15703 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
' CITY OF CUPERTINO 15703 '
INSPECTION DIVISION
• :, JOB INSPECTION RECORD
') � PERMIT EXPIRATION
JOB ADDRESS J_rp 3 S Td SUA/IV ✓'B'�qN,ITry _LOT#, PERMIT EXPIRES IF WORK_•
OWNER S Cow V/c�S m TRACTOR V- `, EYL?'��F�cL IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. I
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION. .
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAUOATION.
CUPERTINO STANDARDS. r
GARAGE SLABS - - v✓ .-p---- y V
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
-T-TF7
UNDERGROUND./SLAB
PLUMBING
ELECTRICAL . [(— .. ,AE.
S 1 �E ISSUANCE UAiC
MECHANICAL - - - — BLDG ELECT. PLG. MECR,�
low at E 11
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED OtrFb1� e2 � 10-26-Q eua NG PERMIT V
.WOOD FLOOR . INFORMATION
2� r S .0 d'2V VALUATION SIFT.
PLUMBING - -
MECHANICAL
ELECTRICAL PERMU TO
FRAMING ' � l
INSULATION
STORIES TYPE CONSTR.
- � �
OCC.GROUP RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO,FT,FLOOR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHINGbijr—ow� I _Z •_ `•1•}. ` RES IND CON PB Oln..
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. •L L El E '11
RCUGH SAN.#'. " ASSESSORS PARCEL NO.
PLUMBING ' O- - ELECT:ENERGY
TRACT NO. PARCEL NO
TUBS&SHOWER PAN yc . PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ELECTRICAL � (,-.L(• + BUILDING ENERGY ' ACC DATE ACCFILE NO
FRAMING ELECT.FINAL TEST
20wNG .
INSULATION ENGSITE NO.
_ �. � PLUMBING GAS TEST GAS '
MECHANICAL
FIRE SPRINK ENERGY LTA
.�
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y L N❑
EXTERIOR SHEAR ELECTRICAL RELEASE
.FLOOD ZONE A,L U C,
zw-
INTERIOR SHEAR FIRE DEPT. 'I(y Y NL Y L' -NL
SHEETROCK GRADE ' FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH TEMPORARY APPROVALS eulLnlNc
SCRATCH COAT ELECTRIC PLAN CHECK
GAS . --
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE `
OCCUPANCY OF BUILDING ISNOT.PERMITTED UNTILBUILDING FINAL.ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ELECTRIC '
H�
ONE WORKING DAY BEFORE REQUIRED INSPECTION. rLumawc
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
"BUILDING PROJECT IDENTIFICATION 1PERMIT NUMBER.
BUILDING APPLICATION & PERMIT
15703T ABUILDING-ELECTRICAL-PLUMBING-MECHANICALL/:C;z S
OWNER'S - PLAN CHECK VALIDATION
•' `;:{,�r, NAME "
ELECTRIC PERMIT FEE
SRI
PHONE
., CONTRACTOR'S
"a
- 17
NAME _ UTLETS-SWITCHES-RECEP 70:01.00
1T' C-. 1=L-1c_CXRIC- CID- 3 LIGHTING FIXTURES 19:00!-}:00
LIC.NO.
CONTRACTOR n O ,a Du 209a PPLIANCES-RESIDENTIAL 4.00
DRESS r
,� 21-7 Q Q PHONE g I p y. PANELS ' 10.00 DATE OF APPLICATION
OgcHlrscr - PANELS(OVER 200 AMP) - 20.00 PLAN CHECK.F EE P.C.NO.
ENGINEER
• LIC.NO, SIGNS TRANS. 3.00
neoE6S ENG. SPECIALCIRCUIT 11� 500 �' -PERMIT VALIDATION
.ZIP TEMP.METER OR POLE INS. - 20.00
AS 'S MOTORS SEE FEE SCH.
ADDREDDRESSS -
SERVICE CHANGE 20.00
o o LICENSED CONTRACTORS DECLARATION •r�0.
a u u I hereby affirm that I am licensed under provisionsol'Chapter-9 •ISSUANCE DATE
yaw fc.mmencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
r o z Professions CodeVV
LiceQaf I my license is in full force and .
z LL.Nnorher3s�
are Contracto '
y ISE013 Qp`
BUILDING PERMIT
Em
w OWNER-BUILDER DECLARATION INFORMATION
w ;n H (hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO RD
I/2
LL o J Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE .y�e VALUATION $/FT.
