15349 POST THIS CARD NEAR FRONT OF BUILDING ;. 4 PFRIAITNUMBERt'-
'' CITY, OF CUPERTINO
_ INSPECTION DIV_ ISION, 15349
M JOB INSPECTION RECORD
• �'� ��I .' PERMIT EXPIRATION
JOB ADDRESS 10123 N. WOLFE ROAD ""UNIT#, 1" 'L LOT# . PERMIT EXPIRESIPWORK.
OWNER . D. J. I S _ comrancroR� - CIARI ' PLMB' '& HTG _ IS NOT'STARTEiD WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 16 DAYS OF P MIT ISSU=
FOUNDATION' - ANCE OR 180 CI FROM
NOTE: LAST CALLED INSPECTION,
LIFER - ' ALL GRADING AND DRAINAGE SHALL BE INSTALLED '
PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CIT�Q F. PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED " • +•�, l.d0/i;�•-� .
UNDERGROUND /SLAB
PLUMBING City
j +f
sof C 1pOk!IAD,
ELECTRICAL -
ISSUANCE'DATE
MECHANICALy e OLDG, ELECL. PLG. MECH.
❑ ❑ �' ❑.{
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
'7 INFORMATION
WOOD FLOOR
PLUMBING" AVLUATION $. IT.
"
MECHANICAL ' - -
.ELECTRICAL - - -• PERMIT TD,
FRAMING .` �.
INSULATION - „ ' STORIES TYPECONSTR.-
• OCC.GROUP. 7 RES UNITS
PLACE NO.SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
.
ROOF ':. . - NOTE:NO FINAL INSP.SHALL BE MADE-BEFORE so.FT.FLoaR AREA TOTAL ACREAGE y
DIAPHRAGM THE CONSTRUCTION TAX IS PAID- -
BUILDING USE
ROOF SHEATHING- '. RE'S IND CON PR 00",
APPLY NO ROOFING UNTIL ABOVE HAS BEEN.SIGNED FINALS DATE INSP: El El 1:1 1:1 .A ❑
ROUGH SAN.a
ASSE55ORS PARCEL NO - -I
' � _
PLUMBING - SA• ELECT.ENERGY ' - -
TRACT
NO. PARCEL NO -
TUBS 8 SHOWER PAN- _ PLUMBING ENERGY : p-
MECHANICAL - MECH.ENERGY
ELECTRICALBUILDING ENERGY - ACC.DATE' ACC.FLLENO.
FRAMING ' •• ELECT,-FINAL TEST -
ZONING y.ENG.SITE NO.
INSULATION PLUMBING
GAS TEST • - GAS
MECHANICAL,
FIRE SPRINK .ENERGY T 24
t.. �
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING , Y ❑ N❑ `•❑ N�''
EXTERIOR SHEARFLOO
ELECTRICAL RELEASE D; C
ZONE A L;U. .
INTERIOR SHEAR FIRE DEPT. Y❑ N❑ " . 'YL N❑;
SHEETROCK GRADE - FEE SUMMARY
, EXTERIOR LATH BUILDING
.INTERIOR LATH TEMPORARY APPROVALS• BUILDING L
SCRATCH COAT , - ELECTRIC PLAN CHECK
GAS _ FEE -
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - ,' ; . SEISMIC'FEE Ty
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM„
LU ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC . ;
ONE WORKING DAY BEFORE REQUIRED INSPECTION PLUMBING
z %PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATIONDATE — -MECHANICAL
IMPORTANT! CO.NST,TAX,.
PLEASE READ REVERSE SIDE BEFORE j
CALLING FOR FINAL INSPECTION. TOTAL'
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT 1 DENT]FICATI ON J .PERMIT NUMBER..
aoDREss
aD""n APPLICATION & PERMITJZp - LF A
�
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL is
O NE V'a c5fmc. _zI.2I PLAN CHECK VALIDATION
HONE OTY• ELECTRIC PERMIT FEE
CONT. . • • PHONE
JAMScrORs OUTLETS-SWITCHES-PIECED 10.00/1.00
aME t
.W i-
LIC.NQ. LIGHTING FIXTURES 10.00/1.00 _
CONTRACTOR'S
ADDRESS PPLIANCES-RESIDENTIAL 4.00 _
PHONE PANELS 10.00 DATE OF APPLICATION
ARCHITECT
OR PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO..
ENGINEER"
LiC.NO. SIGNS TRANS: 3.00 „rylp
AR: :SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
ADDRESS
ZIP TEMP.METER.OR POLE INS. 20.00 1QI`�yv� , 1�s
ADDRESS Ts MOTORS SEE FEE SCH. I(ql, 11'' W�MT"c�
SERVICE CHANGE 20.00Cupeft (I
o 0 z �
h w 0 LICENSED CONTRACTORS DECLARATION
H <U U I hereby affirm that I am licensed under provisi of apter 9 ISSUANCE DATE
w (commencing with Section 7000)of Divisi nes,and BLDG. ELECT. PLG. MECH.
r w Z Professions Co
mi I y license is NI full ❑ ❑ E ❑
O m w� ' Licen las Lic.Numb
I-w Date Contract
Q m w BUILDING PERMIT
a 0 w OWNER-BUILDGR DECL ATION INFORMATION
F.
