17390 POST THIS.CARD;NE,4R FRONT OF BUILDING' PERMITNUM9ER
:. CITY. QF GUPERTINO
INSPECTIONDIVISION ' '�� 0
JOB INSPECTION RECORD
sy
�. 'x'992
,O' /��• .• ' I���� PERMIT EXPIRATION
0•�7 W
• JOB ADORES_S UNIT# LOT 4t -•,
' r y.• :^PERMIT EXPIRES IF WORK,
I OWNER -' - ` CONTRACTOR , : '_ ,.� IS NOT STARTED WITHIN,
INSPECTION DATE INSPECTORINSPECTION RECORD <1 DA
VS OF PERMIT
FOUNDATION Issu `
rc ANCE;OR,180,DAYS ,
- - NOTE: '
LAST CALLED INSPECTION.
UFER ' ALL GRADING-AND DRAINAGE SHALL BE INSTALLED
- PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF �a'PBRMIT V 1 +ION
! CUPERTINO STANDARDS.
GARAGE SLABS
t 4
1° POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED •, - - - .� f �. I` 1'�i� '�'
UNDERGROUND./SLAB � • � ;'=',,E"';S"� -
PLUMBING 4;',.
ELECTRICAL �•' IssuaNCE tinre ti a,
MECHANICAL •.'❑G'., ECECT., h- -m�.: i.
le i
' DD—NOT_POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDBUILDING PERMIT
I WOOD.FLOOR" _ INFORMATION
-< ` e •..
PLUMBING . (_VALUATION , -SIFT.
' 4 ' � „ ,
MECHANICAL „r ••-a'
ELECTRICAL .. I PERMIT TO
. FRAMING..
.INSULATION - - _ ;STORIES TYPE CONS TR
OCC GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
�. y sa FT FLCCR_ARE TOTAL'nCREAGE
ROOF NOTE:NO,F.INAL INSP.SHALL BEMADEBEFORE - .•I .
DIAPHRAGM THE CONSTRUCTION TAXIS PAID
,BUILDING USE
ROOF SHEATHING '. RES. IND CON PB DO—
APPLY NO ROOFING UNTIL ABOVE•HAS BEEN SIGNED FINALS i DATE INSP. ,; "❑' ❑ ❑ ❑ ❑
;. ASSESSORS PARCEL NO �.
'ROUGH SAN.q
" PLUMBING. , • ELECT.ENERGY., ;w
TRACT NO. PARCELNO-
TUBS&SHOWER PAN - PLUMBING ENERGY I "
MECHANICAL - - MECH.ENERGY. +'t. I` •!
" -
ELECTRICAL BUILDING ENERGY- � ' ' _ ACC.DATE ACCf,FILE NO..,'
FRAMING _ :�� ELECT.FINAL TEST01 - "
INSULATION -"a • PLUMBING ",ZONING ENG.SITE NO:
GAS TEST - GAS -
MECHANICAL 'FIRE svawK ENE RGV 124
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ N�. "'❑,. "❑'
FLOOD ZONE - A.,I,U.C:,.
EXTERIOR SHEAR ' ELECTRICAL_RELEASE
INTERIOR SHEAF •.` FIRE DEPT.' °❑ N❑ r.❑ �'N❑
+ SHEETROCK ' - DRADE. " FEE SUMMARY
EXTERIOR,LATH • - BUILDING •^ ,
INTERLOR LATH ' 'TEMPORARY APPROVALS+, I - 'BUILDING
SCRATCH.COAT.' ELECTRIC ' , PLAN CHECK'
- - GAS 1nI FEE _. . .
.. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR: •MICROFILM
: ARRANGE -FOR INSPECTION BY PHONING-252-4505, ececTRlc '
Z�, ' . ONE-WORKING DAY-BEFORE REQUIRED INSPECTION.,, PLUMBING M
o PLEASE GIVE JOB ADDRESS WHEN PHONING.
E.
