12504 (2) POST THIS CARD NEAR FRONT OF BUILDING
ER
CITY OF CUPERTINO „ P RM.TNN5
y '�P INSPECTION DIVISION � �4
"
JOB INSPECTION.RECORD
PERMIT EXPIRATION
JOBADDRESS 7707 SeebeT CourtUNIT# LOT#
PERMIT EXPIRESIF WORK
OWNER, Joll man Assoc.II CONTRACTOR RrjFD WFIly IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
rANCE OR 180 DAYS FROM
FOUNDATION -
LIFER L''ASTCALLED INSPECTION.
PREGUNITE PERMIT VA}I{�gjb
G W G rf�i LJ
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 'L Juj\! �- _ 198',
UNDERGROUND /SLAB r J
PLUMBING City Of Cupertino
ELECTRICAL - ISSUANCE DATE
MECHANICAL BL G, ELECT. PLG. MECH.
J� ❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED, - BUILDING PERMIT
INFORMATION.
WOOD FLOOR � vALuanoN s/Fr.
PLUMBING . .
MECHANICAL
ELECTRICAL - - .PERMIT TO
S2CJ4
FRAMING - ( '
INSULATION JGQ w, 6v STORIES TYPE CONSTR.
OCC.GROUP RES�UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNE
ROOF SO.IT.FLOOR AREA TOTAL ACREAGE
DIAPHRAGM / '/,; f .
_2 CN-h A ABUILDING USE
ES IND CON PB Other
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGN D ❑ ❑ ❑ ❑ ❑
ROUGH - PSSESWRS,vARCEL NO./�
PLUMBING S
GAS TEST M _ _ (' � TRACT NO. PARCEL NO.
ECHANICAL 81./8 9 N „ A
ELECTRICAL - .
•) -SM FINALS � 'DATE INSP. ACC.OATE ACC,FILE No,
FRAMING SAN #
ZONING ENG.SITE NO,
INSULATION PLUMBING
vmolv4. VIP oar --r-at_ GAS
MECHANICAL - EIRE SPRINK ENERGY T 24
COVER NO WORK UNTIL ABOVE HAS BE NSIGNEIII I HEATING Y ❑ NE]
❑ Y ❑ N❑
' . LATH-INTERIOR - ELECTRICAL FLOOD ZONE A.L.UC.
' LATH-EXTERIOR - - � FIRE DEPT. Y 1 N❑ Y'❑ NEI
SHEETROCK -f}''I GRADE - FEE SUMMARY
SHEAR INTERIOR BUILDINGC '12 BUILDING
.y SHEAR EXTERIOR TEMPORARY APPROVALS
FIREWALLS ELECTRIC - j'— i PLAN CHECK
. GAS FEE
J,NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE f `
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
Lu
' 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 ?'f;
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
IBIbILDING PROJECT IDENTIFICATION >•'APPLICATION PERMIT NUMBER
AOD L. A & PERMIT
* aoo Ess a.P,Q CQu �!
BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 12504
OWNEn's /,Q
OTV. ELECTRIC PERMIT FEE 1
PLAN CHECK VALIDATION
',ON, Z� `�
oNT CTOR s,r /-! y� UTLETS-SWITCHES-RECEP 10.00/1.00
/fY11 .-4 C-LIC.ko. /�/v LIGHTING FIXTURES 10.00/1.00
CONTRACTORS
!- M
PPLIANCES-RESIDENTIAL 4.00
ADDRESS PANELS 10.00z ,Y HSO4- Y M -Spp5
DATE OF APPLICATION
HrtFC PANELS (OVER 200 AMP)' 20.00 PLAN CHECK FEE P.C.NO,
OR
L: ENGINEER CS22$7 SIGNSTRANS. 3.00
Q rTV LIC,ND,
ARDR.ORENG. j�pd, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ADDREAs,06-EL
2faHlill ,Plat zIv /IOQ EMP.METER OR POLE INS. 20.00 PAID
AP°Lica - CY/ MOTORS SEE FEE SCH. x-� )v. ..
