14709 (2) POST THIS CARD NEAR.FRONT OF BUILDING
`PERMIT NUMBER
CITY OF CUPERTINO ' 1.4709
- INSPECT.ION.DIVISION '1
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOBADDFESs 10332 CANYON VISTA UNIT# _Lot¢t '' ^
" " PERMIT EXPIRES IF, WORK
OWNER . Bob Rgeu - CONTRACTOR ' Ireland, Const. CO. ISNOTSTARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION - • -ANCE. OR 180'DAYS FROM
NOTE: " LAST CALL ED INSPECT]ON:
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
UNDERGROUND /SLAB - - '. •�
I
PLUMBING ' "
' c .
ELECTRICAL.. "
" .ISSUANCE DATE ..
MECHANICAL ABLuc. ELECT. - PLG. MECH.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDl BUILDING PERMIT
WOOD FLOOR i 4 9 " INFORMATION
UATION $/FT.-
- PLUMBING ,
MECHANICAL 1 • U' l '�" "+t7"` +
ELECTRICAL - PERwr o
FRAMING,
INSULATION - STORIES ryFE CONSTR. .
MMM i
. OCC,GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
$D FT,FLOOR AREA TOTALACREACE,�
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID., ,•-I• -
�' ROOF SHEATHING, ILOUSE
RES IND CON PB Durr
APPLY NO ROOFING UNTIL ABOVE HAS'BEEN SIGNED !" -FINALS" DATE INSP.- ❑ ❑ ❑ ❑ ❑
ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING' " ELECT.ENERGY
• _ TRACT NO. PARCEL NO
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
BUILDING,ENERGY ACC.DATE . ACC.FILE NO,
.. ELECTRICAL , ..
FRAMING - ELECT.FINAL TEST
ZONING ENG.,SITE NO. y
INSULATION PLUMBING - I
GAS TEST GAS ,t,
MECHANICAL FIRE SPRINK ENERGY T 24
�• COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ft
N.❑ Y ❑ N❑
N E Z.^ A.L,U.C.EXTERIOR SHEAR . ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. N❑ r ❑ N❑
SHEETROCK GRADE FEE SUMMARY
I EXTERIOR LATH ` BUILDING
' INTERIOR LATH'SBUILDING
TEMPORARY APPROVALS
' SCRATCH COAT `' ELECTRIC PLAN CHECK -
�. - GAS
FEE'
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED'JOCCUPANCY '' SEISMIC FEE I.
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL IS SIGN ED BY BUILDING INSPECTOR. .MICROFILM
LU ARRANGE FOR INSPECTION'BY PHONING 252-4505, ELECTRIC
ONE WORKING DAY•BEFORE•REQUIRED.INSPECTION. '
PLUMBING
z. PLEASE GIVE JOB ADDRESS WHEN PHONING: E�
--SEE PERMIT FOR EXPIRATION DATE —' MECHANICAL
CONST.TAX '
IMPORTANT!
PLEASE. READ REVERSE SIDE BEFORt
CALLING FOR FINAL INSPECTION. TOTAL r✓
OFFICE COPY
APPLICANT TO FELL'IN INFORMATION WITHIN RED LINES — USEtALL.POI,NT PEN ONLY,
BUILDINGPROJECTIDENTI,FICATION . - • PERMIr,NumeER "
BUILDING APPLICATION & PERMIT 1
ADDRESS A 7 /y�
.gyp t '' . BUILDING'—ELECTRICAL—PLUMBING-MECHANICAL
�.. 1 '1' 1 O.V.Q .
OWNER'S ` , PLAN CHECK VALIDATION -n -
NADpEI ,. CITY. ELECTRIC PERMIT FEE ,
(/�i -C(J PHONE ' S
CONTRACTOR'S _ UTLETS-SWITCHES-RECEP 10,00/1.00
uc.No. 4�ri-jd ' LIGHTING FIXTURES 10.00/1.00
CONTRACTORS APPLIANCES'-RESIDENTIAL 400
AooRE/ss,�''` t
.J O JU GM4 P1 t-� vgory U a22 PANELS '- , 10.00 eDATE OFAPPLICATIONF
ARCHITECT pANEL$�IOVER ZOO AMPI ' 2000 PLAN CHECK FEE PC NO.
OR a
ENGINEER -
• I I '' UC.NO. SIGNS TRANS. 3.00.'
' RCH. PERM IT VALIDATION '
ADDRESS ENG. - } F h..
AOOREss. � SPECIAL CIRCUIT '�I �• ,' 5.00.
- ZIP TEMP.METER OR POLE INS. 20,00
ASrvT's
ADDRESS MOTORS ` - SEE FEE SCH. �/f • "' e'
'
't- - SERVICE CHANGE' ' ' • .2000 AID
x O oo (LICENSED CONTRACTORS DECLARATION ,A(
-Q v v 1 hereby,hf0uan that I am licensed under provisions of Chapter 9 (t Y I:1 ) NICE DATE
Z re (commencing with Section 7000)ofDivision3 of the Business and - BLDG.7 ELECT- PLG. (MECH.