'�•, t'., 'i'.:" - r 'r- !. ` MECHANICAL
—SEE PERIVIMFOR EXPIRATION DATE
IMRORTANT► CONST.-TAX
PLEASE READ REVERSE SIDE BEFORE �gI
CALLING FOR FINAL INSPECTION. ;:TOTAL ;: '. rn rte, r
'OFFICE COPY-.;
APPLICANT-TO FILL IN INFORMATION WITHIN RED LINES - USE-BALL POINT-PEN-ONLY
1= 5,r,¢U I LDING PROJECT I IDENTIFICATION . , • - - , '.,PERMITNUMBER
BDiLDiNG APPLICATION & PERMIT I
ADDRESS �' - -
JQn /
BUILDING.— ELECT RICA L—PLUMBING—MECHANICAL 1`��90• ,'
{ OWNER'
NAME PLAN CHECK VALIDATION
/I CITY, 'ELECTRIC PERMIT .FEE
�' G1�CCLS
PHONE
1 CONTRACTOR'S
0
NAME OUTLETS-SWITCHES:.R ECEP'.10.00/1.00
Cff 3n4 IC.NO.0 LIGHTING FIXTURES ',-,.'r ,10.00/1.00 4
f,ONTRACTOR'S _
' ADORES -/- �J/ p' PPLIANCES�=RESIDEN_TIAL_ '� "' 4.00
A.1 d'V WJ///n(iM�J�PRONE /.J`tf"-IC1Y PANES .-,
12, BBB �. . DATE OF APPLICATION 4
ARCHrtECT PANELS (OVER 200 A P) " 20.00
PLAN CHECK FEE
, OR '
ENGINEER �
` LIC.NO, SIGNS TRANS.- 3.00
ARCH,OR ENG.
ADDRESS SPECIAL CIRCUIT - 5.00 PERMIT VALIDATION
•ZIP TEMP.METER OR POLE INS. ,20 00 • - L..
APPLICANT'S 1 ,1 I%IHI ,11 ,l 1�
APPLICA - MOTORS "' SEE FEE SCH .,'�,•' J (/\n 11--/ly
r, e' C SERVICE CHANGE • " 20.00
2 F
0
000 LICENSED CONTRACTORS DECLARATION -
< z u I hereby affirm that 1 am licensed under pmvlslons'of Chapter 9 ISSUANCE DATE
p.
,HA <w (commencing with Section 7000)of Division 3 of the Businyss and CLOG ELECT. PLG. MECH.
H w z Professions Cod Kin my license''in full far 4 Till
z o in Lena CI LicNumber
m H Date ' Contractor'(=a � . ' �❑ El
W ¢ w u OWNER-BUILDER DECLARATION BUILDING PERMIT
.a 'INFORMATION
w3 iL a y 'I herebyaffirm that I am;cxempf from'the Contractor's License. MISC.— ' REFER TO'Q�9D
IL 0< Caw forthe fmlowingreason.(Sec.7031.5,Businessand Professions ,;,y O, I' VALUATION $/FT.
Code:Any cityPERMIT ISSUANCE
Dr county whichrequiresapermd loconstrucL alteq
1
Q � improve,demolish,of repair any structure,prior to its issuance,also ELEC.CONTE.
Lal.— �,
ELEC.'
- L, DLL requites the applicant for such permit to;file a signed statement that ' TOTAL I „ ;PERMIT TO _
be is licensed pursuant to the provisions of the Contractor's License
H z ¢, Law(Chapter 9-(commencing with Section 70000af.Division 3 ofthe • , \��
x o Business and Professions Code)or that he is exempt therefrom and+ QTY. . PLUMBING PERMITa FEE EI C
I-$ the basis for the alleged exemption.Any violation of Section 7031.5. STORIES T PE CONSTR
i-gam by any applicant fora permit subjects the'applicant toacivil penalty ALTER-M
VENT-WATER.(EA.) 5.00
of not more than I've hundred dollars($500).1: I t,
❑ I,as owner of the property,or my employees with wages as gAC K,F ECT.DEVICE 4.00
their sole compensalibn,-will.d o dhe work,and tlne structure is not. - '- OCC;GROUP. RES.UNITS
intended or offered for Sale (Sec. 7044, Business and Professions - :!CodeTheContracoLicenseLawdoes not apply[Dan owner of - DRAINSOOF,AREA;COND.-'5.00ropertywho builds ar improves thererkFIXTURRAP 5 00 SD FT FLOOR AREA TOTAL ACOEAGEhimselfortroughhis own employees;provided that such imrovememsare notintcbded or offer edforsale Ifhoweverthe building G'AS-EA -I IN C.4 OUT LETS 600imprvementis sold wl[hinneyearer-builder will have the burden of rovin thnl he did noFbuild tel GAS-E -OVER 4 (EA:) 2 00P g 'BUILDING USE
provefor purpose of saleJ ' • INDUSTTE INTER. 3000 - RES ;:IND CON-. APB Our❑ ,I,as owner of,the property am exclusively contracting with
' licensed contractors to construct the Project(Sec. 7044,Business
and ProfLAWN SPRINKLERS-.1 INC 5 V.B. 6.00 ' ASSESSORs PARCEL NO. -
Professions Code:The Contractor's License Law does not apply y
to an owner of property who bmlds or improves thereon,and who LAWN'SPRINKLERS-OVER 5(EA.) 1.00 .
