14512 POST THIS CARD NEAR FRONT OF BUILDING T PERMIT NumBEa
CITY OF- CUPERTINO 14512
INSPECTION DIVISION
JOB INSPECTION RECORD
• ` , ' - ., PERMIT EXPIRATION
JOBAD6RESS"10123 _N- WOLFE ROAD
WIN IT# . 2017 Lor# - -
NATURALIZER PERMIT EXPIRES IF WORK
OWNER CONTRACTOR COMMERCIAL SIGN$ IS NOT STARTED WITHIN
INSPECTION DATE INSPECTORINSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION. - NOTE:' ANCE OR 180 DAYS FROM
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECT ION...
- PR EGUN ITE _ -TO COMPLY WITH THE APPROVED PLANS AND CITY OF - PERMIT VALIDATION
GARAGE SLABS
CUPERTINO.STANDARDS.
., ` '� �
POUR,NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /'SLAB'
PLUMBING:
NI oo
ELECTRICAL -- Ns, DA
TE
MECHANICAL. - . . .., BLDG, ELEC . PLG., -MEcr+.
El o.
DO NOT POUR FLOOR UNTIL-ABOVE HAS BEEN-SIGNED BUILDING vBAM1T
WOOD FLOOR INFORMA ION
'VALUATION $/FT.
PLUMBING -
"' MECHANICAL'
ELECTRICAL PERMIT TO M
I
FRAMING" ,,r •.r'
INSULATION ns _ STORIE5 - ^ TYPE CONSTRI
OCC GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
Sp.FT FLOOD APEA TOTAL ACREAGE
. ROOF 'NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
I
ROOF SHEATHING ries " -BUILDINGUSEIND CON'. PIR Ou.r.
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ' FINALS' DATE INSP. ❑ El El ❑ El
ROUGH SAN.#
ASSESSORS PARCEL NO
- -_ '
PLUMBING - ELECT.ENERGY.
TUBS B SHOWER PANL'' PLUMBING.ENERGY r. TRACT No, PARCEL NO. .
MECHANICAL MECH.ENERGY
ELECTRICAL - BUILDING ENERGY _ .ACC,DATE ACC.PILE NO.
FRAMING ELECT.FINAL TEST
INSULATION ZONING- . ENGPLUMBING, - " i ,SITE
rNO.
GAS TEST GAS, '
"' MECHANICAL FIRE SPRINK "ENERGY T24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ "❑ , ° ❑ "❑
EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE A.L.U.C.
INTERIOR SHEAR. . "FIRE DEPT. - ` 'Y❑ - N❑ v"❑ N❑
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING y,
INTERIOR,LATH . - TEMPORARY APPROVALS BUILDING
- SCRATCH COATELECTRIC PLAN CHECK
` GAS 7 FEES 5 .•.
. - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR: MICROFILM
ARRANGE FOR INSPECTION BY PHONING'252-4505,. . ELECTRIC
H� •ONCWORKING DAY BEFORE"REQUIRED INSPECTION PLUMBING
.PLEASE GIVE JOB.ADDRESS WHEN PHONING., ''
ZMECH '
= SEE PERMIT FOR EXPIRATION DATE — ANICAL ..
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE ° " TOTAL
CALLING FOR FINAL INSPECTION. y
OFFICE COPY-
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION ,PERMIT NUMBER
BGILOING APPLICATION & PERMIT q A j
ADDRESS I 2
l� ,4'-' UILDING-ELECTRICAL-PLUMBING-MECHANICAL 4
OWNER'a PLAN CHECK VALIDATION
NAME -✓/fryX/'x QTY. ELECTRIC PERMIT FEE
fes"CRONE
pNTRAcaors UTLETS-SWITCHES-RECEP- 10.00/1.00
NAME
1�20u .Np,'1Q LIGHTING FIXTURES' 10.00/1.00
CONTRACTOR'S �{!p D 60F L' PPLIANCES-RESIDENTIAL - 4.00
ADDREsqs, µ^,0.a7,,0 r ,�yyqq[�_
` u // PRO OAJC.?� PANELS 10.00 DATE OF APPLICATION
ARCHITECT - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
OR
ENGINEER
LIC.No. ISIGNS TRANS. 3.00 ROQ
ARC".OR ENG, SPECIALCIRCUIT 5.00 PERMIT VALIDATION
ADDRESS
ZIP TEMP.METER OR POLE INS. 20.00
APPLICANTS ��� / L MOTORS SEE FEE SCH.
