15378 POST THIS CARD NEAR FRONT OF'BUI LDING . PERMITNUMBER
CITY _,OF_ CUPERTINO ' ` 15378
INSPECTION DIVISION
JOB INSPECTION RECORD
XX
' PERMIT EXPIRATION
e
JOB ADDRESS '10123 North WolfRnnc9 UNIT# �"X LOT#
AI . I -- . PERMIT EXPIRES IF WORK
OWNER AT &--IT - - � CONTRACTOR ' - � � � 'IS- NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-'�
FOUNDATION" _ •ANCE OR 180 DAYS FROM
- NOTE: -LASTCALLED INSPECTION. '
UFER, ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED,PLANS AND CITU OF PERMIT VALIDATION
PREGUNITE- " - CUPERTINO STANDARDS. -
GARAGE'SLABS - •ry
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - ' . "�•" `f :y ��
- +' '• rte•. .
UNDERGROUND /SLAB
PLUMBING -t r _ 1 ; I'\1 • �F,
ELECTRICAL r `, '�� ISSUANCE DATE`.
MECHANICAL�•` i �y aLRc : ELEcr, PLG. CH
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
- - INFORMATION
,WOOD FLOOR' '' VALUATIONlr, $iET.
PLUMBING - '' -
MECHANICAL - V
ELECTRICAL - - PERMIT To
FRAMING .. F�•s{rr�,'`"� 'tiw'„;`�C'
INSULATION - sroRlEs TYPE coNSTR.
i
. - - OCc.GROUP RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
50 fT,FLOOR AREA TOTAL ACREAGE
.; ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE -
'�. 'DIAPHRAGM 11 THE CONSTRUCTION TAX IS PAID.
ROOF SHEATHING ' - RES, INOUILRCON usEPE 0"",
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNEDA FINALS DATE INSP. ❑" El El E] 'E]
ASSESSORS PARCEL NO
ROUGH' SAN.p
PLUMBING '- ELECT.ENERGY _ TRACT No, PAR GEL No
•
TUBS&SHOWER PAN - PLUMBING ENERGY
MECHANICAL :MECH.ENERGY
ELECTRICAL . BUILDING ENERGY ACC.DATE ACC.FILE NO
.FRAMING „'jam ELECT,FINAL TEST ,zomwc ENC.SITE No.
INSULATION PLUMBING - -
" GAS TEST - GAS - FIRESPRINK ENERGY.T,24'
- - - MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ; El N-1:1 ` ❑ ND
EXTERIOR SHEAR � "_
.ELECTRICAL RELEASE ^_/y^�� • FLOOD ZONE A.L.U.C:
INTERIOR SHEAR FIRE DEPT. Y❑. N❑ ° ❑ � N❑
SHEETROCK - ' , GRADE '." FEE SUMMARY
EXTERIOR LATH "i BUILDING
INTERIOR LATH; TEMPORARY APPROVALS BUILDING , „F .q,
SCRATCH COAT _ ELECTRIC - PLAN CHECK
I _ - GAS - . . ..FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY,' 'SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTEDUNTIL BUILDING FINAL ISSIGNED BY;BUILDING INSPECTOR: ; MICROFILM .
ARRANGE•FOR INSPECTION BY PHONING 252-4505, ELECTRIC
F ' ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLUMBING
I
Z '. PLEASErGIVE'JOB.ADDRESS WHEN PHONING.SEE PERMIT FOR EXPIRATION DATE '= MECHANICAL
CONST TAX
IMPORTANT!
PLEASE READREVERSE SIDE'BEFORE � ° TOTAL , � a'r
,CALLING FOR FINAL INSPECTION:
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
' BO LDI NG PROJECT'fDENTI FICATION
PERMIT NUMBER '1
. B„,LppplllNG w� APPLICATION & PERMIT 15378
-
ADD RFSV/ ,3 N. Li 0 II re /ILJ�
(/ .Z 1 wA BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S
\I NgmE PLAN CHECK VALIpAj�ON
r p�^Ise rr ��D/ TY. ELECTRIC PERMIT FEE Al _ I/
CONTRACTORS [/�JN LCA
NAME T7 UTLETS-SWITCHES-RECEP 10.00/1.00
NO.1 3✓ Z- LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S
,_ AD REss ./ " ///(Q{ PBLIANCES-RESIDENTIAL 4.00
/ A PHON �il Al t PANELS 10.00 DATE OF APPLICATION
/
ARCHITECT/ c ?Z PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE :P.C:NO.
