14444 (2) i
POST THISCARDNEAR FRONT OF BUILDING
+ PERMIT NUMBER
CITY* OF CUPERTINO : 14444
-INSPECTION DIVISION
7 JOB+INSPECTION RECORD
`l " • - PERMIT EXPIRATION
JOB ADDRESS 22325 CARTA BLANCA - UNIT# '' '-- LOT 4* -
- - PERMIT EXPIRES IF WORK',
OWNER M.T.WATSON CONTRACTOR :VALLEY HEATING _ IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU=
FOUNDATIONNOTE: - ANCE OR 180 DAYS FROM
LIFER � ALL GRADING AND DRAINAGE SHALL BE,INSTALLED LAST CAL LED INSPECTION."
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VALIDATION .
CUPERTINO STANDARDS.'.'
GARAGE SLABS PAID
` POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB - _ :MAR 9 - 19R8
PLUMBING - -
ELECTRICAL• - ' INS Nok1D@FfIRO
MECHANICAL - �, - .BLDG. ELECT. PLG. MECR
❑ a ° ❑ ' 4
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
VALUATIONSIFT:
PLUMBING _ +=
MECHANICAL "
- O T
ELECTRICAL PERMIT`
FRAMING
INSULATION - STOH IES TYPE CONSTR,
.. • DCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
.ED FT.FLOOR AREA - TOTAL ACREAGE
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAXIS PAID
•BUILDING USE
ROOF SHEATHING ` RES'' IND • CON PB
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP: 0 El 13 11
ASSESSOHS PAHCEL NO
ROUGH SAN.4
PLUMBING ELECT,ENERGY' -
TRACT NO. PARCEL NO e
TUBS 8 SHOWER PAN PLUMBING ENERGY - -
MECHANICAL. MECH.ENERGY
ACC.DATE ACC FILE NO..
ELECTRICAL BUILDING ENERGY - •w^�^'
FRAMING ELECT.FINAL TEST
INSULATION _ - • �o"I"; emc.slTe NO.
PLUMBING .
' GAS TEST GAS - �G
MECHANICAL L' - . FIRE SPRINT( - .ENERGY T.24 -
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING O •Y _N Y "o
FLODo ZONE A.L,U C.
EXTERIOR SHEAR ELECTRICAL RELEASE '
INTERIOR SHEAR - FIRE DEPT, - Y "� Y L-!
SHEETROCK GRADE FEESUMMARY
EXTERIOR LATH - - BUILDINGp/ - _
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 IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED.BY BUILDING INSPECTOR. ','MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,.; ELECTRIC
F ONE WORKING DAY BEFORE-REQUIRED INSPECTION. PLUMBING- '
v
z�. PLEASE GIVE JOB ADDRESS WHEN PHONING. .
� +.�
— SEE PERMIT FOR EXPIRATION'DATE MECHANICAL.
IMPORTANT! conisT TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. -
OFFICE COPY
APPLICANT TO.FILL IN''INFORMATION.WITHIN 'RED''LINES+— USE BALL POINT.P,EN ONLY
-
BUILDING PROJECT IDENTIFICATION .• PERMIT UMBER 1.
BUILDING I APPLICATION-$! PERMIT+'
BUILDING —ELECTRICAL=.PLUMBING—MECHANICAL 14444
..NER's ''( - - - �! _ ', J -PLAN CHECK VALIDATION
• �.',\ �'�^ DTV. ELECTRIC PERMIT, FE
PE r r-
\�Pub NONE
LO TRACTOR'S
A OUTLETS-SWITCHES'=RECEP 10:00/1!00 .
1 NO LIGHTING FIXTURES 40.00/11.00
CONTRACTOR APPLIANCES-RESIDENTIAL: 4.00
RE55 _
'PHONE PANELS' , _ ^ 10.00 ° DATE OF APPLICATION
ARCHITECT - - PLAN CHECK.FEE P.C.NO.
oR -, PANELS (OVER 200 AMP) 20.00
ENGINEER `. Lie.NO. ,',• SIGNSTRANS. " o! ' 3.00
r 't ARCH OR ENG.
PERMIT.
ADDRESS SPECIAL CIRCUIT' '5,00 VALIDATION !
ZIP EMP. METER OR POLE INS. ,; (" 20 00 PAID
APPLICANT'S''^ ADDRESS MOTORS - SEE FEE SCH,
SERVICE CHANGE 00 MAR
camv." 9t�ry
-
w - :3/9*ageO o LICENSED CONTRACTORS DECLARATION
I hereby efirm'thal 1 em licensed underprovisions ofChapotCtpI�
10U
ra v" pANCE DA
(commencing with Section 7000)of Division 3 of the Business and
Z. - -BLDG. ELECT. ' PLG'. MECH.,
H ve z Professions Co an ase is in full 0 ❑ � .r
p i w a .' L¢eucy�La' Lia Numb e - -
Date d Contractor
F 2 J
'Q s: f st c-;'' � 'I. BUILDING PERMIT r <
•s ¢ a OWNER-BUILDER DECLA A -
Ix W o - - INFORMATION
'r w ;LL H I hereby affirm that I am exempt from the Contractor's License MISC - , f ^REFER'TO ORD
w VALUATION I $/FT.