ADDRESS
C`je(,�Q S7 SERVICE CHANGE 20.00 4
woo LICENSED CONTRACTORS DECLARATION - - -
<u sFi 1 hereby affirm that I um licensed under provisions of Chapter 9 Y• ,
y< w (commencing with Section 7000)of Division 3 ol'the Business and BLDG. ELECT. ECH.
H N z Professions Cod an m 'cense is in full for, a fe L ❑
z o License Class�?�Lic.Numb r ❑ �, ❑
O z w Uatc_�_ Contract I', '
a y f BUILDING PERMIT
Pc II:w a OWNER-BUILDER DECLARATION INFORMATION .
wo A ea MISC.- REFER TO ORD
S a_s- 1 hereby affirm that I am exempt from the Contractor's License VALUATION S/FT.
H u m 4 Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE - - 10.00 I
Code:Any city orcounty which requires a permit to construct,
re aa ¢ 2 improve,demolish,or repuir any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. j�S kIJJ
is -D M requires the applicant for such permit to file a signed statement that TOTAL i MI O
K
$ he is licensed pursuant to the provisions of the Contractor's License
Hzi Law(Chapter 9(courmencingwlth Section 7000)olDivision 3 ol'(he '
a Busineu and Professions Code)or That he is exempt therefrom and QTY. PLUMBING PERMIT FEE
M r D the basis for the alleged exemption.Any violation of Section 7031.5
B RIE TYPE CONSTR.
a
3 by any applicant for a permit subjects the app licunt to a civil penalty
of not more than five hundred dollars(S5001.): ALTER-DRAIN&VENT-WATER IEA.) 5.00 -
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT..DEVICE 4.00 OCC.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 does not apply to an owner of
property who builds or improves thereon,and who does such work' FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mtsarenotintendedorofferedforsale.If,however,the building GAS-EA.SVSTEM-11NC.40UTLETS 6.00
en
or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 IEA) 2.00 BUILDING USE
builder will have . .
the burden of proving that lie did not build or im- RES IND CON PB Other
for purpose of sale.). INDUSTRIALWASTE INTER. 30.00 '❑ 1:1 El 1:1 1:1❑ I,as owner of the property,am exclusively contracting with -
'10eused 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 comraatur(s)licensed POMUant 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 Date WATER SYSTEM 5.00 ACC.DATE ACC FILE N0.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Issuance,ora ceHiI cd
-76 copy thereof(Sec.3600,Lab.C.).
Policy No. Company
O ❑ Certified copy is It q furnished. FIRE SPRINK ENERGY T-24
Z a* III, Cerlifie py 1 1 itll�(IT I� inspection division. MISC.- REFER TO ORD.
� Q Applicant YE]. NE:] Y ❑ N❑
OC CHRTIFICA'TE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE ' 10.00 FLOOD ZONE aL.u.c.
LU �_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. ,
CLO (This Section need oot be completed if Orn permit is for one _ TOTAL Y❑ N❑ I Y❑ N❑
D Z hundred dollars IS 100)or less.)
U O I certify that in the performance of the work for which this Per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
IL I- mit is issued.I shall nal employ any person in any manner so as to
O W become subject to the Workers'Compensation Laws of California. �1�x
Date applicant - BUILDING �/�/
} N NOTICE TO APPLICANT: If,after making this Certificate of
Ex- 00Sorption,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 be deemed revoked: AIR HANDLING UNIT ITO 10,OODQF.M.) 4.00
CONSTRUCTION LENDING AGENCYAIR HANDLING UNIT(OVER 100MC.EM.) 6.00 SEISMIC FEE
i
1 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.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 0�
Lender's AddressYr
1 certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00
. infatuation is correct.I agree to comply with all city and county BOILER-CUMP13 H.P.Dr 100,000 B.T.U.) 6.00 PLUMBING
ordinances and stale laws relating to building construction, and
hereby authorize representatives of this city to enter upon the BOILER-COMP(0ver 100,0008TU)SEE FEE SCH. .MECHANICAL
above-mentioned property for inspection purposes.
(We) agree to s indemnify and keep harmless the City of MISC.r REFER TO ORD.
uperthio against bit ties,judgments, costs and expenses which CONST.TAX
ay in any wa er agui 1 City in consequence of the PERMIT ISSUANCE' 10.00
C.
Y f tis MECH.CONT. LIC.NO. - MELH.
TOTAL ' TOTAL 30
ignatum of Appli n/ ontractor Date
OFFICE COPY