16686 (2) POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO 166$6
INSPECTION DIVISION
�• JOB INSPECTION RECORD
PERMIT EXPIRATI8N
JOB ADDRESS.l L 0 12.- 3 ` " "" d le—c —UNIT AE _LOT# ' U
�H- ''I-- PERMIT EXPIRES IF WORK
DAN. �r 1, e (� - .e�S CONTRACTOR � Cl) �•J ( IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSP CTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION - ANCE 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
GARAGE SLABS - CUPERTINO STANDARDS.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
PLUMBING .9.�-
UNDERGROUND /SLAB
�7
ELECTRICAL - ,� ISSUANCE DATE
MECHANICAL BLOC I ELECT I PLc. MECR
.)d
El
❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION 0 SIFT.
PLUMBING l�4S y/, p�,�PERM O
MECHANICAL PAID .' .
ELECTRICAL „
FRAMING NOVJ lw
' l
INSULATION STORIES rYP CONSTR.
CityofCupertuno
- OCC GROUP RES UNITS
..• PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE so.Fr FLOOR ARA TorAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID QrJ
_• BUIL ING USE
ROOF SHEATHING RES IND CON PB OL..•.
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
ASSESSORS PARCEL NO,
ROUGH SAN.#
PLUMBING ELECT.ENERGY
TUBS 8 SHOWER PAN PLUMBING ENERGY THACI NO, PARCEL NO
MECHANICAL MECH.ENERGY
ELECTRICAL - .//-f% BUILDING ENERGY ACC DATE ACC FILE NO
FRAMING ELECT.FINAL TEST
INSULATION - � PLUMBING 4110
ZONING ENG SITE NO,
GAS TEST GAS
' MECHANICAL FIRE SPRINK ENERGY T.24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ 'I IN E]
Y ❑ No
.
EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE AL.UC
INTERIOR SHEAR RE DEPT. Y❑ N❑ v 01 NEI
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING _
INTERIOR LATH TEMPORARY APPROVAL BUILDING ( of
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
ND TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNE JOCCUPANCY - SEISMIC FEE t
OCCUPANCY OF BU I LDI NG IS NOT PERMITTED UNTI L BUI LDING F INAL IS SIGNED BY BUI LDI NG INSPECTOR. MICROFILM' •�
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
i F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
z.� PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE �,�M TOTAL y�
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
G ILDG PROJECT) FATION :PERMIT
aDLDU1 NUMRER
APPLICATION & PERMIT
ADDRESS U6,0
6
/ � / 5.hI6 � BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
d hj-
OWNER'S �u,
NAME �, PLAN CHECK VALIDATION
DTV. ELECTRIC PERMIT FEE
vlsoNE
CONTRACTOR'Sflo
NAME UTLETS-SWITCHES-RECEP 10.00/1.00 ' a Sx�o
v'TE� uc.No. LIGHTING FIXTURES .10.00/1.00
CONTRACTOR S
ADDRESS I/iL G/6� /_ APPLIANCES-RESIDENTIAL 4.00
� �x-isl' PHONES -yOCF� PANELS - 10.00 - DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE P.C.NO.
OR �, Oj1iG{ 7 PANELS (OVER 200 AMP) 20.00
ENGIN �(A_Lu
i �V/r�\/1C% LIc.No. ISIGNS TRANS. 3.00
nooHHess ENO. SPECIALCIRCUIT 5.00 PERMIT rVALIDATION
.S• zIq TEMP.METER OR POLE INS. 20.00 11 ✓�ji�D s
APPLICANTS MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
00 LICENSED CONTRACTORS DECLARATION
in a U w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
(commencingwith Section 7000)of Division 3 of the Business untl
G ¢y DG. ELECT. PLG. MECH.
Hoz Professions Cod�Iaa my license is in full fo 'e J 1 - El El El a License Class &�J Liu.Nm
F y H j Uate Con Nact.,mr
a m E BUILDING PERMIT
rt o i OWNER-BUILDER DECLARATION MISC.- REF D INFORMATION
w ; LL y I hereby affirm that 1 am exempt from the Contractor's License VALUATION $/FT.
k 0 Law for the following rcasmn.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 00
Code:Any city orcounty which requires a permit to construct,aller, '1 3 Q�D,
ELEC.CONTR. LIC.NO. I^
¢ a improve,demolish,or repair any slru<Rrte,prior m its issuance,also ELEC.
cLL requires the applicant for such permit to file a signed statement That TOTAL PERMIT TO
u w m he is licensed pursuant to the provisions of the Contractor's License TT
Fii