15102 1�" r POSTTHIS CARD NEAR FRONT OF BUILDING PERMITNUMBER
CITY OF CUPERTINO 15102
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOBADDRESS_7971 Woodlark Way UNIT# _LOT#
PERMIT EXPIRES IF WORK
OWNERMrs. r - CONTRACTOR
IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.
FOUNDATION -� NOTE: ANCE QR 180 DAYS'FROM
I UFER 0� ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
"ELECTRICAL
- TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
CRETE UNTIL ABOVE HAS BEEN SIGNED - ,
4..
' NDERGROUND /SLAB
_ /l-
ISSUANCE DATE
- Loc ececr I Pu;. MECR
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ` m BUILDING PERMIT
WOOD FLOOR J INFORMATION
PLUMBING - n` VALunnoN .p g�F T.
MECHANICAL ' V :A' ,Ili E)
ELECTRICAL - PERMIT TO
FRAMING Aw �.
INSULATION STORIES TYPE CONSTR
t ,
OCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL•ABOVE HAS BEEN SIGNED - -
ROOF
- 50 IT FLOOR AREA iOrAL ACH CAGE
NOTE'NO FINAL INSPSHAL. L 8E MADE BEFORE
_ DIAPHRAGM THE CONSTRUCTION TAX IS PAID
ROOF SHEATHING , euaowUSE
RES IND CONN PR OT....
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
,ROUGH , - SANa ASSESSORS PARCEL NO,
PLUMBING ELECT.ENERGY -
TUBS 8 SHOWER PAN PLUMBING ENERGY _ TRACT NO. PARCEL NO
MECHANICAL MECH.ENERGY
ELECTRICAL j �- BUILDING ENERGY ACC.DATE ACC FIDE NO
FRAMING ELECT.FINAL TEST
IN GIG
Q PLUMBING zoNlNc ENG SITE No.
GAS TEST GAS
MECHANICAL FIRE SPRINK ENERGY-T.24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ N❑ I ` ❑ N❑
EXTERIOR SHEAR. ELECTRICAL RELEASE FLOOD ZONE A.L U:c.
INTERIOR SHEAR FIRE DEPT. .Y❑ N❑ Y ❑. IN
SHEETROCK GRADE FEESUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS BUILDING y( �
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
a
NO TAPE OR PLASTER UNTIL gABO VE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINALIS SIGNED By BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
Iw— ONE WORKING DAY BEFORE REQUIRED INSPECTION.
o� PLEASE GIVE JOB ADDRESS WHEN PHONING.. PLUMBING
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANTI coNST.•TAx
PLEASE READ REVERSE SIDE BEFORE TOTAL '
CALLING FOR FINAL INSPECTION. G
OFFICE COPY
-,ANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
UILDINGPRDJECT I DENTIFICATI ON PERMIT NUMBER _I
IAO-RESS
UIWINGAPPLICATION & PERMIT15102,� � / ��;71G 6UILDING -ELECTRICAL-PLUMBING-MECHANICALWNER'S ,.r PLAN CHECKVALIDAJ{ONANE n�� TV. ELECTRIC PERMIT FEE ! ?
'V J G vHONPJ� / 19 J
NpMTRAcroR's OUTLETS-SWITCHES-RECEP 10.00/1.00
//liie Cr � 0LIGHTING FIXTURES 10,00/1.00 6-0
ro"rflgcroR's APPLIANCES-RESIDENTIAL 4.00
CON Ess y
PHONE �/C 3 PANELS - 10.00 GATE OF APPLICATION
OR
PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
R
ENGINEER LIC.NO, SIGNS TRANS. 3.00
ADDRESS EN7 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP EMP.METER OR POLE INS. 20.00
APPLICANT$
ADDRESS MOTORS. SEE FEE-SC-H.
¢z / f
SERVICE CHANGE 20.00 1/// /p
o [ O
F o o LICENSED CONTRACTORS DECLARATION
<O w 1 hereby afHrin that I am licensed under provisions of Chapter 9 ISSUANCE DATE
Nay (Commencing with Section 7000)of Division 3 of the Business and still ELECT. PLG. MECH.
