14819 (2) a
POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
CITY. OF CUPERTINO 14819
INSPECTION DIVISION
JOB INSPECTION RECORD
7 PERMIT EXPIRATION '
JOBADDRESS . 19447 Pruneridge Avenue *4UNIT# _LOT#
PERMIT EXPIRES IF WORK
OWNER Hewlett Packard CONTRACTOR - 'IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE:
' UFEfl ALL GRADING.AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY.OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS - -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 1)./_ojp 44 A
UNDERGROUND /SLAB a� ,,,,• 1 ,
PLUMBING tD -
ELECTRICAL ISSUANCE DATE
MECHANICAL' SLUG ELECT PLG, MECH
❑ ❑ oFLI
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED p�uCU90MOBUILDING
PERMIT
WOOD FLOOR WV' VALUATION siRT.
PLUMBING - -
MECHANICAL
ELECTRICAL PERMIT TO l
FRAMING
INSULATION STORIES TYPE CONSTR.
- - - OCC.GROUP RES.UNITS
- PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
$O Fi FLOOR AREA TOTAL ACREAGE
ROOF NOTE;NO FINAL INSP.SHALL BE MADE BEFORE -
DIAPHRAGM THE CONSTRUCTION TAX IS PAID '
UILDING USE
ROOF SHEATHING HES No CON PB GOP-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ 0 ❑ - ❑
ASSESSORS PARCEL NO
ROUGH SANfi ,
PLUMBING _/ -�B $0 ELECT.ENERGY
TRACT NO PARCEL NO
TUBS 8 SHOWER PAN PLUMBING ENERGY, i
MECHANICAL MECH.ENERGY
ACC DATE ACC.FILE NO
ELECTRICAL BUILDING ENERGY
FRAMING ELECT.FINAL TEST
ZONING [NG.SITE NO.
- INSULATION PLUMBING
GAS TEST GAS
MECHANICAL FIRE.SPRINK ENERGY T.24
.COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ "E) Y ❑ "E]
FL000 zoNF. n.l.uc
- EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT. Y❑ N� v ❑ N❑
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH ' BUILDING
INTERIOR LATH' TEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC PLAN CHECK,
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED iOCCUPANCY I SEISMIC FEE
OCCUPANCY OFBUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
Lu ARRANGE FOR INSPECTION BY-PHONING 252-4505, �, ELEd RIC
z PLEAWORKING
E G VE JOB ADDRESS WHEN PHONINGDAY BEFORE REQUIRED . PLUMBING -
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL ; ye
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
' IL-DINGPROJECTIDENTIFICATION PERNUTNUMBER
BU I i.DI.0 APPLICATION & PERMIT 14819
\ ADDRESS/9 ( � Q(JN 4/ u.
Dd / BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNPLAN CHECK VALIDATION
"AME OTY. ELECTRIC PERMIT FEE
Alecyllar f4cku PHONE
CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00 -
-/ CONTRACTORS a» pSe APPLIANCES-RESIDENTIAL 4.00
`t ADDRESS
2 /7 PHONEJ 4g iZ PANELS. 10,00 DATE OF APPLICATION
ARCRITECT - PLAN CHECK FEE P.C.NO,
OR PANELS (OVER 200 AMP) 20.00
ENGINEER
LIC,NO, SIGNS TRANS. 3.00
ADDRESS ENG SPECIALCIRCUIT 5.00 PERMIT VALIDATION
Zip TEMP.METER OR POLE INS. 20.00 APPLICANT'S MOTORS SEE FEE SCH.
ADDRESS
SERVICE CHANGE 20.00
0 0 - LICENSED CONTRACTORS DECLARATION
¢ o u I hereby affirmilial I am licensed under provisions of Chapter 9 ISSUANCE DATE
Z, ry (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
r y i Professions Code,and y Iteense is in full force and effe t. ❑ ❑
Z i v_r- License Cl — Lic.NumbeCZ-
I V'9
O ,A L Datc '+- Contractor a_
¢ m Zi BUILDING PERMIT
¢ ¢ a OWNER-BUILDER DECLARATION
¢ m u INFORMATION
w ; a.H 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION $/FT.
