15980 POST;;THIS`CARD,NEAR 'FRONT OF.BUILDING
'P ERMIT'NUMBERP
' ' CITY OF, CUPERTINO I5980. .
INSPECTION DIVISION
JOB.INNSPECTION RECORD
I
PERMIT EXPIRATION. '
- JOB ADDRESS�O�oZ_i ' "WOG.{-C' •/�.1J - ? UNIT# .'LOT# ' ' -
"PERMIT,EXPIRES IF, WORK
'OWNER f;:�Co� N � S s —Tc q/ / IS,NOT'.STARTED WITHIN-1
R} �S '_ CONTT RACTOR
INSPECTION DATE INSPECTOR INSPECTION REC D S J7` 180-DAYS OFPERMIT ISSU- '
FOUNDATION * - - ANCE OR.'�180'DAYS,FROM
NOTE: - : LAST CALLED INSPECTION:
LIFER - - .� ALC GRADING.AND;DRAINAGE SHALL'BE INSTALLED: '
PREGUNITE , TO COMPLY WITH THE APPROVED PLANS,AND CIT'OF PER n9T VALIDATION
'f ' CUPERTINO STANDARDS
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' L,�
'- ' •UNDER
GROUND 7SLAB"
{
j, IF
PLUMBING - -�„ ,
ELECTRICAL Y IssUANCE LATE
M
BLLU� ELECT.' -
. . ECHANICAL ' ' � - '- � � PLG MECM,'
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT -
r, INFORMATION
WOOD FLOOR .vALunnoN ': sIET
- PLUMBING - - __- . -
' MECHANICAL.- - + •� 1� °
" ELECTRICAL
" FRAMING
INSULATION ` + , TYPE CONSTR.
OCC.GROUP RESUNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sq ET FLOOR AREA roTAcACREAGE•' -
` , THE CONSTRUCTION'TAX IS PAID "
S.� DIAPHRAGM - - v
B W LDING.USE
ROOF SHEATHING , _ RES' ,IND CON PB
APPLY NO ROOFING UNTIL'ABOVE HAS BEEN SIGNED FINALS :R ` DATE -INSP El .❑ ❑ Q 1
ASSESSORS'PARCEL NO. ,
ROUGH SAN.#
PLUMBING - " ELECT,ENERGY; -
TRACT'NO • ""
TUB$BSHOVVER PANPARCEDN0.
,' - ' -,.i. PLUMBING ENERGY � -
MECHANICAL t MECH.ENERGY •�• - -
. _ 1 _ ACC:;OATE' ACC.FILE NO. 'St
ELECTRICAL - BUILDING ENERGY ' - -
FRAMING ' - ELECT.FINAL TEST-- e . -
ZcING ENG,SITE NO.
INSULATION ., - PLUMBING
GAS'TEST' - GAS - r
a
MECHANICAL i + .FIRE SPRINK ENERGY'r.za `.I -
'COVER NOWORK.UNTILABOVE HAS BEEN SIGNED HEATING :a Y'O_. N[ '' '° n NO
EXTERIOR SHEAR " - ELECTRICAL RELEASE
FLOOD zorve AC•u:c.
INTERIOR'SHEAR _ I FIRE DEPT! - �w � N� Y �] -rv0
SHEETROCK ,. -- v "' GRADE FEE SUMMARY _A
EXTERIOR LATH BUILDING' - - - -
- ' INTERIOR.,LATH- � � �' �
TEMPORARY,APPROVALS euiLDlNc "
' . 'SCRATCH COAT '- - ELECTRIC•,- PLAN CHECK +
GAS, FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY... SEISMIC
OCCUPANCYOF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR.
MICROFILM
. r
ARRANGE'•EOR "INSPECTION-BY PHONING"252-4505 . ELECTRIC
F 'ONE"WORKING DAY BEFORE REQUIRED'INSPECTION. P�uMBINc
C O� PLEASE GIVE JOB:ADDRESS WHEN'PH0NING: i+
..' Z tg
,SEE PERMIT.FOR•EXPIRATION DATE,
IMPORTANT! coNsT.Tnx-
� I .
'P,,LEASE-READ;REVERSE SIDEBEFORETOTAL
-
CALLING FOFINAL,INSPECTION.c,,
R -'
OFFICE COPY, " `
APPLICANT TO FILL IN INFORMATION WITHIN REDLINES = USE BALLPOINT PEN ONLY
BUILDING PROJECTIDENTIFICATION - - ,-PERMIT NUMBER •
DR NG APPLICATION &PERMIT ' ' 15980 C�� O'
ADMDRESS• „� , n I J
d Ir QL BUILDING—ELECTRICAL—PLUMBING—MECHANICAL .. .
M1 ,
OWNER 9
PLAN CHECK VALIDATION
DTV. ELECTRIC PERMIT. FEE n
$ co NT
]n NAMEI cTORs - W1Ca OUTLETS 10.00/1.00 1
NAME 1
T N _-S c.NO,-?76790. LIGHTING FIXTURES 10.00/1.00
ADORESS _APPLIANCES-RESIDENTIAL.
4.00 -
If Q UIQ PHONE B38�� PANEL$ 10.00 DATE OF APPLICATION 1
ARCHITECT• 1- - PLAN CHECK FEE FC NO
OR PANELS (OVER 200 AMP):. 20.00
ENGINEER - -
- LC NO. SIGNS TRANS. - 3,00 .ARCH.OR ENG. - -
ADDREss - _ SPECIAL CIRCUIT - 5.00 - PERMIT VALIDATION
ZIP
TEMP.METEFiORPOLEINS: - 20,00
APPLICANT'S
ADDRESS 5' 'Jp MOTORS SEE.FEE.SCH.
