14814 (2) POST THIS CARDNEAR FRONT OF BUILDING deRMJTDOWER
CITY OF CUPERTINO 14814
INSPECTION DIVISION
JOB INSPECTION RECORD
• PERMIT EXPIRATION
JOBADDRESS 740' Stendhal Lane UNIT# _ _LOT' -
OWNER TlICI E Stet - L PERMIT EXPIRES IF WORK
y CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.
. FOUNDATION NOTE: ANCE OR 180 DAYS FROM
UFER � ALL GRADING ANDDRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION.
PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
GARAGE SLABS
CUPERTINO STANDARDS. .
• -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED y�
UNDERGROUND /SLAB
PLUMBING
^^"/� f C•
ELECTRICAL
' ISSUANCE DATE
MECHANICAL RIOc, eLecr. Plc. MECH,
. ❑ 1:1 ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED •;, BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING
v ALUAT1ON SIFT,
- • -
MECHANICAL
a1� •\
ELECTRICAL - -1 PPIVMn rO
LL
FRAMING '
INSULATION a �,/ - p STORIES -TYPE C,ONSTH.
OCC cHD11P RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED• - -
50.1ROOF - NOTE:NO FINAL INSP.SHALL MADE BEFORE7 1 FLOOR AREA WTAI.ACHEAIIL
DIAPHRAGM THE CONSTRUCTION TA_XIS PAID
ROOF SHEATHING ' RES IN L IL ItON IN USE
PR o
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP" ❑ El E-1 0
ROUGH SAN.p
ASSESSORS PARCEI.NO
� -
PLUMBING ELECT,ENERGY
.
• TUBS&SHOWER PAN - PLUMBING ENERGY- iHACT NOPARCEL NO
MECHANICAL MECH.ENERGY
ELECTRICALBUILDING ENERGY ACC DATE ACC FILE NO
FRAMING ELECT.FINAL TEST
ZONING ENG.SITE NO.
INSULATION - � PLUMBING '
GAS TEST GAS
FIRE SPRINK ENERGY T24
MECHANICAL
• COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑' N❑ ° [D N❑
EXTERIOR SHEAR - -
ELECTRICAL RELEASE FLOOOZONE A.L U.C.
INTERIOR SHEAR FIRE DEPT. Y E] N❑ Y L-1N❑
SHEETROCK GRADE FEE SUMMARY
• EXTERIOR LATH BUILDING - -
INTERIOR LATHTEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC 'PLAN CHECK
GAS FEE . .
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY' SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDMG FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR*INSPECTION BY PHONING 252-4505,-, ELECTRIC
F� ONE WORKING DAY BEFORE REQUIRED INSPECTION.. PLUMBING •v
zo 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 - PERMIT NUMBER '
BUILDING APPLICATION & PERMIT
ADDRESS 1, I / / BUILDING-ELECTRICAL-PLUMBING--MECHANICAL 14814
OwNER'S 7 ,^V J L PLAN CHECK VALIDATION
NAME
0 DTV, ELECTRIC PERMIT FEE
. PHONE S-Vl^-f/
CONTRACTOR s
NAME �e I� uc. OUTLETS-SWITCHES-RECEP 10.00/1.00
NO. LIGHTING FIXTURES 10.00/100
CONTRACTOR ADDRESS OR's
APPLIANCES-RESIDENTIAL 4.00 '
PHONE PANELS 10.00 DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE P,C.NO.
OR PANELS (OVER 200 AMP) 20.00 -
ENGINEER LIC,.0. SIGNS TRANS. 3.00 '
ADDRESS ENG. PERMIT CIRCUIT 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APPLICANT s MOTORS
ADDRESS SEE FEE SCH.
SERVICE CHANGE 20.00 /�-`
0O LICENSED CONTRACTORS DECLARATION
a v I hereby affirm that I am licensed under provisions of Chapter 9 I UANCE DATE
y a w (commencing with Section 7000)of Division 3 o the Business and - BLDG. ELECT. PLG. MECH.
r m z professions Code,and my license is in full force and effect. ❑ ❑
2 0,., - License Class Lie.Num her
O m H w Dmc Contractor _
a x BUILDING PERMIT
CE ¢ a OWNER-BUILDER DECLARATION -
o a u INFORMATION
E
3 LL a 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION
F u 0 a Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10,00
Code:Any city or county which requiresa permit loconstnml,al@r, -
rt6 ¢O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. ' LIC.NO. ELEC.
u m m u requires the applicant for such permit to file a'signed statement that TOTAL - PERMITTO
he is licensed pursuant to the provisions of the Contractor's License
Hzr Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe b-'
4 40 Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
a I- m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. ,
u ; _ by any applicant for a permit subjects the applicant In it civil penalty ALTER-DRAIN -WATER (EA.) 6.00
of not more than five hundred dollars(5500).):
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 DCC.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
C.le: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-
• meats are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner-
builder
wner GAS-EA.SYSTEM-OVER 4 IEA.) 2.00
builder will have the burden of proving that he did not build or inn- BUILDING USE
prove 1,as owner
RES IND CON PB Olher
of sale.). INDUSTRIAL WASTE INTER. 30.00 1:1 � 0 ❑ 1:1❑ I,as ownerer of the property,am exclusively contracting with
licensed contractors to construct the project(Sec. 7044,Business LAWN SPR INKLERS- 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 I'or such projects with a contractor(,)licensed pursuant to SEWER-SANITARY-STORM EA.2001t/10.00
the Contractor's License Law. Q TRACT NO. PARCEL NO.
❑ l am exempt under Sec. B.&P.C.for if WATER HEATER W/VENT ( >� ..-6.00
ol
reas
Own e Dine WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORK COVIPE ATION DeCLARAI'ION WATER TREATING EQUIP. _;��7, ;5.00
I hereby affirm Ilial l have a certificate of consent tosell im.,L, r ZONING
or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.L -
Policy No. Company ,
O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T24
Z Z ❑ Certified copy is filed will, the city inspection division. MISC. REFER TO ORD.
O Applicant Y IN Y O N[]
H T PERMIT ISSUANCE 10.00
CERTIFICA'1'1:01s EXEMPTION FROM WORK Ii RS' .U FLOOD ZONE A.L.U.O.
LU > COht PENSATION INSURANCE PLG.CONTR. LID.NO. PLG. ,,ff
CL Z (This section need not be Completed if the permit is for one TOTAL�V S Y❑ N� Y[3NED
hundred dollars IS 100)or less.)
L) O 1 certify that in the Performance of the work HIT which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I shall not employ any person in any manner so as Io
OW become subject to the Workers'Compensation Laws of Culilornia.
CL Date-Applicant BUILDING
>_ W NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00
I- ? emption,you should become subject to the Workers'Compensation APPLIANCE _ 5.00 PLAN CHECK
provisiots'of the Labor Code, you must forthwith tonlply with FEE
f.1 such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT TO 10=CLF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0MC.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. MICROFILM
3097,Cie.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
Lender's Address HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
. information n correct. I agree to comply with all oily and county BOILER-COMP(3 H.P.Of 100,000 B.T.U.) 6.00 PLUMBING
information
and safe laws relating to building construction, and
hereby authorize representatives of on city es enter upon`the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL
herebynaut
above-mentioned property representatives
ofth i purposes.
(We) agree to save, indemnify and keep handless the City of MISC.'- REFER TO ORD. -
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any way accrue against 'id City in consequence of the
r MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL
Signature of App' ant/Contras Dt e
OFFICE COPY