16361 (2) POST THIS CARD NEAR.FRONT OF BUILDING
PERM IT NUMBER
CITY OF CUPERTINO 16361
INSPECTION„DIVISION '
JOB INSPECTION RECORD
I� 4 - '•� - PERMIT EXPIRATION
JOB ADDRESS •7kSa ��ai--h�B 7TH GTi UNIT# _LOT#j - "^ -
PERMIT EXPIRES IF WORK
OWNER .(„ 'CONTRACTOR` IS,NOT STARTED WITHIN I
.INSPECTION DATE INSPECTOR INSPECTION RECORD - .80 DAYS OF PERMITASSU-',
ANCE,OR '780 DAYS 'FRON I -
FOUNDATION* ' 'NOTE: ' "t
+ LAST CALLED INSPECTION. I
LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE” i
TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT-VALIDATION
CUPERTINO STANDARDS., ' -
GARAGE SLABS _ -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ,
LINDERGROUNpD� /gqSLAB - ' • '`""-' ,
PLUMBING •1 / '/- Vii. . .:. .•.I.
ELECTRICAL " ISSUANCE DATE
MECHANICAL RLDc ELECT,1 PLG. MEC. -
�. 0 .. :� .
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - • P 4ab' B I INFORMATION
NIT
WOOD FLOOR .
A PLUMBING - TION $JET.
PCQ 11111 .
MECHANICAL
ELECTRICAL f1 'TRRIT TO
FRAMING 0tv 6-
'INSULATION, - 'STORIES TYPE;coNs IF
OCC,GROUP - RES.UNI S•
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE - 'sa FrgELODR AREA *oral ncacar.E-
DIAPHRAGM.
THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING � � � 1 � _ RES IND � CON vR Om..
APPLY NO ROOFING UNTIL ABOVE HAS BEEN'SIGNED TINALS,s DATE INSP. ❑ ❑ ❑ ❑ [1
_ ASSESSORS PARCEL NO
ROUGH SAN.a '..- I
"PLUMBING ELECT.ENERGY •r' '
i' PLUMBING ENERGY - TRACT NO. PARCEL NO
TUBS B SHOWER PAN , .. .,1 .
MECHANICAL ' MECH.ENERGY. :I .•
ACC.DATE ACC.FILENO,
E LECTRICAL • � BUILDING ENERGY . � .. _
'FRAMING' ELECT.FINAL TEST .I , _
INSULATION
PLUMBING f ZONING ENG.SITE NO..
GAS TEST . GAS
MECHANICAL FIRE SPRINK ENERGY T SJ
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ 1 N❑ C] N❑
ELECTRICAL RELEASE y= --f1- - I'LDDD ZONE — A:L,uc.
EXTERIOR„SHEAR ' :.� -
INTERIOR SHEAR FIRE DEPT. - Y❑ N'❑ u❑ N❑
SHEETROCK GRADE- FEE SUMMARY
EXTERIOR LATH IBUILDING, -
BUILDING
.INTERIOR LATH - TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC '• PLAN CHECK
GAS FEE-
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE-., ,
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL'BUI LDING III NAL'IS SIGNED BY BUILDING INSPECTOR.
- � - MICROFIUM ,
ARRANGE FOR-INSPECTION BY PHONING 252.4505, ELECTRIC _
~ ' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBIryG D0
o.� PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z - MECHANICAL
EXPIRATION DATE'-
- RE I •
,SEE PERMIT FOR
IMPORTANT! CONST.T4x'
PLEASE READ REVERSE SIDE BEFORE
CALLING'FOR FINAL INSPECTION`. TOTA.0
w OFFICE COPY
APPLICANT TO!FILL IN INFORMATION WITHIN RED'LINES -,USE BALL POINT PEN ONLY
BUILDING PROJECT I DENTIFICATION APPLICATION 63 0- - - PERMIT NUMBER,
aDaDING ,
, s 2'Rar\e�te CDL) y, BUILDING— ELECTRICA11—PLUMBING—MECHANICAL R • 0
• ' OWNER'S DAV - _ PLAN CHECK VALIDATION
NAME 1 t
TV. ELECTRIC
11 LE TRIC PERMIT F
RII¢X► NUYYI 'HONE4+1-510-1 � EE I
CONTRACTORS
NAME- OUTLETS L SWITCHES-RECEP', 10.00/1.00 r ,�
. -
r1c.NO. LIGHTING FIXTURES 10,00/1.00 ,(/—p
ADTOR's APPLIANCES-RESIDENTIAL 4.00
. CONTRACTRAC
PRONE PANELS "10.00 �, _ DATE OFAPPLICATION '3-
ARCHITECT L - - PLAN CHECK FEE' P.C.NO.
' OR _ - PANELS (OVER 200 AMP) 20.00 -
ENGINEER Lie.
'
c.No.• SIGNS TRANS. - 3.00 '
ARCH.OR ENG. . PERMIT VALIDATION '
- ADORESS - SPECIAL CIRCUIT _ 5,00
ZIP TEMP.METER OR POLE INS. 20.00 "
ATs
ADDRESS MOTORS - SEE FEE SCH.
' DRESS E55 -
SERVICE CHANGE 20.00 . -
w¢0 0 LICENSED CONTRACTORS DECLARATION
a u I hereby affirm that I ain licensed under provisions of Chapter 9 ISSUANCE DATE
'H Q n (commenting with Section 7000)of Division 3 of the Businessand BLDG. I ELECT. PLG. MECH.
