14188 (2) -- POST THIS CARD NEAR FRONT OF BUILDING
- rFRMrt NUMBER
r CITY OF CUPERTINO 14188
INSPECTION DIVISION
JOB INSPECTION RECORD (\
733 Stendhal Lane PERMIT EXPIRATION
JOB'ADDRESS UNIT# _LOT#
PERMIT EXPIRES IF WORK
OWNER , Brent Talley CONTRACTOR Dick' Schuster IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
LIFER
LASTCALLED INSPECTION.
' � - -
PREGUNITE - - PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED „
UNDERGROUND./SLAB ;
PLUMBING - '
ELECTRICAL' ISSUANCE DATE
MECHANICAL - ELECT. PLG. MECH.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED n,1 iZ 6 11PUDING PERMIT '
WOOD FLOOR
nR INFORMATION
� dN SIFT.
PLUMBING � _
MECHANICAL ' W�
ELECTRICAL - - PeRMIT TO
C...
FRAMING,
INSULATION - - - STORIES TYPE CONSTR.
OCC GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF SO,I:T FLOOR AREA TOTAL ACREAGE
DIAPHRAGM
BUILDING USE
RES INp CON PB 0,N,,APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ••�❑ ❑ ❑ ❑
ASSESSORS PARCEL NO.
ROUGH
PLUMBING -
GAS TEST - TRACT NO. PARCEL NO,
MECHANICAL-
IN
ELECTRICAL FINALS .DATE SP. ACC.DATE ACC,FILE NO.
FRAMING Ws SAN OF zoNlNc ENc.SITE No.
INSULATION PLUMBING
GAS .
MECHANICAL - FIRE SPRNK ENERGYT24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED , HEATING Y 11NEIE-] N❑
LATH-INTERIOR ELECTRICALFLOOOZONE A.L.U.C.
LATH-EXTERIOR FIRE DEPT. Y❑ 'N❑ Y ❑ N❑
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR - BUILDING
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING -
FIREWALLS ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
i
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
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 I DENT]FICATION PERMITNUMBER
LDING APPLICATION & PERMIT
ApoREss 33 S7L011AL CASE14188
BUILDING —ELECTRICAL—PLUMBING—MECHANICAL
OWNER'S, PLAN CHECK VALIDATION
"am OTY. ELECTRIC PERMIT FEE
2Ea�— � j
� PHONE �'1 p Z
CONTRACTORS oC s
NAME (\� -y (� �b' OUTLETS-SWITCHES-RECEP 10.00/1.00 �0'-
�e-L� LJc H S — u ,No.�G�00 LIGHTING FIXTURES 10.00/1.00 0—
CONTRACTOR'S - PP LI ANCES-RESI DENTIA L 4.00
ADORES 4/
77 -NINA PHONE {4 () PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.N0.
OR
ENGINEER
LIC.No. SIGNS TRANS. 3.00
ARCH,ss END SPECIALCIRCUIT 5.QQ PERMIT VALIDATION
ADDREZIP EMP.METER OR POLE INS. 20.00
APPLICANT'S MOTORS SEE FEE SCH. .4
ADDRESS
SERVICE CHANGE 20.00 ) y
woo LICENSED CONTRACTORS DECLARATION
¢ U U I hereby affirm that I am licensed under provisions of Chapter 9 AA ANCE DATE
(commencing with Section 7000)of Division 3 of the Business and
m ¢ y' G. CT. PLG. MECH.
F o z Professions Cod nd my license is in full force f ❑ El
0 w W License Class Lic.Number y
Dale Contractor
a Y f LDING PERMIT
rem w u OWNER-BUILDf:R DECLARATION INFORMATION
aoa MISC.— REFER TO ORD
wg LL N I hereby affirm that I am exempt from the Contractor's License
ruoJ Law for the following reason.(Sec.7031.5,BusinessandProl'essions PERMIT ISSUANCE 10.00 D — VALUATION $/FT.
Code:Any ciryor County which requires a permit to construct,alter,
!
2 ¢G improve,demolish,or repair any structure,prior IO its issumhac,also NT LIC.^—O..�� ELEC. Z O V
0,
requires the applicant for such permit to file a signed statement that SQ(� TOTAL eJ PERMIT TO
w he is licensed pursuant to the provisions of the Contractor's License
ca La.(Chapter 9(commencingwith Section 7000)of Division 3 oflhe CM60
i o Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
0, h the basis for the alleged exemption.Any violation of Section 7031.5 1 STORIES TYPE CONSTR,
A. by anyzpplicant fora Permit subjects the applicant toa civil penalty ALTER-DRAIN&VENT•WATER (EA.) 5.00
of not more than five hundred dollars($500)):
❑ I,as owner of the 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 or improves thereon,and who Ines Such work FIXTURES,PER TRAP 5.00 S0,FT,FLOOR AREA TOTAL ACREAGE
himse. meats are not hrough
ownemployees,for sale.
If,ed that however,
the
improve. GAS-EA.SYSTEM-1 6.00 .
mems are not omen del or offered for sale.If,however,the building
or improvement is sold within one year of completion,the owner. GAS-EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden of proving that he did not build or im- BUILDING USE
prove for purpose of sale). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omar
❑ I,as owner of the property,am exclusively contracting with ❑ 11 ID 0 0
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 contractors)licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00
the Contractor's 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,
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5,00
I hereby affirm that 1 have a certificate ofconsent to self-insure, ZONING
or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.).
-Yx Policy No. Company
0 ❑ Certified copy is hereby furnished. FIRESPRINK ENERGY T-24
ZZ CICertified copy is filed with the city inspection division, MISC.- REFER TO ORD.
Applicant Y❑ N V [3N�
♦— r/a ` PERMIT ISSUANCE 10.00
CC CERTIFICATE Op EXEMPTION PROM WORKERS' FLOOD ZONE A.L.u.C.
L COMPENSAIION INSURANCE PLG.CONTR. LIC.NO. PLG.
Z (This section need not be completed if the permit is for one TOTAL v EJN V N
hundred dollars(5100)or Iess.)
U O 1 certify that in the performance oI'the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL P mil is issued,I shall not employ any person in any manner so as to �-7,
0W become subject to the Workers Compensation Laws of California. BUILDING
IS. nate Applicant ALTER OR ADD TO MECH. 5.00
} N NOTICE TO APPLICANT': If,after making this Cerlifeate of Ex-
Z emplion,you should becomesubject to the Workers'Compensmion 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 10,000CF.M.) 4.00
CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE S-0 "
1 hereby affirm that mere 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 UNIT ITR 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ.C).
Lender's Name
Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC _'Q
• 1 certify that I have read this application and state that the above _ VENTILATION FAN (SINGLE) 4,00
information is correct. I agree to comply will'all city and county PLUMBING
ordinances and state laws relating to building CORSIMCtm, and BOILER-COMP(3H.P.Or 100,000B.T.U.) 6.00
-hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL
abovo-mentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City or MISC.• REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any way accrue against said City in consequence of the
gmntingoflhis permit. MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL
Signature of Applicant/Contractor Date
OFFICE COPY