13346 (2) �. POST THIS CARD NEAR-FRONT OF BUILDING
PERMIT NUMBER
CITY.. OF CUPERTINO 1
:.INSPECTION DIVISION' 1;3.36- .
JOB INSPECTION RECORD
22901 $TONEBRIDGE. '^ PE RMIT EXPIRATION
JOB ADDRESS • UNIT#' LOT# t ' - '
STANLEY =D,. •-HANSEN STANLEY ,D.•' HANSEN PERMIr'ExPIREs,IF WORK
OWNER CONTRACTOR L . IS NOT, STARTED WITHIN
• , INSPECTION DATE INSPECTOR INSPECTIONRECORD ''18o'DAYSDIP PERMIT iSSU-, '
FOUNDATION t _ ' ANCE OR ;180 DAYS FROM'
LIFER LASTCALLED INSPECTION.'
PREGUNITE •. - , .. PERMITIVALIDATION ..
' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED, t
L.
UNDERGROUND /.SLAB t /
PLUMBING _ - $1,1 Y;, ! -
ELECTRICAL - _ ISSUANCE DATE
MECHANICAL - BLDG. ELECT- IPLc. - MECH.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED " BUILDING PERMIT ;
- f INFORMATION
,WOOD FLOOR vq ugnoN , srET.-
PLUMBING "
MECHANICAL -
PERMIT
ELECTRICAL ' ' • ;• -r
.. FRAMING I , • �,', - �..; a„L„e'{. -.
INSU CATION - sTORIes TYPE CONSTR.
- OCC.GROUP. RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
•� ROOF. .. . .. , , SQ FI.FLOOR AREA TOTAL ACflEAGE.
DIAPHRAGM '
aU ILDING USE -
- r Res IND CON PB O bei
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - - ❑ El 1:1 E) ❑ -
ASSESSORSPARCEL NO.
ROUGH
'PLUMBING TRACT NO . rgRCEL NO..
GAS TEST
MECHANICAL ' ' ,, • .ti
ELECTRICAL 7 FINALS DATE INSP. ACC.DATE Acc,FILE No. ,
' FRAMING SAN
ZONING ENG.SITE NO.
INSULATION _ '• - PLUMBING
GAS P. -
, - - •FIRESPRINK ''ENERGYo]<,
MECHANICAL
'No
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED' HEATING- ° ❑ N Y
LATH—INTERIOR - ELECTRICAL _ FLOOD ZONE A.L.U.C. ' -
.` 'LATH' EXTERIOR..' FIRE DEPT. °❑ NO .^v I] N❑
SHEETROCK •y GRADE - FEE SUMMARY
SHEAR INTERIOR- BUILDING `-
BUILDING� `L+,� �
• sH_EARExTERIOR ' TEMPORARY APPROVAL
FIREWALLS - ELECTRIC PLAN CHECK`-:
FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY,BUILDING INSPECTOR: ,MICROFILM '
ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC
IW-. ONE WORK'ING'•DA Y BEFOREIREQUI RED INSPECTION ' PLUMBING
(
Z 0� PLEASE GIVE JOB ADDRESS WHEWPHONING.
I;} —'SEE PERMIT FOR EXPIRATION DATE -,' MECHANICAL
{
^IMPORTAN.T!
CONST.rnx
PLEASE READ REVERSE SIDE BEFORE r ,TOTAL'
CALLING FOR FINAL INSPECTION. ,
• . +,: COFFICECOPY , . , - ,•
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
t BU I LD ING PROJECT IDENTIFICATION APPLICATION & PERMIT PERMIT NUMBER
BUILDING
ADDRESS_ ���:.� , r; 13,346
UOL BUILDING — ELECTRICAL—PLUMBING—MECHANICAL
OWNER'S PLAN CHECK VALIDATION
N" CITY. ELECTRIC PERMIT FEE
l ���,�PHONE �:3a
NOMTTRACTO 's OUTLETS-SWITCHES-RECEP 10.00/1.00 /0
uc.No. LIGHTING FIXTURES 10.00/1.00
BJo ESsrORs - PPLIANCES-RESIDENTIAL 4.00 '
PHONE ' PANELS _ 10.00 DATE OF APPLICATION
ARCHITECT ,. PANELS (OVER 200 AMP) 20,06 PLAN CHECK FEE P.C.NO.
