16602 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY.,�557
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER- APPLICATION & PERMIT w 1 6602.
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BUILDING -ELECTRICAL-PLUMBING-MECHANICAL ..
Z
OWNER'S PLAN CHECK VALIDATION
NAME i OTV. ELECTRIC PERMIT FEE
• NNNERA Rs� -p OUTLETS-SWITCHES-RECEP 10.00/1.00
/a! �/� uc.N LIGHTING FIXTURES 10.00/1.00 „^I
CONTRACTORS
TORS , APPLIANCES-RESIDENTIAL 4.00 V
1�, ✓ ' E PANELS 10.00 DATE OF APPLICATION' n
TECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEEP,O.NO.
ENGINEER
LIC.No. SIGNS TRANS. 3.00
nue ESS-E.G. - SPECIAL CIRCUIT 5.00 - PERMIT VALIDATION
ZIP rrEMP.METER OR POLE INS. 20.00
Ais
ADDDRESSDRESS MOTORS - SEE FEE SCH.
SERVICECHANGE 20.00 -
D iPAID
F0
o LICENSED CONTRACTORS DECLARATION ,
Q Z 6 I,hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE -.
P a w (commencing with Section 7000)of Division 3 of the Business and tBUILDING
ELECT. PLG. MECH.
r w 2 Professions Code,an m license is in full force an e c 2 O y _LIc.Number-
9 wUnte��`-Dr r. Comructo .�Ify Of rill QrtIRO PERMIT
� a OWNER-BUILDO R DI7CLA ATION
IS o a u INFORMATION
E
;LL I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD
.. O¢ Law for the following reason.(Sec.7031.5,Business and Professions VALUATION S/FT.
� - -I Code:Any city orcoulny which requires a permit to construct,alter.
PERMIT ISSUANCE 10.00
Qa l- ,IS O Improve,demolish,or repair any structure,prior to Its Issuance,also ELEG CONTR. LIC.NO. ELEC.
O u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
A w m he is licensed pursuant to the provisions of the Contractor's License
OTV. - -
FZi
POST THIS CARD NEAR FRONT OF BUILDING PERMITN Me n! `
CITY OF CUPERTINO 166:42
INSPECTION DIVISION
" JOB INSPECTION RECORD
yp 1.C'
• lot 7-3 Iv yv 1 ({•� '�e ^fI PERMIT EXPIRATION
JOB ADDRESS [UNIT# _LOT# PERfu�IT+YF, PFifES IF WORK
OWNERH4 v -e O CONTRACTOR C I IS NO7 STARTED WITHIN'
I EC ON DATE INSPECTOR INS CTION RECORD i80 DA ITS OF PERMIT ISSU-�'
• FOUNDATIONANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION. '•
UFER . - - ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION r
CUPERTINO STANDARDS.
. . GARAGE SLABS "OUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB jq ' 11tAU-CA '
I
PLUMBING -I
ELECTRICAL - _ IssuANCE DATE
MECHANICAL - eLDc ELECT , PLG. MECH.-
❑ ❑ ❑ ' x
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION SIFT.
PLUMBING
MECHANICAL • - PAIL)
fELECTRICAL 'I 1 p e ,PERMIT To
FRAMING OCT ^ u 1988 sronlEs ES , MIFF CONSTR.
INSULATION.
City of Cupertino
OCC.GHOUP- RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO FT FLOOR AREA TOTAL ACREAGE
ROOF• NOTE:NO FINAL INSP.SHALL BE MADE BEFORE t
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING � RES Irvo CON Pa 0",
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ - ❑ ❑
ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING - ELECT.ENERGY
TUBS B SHOWER PAN - 'PLUMBINGENERGY TRACT No. PARCEL No ,
MECHANICAL MECH.ENERGY
ELECTRICAL BUILDING ENERGY AcG DATE ncc.FILE No.
FRAMING ELECT.FINAL TEST
ZONING ENG.SITE NO,
INSULATION PLUMBING
GAS TEST - GAS
• - FIRE SPRI IN Y F] NENERGY T
24 1
MECHANICAL IN
D
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y E] N❑'
EXTERIOR SHEAR " ELECTRICAL RELEASE PL000 zoNE A.L.u.c.
INTERIOR SHEAR FIRE DEPT. Y❑ 'NF Y ❑ N❑
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH - BUILDING -
'' " ,INTERIOR LATH ' - TEMPORARY APPROVALS " BUILDING
SCRATCH COAT ELECTRIC' ' PLAN CHECK
GAS FEE
_ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY L SEISMIC FEE '
OCCUPANCY OF BUILDING IS NOTPERMITTED,UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
,ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC
LU
ONE WORKING DAY BEFORE REQUIRED INSPECTION. y PLUMBING
0'� PLEASE GIVE JOB ADDRESS WHEN PHONING.
• Z= .a'+ I MECHANICAL ` �e
- SEE PERMIT FOR EXPIRATION DATE — 3Or.
IMPORTANT! Liz, iiLij
CONST.TAX
PLEASE READ REVERSE SIDE BEFORE ,
CALLING FOR FINAL INSPECTION. TOTAL J,DD
OFFICE COPY