16366 (2) I
POST THIS CARD NEAR FRONT OF BUILDING
CITY 01 CUPERTINO PERMIT NUMBER
INSPECTION DIVISION. 6366
JOB INSPECTION RECORD`
/ {�–''' `�, /^`' }–' PERMIT EXPIRATION
JOB ADDRESS—i O ` �Y�LL�1n�DUN 1 T# LOT 4t PERMIT EXPIRES IF WORK
OWNER 14 v r3 c-k.,WACTOR ..1 IS-NOT STARTED WITHIN
INSPECTfON DATE INSPECTOR INSPECTION RECORD '180 DAYS OF PERMIT ISSU-.
FOUNDATION -ANCE OR 180 DAYS FROM
NOTE: LAST CALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF I'ERrali VALIDATION
CUPERTINO STANDARDS. 'I
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING SEP 13 lu88. t –. X
ELECTRICAL ISSUANCE DATE
MECHANICAL Gity of Cupemno BLDG, %.ELECT, I PLG. MECH.
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING
VALUATION - $TFT.
• � � - � ^/
MECHANICAL "I J1?u• '•
ELECTRICAL' pD PERMn TO
FRAMING h( w" CI,
INSULATION '' - STORIES TYPE CONSTS, _
OCC GROUP HES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE Su.FT FLODR ARTA TOTAL.ACREAGE
DIAPHRAGM THE CONSTRUCTION.TAX IS PAID
BUILDING USE
ROOF SHEATHING RES'. IND CON Pe O, -
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ El
' ASSESSORS PA
ROUGH SAN.i1 :CEL NO
PLUMBING ELECT.ENERGY
. TUBS 8 SHOWER PAN PLUMBING ENERGY ' TRACT NO. PARCEL NO
' MECHANICAL - MECR ENERGY -
ACC.DATE ACC FILE NO.
ELECTRICALO' BUILDING ENERGY
FRAMING 6 ' S ELECT.FINAL TEST zorvlNc ENG.SITE No.
INSULATION PLUMBING
GAS TEST GAS-
. FIRE SPRINK ENERGY T.24
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y E] N❑ v "�
EXTERIOR SHEAR � � ELECTRICAL FLOOD LONE A.L.0 C.
LEA
INTERIOR SHEAR FIRE DEPT. ° ❑ NEI I E ❑ N❑
SHEETROCK GRADE �,f (� FEE SUMMARY
EXTERIOR LATH BUILDING - '� BUILDING y•
INTERIOR LATH- - TEMPORARY APPROVALS 0,0
SCRATCH COAT - ELECTRIC PLAN CHECK
GAS FEE
_ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY * SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
MICROFILM
' ELECTRIC
uJ ARRANGE FOR INSPECTION BY PHONING 252-4505, . int-•
O~� ONE WORKING DAY BEFORE REQUIRED INSPECTION. + ; PLUMBING
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TAX T
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. Ir
OFFICE COPY
1
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BU I LDING PROJECT I DENT]FICATI ON - - -PERMIT NUMBER
as 6_lr -1RAvoOT bR Ef}I 'APPLICATION PERMIT
'""G q
UILDING -ELECTRICAL-PLUMBING-MECHANICAL 16366
OWNER'S PLAN CHECK VALIDATION
"°ME �y93 TY. ELECTRIC PERMIT FEE
UGO^�:Arat3RUs !E�a'_
NAUERACTORs UTLETS-SWITCHES-RECEP 10.00/1-.00
a*
1� sec No. LIGHTING FIXTURES 10.00/1.00
ADDRESSTOR's - PPLIANCES-RESIDENTIAL 4.00
PHONE PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C..NO.
ENGINEER '
uc.No. SIGNSTRANS. 3.00
goo Ess. SPECIAL CIRCUIT. 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APPUCAN MOTORS SEE FEE SCH.H. .00
AooREss '
SERVICE CHANGE 20.00
F o o LICENSED CONTRACTORS DECLARATION PAW
^Q Q -
a o I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
maw (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
F N Z Prf,,,.ns Code,and my licca e.is in full force and effectSEF 1981 ❑ ❑
o0 .W License Class Lie,Number XUatc Contractor
P: ,c aCity of Cuperti BUILDING PERMIT
¢ ¢ a OR'NER�BUILDER UECL\RATION INFORMATION
wH I hereby affirm that I um exempt from the Contractor's License MISC.- REFER TO ORD
,a u• oa Law for the followingreason,Ines,7031.5.BusinessmdProfeoious PERMIT ISSUANCE 10.00 VALUATION -S/FT.
