15355 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO 15355
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS 10343 North Wolfe Road UNIT# _LOT#
PERMIT EXPIRES IF WORK
OWNER TGI Friday' s CONTRACTOR IS NOT STARTED WITHIN
INSPECTION .DATE I INSPECTOR INSPECTION RECORD 180 DAYS 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
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED E,o-„I • ,� _,
UNDERGROUND /SLAB _
PLUMBING q `
ELECTRICAL ��� 1 ' ISSUANCE DATE
MECHANICAL Ot BLD Gt11GLCCT PLG. NI• CI�J 1 �� VV
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR
VALUATION 5/FT, .
PLUMBING
MECHANICAL r
.+ PERMIT TO
ELECTRICAL
FRAMING
. srovlEs TYPE comsrR
INSULATION
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED /
50.TT FLOOR ARLA TOTAL ACRGA!
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
_ BUILDING USE
ROOF SHEATHING - Hes IND CON PR Do
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El El Q El C
ASSESSORS PARCEL NO I
ROUGH SAN.N
PLUMBING ELECT.ENERGY
T"ACT No PARCELING
TUBS 8 SHOWER PAN PLUMBING ENERGY 1
MECHANICAL MECH.ENERGY
ACC DATE ACC FR.f:NO
ELECTRICAL BUILDING ENERGY
FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO, 1
INSULATION PLUMBING '
GAS TEST GAS t
FIRE SPRINK ENERGY L]<
MECHANICAL v ❑ E NE:]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
Fuuro ZONE A.
EXTERIOR SHEAR ELECTRICAL RELEASE -
INTERIOR SHEAR FIRE DEPT, v 0 N� L N❑
SHEETROCK GRADE FEESUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS BUILDING ...�2
SCRATCH COAT ELECTRIC I PLAN CHECK T
GAS I I
FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY 1 , 1SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
. r ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
0 PLEASE GIVE JOB ADDRESS WHEN PHONING.
z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
IMPORTANT! CONST.TAX
PLEASE READ REVEFjSE SIDE BEFORE TOTAL "
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APBLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
r BUILDING PROJECT I DENTIFICATI ON PERMIT NuweEE
auILGlrvc
APPLICATION & PERMIT 15355
ADDRESS BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
03 3 N, L FE ,
OWNER'S PLAN CHECK VALIDATION
NAME a CITY. ELECTRIC PERMIT FEE
�C P i9 r y�LL
z Y
CONTRACTOR L Da4n/rCha UTLETS-SWITCHES-RECEP 10.00/1.00 31- �
, tQNt_6.3'7U /43 ILIGHTING FIXTURES 10.00/1.00
CONTRACTOR s SSI NM QC(UZ yam$
ADDRESS /T' PPLIANCES-RESIDENTIAL 4.00 _
` N PANELS 10.00 DATE OF APPLICATION
All IiET . PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
OR
ppgycc
%ISE VI V R♦F^I`AJ LIC.No. _ SIGNS TRANS. 3.00
ARCH.OR ENG. R. �9 r �e SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ADDRESS n / , ZIP
7G �,J � -�LE-E" / ZIP TEMP.METER OR POLE INS. 20.00
APPLICANTS 543,1 C� .Z _ P MOTORS SEE FEE SCH.
ADDRESS
SERVICE CHANGE 20.00
02 LICI;NSISD CONTRACTORS DECLARATION p
¢u U I hereby affirm that 1 ain licensed under provio
isns of Chapter 9 9 ISSUANCE DATE
wZ.w (commencing with Section 7000)of Division 3 of the Business an SLOG. ELECT. PLG. MECH.
