING `
PERM,T N..TIER
CITY 'OF.CUPERTINO. s• 1,6900
INSPECTION,DIVISION
JOB INSPECTION RECORD .
PERMIT EXPIRATION
�9CD0 SUNDFhiIitMC� t..
JOB ADDRESS "UNIT# - _LOT#1. -
.. 1� - 'PERMIT EXPIRES'IF WORK' `
,\ OWNER CONTRACTOR I's NOT STARTED WITHIN
INSPECTION DATE ANSPECTOR ` INSPECTION RECORD 166-DAvsDF-PEkMrlssu '-
FOUNDATION. 'r' - . ` ANCE'OR 180 DAYS FROM'.
_ NOTE. ; ; - LAST CALLED INSPECTION.
LIFER ALL GRADING AND.DRAINAGE SHALL.BEINSTALLED
. , PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF NERmrtyv LUTnnory
CUPERTINO STANDARDS:
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED. - p��±'p qq •1'.. F'� �f j.`' '`I i
....'.UNDERGROUND'/SLAB .FEU 21 i x
t:.l
PLUMBING
ELECTRICAL„
City,otCupe inD SSUANCEDnTE
MECHANICAL ' - _ - eLoc.. FLEcr PLc, mECR,
DO NOT POUR FLOOR'UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR - INFORMATION
VALUATION' .SIFT.
1- 1T l''.'� PLUMBING;
MECHANICAL' 'r � •
ELECTRICALi
FRAMING - I m�44
INSULATION - Sro IES TYPE CCNSTR.IT
.. . '
• UCC.GROUP HFS UNITS
,PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
50.FT.FLOOR AREA TOTAL ACREAGE .
r-ROOF+ s;, : NOTE:-NO'FINAL INSP.SHALL BE MADE BEFORE TOTAL,
DIAPHRAGM',. THE CONSTRUCTION TAXIS PAID -
- , - - BUILDING USE. 0,
ROOFSHEATHING' . - ' +es• IND cON PR om.,
G " - GAPPLY'NO ROOFING UNTIL,ABOVEHAS`BEEN,SIGNEO FINALS ,. , -DATE' 'INSP" ❑ ❑
ASSESSORS PARCEL NO. 1 ;
I ROUGH- - SAN.# '
PLUMBING ELECT,ENERGY
TUBS&SHOWER"PAN , PLUMBING ENERGY 'TRACT NO. PARCPL NO
MECHANICAL '• "A MECH.,ENERGY
1 ELECTRICAL '- ACC,OATE •.AcQRILE No.
"%Z— BUILDING ENERGY
- FRAMING - ' • ELECT.FINAL TEST -zoNlNc ENG,SITE No..
INSULATION - PLUMBING
GAS TEST . p. GAS -
MECHANICAL FIRE SPHINK ENERGY T za -�
N[]COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING rv�
EXTERIOR-SHEAR, - '; ELECTRICAL RELEASE - ,FLOODZONE A.L,.0 C.
INTERIOR SHEAR - FIRE DEPT.. Y❑ _ N� y ❑ ' N❑.
SHEETROCK - GRADE FEE SUMMARY F
EXTERIOR LATH, BUILDING - ,BUILDING -
INTERIOR LATH . - TEMPORARY APPROVALS
--h - -. ,SCRATCH COAT ELECTRIC PLAN CHECK
.. - .
GAS
FEE
I - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. ._SEISMIC FEE,. '• i
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDINGINSPECTOR. MICROFILM
LU `; ARRANGE FOR INSPECTION BY PHONING 252;4505, ELECTRIC
WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
~O
Z PLEASE GIVE JOB ADDRESS WHEN PHONING..
SEE PERMIT FOR EXPI RATION,DATE — MECHANIcdL '
- CONST TAX ,
IMPORTANT! ', 4
PLEASE READ REVERSE SIDE BEFORE , xt} ? TOTAL f�
CALLING FOR FINAL INSPECTION.
I " OFFICE COPY / .
i —
APP•�k ANT TO FILL IN INFORMATION WITHIN RED,LINES.- USE BALL'POINT PEN ONLY
♦ PERNUMBER
1 BUILDIEs N13PR07EL*T IDENTI FICATION , .APPLICATION'& PERMIT '
omLDIN[: ,
t goDREss
• r
� BUILDING—ELECTRICAL—PLUMBING—MECHANICAL :16900
,t '
OWN
I a HANE SI \ I M PLAN CHECK VALIDATION
• - L Q Y...f 1 - ELECTRIC PERMIT . u FEE r' '
PMO
CONTRA CTO
rvgM y OUTLETS-SWITCHES-RECEP 10.00/1.00 •' ! .
I' tic. �/ LIGHTING FIXTURES', 10.00/1,00 ,
CONIHAtfO.S PPLIANCES-RESIDENTIAL 4.00
P R
j t�/ aR0 PANELS 10.00 DATE OF APPLICATION:'�
.: OOPcnfTscT _ _ PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE :P.C:NO.
I ENGINEER � �• �.
l¢.NO. ' SIGNS TRANS. 3.00 . 1
neo Ess grvc, SPECIAL CIRCUIT - 5.00 PERMIT VALIDATION ,
ziP EMP.METER•OR POLE INS. ` 20.00
' APPLICANT'$ • :, '+ ^n
aODREss , + - +MOTORS .SEE FEE SCH. - �•�ra-ra-iucc,i
_- •" SERVICE CHANGE - 20.00 rLI2i ISO
o o LI C LN SCD CON'I'R ACTORS DBCLA R ATI ON
a o u 1 hereby affirm that 1 am licensed under provisions Of Chapter') O� •I ISSUANCE GATE
H z w [commenei wdh Semi n 7000)of Uivisinn 3 of the Bu'nz nd
¢h - `BLDG. ELECT: PLG. MECH.
