13373 (2) POST THIS CARD NEAR FRONT OF BUILDING PFRNIITNUMBER
CITY OF CUPERTINO 13373
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS 10463 N. BLANEY UNIT# LOT#
PERMIT EXPIRES IF WORK
OWNER RICH ALT' CONTRACTOR IKE ENTERPRISE IS NOT STARTED WITHIN
ISSU-
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT
ANCE OR 180 DAYS FROM
FOUNDATION LASTCALLED INSPECTION.
UFER
PERMR VALIDATION
PREGUNITE
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED-
UNDERGROUND /
IGNED - "
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL ISS ANCEDA E
BLDG,' EL CT, PLG. MECH.
'MECHANICAL �`
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR _ VALUATION $/FT.
PLUMBING
MECHANICAL
ELECTRICAL .c�LI -F�.•
FRAMING ' I'
STpRIE$ TYPE WN$TR.
INSULATION
gi
OCQ GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SQ FT.FLOOR AREA TOTAL ACREAGE
ROOF
DIAPHRAGM
BUILDING USE
RES IND CON PR OIpeI
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED Q [ ❑ - 0 ❑
ASSESSORS PARCEL NO.
ROUGH
PLUMBING
TRACT NO. PAPCEL NO.
GAS TEST
MECHANICAL
ELECTRICAL FINALS DATE INSP. Acc.onrE Acc.FILE rvo.
FRAMING SAN it I ZONING ENG.SITE NO.
INSULATION - PLUMBING {,
GAS U
FIRE SPRINK ENERGY T 24
MECHANICAL YC] N0 Y'o N�
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOODZONE 0.LLLC.
LATH-INTERIOR ELECTRICAL
LATH-EXTERIOR - FIRE DEPT. YENo ' yo N
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR BUILDING
SHEAR EXTERIOR '
TEMPORARY APPROVALS BUILDING
FIREWALLS ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
uJ
ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC y
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
0� PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING /
Z MECHANICAL
- SEE PERMIT FOR EXPIRATION DATE -
CONST.TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICECOPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
" BUILDING PROJECT IDENTIFICATION' - PERMIT NUMBER
' BUILDING APPLICATION & PERMIT.
ADDRESS/O ^r✓n13373
.� BUILDING—ELECTRICAL—PLUMBING—MECHANICAL
OWNER'$ PLAN CHECK VALIDATION
•
NAME QTY. ELECTRIC PERMIT FEE
Rt-" ALT PHUNE2,530y
OMR NAm OUTLETS-SWITCHES-RECEP 10,00/1.00
�tc rt&q LIC.dO 3 LIGHTING FIXTURES 10.00/1.00
CONTRACTD 'S
ADDRESS APPLIANCES-RESIDENTIAL 4.00
1221 S, H W PHONE WS 13 O PANELS 10.00
ARCHITECT DATE OF APPLICATION
OR PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER
LIC.No. ISIGNS TRANS. 3.00
ADDRESS ENG. PERMIT CIRCUIT '5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20,00 /7
ADDRESS E SCH.MOTORS SEE FE
ADDRESS Wµ/
SERVICE CHANGE 20.00
-
•� G
w o o LICENSED CONTRACTORS DECLARATION L/�Y/0
U w 1 hereby affirm[haft am licensed under provisions of Chapter 9 ISSUANCE DATE '
a (commencing with Section 7000)of Division 3 of the Business and
BLDG. ELECT. PLG. MECH.
r w" Professions Code and n y license is in full for f _ ❑ ❑ ❑
z O w License lass G Lic.Number -
o z Dates, F�_Contractor'
Q y f J
w a OWNER-BUILDER DECLATTTION BUILDING PERMIT
O A O MISC.—• REFER TO ORD INFORMATION
X ; u. N I hereby affirm that I am exempt from the uess'aclor'SLssions VALUATION S/FT.
u O-a Law for the following reason.(Sec.7031.5,Business and Professions 10.00
— PERMIT ISSUANCE
Code:Any city or county which requirese permit toconstruct,,also
0 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
i O w requires the applicant for such permit to file a signed statement that TOTAL
PERMIT—
w$i4 he is licensed pursuant to the provisions of the Contractor's License
H Z TO
Q Law(chapterand
Po.(commencingstintsode)or Section is 00)exempt therefrom and
L(3 45—
Business
f i O the basis
Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
Q F a by any
a for the alleged a exemption.Any violation of Section malty STORIES TYPE CONSTR.
i ; — by any applicant forapenre subjectsthe$500).licant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not more than Coo hundred dollars(my em):
❑ 1,as owner at the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the 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 _ S0.FT,FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.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 im- iGAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE
prove for purpose of sale.). , ' - INDUSTRIAL WASTE INTER3000 RES' IND CON PB 'Omer
❑ I,as owner of the property,am . .
exclusively contracting with 0 ❑ 0 ❑ ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-i INC 5 V.B. 6.00 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 SPRINKLER V 5(EA.) , 1.00
contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑ I aln exempt under Sea ,B.&P.C,for thisy,/qT ER HEATE W/ NT `+tit 6.00
reason
Owner Date WATER SYST 5.00 - ALL.DATE ACC.FILE NO,
WORK ERS'COMPENSATION DECLARATION WATER TREATI fg E IO 5.fte 00
I hereby affirm that I have a certificate of consent to self-insure,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.L
Policy No. Company
O ❑ Certified copy is hereby furnished FIRE SPRINK ENERGY T-24
Z Z ❑ Certified copy is filed with the city inspection division. ❑ ❑
Applicant MISC.- REFER TOPERMIT
y.00
, N Y ❑ No
Cr to CERTIFICATE OI'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00CJS F71 ODZONE A.L.U.C.
Il.l COMPE> (This aBClidh need not
be romple ed Rif thepermitis for one PLG.CONTE. LIC.NO. TOTAL //�/ V❑. N Y N
LG
ao
=) Z hundred dollars C$100)or less.)
U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- mit is issued,1 shall not emplo any p son in any manner ao'as to
U W became b'eci he Workers' pen at on Laws of Calll'or
u Date'�Appliwnt' BUILDING
}'N NOTI E TO A P (CANT: If,a ler ma g this Certificate of Ex- ALTER OR ADD TO MECH. 5.00
♦— Z , 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
U• such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.EM.) 6.00 SEISMIC FEE
1 hereby affirm that there is a 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 UNIT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
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 BOILEfl-COMP(3 H.P.or 100,000B.T.U.) 6.00 PLUMBING b
ordinances and state laws relating to building construction, and
hereby authorize representatives of
this purposes.s city to enter upon the
inspection above-mentioned property forBOILER-COMP hover 100,000 BTU)SEE FEE SCH, MECHANICAL
hi
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which - PERMIT ISSUANCE 10.00 -CONST.TAX
any way accrue against said City in consequence of the
of this permit. MECH.CONT, LIC.NO. MECH.
\ e TOTAL TOTAL
✓�[Sne of Applicant/Contractor ate
OFFICE COPY