H z Professions Codmy license is in fall toI(r' e c
Z
o - License�j y .•EE...-�� Lic.Numb• J t' ❑ ❑ ❑
q �_w Uate�I/i.�_JG..L�Contmc r�p
QysJ I( d u B
¢ ¢ w ¢ WNIi R-BUILDER Dli 1 BUILDING PERMIT
MISC.- Cu 14Ptin0 INFORMATION
w3 a N 1 hereby allirm that I am exempt from Ilia Cantrador's Li<c REFER TO DRQ,4M
LL o a Law for Ilia I'ollnwing rmusun.fSoc.7031.5,Business and Professio . PERMIT ISSUANCE 10.00 VALUATION $/FT.
� - Code:Any city or county whichrequiresapcnnittuconstmcLult ��/-
¢ aa¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. 1 5TO
ii: 0, 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 at(lie Contractor's License
HiQLaw(Chapter 9(commencingwith Section 7000)of Division Sof the
4 D Business and Professions Code)or that be is exwnpt therefrom and QTY. PLUMBING PERMIT FEE
the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
nam by any applicant for a permit subjects the applicant loa civil penalty ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars(5500).1:
❑ 1,as owner of Ilia property,or my anlployces with wages as BACK FLOW PROTECT. DEVICE 4.00 ooG.GROUP SEs.UNITS
sole conlpensmion,will do the work,and the structure a not
intended or offered for sale (Sec. 7044, Basincss and Pral'essions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code The Contractors License Law does not apply to an owner at
property who builds ar improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SM FT.ELDON AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mentsarenotintendedoroffered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or ins-
prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 . RES IND CON PR Om.,
❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct IIIc pmiccl(Sec. 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's Licenso Law does not apply _
to an owner of properly who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with u contradorl s)licensed Panamint In
TRACT NO. PARCEL NO.
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00
❑ lam exempt under Sea .B.&P.C.for this WATER HEATER W/VENT 6.00
reason
Owner Data WATER SYSTEM 5.00
ACC.DATE ACC.FILE NO.
WORK 1iRS'COMPENSA'I ION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affrto that 1 have a certifiable tit consent to schGinaofe• ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insumnec,or a cert it
ropy thereof(Sec 3800,Lrb.0)/A �+
Policy No. Cron anY r_
❑ Ccfbli spy) rCb'f 1 cd. FIRESPRINK ENERGY T 24
Z 2 ❑ Cer p fi i I• 'IY i rection division.
0 Applicannx MISC.- REFER TO ORD. Y❑ IN Y ❑ N❑
(L' y
CERT :11 I.FOPIiXhh/PTION Ir O. WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 c.
Il-1 >_ COMI'IiNSA'ON I NSU t Ch: PLG.CONTE. LIC.NO. PLO.
EL 0 (This stoidn recd not be contploa,l it lite permit is It,, are TOTAL Y❑ IN Y❑ IN El
D 2 hundred dollars(S 100)or Ir,,f
U O I certify that in Ilia performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued,I shall not employ any Person in any manner V as m
O W become subject to the Workers'Compensation Laws of California.
Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING !'1)
} 0 NOTICE TO APPLICANT: If,after making this Certificate of 1!x- v
H-. ? emption,you should become subject to the workers Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE p Z
U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10MC.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IQOOOC.F.M.) 6.00 SEISMIC FEE
I hereby aflirm that them is u construction lending agency I'or EXHAUST HOOD (WITH DUCT) 5.00
Ilia performance of the work for which this permit is issued(Sec. MICROFILM
3097.Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
Leader's Address HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC
1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
ordinances and state laws relating m building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 6.00
hereby authori/e representatives of this city to enter upon Ilia BOI LER-COMP(Over 100,000 BTW SEE FEE SCH. MECHANICAL
above-mentioned property l'or inspection purposes.
(We) agree ns save, indemnity and keep harmless the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs a expenses which PERMIT ISSUANCE 10.00 CONST.TAX
KfAippli
y ay accrue ag sl City in onsa9 uence of the
hiptlEiml MECH.CONT. LIQ N0. MECHTOTALTOTAL ant Contractor ate
OFFICE COPY