F H z FEB
Professiony9(ll�n�JtI yryp license is in full li f ❑ ❑ ❑
zo i m a License CI6�r�_(„f_[�L_Lic Numb -
_ Date Cortmmor City of Cup rti
'¢ se s - - - BUILDING PERMIT
g a, n a OWNER-BUILDER DECLARATION , INFORMATION
w -I hereby affirm that I um exempt from the Contractor's License TMISC,— - , REFER TO ORD VALUATION
IL o ¢ Law for the following reason.(Sec.7031.5,hosinessand Professions pERMIT ISSUANCE '10.00 '$/FT.
� -w Code:Any city or county whichreluiresa permit to construct,alter,
¢ ¢,o improve,demolish,or repair tiny structure,prior to its is lance,also ELEC.CONTR. - LIC.N0. - ELEC. J
.,d, u requires the applicant for such permit to file a Signed statement Ihur .. TOTAL pERMIT TO 'E
w$ he is licensed pursuant to the provisions of the Contractors License
H t a Law(Chapter9(conmtencingwitl,Swtion7D00)of Division3ofthe , `Nq
Business and Profzssions Code)or that hth
e is exempt forefront and CITY. PLUMBING PERMIT - FEE '1' LI11b i
H 6f
¢ =$ the basis for the alleged exemption.Any violation of Section 7031.5 f; �y STORIES TYPE CONSTR.
w. by any applicant for it permit subjects the applicant toacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 s
of not more than five bund red u.11TRIS($500).1: ° '' -
❑ 1,as owner of the property,or my employees with wages as
their sole compensation,will do the work,and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP^ RES.UNITS
intended or offered for sale (Sec.-7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,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 5.00SQ FT.FLOOR qfl EA .TOTAL ACREAGE
himelf or Ihmugh his own employees,Provided that Stith immove- _ -
mentsareart intended oroffered for sale.11,however,the building GAS-EA.SYSTEM-11 NC.4'OUTLETS 6.00
/- or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 (Ek) 2.00
builder will have the burden of proving that he did not huild or ire - .- BUILDING USE
RES IND CONPB ,Other
prove for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 • 1:1❑ 1,as owner of the property,am exclusively contracting with
licensed cartmetors to,construct the project(Sec.7044, Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Codm The Contractor's License Law does not apply - e
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 '
contracts for such projects with a contractors)licensed pursuant to a
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCELNO. -
❑ Iamexcmptundcr Sec. ,B.&P.C.for thisWATER HEATER W/VENT tT
reason
Owner - Dam WATER SYSTEM ,5.00 Ace.DATE ACC.FILE NO
WORKERS'COMPENSAT'ION DECLARATION WATER TREATING EQUIP. 5,00 -
-, I hereby uRirm MA,] huve a ecrlificum of consent 1O self-ins, - -
or acertificate of Work.i Compens'I i 1 sur mz or a ca Y ed — ZONING ENG.SITE NO.
copy I1��ywpq�s
0 ❑ art m y' to •b famished. 'FIRE SPRINK ENERGY T�20
Z Z erti0cd c Iy II' i0 H 't cti t
O A Ilicant" MISC:- _ REFER TO ORD. � .'y �. . NO •Y ❑ NQ
~ rn PERMIT ISSUANCE _'0.00
. � — CF.R ' t ATI:OFIiXEMPfION FROM ORKIiRS' FLOOD ZONE A.L.u.O.
.L 7 COMPENSATION INSURl N PLG.CONTR. LIC.NO. I.G.PV O N O V N
Z
if tion need not he completed if H c permit is for one TOTAL ,//T/
hundred dollc,S(S 100)or Itss.)
L) O 1 certify Hwt in the performance of the work for which Hits per- CITY. MECHANICAL PERMIT - :FEE, FEE SUMMARY
LL {- mit it issued,I skull not employ any person in any manner so as to
O W become subject to the Workers'Compensation Laws of California.
- a.--, Date' - Applicunl ALTER OR ADD TO MECH. 5.00 BUILDING ,
} N
NOTICE TO APPLICANT: If,after making this Certificate of IN-
F,Z-�
e,nption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
'prlslons oI (he Luber Code, you mus( I'otlhwith comply with FEE '
U sucovh provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 '
..CONS'1'ROCIION LENDINC AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
1 hereby affirm that there is a construction lending agency lit EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.), - HEATING-UNIT(TO 100,000 B.T.U.) ' 8.00
Lender's Nam. HEATI NG UNIT 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I certify that 1 have read This application and slue that the above VENTILATION FAN (SINGLE) 4,00
information is correct. I agree to comply with all city and county g01LER-CUMP(3 H.P.Or 100,000 B.T.U.) 6.00 PLUMBING -
ordinances ad state laws rel,ling to building construction, and ..
hereby uueorize represcnlu0ves Of this city to enter upon the BOILER-COMP (Over 100,000 BTU)'SFE FEE SCH. MECHANICAL
uhove-men toned property for inspection purposes' .
(We) ag . to acts, indemnify and'keep harmless theCityof MISC.- REFERTO ORD:
GJ perhoo a last liabilities,judgments; costs and expenses which PERMIT ISSUANCE 10.00 - CONST.TAX
m
ay ay accrue against Said City in consequence of the _
ting of penniL MECH.CONT. LIC.NO, MECH.
TOTAL TOTAL Q
Applicant/Contractor Date
OFFICE COPY