16787 POST THAIkARD NEAR FRONT OF BUILDING PERMIT NUMBER
C FY OF CUPERTINO 16787
INSPECTION DIVISION
• JOB INSPECTION RECORD
JOB ADDRESS 16 ` Z� /� ^ w D ACI. PERMIT EXPIRATION
UNIT# _LOT#
�A� 'I� PERMIT EXPIRES IF WORK''; '
OWNER Z�1 CONTRACTOR .\��.�--7` .s�hr Re P1 IS NOT STARTED WITHIN..'
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OFPERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM •'
NOTE:
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PREGUTO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
GARAGE SLABS ITE - CUPERTINO STANDARDS. aa.�
GARAGE /_- Z2, —9Y"
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - -
UNDERGROUND /SLAB
PLUMBING. V1A•'�` UL
ELECTRICAL • IssuaNCE DATE
MECHANICAL - - - -BLDG ELECT I PLG. I MECR.
❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABGVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
VALUATION $IFT.
PLUMBING
p
MECHANICAL
ELECTRICAL �jPERMIT To
FRAMING TI \ `�LA
INSULATION STORIES TYPE CONSTR.
city of cuporting OCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.'SHALL BE MADE BEFORE so.Pr FLoon AREA TOTAL neBFAee
DIAPHRAGM THE CONSTRUCTION TAXIS PAID '
ROOF SHEATHING HES 'IND BUILDING� USE
CON PB Omn
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0 ❑ ED 0 11
ASSESSORS PARCEL NO
ROUGH SAN.k
PLUMBING ELECT.ENERGY '
.
TUBS&SHOWER PAN PLUMBING ENERGY TRACT NOPARCEL.NO
MECHANICAL - MECH.ENERGY
ELECTRICALBUILDING ENERGY ACC,DATE ACC FILE NO
FRAMING ELECT.FINAL TEST
INSULATION PLUMBING i ZONING ENG.SITE No. -
�`St '
GAS TEST - GAS Z 37`b� -
MECHANICAL FIRE SPRINK ENERGY 1 2
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ ` 0 ' N❑.
EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE AL.0 C.
INTERIOR SHEAR - FIRE DEPT. Y❑ .N❑ .Y ❑ NQ,
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC _PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
1
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
�� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
o PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z
- - SEE PERMIT FOR EXPIRATION DATE.- MECHANICAL
IMPORTANT!
CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
elx`
I
CALLING FOR FINAL INSPECTION. '
OFFICE COPY
4PPLICANT TO FILL IN INfa WITHIN REDa1 INES - US ALL POINT PEN ONLY
BUI LD1 NG PROJECT I DENTI F ION - PERMIT NUMBER,
GILLL1�/h2q 03p' Q PZ3�B APPLICATION & IT
BUDING-ELECTRICAL-PLUMBING-MECHANICAL q 67p
7
tl OW R'S
NA E PLAN CHECK VALIDATION
PAZ_?+PRONE OTY. ELECTRIC PERMIT FEE
CONTRACTOR OUTLETS-SWITCHES-RECEP 10.00/1.00
NAME//
µLC- T L LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'$
ADORE ss APPLIANCES-RESIDENTIAL 4.00
Ai erONE S PANELS 10.00 DATE OF APPLICATION
ARCHITECT
OR PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.Cr,NO.
ENGINEER -
uc.NO. . SIGNS TRANS. 3.00
ARCH.OR ENG,
AOOREss SPECIAL CIRCUIT S.00PERMIT VALIDATION
ZIP -TEMP.METER OR POLE INS. 20.00
nooeEss TsMOTORS
SEE FEE SCH. ,
SERVICE CHANGE 20.00
° mzPAID
O 0 LICENSED CONTRACTORS DECLARATION '
U 0 1 herebyaffirm that I am licensed under r visions of Chapter 9 t
p O p .Y rl t ISSUANCE GATE
y 4 H (commencing with Section 7000)of Division 3 of tire Business and BLDG. ELECT. PLG. MECH.
r D z Professions C t-, td r license is In ILII force m 1 of L
Z O,�- License Close Lic.Number I,JEC
Uate�Contractor ❑ ❑ ❑ IJ
rc ¢w a OWNER-BUILDER DECLARATION M City of Cupertino BUILDING PERMIT
U
MISC. REFER TO ORD INFORMATION
R:
;` 1 hereby affirm that 1 am exempt from the Contractor's License -
u0oj