F z Professions Cade,and my license is in full force and effect - ❑ ❑
o z m W License Class Lie.Number
w�
Uate Contractor
¢ x s _ " . BUILDING PERMIT
¢ rt w u
OWNER-BUILDER DECLARATION _ D INFORMATION
w;e uHi I hereby affirm that I am exempt from the Contractor's License IMISC.— " REFER TO ORD
LLoa Law for the following reason:(Sec.7031.5,Businessand ProfessionsPERMIT ISSUANCE 1 (ti V4WTION - SIFT.
� — Code:Any city or county which requires a permit to construct,alter,
190
rtm H ELEC.CONTR. - LIC.NO. _/�,
¢ ¢Q improve,demolish,or repair any structure,prior n its issuance,also ,. _ TOTA '1I {�YFIL.N_ '
n m LL requires the applicant for such permit l0 file a signet statement that TOTAL rx ERMIT TO
n w he is licensed pursuant to the provisions of tire Contractor's License
Hii0 Lew(Chapter 9(commencing with Section 7000)ofl)ivisinn 3ofthe � '�/, ,OC- 96-
¢ Business and Professions Code)or that he sexempt Rmrefrom and DTV. PLUMBING PERMIT
a ss- 0 the basis for the allegedexemption.Any violation ofSection703L5 STORIES TYPE CONSTR.
a;m by any applicant for a permit subjects lire applicant to a civil penally ALTER-DRAIN -WATER (EA.) 5.00
o[npf more than five hundred dollars IS500).1: - -
�ir 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 0fferedfor sale (Sce. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of 1
property who builds or Improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALWCREAGE•
himself or through his own employees.provided that such improve-
menu are not intended or offered for sale.If,however,tileGAS-building 76:00
or improvement is sold within one year of completion,the owner• GAS EASYSTEM-OVER 4 (EA) 200 BUILDING USE
builder will have the burden of proving that he did not build or ire - . . .
- RES IND - CDN pB Omer
- prove for purpose of sole.):. INDUSTRIAL WASTE INTER.' - 30.00
❑ I,as owner of the property,um exclusively contracting with ❑ •❑ ❑ ❑ ❑
- licensed contractors 1. Construct tlm project(Sec.7044,Business LAWN SPRINKLERS- 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'hoproves thereon,aaul who LAWN SPRINKLERS-OVER 5(EAX 1.00
contracts for such projects with a ttlmraclorl sl license(]pursuant to SEWER-SAN ITARV-STORM EA.200ft/10.00
the Contractors Lie• sC Law TRACT NO. PARCEL NO,
❑ lame a ,BAP C.l in this WATER HEATER.W/VENT 6.00
reason
wner Uo]n WATER SYSTEM 5.00 ' ACC.DATE ACC.FILE NO.
WORKER coMPENSATION UI?CL/00lif'ION WATER TREATING EQUIP. 5.00 e ,
1 hereby at I tut I have apenicertificate on of InsuraneTitce,
or nal erlitire, '• -' ZONING 'ENG.SITE NO.
or a thereof tc of Workups'b CnlpCllaal on Iltsunmcc,nr a cert if icd _
copy thereof(Sec.3&00, pab,CJ, - -
Policy No. Conspany .,-
O ❑ Certified copy is hcroby funtished, FIRESPRINK 'ENERGYT-24 -
Z Z ❑' Certified copy is filed with the city inspecllon division,
0 Applicant MISC.- REFER TO ORD. Y ❑ IN v ❑ N❑ s
r W > CER'I'IFICCAI 17 OM 017 EXEM
OIN INSURANCENTH.TION 17ROMWORKERS; Plc,c PERMIT ISSUANCED NOPL 1-tB4O0/a FLOOD ZONE A.L.U.C.
CL 0 (This section need not he completed if IIID permit is I'll one TOTAL V[:] N❑ Y [:] N❑
Z hundred dollars(SIGO)or less.)
U O_ 1 certify that in the performance of the work]or which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I shall not employ mry person in any manner u+as Io
,
+ W' become subject to the Workers'Compensation Laws of Culiifornia.
y Date Appliconl ALTER OR'ADD TO MECH. 5.00 BUILDING
} w NOTICE '10 APPLICANT: IL after making this Certificate of H.-
F Z emption,you should become subject to the Workeri Con+pensalion APPLIANCE 5.00 PLAN CHECK "
provisions of tide Labor Code, you must forthwith comply with FEE -
U such provisions or this permit shell be deemed revoked, AIR HANDLING UNIT(TO 10AMC.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 -SEISMIC FEE
I hereby affirm 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.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
Lender's Address HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I cerlify that l haveread thisupplication and slide shat If,above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all City and countyR-COMP I3 H.P.Df 100,000 B.T.U.)- 6.00 PLUMBING /
�- ordinances and state laws relating to building construction. and BOILE
hereby authorize representatives of this city to enter upon the BOILER-COMP Oval 100,000 BTU)SEE FEE SCH. MECHANICAL.
above-mentioned property for inspection purposes.'
(We) agree to save, in ema py an
keep harmless the City of MISC.- REFER TO ORD.
Cupertino again liabili' ,judgments, Costs :uW expenxs which - CONST.TAX
Fay in an . a against City in -.nseq cote of the PERMIT ISSUANCE 10.00
ran" D er i MECH.CONT. - LIC.NO. MECH.
�(� TOTAL TOTAL /6411
V
Sign ore of Applic t/Contractor Dam
OFFICE COPY