18798 (2) POST THIS CARD NEAR FRONT OF, BUILDING
, PERMIT NUMBER
• . �•: ; CITY OF CUPERTINO Q"`° ' 16798
INSPECTION'DIVISION
JOB INSPECTION.RECORD
�'� Qity at CuaerNRa
r�. 10�q(p C� PERMIT EXPIRATION
JOB ADDRESS a HUk.Li�- UNIT# LOT# F.
,- _ PERMIT EXPIRES IF-WORK-
OWNER ,��VY�..�, '] '• _ COr TRnCTO14 33 .'. -'� IS NOT STARTED WITHIN
INSPECTION - DATE INSPECTOR • INSPECTION RECORD - 1B0 DAYS OF PERMIT ISSU-
ANCE'OR 180 DAYS FROM
FOUNDATION ? - NOTE: T .LAST CALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE;INSTALLED '
PREGUNITE - „ TO,COMPLY.WITH THE APPROVED.PLANS AND CITY OFA weRnnr VALIDATION
CUPERTINO STANDARDS., -1
GARAGE'S LABS - '• J fU1i `�. ! < �'n
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB '- - -• ` _
PLUMBING - '• .t U" wrT
ELECTRICAL _ _ IssuANCE'CAT E -
MECHANICAL y. _ BLUG. ELECT. Lc,
MECR.,
'. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR - - .. . VALUATION SIFT.
'PLUMBING
MECHANICAL
ELECTRICAL - PERMIT To
FRAMING - as �� --�� JJII":
INSULATION STORIES YPE CONSTR.
OCC.GROUP .RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
ROOF r + - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
sn.F..TI-00H AREA TOTAL ACREAGE
• �• DIAPHRAGM '- .THE CONSTRUCTION TAX IS PAID - -
ROOFSHEATHAG. `.' '' PCs INDUILOCON usEPB OR„•,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS. - DATE " INSP. ❑ ❑ ' �
- ASSESSORS PARCEL NO, ,
ROUGH SAN:q `
PLUMBING', ' - ELECT.ENERGY' -
' TRACT NO i PARCEL NO. -
_ TUB5,8 GAN //-3-- 3- PLUMBING ENERGY � '
MECHANICAL - MECH.ENERGY.
ELECTRICAL - - ACC.DATE ACC FILE No.
BUILDING ENERGY -
FRAMING ELECT.,FINALTEST - m'�
_ ZnNING . ENC SIT '
INSULATION PLUMBING .
GAS TEST GAS
FIRE SPRINK ENERGY Tp4'
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING'. - Y ❑ N YE) .
❑ . N�
FLOOD ZONE .A.LUC.
EXTERIOR SHEAR. ELECTRICAL RELEASES -
INTERIOR SHEAR - FIRE DEPT. - Y ❑ N❑ .YL. A[
:. '
SHEETROCK; :�7-3 1 GRADE - - FEESUMMARY
EXTERIOR LATH BUILDING Y IF-
INTERIOR LATH, , TEMPORARAPPROVALS 'BUILDING.- ley ..-
' SCRATCH COAT . ' ELECTRIC - PLAN CHECK
i GAS _ - FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCYSEISMIC FEE
OCCUPANCY OF BUILDING.ISNOTPERMITTED UNTIUBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM
%ARRANGE FOR INSPECTION BY PHONING 25274505 ' ELEcrRIC
Iw� i :ONE WORKING DAY BEFORE REQUIRED INSPECTION PLUMBING
PLEASE GIVE JOB ADDRESS WHEN•PHONING: I? 3
' . 'SEE PERMIT'FOR EXPIRATION DATE'—". MECHANICAL
C . - IMPORTANT! CONST.TAX
v PLEASE READ REVERSE SIDE BEFORE - 'TOTAL
` CALLING FOR FINAL INSPECTION.
OFFICE COPY _
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .
UI LDI NG PROJECT I DENTI FICATION PERMIr NUMRER
-' BUILDING APPLICATION & PERMIT
6E$ya 61C� � 18798
UtE dt� BUILDING - ELECTRICAL-PLUMBING -MECHANICAL
OWNER'S • PLAN CHECK VALIDATION
"AMEr 1 iQTY. ELECTRIC PERMIT FEE PAID
0N� Y PHONE
CONTRACTORs a1�fi UTLETS-SWITCHES-RECEP 10.00/1.00
- se {�
T Mr c NO OST LIGHTING FIXTURES. 10.00/1.00
CGII&TRiliCTOR E. _ PPLIANCES-RESIDENTIAL 4.00
LfP/] ,y vROrvE City of.ClIflartinn.-
PANELS 10.00 DATE OF APPLICATION
ORPANELSPANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO.
ENGINEER
LIC.NO SIGNS TRANS. 3.00
ARCH Ess ErvG. SPECIAL CIRCUIT 5.00 PERMIT/VALIDATION
zIP
AEMP.METER OR POLE INS. 20.00
ADDRESS
MOTORS - _SEE FEE SCH.
' '
SERVICE CHANGE20.00
o o LICENSED CONTRACTORS DECLARATION LV•��v v�', (\/`/��
< U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
H<h (commencing with Section 7000)of Division 3 of the Business and - - BLD�C,"� ELECT. PLG. MECH.