Code:Any city or county which requires a permit to consmmt,alter, 2'�_/��
ar B,¢0 Improve,demolish,Or repair any straitem.prior In Its issuance,also ELEC.CONTR. LIC.NO. ELEG /- (%-•• ,
c¢ requires the applicant for such permit to file a signed statement that TOTAL '(/ �I PERMIT TO -
e m he is licensed pursuant m the provisions of the Contractor's License
or Law(Chupler9(co mmencing mu,Section QTV. PLUMBING PERMIT
7000WI'Divisicn Sol tie fir. •�
¢ o Business and Professions Code)or that he is exempt therefrom and FEE • c�G C t `
IS H r� the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
d3 � by any applicant for apemedSubjectsdollar,the applicant penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred callous(8500).): ,
❑ 1,as owner of Ore 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,COND. 5.00
• Code:The Contractor's License Law does not apply to an owner of
property who builds.r 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-
mintsareGetintendedoroffered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4 (EA.) 200
builder will have the burden of proving flint - . - . .
l he did not build or im- BUILDING USE
prove for purpose of safe.). RES IND CON PB Other
❑ 1,as owner of the property,am exclusively contracting-with INDUSTRIAL WASTE INTER. 30.00 0 ❑ ,❑ 0 El
licensed contractors to construct the project(See.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 - ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law docs not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such projects with a contmctods)liwnsed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 - TRACT NO, PARCEL NO.
❑ into exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00
0
Owner [)ate WATER SYSTEM- 5.00 ACC.DATE ACC.FILE NO,
WORK E RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
- 1 hereby affirm that I have a certificate of consent t.SLINnsum. ZONING or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO.
opy thereof(Sec.3800,Lub.C.).
Policy Nn. - Company ` -
O ❑ Cernfiedcopyis hereby furnished. FIRE SPRINK ENERGY T-24
Z Z ❑ Ca',I rpy tilled w' Ir to ci 'nsnction division. MISC.- REFER TO ORD.
Ap plicunl r - _ Y N .Y N
PERMIT ISSUANCE 10.00
LU CIiR FICATE E 1:K IO TION PROM WORKERS'I FLOOD ZONE A.L.U.C.
W � COMPENSATION INSURANCIi PLG.CONTR. LIC.NO. PLG.
CL 0 (This section need not he completed if the permit Is for one TOTAL Y❑ NY C:] NF]
::� Z hundred dollars IS 100)or less)
L) O 1 certify that in Ilse performance of the work for which This per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued,I shall not employ an person in any mon•r so xs I.
O d become subject to the Workers' t ons: 'fin f C iforniu.
Date (r¢IRQ.A Iicunt ALTER OR ADD TO MECH. 5.00 BUILDING
m NOTICE (TA (CAN"1': If, ter nl it a Lc I¢ C o P.♦
F Z Sorption,you should become subject m the Worked Compensation APPLIANCE 5.00 PLAN CHECK
Provisions of the Labor Code, you most forthwith Comply with FEE
C„) such provisions or this permit Strait be deemed revoked AIR HANDLING UNIT(TO 10)000QF.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.L HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Nude H EATI N G UN IT(0 V E R 100,000 B.T.U.)9.50
Lender's Address - ELECTRIC
I certify that l have read this applicat ion and state that the above VENTILATIONFAN (SINGLE) 4.00
information is correct.I agree to comply with all city and county BOILER•COMP(3 H.P.Of 100,000 B.T.U.) 6.00 PLUMBING
.durance, and state laws relating to building construction, and
hereby authorede representatives inspection
this City to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
aboveanautio riz property tativ sp of this
purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. -
upertiro against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 - CONST.TAX-
#any
' way accrue gains! said•City in consequence of the
of 0 h e111- ECH.CONT. LIC.NO. MECH.TOTALTOTAL
e of Applicant/Con Vu<tor Date '
OFFICE COPY