15997 POST THISD NEAR FRONT OF BUILDING p,ERM ITNUMBER
.
' CITMOF CUPERTINO
INSPECTION DIVISION, 15997,
JOB INSPECTION RECORD
,/ - _ PERMIT EXPIRATION
A
JOB ADDRESS �O jo1.3 �o4=15 � UNIT# _LOT#'
PERMIT EXPIRES IF WORK
OWNER c VCONTRACTOR ��J- L-- ,Ayres, Aj IS NOT STARTED WITHIN
INSPECTION I DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.
FOUNDATION NOTE: _ ANCE OR 100 DAYS FROM
- .
'LIFER ALG GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTI ON.
PREGUNITE TO COMPLY:WITH THE APPROVED PLANS AND CITY OF PFRMIT,VALIUFTION
CUPERTINO STANDARDS.• -
GARAGE SLABS - •• '
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED-
- UNDERGROUND /SLAB,
IGNED_ UNDERGROUND /SLAB
PLUMBING
ELECTRICAL IssuarvcE OarE
MECHANICAL - . . .BLDG ELECT. PLG. MECH,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDIN PERMIT
WOOD FLOOR - INFORMATION
PLUMBING VALUATION s/FT.
I
MECHANICAL
ELECTRICAL - °eR^^!T1rO
FRAMING A//EG
INSULATION _ - STORIES TYPE CONSTR.
OCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED "
-ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO FT.FLOOR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING - RES IND 'CON PB ' 00",
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
ROUGH SAN.k
ASSESSORS P..ARCEL NO
. - � - �
PLUMBING - - ELECT.ENERGY '
TUBS 8 SHOWER PAN - TRACT NO, PARCEL NO _
_ PLUMBING ENERGY
MECHANICAL MECH.ENERGY -
ELECTRICAL BUILDING ENERGY ACC.DATE ACC FILE NO.
FRAMING ELECT.FINAL TEST
INSULATIONPLUMBING_ .. - ZONIN& ENG SITE.NO.
GAS TEST G -
AS - -
.. MECHANICAL / .� FIRE SPRINK ENERGY Tsa
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING N❑ Y ❑ N❑
EXTERIOR SHEAR- - ELECTRICAL RELEASE VE—LOOD ZONE A.c.u,C.
INTERIOR SHEAR FIRE DEPT. `A v O N❑ r ❑ N❑
SHEETROCK - GRADE FEE SUMMARY
EXTERIOR LATH - BUILDING'
INTERIOR, LATH TEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC PLAN CHECK `b
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE"
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTILBUILDING FINALISSIGNED.BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
. ONE WORKING DAY BEFORE-REQUIRED INSPECTION. PLUM81NG
o PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANTICON'ST..TAX'
L
PLEASE READ REVERSE SIDE EtEFORE ,.' TOTAL
CALLING FOR FINAL INSPECTION. <'
OFFICE'.COP.Y W i
JOB 588-478 BLDG. PERMIT #16423
APPLICANT TO FILL IN INF ATION WITHIN RED LINES - USE LL POINT PEN ONLY
BUILDING PROJECT IDENTI FIC PERMITNUMBER
APPLICATION & PART
ADDRESSGIN` Space 1004
G10123 North Wolfe Rd. BUILDING—ELECTRICAL—PLUMBING—MECHANICAL !' 15997
O NER'a
NAME
Afterthoughts- Boutique OTY ELECTRIC PERMIT FEE PLAN CHECK VALIDATION
PHONE
NAMERAcroRs OUTLETS-SWITCHES-RECEP 10.00/1.00
Cal-Air Inc. LIC.NO. 137195 LIGHTING FIXTURES 10.00/1,00
nmRRess'oRs APPLIANCES-RESIDENTIAL 4.00
1775 S. 1st St. PHONE 947-.0155 PANELS 10.00 DATE OF APPLICATION .
OR
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C..NO.
ENGINEER
LIC.No. SIGNS TRANS. 3,00
ARCH.
oo'Ess ENG. 5.00 CIRCUIT S,OO PERMIT VALIDATION
ZIP ,EMP.METER OR POLE INS. 20.00
APPLICANT'S
ADDRESS MOTORS SEE FEE SCH.