iwi Code Any city or county which requiresa permit toconstmc4 alter, ZO ODQ.��
¢ x ¢O O improve,demolish,or repair any structure,pour m Its issuance,also ELEG CONTR. LIC.N0. ELEG I ,Q
¢ rryuims the applicant for such permit to file a signed statement that TOTAL
w es" he is licensed pursuant Or the provisions 0f the Contmetoi s License PERMIT TO
Pro
ti, ve a Law(Chapter 9(commencing with Section 7000)of Division 3 of the � 1I
i 4 O Business and fessions Code)or That he is exempt therefrom and ATV. PLUMBING PERMIT' FEE �T �Y-
¢ I- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
u ; by any applicant fora permit subjects the applicant toaciril penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred dollars 65001.1: '
D 1,as owner of the property,or my employees with wages m BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for tole (Sec. 7044, Business and Professions DRAINS-FLODR,ROOF,AREA,COND. 5.00
Code:The Contractor's License law docs not apply to an owner of
property who huilds or int proves thereon,and who dos such work FIXTURES-PER TRAP 5.00 SO,IT,FLOOR AREA TOTAL ACREAGE
himself or through his own employtts,provided that such improve-
ments are not intended or offered for sales If,howeveq the building GAS-EA.SYSTEM-1 INC.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 int- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND• CON PS Om.,
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ 1:1 ❑ 1:1licensed contractors to construct the project(Seo. 7044.Busincu LAWN SPRINKLERS-1 INC 5 V.B. 600 ASSESSOR SPARCEL NO.
and Professions Code:9'he Contractor's License Law does not apply
to an owner of property who builds or'improves thereon,and who L .
AWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a Contructorts)Ilcenod pursuant to '.
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ tum excmptl der Sec. ,B.&PI for tis ' WATER HEATER W/VENT 6.00
Owner_ fp Q_ w Date _ WATER SYSTEM 5.00
ACC DATE ACC.FILE NO.
WORK Ii RS'COMPENSAt'l0N DI:CLA RATION WATER TREATING EQUIP. 5.00
I Innehy infirm flom 1 huvc a certiliente w consent lis selb n me,
or a certificate of Workers'Compenmtum Insurance,or a ceni0ed ZONING ENG.SITE NO.
copy thereof t Sec.3800,Lab.C.l.
Policy No. Company
O ❑ Ce,UCed Copy is hereby furnished.
Z Z 0 Certified Copy is tiled with the city ino,clion division. FIRE SPRINK ENERGY T 24
F- O Applicant MISC.- REFER TO ORD. Y❑ N❑ Y [] N❑
f= y CER'I'1 FWA'1'Ii 01'IiXEM PTIONI'ROM WORK17RS. PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LU 1 COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
Q_'0 ('this wction need not be completed if the permit is for one TOTAL Y❑ N C] Y❑ N❑
:D Z hundred dollar IS 100)or less.) -
U O 1 certify that in the perlormmme ol'the work for which this per. QTY
MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued,1 shall not employ any perxm in any ma Acer So as to
become subject to the W'0rkuri Compensation Llws of Calilornia.
0 LUy Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING o0' DO
} t4 NOTICE TO APPLICANT; If,alter making this Cerifi xte of Ex. C
? emR1011,you should become subject to the Workers'Compensation APPLIANCE - 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with U FEE such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE ! b
I hereby afNna.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.l. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
Lender,Addr,ss HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC ,00
1 certify that 1 have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00
information is correct I agree t0 comply with all city and county PLUMBING
ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00
hereby authorise apresentativn of this city to enter upon the BOILER-COMP Over 100,000 BTUI SEE FEE SCH.
abovu-nicnliouad p...pony for,u,pection purpoms, MECHANICAL
(We) agree t e, naIf nlfy and keep harmless the City of MISC.- REFER TO ORD.
upertino ugah t blhtics,judglnems, costs and exlsenses which CONST.TAX
may in any wN zc re against saij---�ty In consequence of the PERMIT ISSUANCE 10.00
+nt' g f this I O i , MECH.CONT. LIQ NO, MECN.
TOTAL TOTAL
Signature of A}q#ieaut/Contractor Uate
OFFICE COPY