contracts for such projects with a contractor(s),licenaed pursuant to ," ' .I
the Contractor's License Law. I SEWER-SANITARY-STORMEA.2001t/10:00 - TRAOLNo. PARCEL NO.
'❑' 1 am exempt under Sec. ,B.&P.C.for this c
reason WATER HEATER W/VENT '6'00 '
i Owner _ , _ Date , WATER SYSTEM
" ACC.DATE ACC.FILE NO ,
WORKERS'COMPENSATION DECLARATION. - WATER TREATING'EQUIP-+• 500
1 hereby affirm that I have a certificate of consent Ri self-insure
Ur a certificate of Workers'Compf'asention Insurance,or.ry certified ZONING ENG SITE NO.
p( c •c.3 00,Lab.CJ. (/
' wI•/ r!0. �. 1:
IS icy or Is a y ! Y
O' entified is r fu is FIRE SPRINKr, ENERGY T2< ,
Z Z anuria is d thcicity.iinpectmn division.
P: 0 nP icant ' _ MISC.- ' REFER TO ORD. ' Y,E] tN[:] J,E]' rv�
.CcW CERTIFICAT EOF EX PTION FROM WORKERS' _ PERMIT.ISSUANCE _ ,1000 , FLOOD ZONE t'?A_L'u.C.
W COMPENSATION INSURANCE PLG_.CONTR. - LIC.NO. PLG. - '
1 0 (This section need'not be completed if the permit is for one TOTAL' Y�- N❑ ;'Y"❑ • N❑ '.
Z hundred dollars(S 100)ar less.) -
•U 0 - 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT ' FLEE FEE SUMMARY
IL H mu is issued,1 shall not employ any person in any insurer so as to
O W become subject to the Workers'Compensation Laws of Callfornia
c Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} w NOTICE TO APPLICANT: If,after making this Certil icate ofEx -
F;? emption,you should become subject to the Workers'Compensation APPLIANCE _ 5.00 PLAN CHECK '
provisions ofdhe Labor Code, you must forthwith comply with, ' - i
V such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C,F.M.) 4.00 FEE '
CONSTRUCTION LENDING AGENCY, > AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEEY
I hereby affirm that there E.a construction lending agency for 'EXHAUST HOOD(WITH DUCT). 5.00
the performance of the work for which this permit.is issued(Sec. MICROFILM '
i 3097,CN.C.). . HEATING UNIT(TO 100,000,B.T.U.) '6.00
Lender's Name - n
HEATING UNIT(OVER
Lender's Address ' 100,000 B.T.UJ 9 50 "
_ - - ELECTRIC
1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) -4.00
- -
1' information is correct. I agree to comply with all city and county y PLUMBING
ordinances and state relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 600
hereby authorize representatives of this city to enter upon the BOI LER-COMP IOver 100,000 BTU)SEE FEE SCH.
MECHANICAL :i •' t `
- above-mentioned property for in pection.purPoses.
(We) 4o'save,`mile fy-and-keep harmless the"City'of MISC:, REFER TO ORD' -
aped ai t bilin- dgments, costs and expenses which PERMIT ISSUANCE .10 00 CONST:;TAX
ay" a cc 'met sald,City in consequence of the '
ran ' f in 'rn, MECH.CONT. _ LIC.NO., MECH.b ,J .., � - e••7
TDTAL TOTAL
&gnature of Applic nt/Contractor Date' � w - '
', .. OFFICErCOPY
+