1775 S. 1st St. Bldg. 66 San Joe SERVICE CHANGE 20.00
' 2
F0
o D LICENSED CONTRACTORS DECLARATION ��✓/
a u u I hereby affirm that I am licensed under provisions of Chapter 9 ISS(J/ANCE DATE
H z w (commencing with Section 7000)of Division 3 of the Business and w< n - BLDG. ELECT. PLG. MECH.
F N Z Professions Cod a y license is in full force a — —
p D License C{� p�r Lic.Number- ❑ El ❑
F w J Dale_ll(_6 Contractor
M >!g BUILDING PERMIT
E S w a OWNER-BUILDER DECLARATION
o a v INFORMATION
E
a. t- 1 hereby folio that I am exempt from the Contractor's License MISC.— REFER TO ORD
FUN J Law for the following reason.(Sec.7031.5,Basin essand Profess ions PERMIT ISSUANCE 10.00 VALUATION $/FT.
Code:Any city or county which requires a permit to construct'alter,
improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
¢ requires the applicant for such permit to file a Signed statement that TOTAL
e w LL he is licensed pursuant to the provisions Of the Contractors License PER jO
FZQ Law(Chapter9(commencingwithSection7000)ofDivision3ofthe
g i D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
SE H a the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
i ; � by of in. than
for apenre subjects $5000.applicant toacivil penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than Cive hundred Dollars(25001.):'
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCD.GROUP RES.UNITS
their sole compensation,will do the work,and toe structure is not
1 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 F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
1 himself or through his own employees,provided that such improve-
mentsarenotintendedorofferedmrsafe.If,however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 6,00
or improvement is Sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA.) 200
builder will have the burden of proving that he did not build or i .nn. . . BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER3000 RES IND CON PD Other
❑ I,as owner of the property,am exclusively contracting with . .
❑ ❑ ❑ ❑ ❑
licensed contractors m construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Cade: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
(he oforsuchprojects with ocontmetor(s)licensed pursuant to SEWER-SANITARY-STORM EA.20057/10.00 -
the
contracts
s Contractor's License Law. TRACT NO. PARCEL N0.
reason❑ I am exempt under Sec.—,BAP.C.for this WATER HEATER W/VENT 6.00 -
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKERS'COMPENSATION D17CLARATION WATER TREATING EQUIP, 5.00
1 hereby affirm that I have u certificate ofconsent to self-insum' ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereo C(4c.3800,Lab.C.I -
Policy No. Company _
0 ❑ Certil'iedcopyisharebyfumished. - - FIRE SPRINK ENERGY T-24
Z.Z ❑ Certifi py is filed ayillt_the city inspection division.
H O APP lrlcymw, �,'1 (A1�q qr("�-7(1151(7.- MISC.- REFER TO ORD. Y ❑- N❑ v ❑ N❑
OC "t1:RT ATP&5PA1SMP1Y1�7FROM WORKERS' PERMIT ISSUANCE 10. LOOD ZONE A.L.U.C.
DU �_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLD.
1 o
(This section need not be completed i(the permit Is fat one TOTAL V N❑ V❑ No
Z hundred dollars IS 100)or less.)
V O I certify that in the performance of the work for which this per- DTV. MECHANICAL PERMIT `kQ Fix FEE SUMMARY
LL H mil is issued,I shall not employ any person in any manner so as m
O w become subject to the Workers Compensation Laws of California. 141
G. Date Apphcanl ALTER OR ADD TO MECH. 5.00 BUILDING
>_ N NOTICE TO APPLICANT: If,after making this Certificate of lix-
f— 2 entption,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 10000 AO
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 performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I certify that I have read this application and smm that the above VENTILATION FAN (SINGLE) -4-0073706
information is correct. I agree to comply with all city and county PLUMBING
ordinances and stale laws relating to building construction, and BOILER-COMP(3H.P.or100,000B.T.U.) 6.00 �1
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCM. MECHANICAL (�S
above-mentioned properly for inspection purposes.
(In.) agree to S e, indemnify and keep harmless the City of MISC.- REFER TO ORD.
u an against a 'I ies,j gments, costs and expo ses which PERMIT ISSUANCE pg-66 d � CONST.TAX
n any way c agai at
said ity in cousequ ce f the
Il��(t mjigpt/ MECH.CONT. LIC.NO. MECH.
YY■"/Ii TOTAL i TOTAL ,2-
Signature of Applicant/Contractor Uat01-� Cal-AlrrInc. 137195
OFFICE COPY