13945 -POST THIS,CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
- L CITY OF CUPERTINO 13945
INSPECTION DIVISION
JOB INSPECTION RECORD
L PERMIT EXPIRATION 1
J�1/l1•
JOB ADDRESS 70123 N. Wnl fa Road 1 UNIT# LOT#
PERMIT EXPIRES IF WORK
OWNER FOX Photo CONTRACTOR' S.L." Builders. ISNOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSPECTION RECORD - 180 DAYS OF PERMIT ISSIr.
FOUNDATION - ANCE OR 180 DAYS FROM
LIFER '
LASTCALLED'INSPECTION.
PREGUN TE - PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I
UNDERGROUND/SLAB � � { S
I.
PLUMBING
ELECTRICAL - " IssuANCE UnrE I_
MECHANICAL BLDG. ELECT. PLG. MEC14
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING VALUATION - $IFT,
MECHANICAL
ELECTRICAL - vERMIT To
FRAMING.• '
INSULATION - STORIES TYPE CONSTR.
7.
' OCC.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO Fi.FLOOP'AREA ' TOTAL ACREAGE
ROOF
DIAPHRAGM '
BUILDING USE
_ RES IND CON PS 00",
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ 11
ROUGH ASSESSORS PARCEL NO.
PLUMBING
GAS TEST TRACT N0, PARCEL NO.
MECHANICAL -
NO.
ELECTRICAL � FINALS DATE INSP. ACC.DATE ACC.FILE
FRAMING - - ' `' SAN,#
ZONING ENG.SITE NO.
' INSULATION PLUMBING
GAS' I
,. MECHANICAL FIRE SPRINK ENERGY T 24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' ❑ N❑ I Y ❑ N❑
LATH—INTERIOR ELECTRICAL FLOOD ZONE A.L.U.C.
' LATH—EXTERIOR FIRE DEPT. Y❑ "EJ Y ❑ N❑
SHEETROCK GRADE' FEE SUMMARY
. SHEAR INTERIOR - BUILDING
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING �a!i�1
- FIREWALLS - ELECTRIC PLAN CHECK
GAS - FEE 1..3.- .
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY+BUILDING INSPECTOR. MICROFILM -
-ARRANGE FOR INSPECTION BY PHONING 252-450 , r ELECTRIC
ONE WORKING DAY BEFORE REQUIRED INSPECT"ON. PLUMBINGF�
o PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE — '.
IMPORTANT!
CONST.rnx
PLEASE'READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. ��•%
,I - OFFICE COPY '
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
DOILDING APPLICATION & PERMIT
&/.g < 13945
BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
NCITY. ELECTRIC PERMIT FEE
A
^D P OTO PNONEZ.
NAMERACTofls UTLETS-SWITCHES-RECEP 10.00/1.00
U J- e S uc.rvo.J LIGHTING FIXTURES 10.00/1.00
roNTRACTOR's
C#STflor,4AA Noy APPLIANCES-RESIDENTIAL 4.00 '
AOORE55
pa3. 72' d�i'e�S3g/3� PANELS, 10.00 DATE OF APPLICATION
OR
PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER e_- uc NO, SIGNS TRANS. 3.00
noonEss ENG' SPECIALCIRCUIT 5,00
PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APPLICANT'S
ADDRESS MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
_ U
wO o LICENSED CONTRACTORS DECLARATION - -
rt u u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUA CE GATE
w a n (commencing with Section 7000)of Division 3 of the Business and siBL'DG! / _ u I PLG. MECH,
Z H m z Professions Code/ d my license is inA01 -
f I. ',{_„- O ❑ ❑
O y - License C ass�7/;r.;� Lie.N4 mwDutS7LContry ��((%% BUILDING PERMIT
¢ ¢ U s OWNF.R-BUILDER UION
sono MISC.- - REFER TO ORD INFORMATION
X
; H I hereby affirm that I am exempt from the Contractor's License
x VALUATION $/FT..
F u_N j Law for the following reason.(Sec 7031.5,Businessand Professions PERMIT ISSUANCE 10.00
Code:Any city or county which requires a permit to construct,alter,
Q aa¢Q Improve,demolish,or repair any structure,prior ID Its issuance,also ELEC.CONTR. LIC.NO. ELEC.
O e, requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
K
$x he is licensed pursuant to the provisions of the Contractor's License
Hi> Law(Chapter 9(commencingwith Section 1000)ofDivision 3 ofthe
a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
re F$ the basis for the alleged exemption.An
ge p yvinlalion of Section 7031.5 STORIES TIPE4VNST..
by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00
of not mote than five hundred dollars($500).):
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCG.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who docs such work FIXTURES-'PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
meats are not intended or offered for sale.If,however,the building
or improvement is Sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4(EA.) ' 2.00 BUILDING
builder will have the burden of proving that Ise did not build or im- BULDIG USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 flE5 IND CON PB Omar
❑ 1,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:The Contractor's License Law does not apply
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 contractods)licensed pursuant to '
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ I am exempt under Sec..,B.&P.C.for this WATER HEATER W/VENT 6.00
reason
Owner Late WATER SYSTEM - 5.00
-ACC.DATE ACC.FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate ol'cnnsent to self-insure, ZONING ENG.SITE NO.
or a certificme of Workers' rel T' vrznnce,or a certified
'copy t�C[9t see 3800,Lah. .
Policy pkf!/J S S O:omp
(] ❑ Cert-Ifo copy is he (shed. - FIRESPRINK ENERGY T"24
Z Z O Certified copy is Qd with the city inspection division. MISC.- - REFER TO ORD.
0 Applicant Y❑ No , Y ❑" N❑
� y CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LLJ ? COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
0-Z ' (This section need not be completed if the permit Is-for one TOTAL Y L] N❑ Y[:] N❑
hundred dollars($100)or le.)
U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I Shall not employ any person in any manner so as to
O become subject to the Workers'Compensation Laws of California. rye
Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING JI/
} y NOTICE TO APPLICANT: If,after raking this Certificate of Ex- P
? enmp ion,you should become subject to the Wi rkeld Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE p7/
C..1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00 113,
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ.CJ.
Lender's Name -
Lender's Address HEATING UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC
I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00
information is correct.1 agree to comply with all city and county PLUMBING
ordinances and state laws relating to building construction. and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorizesrepresentalives of this city to enter upon the BOILER-COMP Over 100,000 BTUI SEE FEE SCH. MECHANICAL
above-mentioned properly for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs an J expenses which CONST.TAX
Amay i way accrue,against sai�Citym quence of thePERMIT ISSUANCE 10.00t it t. MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL
Ignalure of Applicant/Contractorto
OFFICE COPY '