IT• .ENGINE
lu Kg LIC.NO.0 7/p
SIGNS TRANS. 3.00
ADDRESS ARCH.OR ENG. / r-e SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
3 014 E 7#006 s' C� �Z,k y EZ EMP.METER OR POLE INS. 20.00
A - MOTORS SEE FEE SCH.
ADDRESS DREES -
SERVICECHANGE 20.00
w ce O o LICENSED CONTRACTORS DECLARATION k'U-
FU w 1 hereby affirm that 1 um licensed under provisions of Chapter 9 A ISSUANCE DATE r'
<a (commence th 5 'on 70001 of Division 3 of the Business and •,s,`` 1 ,BLDG. ELELT. PLG. MECH.
H D i Professions o dm license is in full forge a 1 effec Z ,s LD r❑ ❑ ❑
o i�,D . Licen I Lin.Numbe d�
H w r w ate Contractor
owOWNER-BUILDER DECLARATION A C•a.. BUILDING PERMIT
w g LL y 1 hereby affirm that I not exempt from the Contractor's Licenso
M ISC.- REFER TO ORD INFORMATION
Hu Oj Law for the following reason. 703 L5,Businessand Professions PERMIT ISSUANCE 10.00 `VALUATION $/FT.
Z 'A0 Code:Any city or county which requires a permit to construct,alter, ��d6"
D ca ¢,i improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC.
Ou requires the applicant for such permit to file a signed statement that TOTAL PERMIT T
w m w he is licensed pursuant to the provisions of the Contractors License
Z a
Law(Chapter 9(commencingwith Section 7000)of Division 3 oflhe
4 D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
M the basis for the alleged exemption.Any violation of Section7031.5 STORIES TYPE CONSTR.
n ; _ by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not more than five hundred dollars($500).):
❑ 1,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-
mathsarenotintendedorofferedforsale If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden of proving that he did not build or int- BUILDING USE
prove for purpose of sale). INDUSTRIAL
IND CON PB Omni
❑ 1,as owner of the properly,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑
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 contraclons)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑. l am exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 `
reason
Owner' Date WATER SYSTEM 5.00
. ACC.DATE ACC.FILE NO.
WORKF.RS'COMPENSAT1ON DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to selhinsure,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
f
opy the of se 38 0 Lab.0 IoQ ❑ Certified copy reby furz Z ❑ Cerll ilhns rrfn� dlvlsi0h FIRE SPR INK ENERGY T.Y4
Op MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑
~ rn PERMIT ISSUANCE 10.00
LUCE IPICCOIPFNKAFIPTINSUFROM WORK F:RS' FLOOD ZONE '. A.L.U.C.
W � COMI'fiNSATION INSURANCIi PLG.CONTE.. LIC.NO. PLG. .
CL 0 (This section need not be completed if the permit is for nm, TOTAL Y C:] N❑ Y E] N❑
h u ad red dollars 1$100)or loss,) ,
U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued,I shall not employ any person in any manner so as to
Q L) become subject to the Workers'Compensation Laws of California.
y
Date-Applicant ALTER OR ADD TO MECH. 5.00 BUILDING LL�S'0
>_ m NOTICE TO APPLICANT: If,after making this Certificate of E.- 7
F.. ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 - PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MOC.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 .SEISM IC FEE 8
I hereby affirm that there is a construction lending agency I.. EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this permit is issued(S".. MICROFILM
3097,Civ.C.L HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATINGUNIT(OVER100,000B.T.U.)9.50 ELECTRIC
Lender's Address
1 certify that 1 have read this application and state that the above VENTILATION FAN ISINGLE) 4.00
information is correct..I agree to comply with all city and county PLUMBING
ordinance, and state laws relating to building construction, and BOILER-CUMP13 H.P.Dr 100,000 B.T.U:) 6.00
hereby autlmri, representatives of this city to enter upon the
above-mentioned property for inspection purposes. g01 LER-COMP IGVBr 100,000 BTU)SEE FEE$CH. MECHANICAL
(W6 agree to s' indemnify and keep harmless the City o1' MISC.- REFER TO ORD.
agar abilities 'uJgments, casts and expect s whi h CONST.TAX
4�uperlino
ay in an ay agar I said consect. aof he .PERMIT ISSUANCE '10,00
MECH.CONT. LIC.NO., MECH.
TOTAL TOTALgn roof Applicant/ContraL a[c '
OFFICE COPY