Law for the following reason:(Sec.'7031.5,Business and Professions
H - PERMIT ISSUANCE 1000
e w Code:Any city or county whish regdlrea a permit to construct,alter, ' -
Q � QO tmpmve,demolish,or re pair anysmuct"re"prior to its issuance,also ELEC:LONTR! LIC.No. , ELEC
O 0 requires the applicant for such permit to file a signed statement her TOTAL"
i >e m w - - r' PERMIT.TO
he is licensed pursuant to rhe.provisions oLihe COnhaclose License - '� ,
FZ>' Law(Chapter 9(commencinIwith Section 7000)Of Uivision3of the
4 0 Business and Professions Code)or that he is exeinp(therefrom and CITY. PLUMBING PERMIT r FEE 1 ,
¢ to the bests for the alleged exemption.Any violation of Section 7031.5 - •' STORIES TYPE CONSTR. Y
A. 3.� byzny applican t fora permit subjects[he applican[lo_a civil penalty ALTER-DRAIN&,VENT-WATER (EA.) 5.00
of not more than five hundred dollars($500).1: -
❑.-0 as owner of the property,a my employees with wages as BACK FLOW PROTECT. DEVICE. 4.00 DCC.GROUP. _ RES.UNITS
their sole compensation,will'it [he work,and[he structure is not
intended or offered for Sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON_ D. 5.00
Code:The Contractors License Law does not apply t0 an owner of - " "`
4. property who builds;or improves thereon,and who does such work, FIXTURES-PE TRAP e ,.'� ., 5.00 SG,FT.FLOOR AREA TOTALACREAGE r
himself or through his own employees,provided that such improve- ; -
mGAS INC.4OUTLETS 6.00
r,
(�
mems are not intended or offered for sale.If,however,the building . - `
or improvement is sold within one year.of completion,the owner- GAS-EA:SV STEM,-OVER 4(EA.) 200 BUILDING USE
. builder will have the burden of proving that he did not build of im- - .RES'. IND - CON PB Other
prove for purpose of sale:). INDUSTRIAL WASTE INTER: ': '30.00
❑ I,as'owner of the property,am exclusively contracting with ❑, ❑t" ❑ j ❑- ❑
licensed contractors to construct the project(Sec.7044,Business " LAWNSPRINKLERS-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
confiacts for such projects with a contractor(s)licensed pursuant to - SEWER-SANITARY-STORM_ EA.20Gft/10.00
the Contractor's License Low. TRACT NO. PARCEL NO.
❑ I am exempt under Sec: ,B.&P.Cfor this WATER HEATERIW/VENT '6.00 '
reason
' Owner Date WATER SYSTEM' :
- - 5.00
-1 t ACC.DATE .',ACC.FILE NO.
WORKF.RS'COMPE.NSATION DECLARATION WATER TREATING.EQUIP. 5.00
Phereby'affirm that I have a certificate of consent to self-insure, ,ZONING ENG.SITE NO.
' or a certificate of Workers'Compen ation Ins u ane r a certified
copy
' Policy
0 rtifie cop is herebyumished. - _ FIRESPRINK ENERGY T"24' "
Certlf�'ed filed, on division.
Z
Z 'w Pach0. APFI¢am 1 11'�r��' Misc.- REFER TO ORD. Y❑ No , .V^❑ 'N❑
~ wE
I
IT, SSUANC
10.00 .
CERTIFICATE OF'PPTIFROMWORKERS' PERM , FLooD ZONE.- A.L.U.C.
r W > COMPENSATION INSURANCE
URANCE PLG.CONTR. LIC.NO. � PLG.
d O ' (This section need not be completed if the permit is for one TOTAL _ 's Y❑' ,'N❑" Y ❑ N❑
-� Z hundred dollars IS 100)or less.) "
U O I'cerlify that,in the performance of the work for which this per- 4 CITY. MECHANICAL PERMIT FEE .FEE SUMMARY -
LL 1- mit is issued,1 shall not employ any person in any manner so as to:
O Wbecome subject to the Workers'Compensation Laws of California.
M _ Date - Applicant ALTER OR ADD TO MECH. - 5.00 BUILDING' '
} N NOTICE TO APPLICANT: If,after making this Certificate ofIF.- ' APPLIANCE 5.00 'PLAN CHECK
Z eniption,you should become subject to the Workers Compensation -
•I provisions of the Labor Code, you must forthwith comply with FEE ".
(� such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4,00 f
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 1000011F.M.)'6.00 - 'SEISMIC FEE
I hereby'.affam thai 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.) 8.00
Lender's Name' _ HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 -ELECTRIC '
Lender's Address
1 certify that I have read this application and state that the above - VENTILATION FAN (SINGLE) 4.b0
information is.correct. 1 agree to comply with all city and county, PLUMBING o
ordinances and state'laws relating to building construction, and BOILER-COMPI3 H.P.Dr.100,0008.T.U.) 600 I8 CoA
hereby authorize representatives of this city to enter'uPoti the .. r
abobe-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE BCH MECHANICAL ,
' - (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
a in ori way accrue,against said City in'consequence of the PERMIT ISSUANCE - 10.00
gra
i0 is Fermi M H. 0 T. LIC.NO. MECH.'r - -
TOTAL
A ` — TOTAL
e
Si tr o pplicanl/Contractor Date V O
-
Y 'OFFICE COPY..