Hoz Professions Cod' and my license is in lull fore e t ❑ ❑
p
0.o License Class_�j Lia Number
2 y r aw Datcf-'-/),e-L Contractor -�-
¢ 0. - OWNER-BUILUIiR DIiC1.AftA' IONy AI BUI INGORMPER
ONT
X. 3 a. I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD
w UATION $/FT.
Fu Oj Law fortheity (See. Bushuns Incne Professions PERMIT ISSUANCE .}Q80-�
Code:Any city or county which requirese permit to construct,also
Q ¢< improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. /
wD Inrequires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
B m Ire is licensed pursuant to the provisions of the Contractor's License ,1r�,,11
Law,(Chapter 9(commencing with Section 7000)ofDivislon 3 of the /}d4J/TL4I .
S 4 o Business and profession,Code)or that lie is exempt therefrom and CITY. PLUMBING PERMIT FEE
¢ I the basis for the alleged exemption.Any violation ofSection 7031.5 STORIES TYPE CONSTR.
d; by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5,00
Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
m
himself re of intended
his own employees.provided(hal such improve.
m improv mens is sed w thinollfered
onefor
year
If,however,tirebuildingo ding GAS-EA.SYSTEM-1 1NC.4OUTLETS 6.00
or improvement is sold within one your 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- RES IND CON PB Other
Prove fors owner of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ L as owner of the property,he exclusively.7044,1[ju with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec.7004,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6:00 ASSESSORS PARCEL NO.
and Professions Code:The honbuclsr s License Law docs not apply
to tr owner of property who builds or improves thereon,sea who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects wish n nnitracmKs)licensed Pursuant m SEWER-SANITARY-STORM EA.200ft/10.00
the Conhaelrn s License Law. TRACT NO. PARCEL NO.
0 I ani exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00
reason
owner Date WATER SYSTEM 5.00
ACC.DATE ACC.FILE NO.
WORKHRS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have it certificate of consent 10 self-insure, ZONING ENG.SITE NO.
or a certificate of Workers'Compensellon Insurance,or a certified
copy therey�(Sec.3800,Lab.C.). /J_ �
Policy NrN_ CompunY-((Q!-}4��h�/1tLQ'��
0 0 Certified copy is hereby I'conshed. FIRE SPRINK ENERGY T 24
Z 2 pLT Cerl ifle y i' filed !L 'Aspen_ z JJvisiun" MISC.- REFER TO ORD.
Applicant //a(L-G v ❑ N❑ Y ❑ N❑
CC rn PERMIT ISSUANCE 10.00
LU CIiRTIFICATEPENSA MPfINS FROM WORKERS' FLOOD ZONE A.L.U.C.
W COMPENSATION INSURANCE the PLG.CONTR. LIC.NO, PLG. Y❑ N❑ Y❑ N❑
� Z (This dollies need not be completed if the permit is for one TOTAL
hundred dollars f$1001 or less)
0 O 1 certify that in the performmice of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- alit is issued,1 shall not employ any person in any msnnerso ns to
0 w become subject to the Workers'Compensation Laws of California.
y Date ApplicantALTER OR ADD TO MECH. 5.00 BUILDING ev
} rn NOTICE TO APPLICANT: If,after nuking this Certificate of Ex-
F- ? emption,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK
provisions of tire Labor Code, you must forthwith comply with FEE
C,1 such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 1Q000C.F.M.I 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.F.M.) 6.00 SEISMIC FEE
I hereby afl'Ina that there is o construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 6.00
Lender's Name HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 � 1
Lender's Address ELECTRIC 6 d "
I certify that l have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
q� ordinances and state laws relating to building construction, and
BUILER•COMPI3 H.P.Of 100,0008.T.U.) 6.00
hereby au n representatives of this city l7 enter Upon tire BOILER-COMP IOver 400,000 BTU)SEE FEE$CH. t'MECHANICAL
in,wo-m• lined roperty forinspecllon pu rpises.
( agree t save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
er' a '' s habiliii s,judgments, costs and expenses which CONST.TAX
i ''sst said City in consequence of the PERMIT ISSUANCE 10.00
f spe 1 MECH.CONT. LIC.NO. MECH.
/` TOTAL TOTAL ]'O
ignatureof Applicant/C n r Date
OFFICE COPY