FLLO ¢ Law for the following reason,(See 7031:5,Businessund Professions PERMIT ISSUANCE 10.00
Code:Any city or county which requiresa permit to construct,attar, -
¢ Q Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
n wOu requires the applicant for such permit to file assigned statement that TOTAL PERMITTO
raw he is licensed pursuant to the provisions of theContractor'sDivision License � p P 4 � _ v/
r Z>
Business
(ess andr9(wmmn Code)
Section 7s exempt
Division c r-+O
a Business unJ Professions Code)or that he is exempt therefrom and OT PLUMBING PERMIT FEE
rc r$ the basis for the alleged exemption.Any violation of$ectic ]031.5 STORIES TYPE CONSTR.
by any applicant for a permit subjects the applicanatoa civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00
clout more than five hundred dollars(S500th
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00
their sale compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions Z_ DRAINS-FLOOR,ROOF,AREA,COND. 5.00 0 '^
Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,'and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mentsare not intended oroffeyed for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
orImp, vemem is sold within one year of completion,the owner- GAS EA.SYSTEM OVER 4(EA.) 2.00
builder wi - -
ll have the burden of proving that he did nal build or hit-
to BUILDING USE
prove for purpose of sale.). INDUSTRIALWASTE I NTER. 30 RES IND El PB Omar
❑ I,as owner of the property,am exclusively contracting with
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORSPARCEL NO.
and Professions Code:The Contractor's License Law does not apply
to an..net or noperty who builds or improves Ihcrcon.and who LAWN SPRINKLERS-OV ER 5(EA.)
contracts for such projects,with a commands)licensed pursuant to
the Contractor's License Law. I SEWER-SANITARY EA.200ft n ACT NO. PARCEL NO.
reason WATER am exempt under Sec. ,li.&P.C.for Ibis WATER HEATER W/VENT 00
Owner - Date WATER SYSTEM ACC.DATE ACC.FILE NO.
WORK E RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
_ I hereby affirm thin l have a ecrificate of consent to self-insure, ,
' or a certificate of Workers'Compensation Insurance,
or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,J(,v Ib�gC.l. ,,/�nss
Policy No,t0t-JJJA-CM
F-�
O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z Z [rCertified copy is filed with the city inspection division.
p) Applicant _ MISC.- REFER TO ORD. v N v ❑ N�
G: \ CERTIFICATE 01'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 IH
FLOOD ZONE A.L.U.C.
L COhIPENSATION INSURANCE R1LL ONTR. J.C.NO. PLG. S'O
d O (This section need not be completed if the permit is for one xye- Y T / «7 TOTAL �� Y❑ No Yo No
:) Z hulldreddoIIaR(SI00).0 Ic..) '
0 O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- - out is issued,I shut not employ any person in any nwnner m as to
0 Q become subject to the Workers'Compensation Laws al'Colifornia.
a Datc ApplicantBUILDING
>- to NOTICE TO APPLICANT: If,after making this Certificate of Ex. ALTER OR ADD TO MECH.
Z
emp tion,you should become subject In the Workeri Compensation APPLIANCE5.00 `T'r• PLAN CHECK
Provisions of the Labor Code, you most forthwith comply with FEE
U such provisions or this permit shall he deemed revoked, AIR HANDLING UNIT(TO 10p00C.F 4.
CONSTRUCTION LENDING AGENCYAIRHANDLING UNIT(OVER IO .16.0 _. SEISMIC FEE
1 hereby affirm ilial there is a construction lending agency for EXHAUST HOOD(WITH DUCT)
the perbormance of the work for which this permit is issued(Sec. MICROFILM
3097,CH.C.). HEATING UNIT(TO 100,0008.Too!
Lender's Name H EAT[NG U N IT(OV ER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I certify that I have read this application and stun•that the above VENTILATION FAN (SINGLE) 4,00 Q
information is correct. I agree to comply with all city and county PLUMBING CR
ordinances and state laws relating to building construction, and BOILER-COMP13 H,P.Or 100,000B.T.U.) 6.00
hereby authorize representatives of this city to anter upon the 801 LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL 3
above-mentioned property for inspection purposes.
(We) agree to save, indemnify and keep hani less the City of MISC.• REFER TO ORD.
upertino against liabilities,judgments, costs and expenses--i1_M PERMIT ISSUANCE PC CONST.TAX
uy in y way accrue against said City in consequence of the
. TO
MECH.CONT. LIC.NO. ETAAL 3 A. �L—
�— TOTAL
Sign cot Applic nt/Contractor C;itc
OFFICE COPY