15994 POST THIS CARD NEAR FRONT OF BUILDING.
7. CITY OF, CUPERTINO 15994
INSPECTION DIVISION
JOB INSPECTION RECORD c'
'�) h/� (` ,' c 1/ • "S/ * . (•�� PERMIT EXPIRATION
JOB ADDRESS 101
Z3 'v �✓ D rTC `UNIT# _LOT# '
/ - PERMIT EXPIRES IF WORK
OWNER S CONTRACTOR C -- `�- '� IS NOT STARTED WITHIN
INSPECTON DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU..
- FOUNDATION1. ANCE OR 180 DAYS FROM ,
NOTE: LASTCALLEDINSPECTION. -
UFER - ALL GRADING AND DRAINAGE>SHAL IJy�7ALLED
' TO COMPLY WITH THE APPROVED PLA SgIAl•WITY OF {' ,PERMIT.vALloArlory e
CUPERTINO STANDARDS..
PREGUNITE
GARAGE SLABSq
UR 21 1988_
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED " -
UNDERGROUND /SLAB p k�l
PLUMBING
ELECTRICAL • •' ISSUANCE DATE
MECHANICAL ' - - BLDG ELECT. PLG." MEMCR,-
❑ ❑ ❑ i
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD
WOOD FLOOR VALUATION $/FT. I
MECHANICAL,
PLUMBING .
I . .
.PERMIT TO .,
ELECTRICAL•.
FRAMING.
STORIES TYPE CONSTR.- .
INSULATION
- -OCC.GROUP RES,UNITS
J '
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED "
SO.FT FLOOR AREA TOTAL ACREAGE
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE '
(� DIAPHRAGM - - THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING RES IND CON PB 0111,.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS• DATE INSP. * ❑ ❑ ❑• ❑NO. ElASSESSORS PARCEL -
ROUGH SAN.#-
PLUMBING ELECT.ENERGY
TUBS 8 SHOWER PAN - PLUMBING ENERGY .TRACT No, PARCEL No
- MECHANICAL MECH.ENERGY
E LECTRICAL: 1 BUILDING ENERGY - Acc.DATE ACC,FILE No.
• FRAMING , .ELECT.FINAL TEST
INSULATION PLUMBING - - ,Zowrvc ENa.SITE No:'
GAS TEST , GAS
1 MECHANICAL , ,. "FIRE SPRINK ENERGY L}A
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑
EXTERIOR'SHEAR - ELECTRICAL RELEASE % FLOOD ZONE A.L.Uc. .
INTERIOR SHEAR - '
FIRE DEPT. Y ❑ N❑ Y ❑ N❑
SHEETROCK._ GRADE 7 FEE SUMMARY
EXTERIOR LATH BUILDING _
INTERIOR LATH T• -TEMPORARY APPROVALS BUi L6111 G'
SCRATCH COAT ELECTRIC ;. ,PLAN CHECK
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE '
OCCUPANCYOF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
"ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
F �: ONE WORKING DAY BEFORE REQUIRED.INSPECTION k " PLumelNc
o . P,LEASE.G'IVE JOB:ADDRESS,WHEN PHONING.
p Z .a- '. {' ( . MECHANICAL J
Iwo SEE PERMIT FOR EXPIRATION DATE
.IMPORTANT!
CONST,.TAX
-PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION: TOTAL 3rDir
OFFICE COPY '
APPLICANT-TO F.ILLA N INFORMATION WITHIN RED LINES- USE BALL POINT•P,EN ONLY -
~^ ILDING PR08ECT'1 DENTI FICATION - "• - �,. , ;PERMIT NUMBER r
RUILDfl,G x' pace = APPLICATION &'PERM,IT f
ADDRESS .. 15994.1
10123. N; Wolfe Road' . BUILDING.--ELECTRICAL-P.LUMBING�-MECHANIC AL '
\. OWNER'S - 1 PLAN CHECK VALIDATION
•`J� NAME QTY: 'ELECTRIC PERMIT FEE
` Bresslers 11
PHONE -
CONTRACTOR ,
NAME t h UTLETS-SWITCHES-RECEP`10.00/100 r =
J Cal-Air' company. LIC.No; 137195 .LIGHTtNG FIXTURES
ConTRACTOR's APPLIANCES-'RESIDENTIAL 4.00'
AO DRESS
p -' L , ,
1775 S • 1st St PHONE( ANELS nl_ '10.00 'DATE OF APPLICATION
ARCHITECT. _ PLAN CHECK FEE': P.C:INO.
- - _ PAN ELS'IOV ER 200 AMP) 20.00 -.
OR
ENGINEER - •- '
uc.NO. '•�. SIGNSTRANS. X1 '3.00. _ '
ARCH.OR ENG. ,5,00 ! PERMIT VALIDATION
ADDRESS SPECIAL CIRCUIT . - _
ZIP TEMP.METER OR POLE INS 20.00
APPLICANTS MOTORS ;SEE FEE SCH.
ADDRESS 1775 $': 1St. $t. $dn O -- SERVICE CHANGE ' 20.00
o o ' LICENSED CONTRACTORS DECLARATION - ^ ��?
a v v I hereby affinn'lhut 1 am licensed under provisions of Chapter 9 .. ISSUANCE DATE
I- a w (commencing with Section 7000)of Division 3 of the Business and r BLDG: ELECT. PLG MECH.
