12935 (2) POST THIS CARD-NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO 12935
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS 7794 -Huntridge Lane UNIT# _LOT#
PERMIT EXPIRES IF WORK
• OWNER John and Frances Robbins CONTRACTOR A & P Electric, Inc. IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION . ANCE OR 180 DAYS FROM
UFER
LASTCALLED INSPECTION.;
PREGUNITE PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB, t s "r:''.
PLUMBING
ELECTRICALt
' ISSUANCE UATE
MECHANICAL BLDG. ELECT. PLG. . MECH.
El ❑ ❑ . ,E
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMITY.
WOOD FLOOR - INFORMATION
PLUMBING - VALUATION S/FTY`-
MECHANICAL �
ELECTRICAL 'PERMIT TO
FRAMING - "
INSULATION STORIES V TYPE CONSTR.
- OCC.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF So.FT FLOOR AREA TOTAL ACREAGE
DIAPHRAGM s
. ' BUILDING USE
..
HES IND CON PB OIhr,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑. ❑ ❑ ❑
ROUGH - ASSEJSORS PARCEL NO
PLUMBING -
GAS TEST TRACT NO. PARCEL NO.
MECHANICAL -
ELECTRICAL FINALS DATE INSP. ncc.DATE ACC FILE DID
FRAMING SAN #
INSULATION - PLUMBING zoNlNc- ENG.SITE
GAS
MECHANICAL FIRE SPRINK �� ENERGY T24.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ V ❑ N❑
LATH—INTERIOR ELECTRICAL FL000 ZONE A.L.U.C.
=�o'
LATH—EXTERIOR FIRE DEPT. - Y❑ N❑ Y ❑ N❑.
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR - BUILDING
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING
FIREWALLS ELECTRIC
PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ' SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED
BY BUILDING INSPECTOR.
MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ' a
I_� ONE WORKING DAY BEFORE REQUIRED_INSPECTION. PLUMBING .
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
= SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT!' CONST.TAX
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
•bUI LDING PROJECT I DENT]FICATI ON PERMIT NUMBER
9DI10ING APPLICATION & PERMIT
ADDRESS 12935 .
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
"AME - OTY- ELECTRIC PERMIT FEE
ndVN
CONRACTO,,RR/S UTLETS-SWITCHES-RECEP 10.00/1.00
ep 'uc.ND. p LIT
NG F IXTURES 10.00/1.00
coNTRAc7ogs OO APPLIANCES-RESIDENTIAL 4.00
PRONE PANELS 10.00 DATE OF APPLICATION
OR RITE
oR PANELS (OVER 2 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER
LIC.NO. SIGNS TRANS, 3.00
ADDRESS NG. SPECIAL CIRCUIT S.DD PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00 I r�
APPLICANTS MOTORS Z SEE FEE SCH.
Aoogess / y
SERVICE CHANGE 20.00 4-
0 0
-oo LICENSED CONTRACTORS DECLARATION
a u U I hereby affirm that I am licensed under provisions of Chapter 9
as G w (commencing with Section 7000)of Division 3 of the Business aISSUANCE DATEnd C_ BLDG. ELECT, PLG. MECH.
F,N z Profess Cod a ase is N full for nfl ffe tG - ❑ ❑ ❑
zo L w o Licca I 'o Numb 1
_ ,A H j Date
Contractor
wOWNER-BUILDER DECLARATION, BUILDING PERMIT
w ;LL r I hereby aifunl that I nm exempt from the Cuntraetor's License MISC.- TO ORD INFORMATION
H u O¢ Law for the following reason.(Sea 7031.5.Business and Professions PERMIT ISSUA VALUATION S/FT.
Code Any city or county which requires a permit to cons.....LSlteq 10.00
EE Q Q improve,denmlish,lir repair any structure,prior to its issuance,also ELEC. ONTR. LIC.NO. ELEC.
o u requires the applicant for such permit to file a signed statement that Y�/(/ TOTAL 3
u w m m he is licensed pursuant to the provisions of the Com me to rs License PERMIT TO
FZQ
Law(Chap ter 9(commencing wi in Sect ion 7000)of D ivision 3 of the t�
i o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE C.•
IT Q the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.'
by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars(8500).):
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 5.00
Code:The Contractor's License Law does not apply to an owner of
property who builds or improves(hereon,and who does such work F IXTUR ES-PER TRAP 5.00 SD.FT FLooR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve.
meats are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.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 im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
prove lot purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON Pe Omer
❑ I,as owner of the property,am exclusively contracting with
licensed contractors to Comtruo Ole project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 600 ASSESSORS PARCEL NO.
El El El El 1:1
and Professions Code:The Contractors License Law docs not apply .
In an owner of property who builds or improves Omreon.Slid who LAWN SPRINKLERS-OVER 5(EA.) 1.00
cmltmCIS fur such projects with a contructorts)licensed purstmnt to
the Contractors License Law, SEWER-SANITARY-STORM EA.200ft/10.00 TRACT No. PARCEL NO.
❑ lair ,B.&P.C.lar this WATER HEATER W/VENT 6.00
reason
Owner .,.... WATER $V$TEM 5.00 ACC.DATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00
I hereby affirm that I have a certificate mr,r nsent to sell-insure,
or a certificate of Workers'Compensation Insur Ce,ora certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.
Policy No.-Company ✓y'(
O ❑ Ci,nifiedcopyisherebyfurmshed. FIRE SPRINK ENERGY T-24
Z Z ❑ Certified copy is filed with the city inspection division.
F O Applicant MISC.- REFER TO ORD, r N v Ej N0
CCT CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C.
LL > COMPENSATION INSURANCE PLG CONTR. LIC.NO. PLG.
CIL O ('Phis section need not be completed if the permit is for one TOTAL v N v❑ NE]
� Z hundred dollars(S 100)or less.)
0- "-I certify'thafin'iire'piffo'rmanee of lire work for which,this per- QTY - MECHANICAL PERMIT �� FEE
-,,FEE SUMMARY
LL H mit is issued,I shall not employ any Person in any In:mner sr as to
U become oth,,cl to tire Workwd�uv>_L L ws of Callfomia. �� ..
0 y Dam Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} 2 NOTICE '1'O APPLICANT: If,after making this Certificate of E..
♦- _ emption,you should become subject to the Workers Compensation qpp LI ANCE 5.00 PLAN CHECK
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 10010CF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNITIOVER 10=C.F.M.) 6.00 SEISMIC FEE
I hereby affirm that them is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
k for which th
the performance of the ris permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lenders Name
Lenders Address HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRICC3 s��
i
I 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 city and county PLUMBING
ordinances and state laws relating to building construction, and BOILER-COMP13 H.P.Or 100,0008.T.U.) 6.00
hereby authorize representatives of this city to emcr upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH.
_ above-memioneJ properly for inspection purpows. MECHANICAL
e) o save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Caperagaio.f liabilities,jud c Is and expenses which CONST.TAX
may i any wu accrue a ai t s Id Cit in consequence of fire PERMIT ISSUANCE 10.00
'I of this ennitr MECH.CONT. LIC.NO. MECH.
G v TOTAL TOTAL
"mite, Applicant/ R for Date
OFFICE COPY