F ❑i' Professions Code, rid y license.is in full for rid c
qq �b
CY- S pp�
O y� Lmense aas' Luc.Number � .. -❑
2 'YYI a❑
� y f pipe
9:m r� Dale'L Contractor
� I `
a m BUILDING PERMIT
¢ IS w a ' OWNER-BUILDER DECLARATION - INFORMATION ,
' w 0 LL N I'.hereby'affum that 1 am exempt from the Contractor's License MISC.,— - - _ REFER TO ORD .,a:, " _
LL o ar Law for the,following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10,00 VALUATION
Code:Any city or county which requiresa permit to construct,alteq " " eZ _
�0
,Q Q 0 )mpmve;demolish,or repair any structure,prior to Its issuance,also ELEC.CONTE; LIC.NO. ELEC _ - n d-
O ¢ requires lheappllcant for audl jwrmit to file a signed statement that TOTAL PER MIT,$0
w $u' he is licensed pursuant to the provisions of the Contractor's,License
Fy � Law-(Chapter9(commencing with Section 7000)of Division 3 of the f- T
a Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE
¢ = $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES .'TYPE CONSTR.
dsg _ by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN -WATER (EA:')1,5.00 � -
of not more than five hundred dollars(8500).):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE •`4.00 OCC.GROUP FES UNIrs '+
their sale compensation,will do the work,and the structure is not -
- intendedor'offered for sale'i(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 bullds'or improves thereon,and who does such work FIXTURES-PER TRAP 5:00 50.FT.FLOORAREA TOTAL ACREAGE
menu re not hrough
ownemployees,for sale.
If,ed that however,
the
improve- GAS,
600
mentP are not iiaended or offered for sale.IL however,the building
or improvemem is sola within one year of completion,the owner--
GAS-,EA.SYSTEM'-OVER 4 (EA.) 200 BUILDING USE
builder will have the burden of proving that he did not build or im- RES IND. .CON' PB Orbe,
prove for purpose of sale.). - INDUSTRIALWASTE INTER. 30.00
- ' ❑L I,as owner,of the property,am exclusively contracting.with - ❑ . , ❑ ❑ - ❑
t t licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS'-1 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'SPRINKLERS-OVER 5(EA.) ,. •1.00 ,I
contracts for such projects with a contortions.)licensed puisuant to
the Contractor's License Law, SEWER-SANITARY-STORM EA.200ft/10:00 'TRACT NO, PARCEL NO.
❑ I am exempt under Sec. - ;B.&PCJmthla ' WATER HEATER W/VENT 6:00
reason -
Owner - Date WATER SYSTEM -5.00 ACC.DATF ACC.FILE NO. .-
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 ,
'•I hereby affirm that have a certificate of consent to self-insure, 20NING• 'ENG.SITE N0.
Gra certificate of Wor ers'Compensation Insurance,or a certified - -
copy thereof(Sec.38 ab C)
Policy No. o any
❑ Certifie y sl yfurnished. - - FIRESPRINK, .ENERGYT24
Z Z ❑ Certifi o y led with the city inspection division. MISC:- REFER SO ORD.
.
O, Applicant - - Y❑ N Q, Y ❑- •N❑
F' w ' PERMIT ISSUANCE ' 10,00 FlooO zO_NE •A L u C.> CERTIFICATE OF EXEMPTION FROM WORKERS'
UJ -COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG.
.I1 O' (This section need not be completed if the permit is'for one TOTAL `Y.❑ N❑- Y ❑- N®'
-0 Z . hundred dollars IS 100).fleas.) .
U O 1 I certify that in the performance of the work for which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY
:LL F mit is issued,I shall not employ any person in an m inner so as to
W "coin s ect o the Workers' p isaC n L s lifornla.
�p
G Dalc L/L�SYfApplicam - ALTER OR ADD TO MECH. 5.00 BUILDING
} y NOTIC. TO PPLICANT: r making this r u'cale of Ex-
F2 emption,.you should become subject to the Workers'Compensation APPLIANCE -5.00 PLAN CHECK lya
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 10,000 C.F.M.) 4,00 "
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER lomoaF,M-1 6.00 SEISMIC.FE E-
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(W ITH.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.) .8.00 S..
- -- Lender's Name
Lender's Address U:)HEATING UNIT(OV ER 100,000 B.T. 9.'50 ^ ELECTRIC
'tt i
1 certify that I have read this application and state that the above' VENTILATION FAN'(SINGLE) _ 4.00
information n correct. I agree to comply with all-construction,
county PLUMBING`
ordinances and stale laws re to c to mply lith construction, and BOILER-COMP(3 H.P.Or 10000013TU.) 600
hereby authorize representatives of this.city to enter upon the BOILER-COMP,(DVa,100,000BTU)5EE FEE SCH MECHANICAL
above-mentioned property for inspection purposes. - `
:(We) agree to save, indemnify and keep harmless the City of MISC.- `- REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which •CONST:TAX ,
may in'anyway,.ccme'against d 'ly inconsequence of the PERMIT ISSUANCE 10.00 -�
ranting t 's etm' . +' - MECH.CONT LIC.NO.
TOTAL b ° �
\ TOTAL J
7(1, Signature of Applicant/Contractor Data `
OFFICE COPY: