13180 (2) T—
POST THIS CARD NEAR FRONT OF BUILDING
' PfIRMIT NUMB[
CITY OF CUPERTINO 1318Q
INSPECTION DIVISION
JOB INSPECTION RECORD
.. � PERMIT EXPIRATION
JOB ADDRESS 733 STENDHAL LANE UNIT# Lor# '
PERMIT EXPIRES IF WORK
OWNER BRENT R. TALLY CONTRACTORBRENT TALLEY IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSu-
FOUNDATION ANCE OR 180 DAYS FROM
LASTCALLED INSPECTION.
UFER
PERMIT VALIDATION
PREGUNITE "
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB �1
PLUMBING
ELECTRICAL ISSUANCE DATE
RLD
MECHANICAL ELECT. PLG. MECH.
❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION SIFT,
PLUMBING
MECHANICAL
ELECTRICAL . . PERMIT ro
FRAMING 1 ,Roof
STORIES' TYPE CONSTR.
INSULATION '
(CC.GROUP RES,UNITS
�,..., PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $D.IT.PLaDRAREA TOTAL ACREAGE
ROOF I -12-
DIAPHRAGM - '
WOOF f m)rr /2- �i N FOR rr?9' BUILDINGCON USE
.v v e Es IND CON PR OV
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ 1:1
ASSESSORS PARCEL NO.
ROUGH
PLUMBING. - '
TRACT N0. PARCEL N0.
GAS TEST
MECHANICAL '
ACC.DATE ACC.FILE NO.
ELECTRICAL � - FINALS DATE INSP. '
,FRAMING SAN #
ZONING ENG,SITE NO.
INSULATION PLUMBING
GAS
FIRE SPRINK ENERGY T@4
MECHANICAL Y ❑ No Y ❑ NE]
COVER NO WORK,UNTIL ABOVE HAS BEEN SIGNED HEATING
' LATH-INTERIOR ELECTRICAL FLOOD ZONE aL.0 c. .
LATH-EXTERIOR FIRE DEPT. Y❑ N❑ Y 0 N❑
SHEETROCK GRADE U1 FEE SUMMARY
SHEAR INTERIOR BUILDING -
SHEAR EXTERIOR TEMPblkf �wfiiO ALS BUILDING z.
FIREWALLS ELECTRIC PLAN_CHECK
GAS . FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
1 ' ARRANGE FOR INSPECTION BY PHONING 252=4505, ELECTRIC
o� ONE WORKING DAY BEFORE.REQUIRED INSPECTION. PLUMBING
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
CONST.TAX
IMPORTANT! '
PLEASE READ REVERSE SIDE BEFORE TOTAL ( ?
CALLING FOR FINAL INSPECTION. J' GYJ
OFFICE COPY -
Y �.--
/jPPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
_ BUILDING PROJECT I DENTI FICATIONPERMIT NUMBER
BUILDING E APPLICATION & PERMIT
ADDRESS.,733 5$ r DNAL 13,18 0
�Ev/�r1ND C !04 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
� OWNERS -/ L •7 NOV
PLAN CHECK VALIDA�
�'01i NAME
Nom. • /�.• 0/s OTY. ELECTRIC PERMIT FEE
ary 6 a
NOME crofts UTLETS-SWITCHES-RECEP 10.00/1.00
C�,tib✓ NAME '
LC.No. LIGHTING FIXTURES 10.00/1.00
CONTRASDDRESS off
As APPLIANCES-RESIDENTIAL 4.00
PHONE PANELS 10.00 DATE OF APPLICATION
ROHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.O.NO,
O
OR
ENGINEER
uc.No SIGNS TRANS. 3.00
ADDDRESS ENG. , ' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP EMP.METER OR POLE INS. 20.00
APnucANTS MOTORS SEE FEE SCH. C
ADDRESS
SERVICE CHANGE 20.00
w,02 LICENSED CONTRACTORS DECLARATION
a v u I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE
H 2 w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
r�i Professions Code,and my license Is in full force and effect. ❑ ❑ ❑ ❑
Z o= License Class Lia Number
-
2 F Date Contractor
BUILDING PERMIT
¢ ¢ OWNER-BUILDER DECLARATION
a z w u INFORMATION
is. REFER TO ORD
R
i LL N I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT.
u o¢ Law for the following reason.(Sec.7031.5.Businessand Professions PERMIT ISSUANCE 10.00
f � > E Code:Any city or county which requiresa permit to construct,alter, - oo^,
Q Q ¢ D improve, Or repair any Structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. (�
O e requires the applicant for such permit to file a signed statement that TOTAL PER T TO
n w $ he is licensed pursuant to the provisions of the Contractor's License
H 2 a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe
Business and Professions Code)or that Im is exempt therefrom and QTY. PLUMBING PERMIT FEE
¢ = 0 the basis for the alleged exemption.An
g p y violation of Section malty STO 5 TYPE CONSTR.
> 3 � by any applicant fora permit sdM1llarsthe$500).licant loa civil penally ALTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred dollars(my em):
❑ I,as owner at the property,or my employees with wages as BACK FLOW PROTECT.DEVICE - 4.00 OCC.GROUP RES.UNITS
their sole compensation,will(S the work,and the and
Pro a is not
intended or offered for sale (Sec. 7044• Business and Professions DRAINS-FLOOR,ROOF,AREA,GOND. 5.00
• Cade:The Contractor's License Law does not apply to an owner of
property r who builds or improves thenar,and who docs such work FIXTURES-PER TRAP 6.00 SD.FT.FLOOR AREA TOTAL ACREAGE
himself re of ince his own employees,provided ev such improve-
0numls
Improvement
or within
on year oIf.mpletion the the owner,
GAS-EA.SVSTEM-I1NC.40UTLETS 6.00
*/ or improvement is sold within one year of completion,build
owner-
tAv" builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
pr v�for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES INC CON PO Omer
pl 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 ASSESSORS PARCEL NO.
and Professions Code:The 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
contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractors License Law. TRACT NO. PARCEL NO.
❑ I am exempt under Sec. B.&P.C.for this WATER HEATER W/VENT 6.00
reason
( Owner Date _/� WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
F C MP'NSATION D . LARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent to self-insure.
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.).
Policy No. Company
O ❑ Certified copy is hereby furnished.- FIRE SPRINK ENERGY T-24
Z Z ❑ Certified copy is filed with the city inspection division.
O Applicant MISC.- REFER TO ORD.
Y ❑ N❑ Y ❑ N❑
F -y
CERTIFICATE OF EXEMPTION PROM WORKERS' A
PERMIT ISSUANCE 10.00 FLOOD ZONE L.U.C.
�
LU COMPENSATION INSURANCE PLO.CONTR. LIC.NO. PLG.
d O This section need not be completed if the permit is for ma TOTAL Y[:] N❑ Y C] NE]
Z) Z hundred dollars(S 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 F mit is issued,I shall riot employ any person in any manner so as to
O W become subject to the Workers'Compensation Laws of Cutifornia. BUILDING
y Dale Applicant ALTER OR ADD TO MECH. 5.00
} N NOTICE TO APPLICANT: If,alter making this Certificate of Ex- -'�
F Z am Prior,you should become subject to the Workers'Compensation APPLIANCEPAID 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply wish FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000CF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HAND I U T1b • -;000C.F.M.) 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. HEATING B.T.U.) 6.00 MICROFILM
3097,Civ.C.).
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
04 ",
Lender's Address ELECTRIC
1 certify that 1 have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00
information n comae la agree to comply with all city and county PLUMBING
ordinances and stale laws relining to building construction, and BOILER-OOMPI3 H.P.of 100,000 B.T.U.1 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL
abovomentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cu perliuo ainat liabilities,=mnci�
nd expenses which CONST.TAX
may in way accrue agnof the PERMIT ISSUANCE 10.00
granlin this pe itMECH.CONT. LIC.NO. MECH.
TOTAL TOTAL cg, OK
Signature o Ap icon/Con r nor
Dar
OFFICE COPY '