14618 (2) I
POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO - 14618 .
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS �oa? �.35 S'- rL�l�'� eU UNIT# _LOT# 9
PERMIT EXPIRES IF WORK
OWNER GL CONTRACTOR E.CJ '� �Pi.Q�p, IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD tBB DAYS OF PERMIT ISSU-
FOUNDATION - ANCE OR 180 DAYS FROM
NOTE:
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALL ED INSPECTION.
PREGUN ITE— TO COMPLY WITH THE APPROVED PLANS AND CITY OF PEHMIT VAuuATION
CUPERTINO STANDARDS.-- ,
GARAGE SLABS -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGRO ND /SLAB
PLUMBING (,pEv 3�Z� '-�' ✓CY
ELECTRICAL • ISSUANCE DATE
MECHANICAL BLDG ELECT PLG. MECH
❑ ❑ 50 1 ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING
VALUA710N $/FT.
� - -
MECHANICAL -
ELECTRICAL
3-2f
PERMIT TO -
FRAMING lwmilft VOL /LLgjn. o K vNi6 ''a'� , •—{ - _ ,v.•.. ,�
sroHlEs TYPE CONSTR
INSULATION .
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
. - T 1'IOCR AREA TOTAL ACREAGE'
ROOF � - NOTE:NO FINAL INSP.SHALL BEMADE-BEFORE SO.,I
DIAPHRAGM. THE CONSTRUCTION TAX IS PAID -
SOLDING USE
ROOF SHEATHING - RES IND. CON PB - Om,-.
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED- FINALS DATE INSP. ❑ ❑ El ❑ ❑
ASSESSORS PARCEL NO
ROUGH SAN.H /.
f PLUMBING ELECT.ENER Y �
TUBS BSHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO
MECHANICAL - MECH.ENERGY
ELECTRICAL - BUILDING ENERGY •ACC,DATE ACE.FILE NO,
FRAMING ELECT.FINAL TEST '
INSULATION - - PLUMBING ZONING ENG.SITE NO.
GAS TEST GAS '
MECHANICAL FIRE SPRINK ENERGY T-24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING'. ° NEI ° "0
EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE AL UC.
INTERIOR SHEAR FIRE DEPT. Y❑ Na Y ❑ N❑
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
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
LEI ONE WORKING DAY BEFORE REQUIRED INSPECTION, PLUMBING .
0 o• PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z IMECHANICAL'
SEE PERMIT FOR EXPIRATION DATE
IMPORTANTF CONST.TAX,
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. .
I OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN REDLINES —.USE BALL POINT PEN ONLY
I' BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER -
BUILDING APPLICATION & PERMIT - -
ADDRESS IOZ7 14'61 '8
' BUILDING —ELECTRICAL—PLUMBING—MECHANICAL
owNEF's4il - PLAN CHECK VALIDATION
AME ' QTY. ELECTRIC PERMIT FEE
a HONE
' AMEPACTORs, ? UTLETS-SWITCHES-RECEP 10.00/1,00 ,
De CArcorp. UC.NO. •38;71 LIGHTING FIXTURES 10.00/1.00 - -�
CONTRACTORS �" PPLIANCES-RESIDENTIAL 4.00 -
a Zas IC}p V PHONE.y"J p—19
PANELS 110.00 . DATE OF APPLICATION "
ARCHITECTr - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE . P.C.NO.
ENGINEER
uc.NaSIGNS TRANS. 3.00
ARCH,OR ADDRESS ENG SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
A' NT'S ZIP TEMP.METER OR POLE INS. 20.00 - -
ADDRESS MOTORS SEE FEE SCH. - �•�D (/��_'�-- j .-
SERVICE CHANGE 20.00
wO o LICENSED CONTRACTORS DECLARATIONY/fid/a r
a is u I hereby affirm that I am licensed under provisions of Chapter 9
H 2 1O (commencing with Sectio ] ISSUANCE DATE
Section 000 of Div
¢ A B 7 Icon 3 of the Business and
BLOG� ELECT. PLG. MECH.