F y z professions Code,and my license is in full for64Iu1d[�+cY s ❑ ❑ ❑
'i o w - License Class Lic.Nwnbe rl V
m °w° Date -ff-(-Commtlar _
a m �'¢ ownrR-BulLuliR DBCLARnnON BUILDING PERMIT
E,
d u INFORMATION
w3 N Thereby affirm that I am exenlp(Grnn the Cunt actor's License MISC.- REFER TO ORD
LL O a Law for.thc following reason.(See.7031.5,Businussand I'ns(cainns VALUATION SIFT,
_ PERMIT ISSUANCE 10.00
Code:Any city or county which rcyuimsa permit do constnsnt,ulcer,
CE Q 0 improve,demolish,or repair uny'slruclum,prior la its osuinee,also ELEC.CONTR. LIC.N0. ELEC.
O ¢ requires the applicant for such Nouil to file a signed statement that TOTAL•
w$ he is licensed,pursuant to the provisions of the Contractors License PERMIT TO
Law(Chapter 9(Commencing with Section 7000)of Division 3 ofthe 5
Z 4 o Business and Professions Code)or that he is tsempt Froclrom and QTY. PLUMBING PERMIT FEE
M I- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES T PE CONSTR.
a � by any applicant for a permit subjects the applicmR to a Civil penalty. ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars 155001.1: '
❑ 1,as owner of the property,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 fur cele (Sec. 70U,l. Busim'cs and Profassions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code. The Contractor,License Law does not apply to an owner of
property who builds or irulnoves thereon,and who does such work F IXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employes;provided that such inlpruve-
mendsarenotintendedorofferedforsale.If,however,the building GAS-EA.SVSTEM-11NC.4OUTLETS 6.00 ,
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or up-
proveforpurposeofule.). ' INDUSTRIAL WASTE INTER - 3000 RES IND CON Pe Omer
. .
❑ 1,m owner of the property,am exclusively contracting with Q ❑ 1:1 ❑ 0
• licensed cnDINNA N, to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 AsTE ORS PARCEL NO.
and Professions Code:1'he Contractor's License law does not apply
In an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a contmetons)licensed pursuant to -
the Contraetor'sLicenseLaw. SEWER-SAN ITARY-STO RM EA.200ft/10.00 TRACT NO. PARCEL NO.
C, in exempt under Sec. ,B.&P.C.lin mis WATER HEATER W/VENT 6.00
reason
Owner Dme WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
W'ORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a cenifwale of consent to self-insure' ZONING ENG:SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy there�'S�e�3jl0,Qplph.C.).
I'o is
QCCrdlflcd copy is hereby furnished.
Z Z ❑ Certified copy is Bled with the city uspecllsm division. FIRESPRINK ENERGY TQA
O Applicant MISC.- - . REFER TO ORD. • YE] No Y ❑ N�
~ m PERMIT ISSUANCE 10.00
LU CI?RTIIICATEOPIiAIION[0 N PROM Ar ORKIiRS' - FLOOD ZONE - A.L.u.C.
W COA1PIiNSAT10N INSURANCE PLG.CONTR. LIC.NO. PLG. Y� N� V� ry�
CL Z 1'1'his section need not he c mpleted if the Permit is for one TOTAL
hundred dollars IS 100)or lea.) o
U O 1 certify that in the performance of the work for which this per- QTV MECHANICAL PERMIT •FEE FEE SUMMARY
LL I- mil is issued.I shall not employ any person in any manner so as to
O W become subject to the Workers'Compensa l ion Laws of California.
Ualc A Imam BUILDING
} N NOTICE
TO APPLICANT: IC after making this Certifi vde of lux- QLTE R.OR ADD TO MECH. 5.00
F ? emption,you should become subject to the Workers'ComNnmlioR APPLIANCE 5.00 PLAN CHECK
U orthwith
such pvisio ns of the Laor Coe,visions or thispermit shall be d emeou mustfd revok dcomply with AIR HANDLING UNIT(TO 10,000CF.NL) 4.00 FEE
CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10MOC.F.M.) 6.00 SEISMIC FEE �So
I hereby affirm dhot there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work fin which this permit is issues](Suo. 'MICROFIL'M
3097,Civ.C.). HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lender,Address ELECTRIC
I certify that I have read this application and state that the above .VENTILATION FAN (SINGLE) 4.00
information is correct. 1 agree to 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 authorize representatives of this city to enter upon the BOILER-COMP 00w,100,1X10 BTU)SEE FEE SCH. MECHANICAL
above-mentioned properly for inspection purposes. -
T'
(We) agree to save, indemnify and keep harmless the City of MISC.: REFER TO ORD.
upertins, against liabilities,jut 'CONST.TAX
judgments, eosin and expenses which PERMIT ISSUANCE 10.00
nay an, way acct c innt salU City conscqucncc of the
'
•runh this perm'. MECR.CONT. LIC.NO. MECH. "
TOTAL TOTAL
[)are 7u
s ateocof Applicant Contmetor
OFFICE COPY "'