BC, COU T SERVICE CHANGE 20.00
wo o LICENSED CONTRACTORS DECLARATION
¢ U. - 1 hereby affirm then Pam licensed under provisions Of Chapter 9 ' ISSUANCE DATE I ('
(commencing with Section 7000)of Division 3o the Business and 'BLDG. . ELECT. PLG. MECH.
H o z� Professions C a Sidi cense IS in.full tor�'e,"ynyd��ff'fy�j-, .'
z z O Lwensc Class Lm. Tactor ,>-io El 1:1 JP
-
o I- w Date _Contractor . - w
¢ " � A BUILDING PERMIT
a/ sysve.t, P
tt le w OW DECLARATION - - v NFORMATION
w.;LL a, I hereby affirm that 1 am exempt from the Contractor's License MISC.— REFER TO ORD
u O Sr Law for the following reason(Sec.7031.5,Business andProfessions ALUATION $/FT.
fwy2 Code:Any city or county which renciresapermit to construct,alter
PERMIT ISSUANCE 10.00 '
ly Q O Improve,'demolish,or repair any structure;prior to its issuance,also ELEC.CONTRt LIC.N0. - - { Dol— -,
ELEC. DI
i iE au O ¢ requires the applicant for such permit to file a signed statement that - TOTAL' l 1 �PERMIT
w m he is licensed pursuant to the provisions of the Contractor's License
_iQ Law(Chapter9(commencing with Section 7000)of Division 3 ofthe ? e
4 0, Business and Professions Cade)or that he is exempt therefrom and OTY. .PLUMBING PERMIT FEE •t
arch the basany
the Sara exemption.Any tsthea plica otooction malty .I STORIES' TYPE CONSTR.
031.5
n"3� by any applicant fora permit subjects th500o.)canitoacivil penalty ' ALTER-DRAIN&VENT-WATER (EA.), 5.00
of not more than five hundred dentals(5500)J,
❑'.L as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICEr 4.00 OCC.GROUP RES.UNITS
their Sole compensation,will do thowork.and One structure is not
intended or offered for sale (Seo.e7044, 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 docs such work FIXTURES-PER TRAP - n S.00 SO.FT.FLOOR AREA TOTAL ACREAGE,
himself or through his own employees,provided that such improve-
. ments are not intendedor offered for sale.If,however,One building GAS-EA.SYSTEM-I1NC.40UTLETS 6.00
or,improvemen Pis,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 for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND '• CON PB _ Orner -
❑ 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:Tine Contractor's License Law does not apply
to an owner of property who,buildsor improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 -
- contracts for such Projects with a contractors)licensed pursuant to - '
the Contractor's'License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ I'amexemptunde}Sec. ;B.&P.C.for thii WATER HEATER W/VENT • 6.00
reason
s Owner Date WATER SYSTEM ' 5.00 - ACC.DATE ACC.FILE No.
WORKERS;COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1,_ I hereby affirm that I have a certificate of consent to self-insure,
or a certificate of Workers'Compensation Insurance,or a certified_ ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab C I - -
Pat No.1' - Company aNSTADr,S
OCertifiedc py is hereby furnished
z Z' ❑ Certifie y is f e BE P ci a speetion division. FIRE SPRINK, ENERGY L24
1'- O.j, Applicant— '• MISC.- 'REFER TO ORD. vl� NE] v0 NQ, ".
CLy CFRTIFICATE OF EXEMPTION•FR WORKERS: PERMIT ISSUANCE 10.00 ' FLOODZONE A.L.UL. -
LU �'' 1 : COMPENSATIONJNSURA E PLG.CONTR. LIC, . .NOPLG.
CL 0 (This section need not be'eompleted'if the permit is'for one - TOTgL ' YE] N� YE] N�
DZ hundred dollars IS 100)or less.) - -
-
U2 1 certify.Omt'in the.performance of the work fur which this per-, QTY MECHANICAL PERMIT' FEE FEE SUMMARY
LL U not is issued,I strait not employ a ly.person in any manner so as to ,
become subject to the'W orken'Compensation Laws of California.
O 0. Date=' ApplicantALTER OR ADD TO MECH. 5.00 BUILDING
>_ to NOTICE TO.APPLICANT:,If,nflel'imking this Certificate of L.-
)— ? - pontoon,you should become subject to the Workers'Compensation APPLIANCE 500 PLAN CHECK
provisions of the Labor Code, you most forthwith .
comply with f FEE
,U such provisions or this permit shall be deemed revoked, AIR HANDLING UNIT.(TO 10MC.F.M.) "4.00 '
- CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 14000 C.F.M.) 6.00 , SEISMIC FEE
1 hereby affirm that there`is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
lire performance of the work for which this permit is issued(Sec MICROFILM
3097, ). >< HEATING UNIT(TO 100,000 B.T.U.) '8.00
Lender's Na me -
. Lender's Address - HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC '
I certify that have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information n estate la agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING' •"
ordinances and state laws relating c to comply
with construction,nco and
above-hereby entioed ropertyfor ins inspection
city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH MECHANICAL �
above-mentioned property fativsp of this
purposes'
(We) agree to save indemnify and keep harmless the'City of MISC.= '':'.q - REFER TO ORD. - - -Cupertino against-liabilities,judgments, costs and expenses which PERMIT ISSUANCE 49.90 �� CONST.TAX
ti.. may in any way accrue against sai City in consequence of the -
rantin fthis permit. MECH.CONT., LIC.NO. MECH •,
\x� •? ,,a TOTAL TOTAL'
r ` Signature of Applicant/Cont a Or -
OFFICE COPY