14481 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NumaEN
CITY OF CUPERTINO 14481
INSPECTION DIVISION
JOB INSPECTION RECORD .
�4 �• ,,// PERMIT EXPIRATION
N
JOB ADDRESS ZZQ_00 L WOLF.`' h UNIT# _LOT#
PERMIT EXPIRES IF WORK
, a
OWNER -wt_,=77 Ck4- i //.1.tet CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.'
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER IALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY.OF BEWAIL VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - 4-^I •'`•
UNDERGROUND /SLAB
PLUMBING 1pfk
ELECTRICAL ISSUANCE DALE
Hl -LECs PLG MECN
MECHANICAL MPy ❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED rV%VMWILDING PERMIT
INFORMATION
WOOD FLOOR
VALUATION $/FT.
PLUMBING.
7 �'O I(t
MECHANICAL
PERMIT TO
ELECTRICAL
FRAMING )R RRM01iRl,
SLORILS TYPE CONSTH
INSULATION
OCC GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
Sp.FI f1.001i AR EA TOTAL ACREAGE
�.•� ` ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE
./ DIAPHRAGM THE CONSTRUCTION TAX IS PAID
ROOF SHEATHING BUILDING USE
R1:$ IRU CON PH 0111.'r
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE ' INSP. El ❑ El El El
ASSF.SSUHS PAHCE I.NO
ROUGH SANA
PLUMBING ELECT.ENERGY
ni ncT NO PARCEL No
TUBS&SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ACC DATE ACC PILE NO
ELECTRICAL. BUILDING ENERGY
FRAMING ELECT,FINAL.TEST ]ONkNG ENG SITE NO.
INSULATION PLUMBING
GAS TEST GAS
FIRE SBNINK ENERGY L.jG
MECHANICAL - Y N❑ v 0 NE]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
_ BLOOD I.UrvE ALUC.
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT, v� N� L-1 rv❑
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING _
BUILDING
INTERIOR LATH TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCVOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM .� ^
_ ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
A Z PLEASE GIVE JOB ADDRESS WHEN PHONING...
T / - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTI FICATION
PERMIT NUMBER
BUILD - �' �, `�._Bldg--#,43 APPLICATION & PERMIT UIL14481
- WILDING - ELECTRICAL-PLUMBING-MECHANICAL
Oa-N. WOLFE RD. - - b
f�r OpMER's �0QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION
� (.JLLG��I/}L�•�RY�HONE �
./ ONTRACTOR'S
L / NAME - OUTLETS-SWITCHES-RECEP 10.00/1.00
uc.NO. LIGHTING FIXTURES 10.00/1.00
CONTRACTORS APPLIANCES-RESIDENTIAL 4.00
ADDRESS
PHONE PANELS 10.00 DATE OF APPLICATION. ^
ARCHITECT PANELS (OVER 200 AMP) 24.00 PLAN CHECK FEE P.C.NO.
OR
ENGINEE
' LIC.No. SIGNS TRANS. 3.00 t
ARCH,OR ENG. PERMIT VALIDATION
oDRELsrs D n ',A SPECIAL CIRCUIT 5.00
ILTS ` E 1 y pA(eE /4(�(� F• EMP.METER OR POLE INS. 20.00
ADDRESS r'a MOTORS SEE FEE SCH.
ADDRESS
SERVICE CHANGE 20.00
w O O LICENSED CONIRACTORS DECLARATION
c u U I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE
(cominencing with Section 7000)of Division 3.of the Business and BLDG. ELECT. PLG. MECH.
rn i Professions Code.and my license is in full force and effect ❑ ❑ ❑
z o m - Licese Class Lic.Number
o z a Date' Contmctor
a r s �D� BUILDING PERMIT
¢ a, w ¢ OWNER-BUILDER DECLARATION INFORMATION
a: 0 MISC.- REFER TO ORD
wLL y I hereby affirm that I am exempt frum the Cont..car's License
u o 4 I.aw for the following reason.(Sec.7031.5.Businessand Pmfessioms PERMIT ISSUANCE vale ATtON
r -yam Code:Any city or county which requires a permit construct,alter. ��-�
¢¢Q 2O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIG NO. ELEC.
DLL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
w$ he is licensed pursuant to the provisions of the Contractor's License
F z a
Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe INTERIOR REMODEL
Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
¢ I=-c the basis for life alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
u ;m by any applicant for a permit subjects the applicant toe civil penally ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars f 45001.)'.
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP REB.urvlTS
their sole cum pensation,will do Ilse work,and the structure is not
intended or offered for sale (Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of
-!'
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00
\•�' p pC y p SO.FT.FLOOR AREA TOTAL ACREAGE
�\ himselfe throughhis ownemployees,fors,provided evesuchintprrmo
al menus are not intended or offered for sale.Il,however,the builJing GAS-EA.SYSTEM-1INC.4OUTLETS 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 it RES IND CON PB Omer
prove for purpou of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec 7044,Business LAWN SPRINKLERS-1 INC 5'V.B. 6.00 .ABBEssoRS PARCEL No.
and Professions Code I'lie Contractor's License Law does not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00
tcontracts he Contractor's License Law.forsuchprojectswiouacontractorts)li«Hud pursuant In
the SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
Cont
❑ I enl ex nq undo Scc. _.If B.&P.C.lot this WATER HEATER W/VENT 6.00
mu
weer r Date WATER SYSTEM 5.00 ACC.OATE ACG FILE NO.
WO RKI>RS'CObIPF:NSAI'I N I'CLARATION WATER TREATING EQUIP. 5.00
I hereby alflrm that I have a certificate of Consent to sclt-mAlfC ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800.Lub.C.). '
Policy N..-Cf....party
O ❑ Certified copy ishereby furnished. FIRE SPRINK ENERGY T 24
Z Z D Certified copy is tiled with flue it, inspection division,
O Appliemll MISC.- REFER TO ORD. y❑ N❑ Y N❑
~ rn PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
'� - CIiRI'1 PIGA'f15 OP IiXI?MPl'ION PROM WORKERS'
LLI > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
d O (This section need not be completed if the permit is for one TOTAL V❑ N❑ V ❑ N❑
::) Z hundred dollme(SI00)or leas,)
U O I OcRily that in the performance of me work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued.I shall not mnploy any person m any Hamner,so as to
U become subject to the Workers'Compensation Laws of California.
U d Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 193.00
} GO NOl'ICE 'f0 APPLICANT: If,after making this Certificate of F.x-
F Z mCRioa,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this Permit Shall be deemed revoked. AIR HANDLING UNIT(TO 1Q000C.F.M.) 4,00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 2. 10
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
thenxnce of the work lir which this permit is issued(Sec.
3097,,CiCis.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
Cis.C.).
Lender's Name
Lender's AddHEATING UNIT(OVER'100,000 B.T.U.)9.50 ELECTRIC
ress
1-Y>" I certify that l have read this application and slalcthot the above VENTILATION FAN (SINGLE) 4.00
1� in 1'onnation is correct. I agree to complynt
with all city and couy PLUMBING
ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
u ) hereby authorize representatives of this city to enter upon she BOILER-COMP C.,100,000 BTU)SEE FEE SCM. MECHANICAL
�V above-ew.tioned properly for inspection I.a,, cs.
(Wc) a save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
ainst liahili lies,judgments, costs and expenses which CONST.TAX
ay Io y\ aceru cons uence of lite PERMIT ISSUANCE 10.00
ting f I L nit. MECH.CONT. LIC.NO. MECH.
l g$
TOTAL TOTAL IQ-/O
reo'A nt/Contracor D tc
OFFICE COPY