F w
Professions Code,.11y 1 my Ihense Is In full for [ -
z o m — License .lass L, Lin.Number 2 .alt I
9 w I-� Date p�Ft�Contractor
�( _
Q m m BUILDING PERMIT
¢ ¢ Q OWNER-BUILDER R-BUILDER DECLARATION -
E o o ° . INFORMATION
w 3 y 1 hereby affirm that I am exempt from the Contractor's License MISC.— 'REFER TO ORD -
FLLO ¢ Law for the following reason.(See,7031,5,Businessand Professions ,. Fs(4WATION
$/FT.
m � Code:Anyclty orcoutny which requires a permit to construct,alter, PERMIT ISSUANCE. 10.00
ELEC.CONTR. LIC.NO.
rt ¢ ¢o improve,demolish,or repair any structure,prior to its issuance,also ELEC.
D ¢ requires lhe'applicant for such permit to file a signed statement that TOTAL -n
h PERMIT
the
E
m>m he is licensed pursuant en the provisions of the Contractor's License T L�
=z st Law(Chapter ndProfessions
Code)or that
is 00)exempt therefrom
and -
� i o Business and Professions emption that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
a I- $ by basis for the alleged exemption.Any violation of Section 6nalty Cj .TYPE CONSTR.
u 3 by any applicant fora permit subjects the applicant tuacivil penalty ALTER-DRAIN&'VENT-WATER (EA.) 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 OCG GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 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 ' SO.FT.FLOOR AREA TOTAL ACREAGE-
himself or through his own employees,provided that such improve-
1� mems are not intended or offered for sale,If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 -
or improvement is sold within one year of completion,the owner-
^- builder will have the burden of proving that he did not build or iin- GAS.-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE
prove for purpose ofsale.)! FES IND CON PB -' Other
❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 - �
V.B. .
licensed contractors to construct the project(Sec 7044,Business LAWN SPRINKLERS.-1 INC 5 B .600 - ASSESSORS PARCEL No.
and Professions Code:The Contractor's License Law does not apply -
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS,-OVER 5,(EA.) 1.00
' contracts,l'or such projects with a contractous)licensed pursuant to - 1
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10,00 Q � TRACT NO. PARCEL NO.
❑ lam exempt under Sec. ,B.&P.C.to,this
reason .00 WATER HEATER W/VENT 6
Owner Date WATER SYSTEM 5.00 ,. ACC.DATE ACC.FILE NO.'
WORKERS'COMPENSATION DECLARATION WATER'TREATING EQUIP. 5.00
hereby affirm that I have a certificate Of CmHzml to self-insure, 1.
ora certificate of Workers'Compensation Insurance,or a certified s ZONING ENG.SITE NO
copy thereof(Sec.3800,Lab.C)�1
_ Policy No. Company
Q ❑ Certified copy is herebyfomishQ FIRE11 SPRINK ENERGY LY4
Z Z ❑ Cert
if d I- n Iled with the city Inspection division.
C, Applicant _ig ri MISC.- REFER TO ORD. Y'E r NQ •Y ❑ NO
CC w CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 /Q FLOOD ZONE A.L.0.0.
W COMPENSATION INSURANCE PLG.CONTR, LIC.NO. PLG
Z (This section need•not be completed if the permit is for one TOTAL ,2 0 V N� VIJ
NC]
hundred dollars 1$100)or less.) ,
U O 1 certify that in the performance of the work for which this perDTV. - MECHANICAL PERMIT FEE FEE SUMMARY
LL h mit is issued,I shall not employ any person in.any manner so as to
O W become subject to the Workers'Compensation Laws of California.
y Datc Applicant - BUILDING
} W NOTICE TO APPLICANT: If,after making this Certificate of lix. ALTEfl OR ADD TO MECH. 5.00 �"
F ? 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
such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10p=MCF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 . SEISMIC FEE
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITWDUCT) 5.00 -
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Cis C.). - HEATING'UNIT ITO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.19.50 ELECTRIC_
Lender's Address
I 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 to building construction, and BOILER-COMPI3�H.P.or100,000B.T.U.), 6.00
hereby authorize representatives of this city to color upon the BOI L'ER-COMP IOver.100,000BTU)SEEFEESCH. MECHANICAL
above-mentioned property for representatives
of
purposes.
(We) agree to save, indemnify and keep harmless the City of MISC., REFER TO ORD. -
upertino against liabilities,judgments, casts and expenses which. PERMIT ISSUANCE _ 10,00 CONST.TAX
may in any way accrue against said City in consequence of the
rantin f this pe t
MECH.CONT. LIQ - CH.
NO. Ma
\ l7ebcar alto TOTAL TOTAL
JC Signature of A p' ant/Con[racmr Uate
OFFICE COPY .b