Ihereby affirm,ihal I am exempt from the Contractor's License MISC-- REFER TO ORD
F LLO'Q Law for the following reason.(See,7031,5.Business and PtOfl'S,IDns VALUATION $/FT.
� m0� Code:Anycityorcounly which requires a permit to construct,alter, PERMIT ISSUANCE 10.00
re
R Q'p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0.'
c,LL requires ole applicant for such permit to Elva signed statement that TOTAL
o- m he is licensed pursuant to the provisions of the Contractor's License PERMIT TO
.ca La.(Chapter 9(commencing with Section 7000)of Division 3 ofthe
4 D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING'PERMIT FEE
H the basis for the alleged exemption.Any violation of Section 7031.5
S STORIES TYPE CONSTR.
n ; � by any applicant fora permit subjects the-pplicannoacivil penalty STORIES
5.00
of not more woethan five the prop rty,or
(my employees
-
❑ I,as owner at the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00
inter sole compensation,will(S the work,and the structure is not OCC.GROUP RES.UNITS
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[hereon,and who does such work FIXTURES-PER TRAP 5.00 SQ.FT.FLOOR AREA TOTAL ACREAGE
• himself re through his own employees,provided that such improve
or nts improvemenotnt is sold or within ted one or year o If, thebuildingo nee- GAS-EA.SYSTEM-.1 1NC.4OUTLETS 6.00
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that he did not build or im, GAS-EA.SYSTEM-OVER 4 (EA.) ,2.00 BUILDING USE
prove fors owneeof sale.). INDUSTRIALWASTE INTER. 30.00 ' RES IND CON PB orae.
❑ d as owactors the property,tan exclusively con@acting with - ❑ ❑ , ❑ ❑ ❑
licensed contractors to construct the project(Sec.7099,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS FARCE L 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 contractor(s)licensed pursuant to
the Contractor's License Law: SEWER-SANITARY-STORM EA.200ft/10.00 TRACT No. PARCEL No.
❑ lam exempt under See.-,B.&P.C.for this WATER-HEATER WALGW"T 6.00
reason
- Owner uy-
Date WATER SYSTEM 5.00 -
ACC.OATE ACC.FILE NO,
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 -
1hereby effi rm Ihat 1 hove a ter 'cute of consent to self-insure. _
or a certificate of Worker'Co -tion Insurance,or u certified - ZONING ENG.SITE NO.
copy thereof( ec. Qa
,),Policy No.❑J�c��tilied bmeshed. FIRE SPRINK E_NERGV T-
Z Z l�Certifie le wiW...yle city in'speclion division. 24
pO . Applicu MISC.- REFER TO ORD. - v ❑ N❑ Y ❑ nl❑
m CERTI LATE OE EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.001 FLOOD ZONE A.L.0 e.,
IL 0 (This sealidm need nett bc)COOmple cd"f tl tile is for one ONTI� LIC.NO. . TOTAL I� T� V❑ N❑ Y ❑ N❑
ao
U 0 hundred dollar,(S 100)or IessJ -
I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT 'FEE FEE SUMMARY
LL F mit is issued,I shall not employ any person in any manner so as to
U become subject to the Workers'Compensation Laws of California.
0 y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
>_ W NOTICE TO APPLICANT: If,after making this Certificate of F.- '
_ emption,you should become subject to the Workers'Compensation APPLIANCE 500 PLAN CHECK
p .
roFEE
visions of the Labor Code, you must forthwith comply with
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.NL) 4.00 -
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 pc,fornance'of the Work for which this permit is issued(Sec. MICROFILM
Lender's Na
3097,r's Name , - HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Address HEATING UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC '
. 1 certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 �� r
information is correct.I agree to comply with all city and county PLUMBING
ordinances and state laws relating to building construction, and BOILER-COMP(3H.P-or 160,000B,T.U.1 6.00
hereby authorizepresenialives of this city to enter upon the BOILER-COMP'IOvar 100,000 BTU)SEE FEE SCH. .
above-merino oper rInspection purposes., MECHANICAL
e so , in mnify and keep harmless the City at MISC.- REFER TO ORD.
_ perti In bilit a,judgments,'costs and expenses which CONST.TAX
in i a wa ace against said City in-conwqucnce of the PERMIT ISSUANCE 10.00
into this crm' MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL 2(v�
I ate of Applicant/Contractor Date �
OFFICE COPY,