_ SERVICE CHANGE 20.00
Cr O o LICENSE ONTRACTORS DECLARAT N V„l V1 �f1el l�ll
¢v w I hereby affirm at I am licensed under provisions of Chapter 9 ISSUANNNCE DAT7 I l
h rt y (commencing with Ilion 70001 of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
H m Z Professions license is in full forcLd��'f/e./.
z O p - License, 1 s Lia Number ✓ 7
Q m r w-1 Datc Contractor
¢ M E BUILDING PERMIT
rc w u OWNER-BUILDER DECLARATION INFORMATION
E:
O e y I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
U. VALUATION $/FT.
Huo¢ Law: the city or countng which c.requires
5.u permit tocoad Professions -PERMIT ISSUANCE 10.00
Code: e,dem y demolish,
county it any structure,
u tune permit to cons uanL,also
6 ¢Q C improve,demolish,or repair any s't mcturc,Prior hr its issuance,also ELEC.CONTR. LIC.NO. -ELEC.
-O u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
u w m he is licensed pursuant to the provisions of the Contractor's License
Hior Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe �r-� k/
- ¢ Business and Professions Code)or that he is exempt therefrom and QTY. - PLUMBING PERMIT FEE
M =$ the basis for the alleged exemption.Any violation of Section 7031.$ STORIES TYPE CONSTR.
a ; _ by any applicant fora permitsubjects($500.lcant toacivil penalty
of nmore cant ALTER-DRAIN&VENT-WATER (EA.) 5.00 SN�
nor five hundred dollsrs dollathe appi
❑ I,as owner of the properly,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
properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SQ.FT.FLOOR AREA TOTAL AC41AGE
himself or through his own employees,provided that such improve-
mentsarenotintendedorofferedforsale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 iGQ
or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA.) 2,00 / BUILDING USE
builder will[lave the burden of.Proving that he did not build or im . REB IND CON PB Omer
prove for purpose of sale.). I N D USTR I A L W ASTE INTER. 30.00
❑ 1,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 ASSESSORSPAR CEILING.
and Professions Code:*rhe Contractor's License Law does not apply /
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 3 (e
contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑ I am exempt under Sec.�,BAP.C.for this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00
ACC.DATE ACG FILE NO.
WORK ERS'COMPENSAT70N DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent loself-insure,
or a certificate of Workers'Compensation It uranceT,or a//certified ZONING ENG.SITE NO.
copy there 0,Lab.C,). ` 2 L f/✓a!/Y/!11 Q
Policy No. ompuny
O QJ Certificd co ¢hereby furor ed. FIRE SPRINK ENERGY T-24
Z
C] CPD Cerci Jed. wi the ms ec t Ivision. - REFER TO ORD.
Oma( Applicant Y
P: ❑ N❑ Y EJ NEI
va PERMIT ISSUANCE 10.00
LU - CERTII'ICCObPE'E .ONIONPROMWORK S' FLOOD ZONE A.L.U.C.
W COMPEN TION INSURANCE PLG.CONTR. LIC.NO. PLG.
d O CI'his section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑
Z) Z hundred dollars($100)or less.)
U O I certify that in the performance of the work for which this per, QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued,I shall riot employ any person in any manner so as to
U become subject to the Workers'Compensation Laws of California.
U y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} W. NOTICE TO APPLICANT: If,after making this Certificate of F:x-
I- Z emption,you should become subject to the Workers'Compensation APPLIANCE 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 10;MC.F.M.) 4.00
a CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000GEM.) 6.00 SEISMIC FEE
I hereby affirm that there is a construction lending agcney for EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ.C.). _
Lender's Name H EATING UN IT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
1 certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct.I 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 authori a representatives of this city to enter upon the
above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino agI' liahilitics,judgments, costs an expenso which PERMIT ISSUANCE 10,00 CONST.TAX - 7 7 9O
may in way accrue agai said City c sequen of th 'd c�
grantin f his permit. MECH.CONT. LIC.NO. MECH. --
�� 3 2 TOTAL TOTAL 70
gnatureof Apphca tthGCI r [)Ste '
OFFICE COPY