F ¢a
o i Professions Code,a 4a se is in full force and f 1{�1'
Z O vr' License 's - Lic.Number' ❑ ❑ ❑ r�J
z - o i�s _
0 7
nli
H w r J. D'a[e Contractor - 1L-_ 1 /1i�t' ,.L pu e�lno
V y VI Y p BUILDING PERMIT
4 m ¢ ¢ OWNER-BUILDER'DECLARATION ,L -
g ¢ u, _ re 'INFORMATION
E O a I hereby affirm [hut 1 dm exam t Crom the Contradois Lmensc MISC., REFER.TO ORD
w 3 u y P _ VALUATION
H,c
O < Law for the Collowing reason.(Sec.7031.5,Business and Professions PERMIT,ISSUANCE {j 10.00
Code:Any city or county which requires a permit to construct,alter, _
ac ¢ ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR.- LIC.NO: . ELEC h
sa
O u requires the applicant for such permit l0 file a signed statement that' TOTAL' PERMIT TO
w& he is licensed pursuant to the provisions of the Contractor's'License - .p -
Hzs- Law(Chapter 9(commencing with Section 7000)of Division 3 of the "l
Business and Professions Code)or that he is exempt therefrom and QTY., PLUMBING PERMIT - FEE
r o the basis for the alleged exemption.Any violation of5eclion 7031.5 STORIES TYPE CONSTR.
La '3 f' by any applicant fora permit subjects the applicant to a civil penalty gLTER-DRAIN&VENT-WATER (EA.) 5.00
ofnot more than fivchandred dollars($500).): - - • '
❑ 1,as owner of ilia property;or my employees with wages as' BACKFLOW 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.n!Improves thereon,and who does Such work FIXTURES-PER TRAP, 5.00 SO.FT.FLOOR AREA 'TOTAL ACREAGE
himselfEnough his own employees,providedthat such improve- - GAS-EA.SYSTEM OUTLETS 6.00
mems arere not intended or offered for sale.If;however,the building -
/"• or improvement,is sold within one year of completion,the 'or Im- t4. GAS-EA.SYSTEM-OVER 4 (EA.) . 2.00 '• • ,-
builder will have the burden of proving that he did not buil)Or im- BUILDING USE
RES IND CON PB Other
prove for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 -' El E] El11 1:1❑ I,as owner of tire m e property,aexclusively contracting with
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-,I 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 Cor such projects with a contractors)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EAa200ft/10.00 TRACTNO., PARCEL No.
❑ Iminexemptunder Seca ,B.&P.C,'f .this WATER HEATER W/VENT. 6.00 I, -
reason
Ow= Date" WATER SYSTEM 5.00 .
I � •„ ',• � � ACC DATE ' ACC.FILE N0.
�\ WORKERS'COMPENSATION DECLARATION .WATER TREATING EQUIP. 5.00
1 hereby affirm that Phave acer[ificate of mnscm to self-lure -
ZONING
or acertif¢ate of Workers Com ensation Insumnre:Or a Eertil'icd
_ ENG.SITE NO.
p
'� LopythereofkSee.3so0,Lab.C.)T'i hr�rt,� `Mutual _
Pollcy No.. Company----__ - - - ` -
O ❑ Certified copy is hereby furnished. ' y ) FIRE SPRINK ENERGY T$4 t
Z 2 ❑ Certified,yo is JCd whit the cit�y,.{Inspection division MISC -• ' - REFER TO OR D.
O_ APPhcant W IN�- - Y N❑ Y ❑ N❑
� y " CERTIFrCATF. E E O w Rs• - PERMIT ISSUANCE 10.00 FI:ODD ZONE •_ ALUC.'•
lJJ .Y - COMPENSATION'INSURANCE PLG.CONTE, - LIG.NO. PLG.
Lu .. S Y - TOTAL V❑ N❑ V❑ -'N El
Z . (This section need not,be ompleted if the permit is Cor one It" - '
• hundred dollars($100)oNesc) -
'U O 1 certify That in the performance of the work for which this per- QTY. 1 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 ho the Workers Conhpensaton Laws of California .
ED 0. Date 'Applicant - ALTER OR ADD TO MECH.;' .5.00 (BUILDING
}"up NOTICETO APPLICANT: If,after making this Certificate of Ex-
'F ? emption,you sliouldbecome subject to the Workers:Compensation APPLIANCE > 5.00 PLAN CHECK
Provisions of the Labor Code;you most,forthwith comply with AIR HANDLING UNIT ,FEE
V s N provisions Or this Permit slhall'be deemed revoked (TO 10,000 C.F.M.) 4,00
CONSTRUCTION LENDING AGENCY + AIR HANDLING UNIT(OVER 10,C00C.F.M.) 6.00 SEISMIC FEE
I hereby affirm that there Is a construction lending agency for St. i EXHAUST HOOD(WITH DUCT) 5.00
+' the performance of the work for which this permit is issued(Sec
3097,Civ.C.).r HEATING UNIT(TO 100,000 B.T.U.1. 8.00
J�bmr'za
' me' - - ' HEATING UNIT(OVER 1001000'B.T.U.)9.50 ELECTRIC
dress ` - -
that 1 have
thisapplication and state that the above r" VENTILATION FAN (SINGLET. - 4.00
n is correct"I agree to c mply with all city end county _ PLUMBING
and state laws elating to building construction and ' BOILER-_COMP(3 H.P.or 100,0008.T.U.) 6.00 -
,�� horize rep'a" t .,as of'this'cIty m'enter upon the BOILER-COMP (Over 100,000BTU)SEEFEESCH. MECHANICAL, as �D
Toned property or nspeUion purposes.tee lo'shSe. d ify'an ;keep harmless the City aCMISC.-.gainst liabi ie, dgmen casts a El expenses which PERMIT ISSUANCE '1800 (013way�wr e a al au City in onsequence of the
th' p Imi MECH.CONT. LIC,NO - MECH. , .gyp TOTAL ( d0 T
7 VA
- 1 TOTAL
igna[ure of Appliclint/Contractors,"' - Cal-Air, 1371 IrJ
a.a '.. OFFICE COPY : i -