18585 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
CITY OF CUPERTINO 18585
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS—( d �3 O '*" VQ �--� 1�d UNIT# -LOT# -
PERMIT EXPIRES IF WORK
OWNER 81J ♦�. CEi- Assoe CONTRACTOR' B S C.V C COIA�► IS .NOT STARTED WITHIN
INSPECTION DATE 1 INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: - LAST CALLED INSPECTION.
UFER ALL GRADING AND DRAINAG EINSTALLED
PREGUNITE -TO COMPLY WITH THE APPRO AND CITY OF ctarnnT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS �f rP
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED — - -
UNDERGROUND /SLAB �--
PLUMBING Vi
ELECTRICAL - ISSUANCE DATE !
MECHANICAL - BLDG. ELECT PLG. MEC..
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - • BUILDING PERMIT
INFORMATION
WOOD FLOOR -
PLUMBING VALUATION c.V $IFTJ
� U
MECHANICAL 7 .o
ELECTRICAL PERMIT TO- � h ry—
FRAMING r+' e�1/4 __QZt
INSULATION, - STORI LS TYPE CONSTR.
OCC.GROUP RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO.IT.11_00.AREA TOTAL ACREAGE
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING RES IND CON PB Om",
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑• ❑ ❑ ' ❑
ASSESSORS PARCEL NO.
ROUGH SANT
PLUMBING ELECT.ENERGY
TUBS 8SHOWER PAN - PLUMBING ENERGY TRACT NO, PARCELNO.
. MECHANICAL MECH.ENERGY .
ELECTRICAL- BUILDING ENERGY ACC.DATE ACC.FILE NO.
FRAMING ELECT.FINAL TEST
INSULATION PLUMBING ZONING -ENG.SITE NO.
GAS TEST GAS
MECHANICAL FI.ESPRINK E-NERGY T 2
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ v ❑ N❑
EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD 20NE A L U,C.
INTERIOR SHEAR FIRE DEPT. ❑ "❑ Y 0 N
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING BUILDING _U/1
INTERIOR .LATH TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC PLAN CHECK
GAS
FEE �r
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE ', rD
OCCUPANCY OF BUILDINGIS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY'PHONING 252-4505, ELECTRIC
H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
'. O� PLEASE GIVE JOB ADDRESS WHEN PHONING.
z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE =
IMPORTANT!, CONST.TAX .
PLEASE READ REVERSE SIDE BEFORE TOTAL S -�
CALLING FOR FINAL INSPECTION.
OFFICE COPY
• e
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY '
BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER
B ,Lp,ND
Ao 1885 APPLICATION & PERMIT (�
�REs
o�fIo �� dl✓ d BUILDING-ELECTRICAL-PLUMBING-MECHANICAL V VV
OWNS W$ PLAN CHECK VALIDATION'
NAME 7 OTY. ELECTRIC PERMIT FEE
s• NAMER^cTOBs OUTLETS-SWITCHES-RECEP 10.00/1.00
o. LIGHTING FIXTURES 10.00/1.00
coNT eon's PPLIANCES-RESIDENTIAL 4.00
noon �/ f///-/
d.✓ •r"� DA!^ PANELS 10.00 DATE OF APPLICATION
ARCHITECT `,NEER PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
LIC,No. SIGNS TRANS. 3.00
Hoo ESS E "D SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP EMP.METER OR POLE INS. 20.00
AD..
AM"
's al MOTORS SE EE SCH.
oR s
SERVICE CHANGE 20.00 V2
S o o ICENSP.D CONTRACTORS DECLARATION •`'��'�'�•
F 0P 1
w S I hereby afllrm Ilial I:un licensed under provisions Of Chap(cr 9 ISSUANCE DATE
4 % (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. CH.
H D z Professions Code,a y license is in full fo e b El El z o License Clus Lic.Number,
o m r w Dale ContructOr
OWNER-HUILARATlO BUILDING PERMIT
rc Ea a DER Df:CL
re' w u INFORMATION
Ao MISC.- E REFER TO ORD
X ;e H I hereby alfinn that I am exempt from the Contractor's License
.. o j Law for the following reason.(See.7031.5,Business and Pomexsions PERMIT ISSUANCE 10.00 VALUATION $/FT.
r - Code:Any city orcounty whichrequiresapermit to construct,alter, ''r^. D
2 al Fimprove,demolishor LICNO
¢O p , , repair any structure,prior to its issuance,also ELEC.CONTR. . . ELEC. V
C IS requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
A w m he is licensed pursuant to the provisions of the Contractor's License ys
Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe J
sc Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ev+nD
,- the basis for the alleged exwnptace.Any violation o f Section7031.5 STORIES TYPE CONSTR.
i ;- by my applicant for a perolt subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER IEA.) 5.00
of not more than five hundred dollars(5500).):
❑ I,as owner of the properly,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
Code: ROOF,AR EA,CON D. 5,00
Code The Contractor's Liecnsc Law does not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00
$o.FT.FLOOR AREA TOTAL neREAGE
himself or through his own employees.provided that such improve'
ments are not intended or offered for sale.If,however,the building GAS EA.SYSTEM-1INC.4OUTLETS 6.00
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that he did not build or int- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE
Prove for purpose of sale.). IND CON PB Cther
th . INDUSTRIAL WASTE INTER. 30.00 1:1 El ❑ ❑ ❑
❑ 1,as owner of the properly,am exclusively contracting with
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:l'he Contractor's License Law does not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the lam exempt
License Sec. TRACT NO. PARCEL NO.
❑ I am exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM - 5.00 ACC.DATE ACC.FILE NO,
WORKS RS'COMPI?NSA'1ION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to self-insure,
or a certificate of Workers'Compensation Compensation Insurance,or a certified ZONING SITE NO.
copy thereof(Sec.3800,Lab.C.).
Policy No. Company
0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z 2 Si.CerIifi�gtdL�,copy fit with the oily inspection division.
O A plicanl ..� MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑
~ rn PERMIT ISSUANCE 10.00
LU CfiR'fIFICA MPENSAEION NSUROMWORKIiR$' FLOOD ZONE A.L.O.C.
W � COMPENSATION INSURANCIi PLG.CONTR. LIC.NO. PLG.
CL Z This section need not be completed if the permit is for one TOTAL Y EDN❑ Y❑ N❑
hundred dollars(S 100)or I.S.)
0 O 1 cerlify that in the performance of 01e work for which This per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued I shall not employ any person in any mariner.. as to
DL) become subject to the Workers Compensation Laws ofCaliforniu.
O_ Date' Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} to NOTICE TO APPLICAN"f: IL alter making this Certificate of Ex-
2 emplion,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Cade, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10000CF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 4 S-Q
I hereby affirm that then, is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the iperformance
orance of the work for which this permit u;issued(SecMICROFILM
. HEATING UNIT(TO 100,000 B.T.U.) 6.00
Lender's Name H EATI N G UN IT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
. . I certify Chat 1 have read this application and state Wet the aboveI
TILATION FAN (SINGLE) 4.00
information is correct.1 agree to comply with all city and county PLUMBING
ordinances and'slale laws relating to building construction, andER-7M PLUMBING H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of This citytoenter upon theLER-COMP lose,100,000BTUISEE FEE SCH. MECHANICAL
above mentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City ofC.- 'REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
ay in way accrue against said City in once ence of the
met go his per MECH.CONT. LIG NO. MECH.
9 TOTAL TOTAL S ( S-D
n are A
T'pprt7anaTcontractor fcuore
OFFICE COPY