DR
ENGINEER
uc.No. SIGNS TRANS. 3.00
AARCH. R RCHEBR ENG. - SPECIAL CIRCUIT 5.66, PERMIT VALIDATION
.. ZIP EMP.METER OR POLE INS.- 20.00
APPLICANTS MOTORS •t SEE FEE SCH. �/J
Alio Ess ' '
SERVICE CHANGE . 20.00 7
wO o LICENSED CONTRACTORS DECLARATION IO
•a U I hereby affirm that I am licensed'under provisions of Chapter 9
ISSUANCE GATE
n 4 % (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
H m z Professions Code,anti my license is in full force and effect. ❑ El
C m — License Class Lic.Number - '
9 z �,w . Dale Contractor _
Y s - - BUILDING PERMIT
w U - OWNER-BUILDER DECLARATION - INFORMATION
D a ' " MISC.— ' ' REFER TO ORD,
F.
; LL I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT.
FLLea Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 — ,/- _ uj
wm Cade:Any cityorcounty which requiresepermit loconstR¢t,alter, /Y—_)T-�1
6 a:¢ improve,demolish,or repair any structure,prior to i6 issuance,also LEC,CONTR. LIC.NO. ELEC. Ulf /
c u requires the applicant for such permit to file a signed statement that TOTAL �Q PERMIT TO
A w m he is licensed pursuant to the provisions of the Contractor's License /-/,'j
Lex i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe C6kCr_
e. Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
s s.o
¢H $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
by any applicant for apermit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 '
I of not more than'five hundred dollars(5500).1:
❑ I,as owner of the property,or my employees villi wages ui BACK FLOW PROTECT.DEVICE 4.00 lice.GROUP, RES.awns,
their sole compensation,will do lite work,and fl e,sUucture is not I
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 -' -
O property who builds or improves lhencon,am,who does such work FIXTURES-PER'TRAP 5.00 So.PT,FLOOR AREA TOTAL ACREAGE'
himself or through his own employees,provided that such improve-
mentsarenot intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion, the owner-
builderGAS-EASYSTEM-OVER 4 (EA.) 200 will have the burden of proving that he did not build or im . USE
. . BUILDING
IND LNG NG PB Orae.
prove for purpose Of sale.). INDUSTRIAL WASTE INTER. 30.00 '
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contraemrs d construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 " ASSESSORS PARCEL NO.
and Professions Co e.'('hu ntr:mlor's License Law Aws not apply - ,
to ua owner of p p rty o.builds or an is thereon,and who LAWN SPRINKLERS-OVER 5 (EA1- 1.00contr -
theCoutmot.0 oj- with tonin is)licedsed pursum+lM SEWER-SANITARY-STORM EA,200ft/10.00 ' TRACT NO, PARCEL NO,
the l arador' Lice Sec
'
O lame tder Sec - 1`C:for Blis WATER HEATER W/VENT 6.00
reason —
Owner Date ' WATER SYSTEM - , 5.00 ACC.DATE ACC FILE NO.
WORKERS'COMPfi ATION DECLARATION WATER TREATING'EQUIP, 5.00
1 hereby affirm that I have a certificate of consent to sell'-insure,
or a certificate of Workers:Compensation Insurance,or a certified ZONING ENG,SITE NO.
copy thereof(Sec.3800,Lab C.). _policy No M Company
O ❑ Certified copy is hereby furnished. . FIRESEEINK ENERGYT-24
Z Z El Certified copy is fled with the city•inspection-division. -
F 0 Applicant MISC... REFER TO ORD. Y❑ NE] Y ❑ N❑
it W CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT.ISSUANCE 10.001 FLOOD ZONE A.L.U.C.
LU COMPENSATION INSURANCE: - PLG.CON To. LIC.NO. PLG. -'
CL Q (This section need not-.he completed if the permit is for one TOTAL V❑ N❑ V ❑ N❑
0 2 hundred dollars IS 1001 or less.)
U O 1 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 not employ any person in any manner so as to
U become subject to the Workers'Compensation Laws of California.
DO Dare & ApplicantALTER OR ADD TO MECH. 5.00 BUILDING Q �
>_ w NOTICE TO APPLICANT': 11,after nmking this Certificate of Fs-
F ? mnplion,you should become subject to the Worker,'Compensation APPLIANCE, - _ 5.00 PLAN CHECK
provisions of the.Labor Corte, you must forthwith comply with FEE
U such provisions or this perntil shall be deemed revoked. AIR HANDLING UNIT(TO 10MOC.F.M.) 4.00
- CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE S(�
I hereby affirm that there is a construction-lending agency l'or EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec. - MICROFILM
3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 - do df�
T Lender's Address - ELECTRIC '
I.certify that 1 have read(his application and stale that the above VENTILATION FAN (SINGLE) 4.00
V information is correct. I agree to comply with all city and county PLUMBING '
I BOILER-COMPI3 H.P.or 100,000B.T.U.) 6.00
liedE ens and stale esen relating to building constR¢Iibom and
hcieby null)�il'ze representatives of this city to enter upon the 'BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL
ab en fon it operty for inspection purposes.
(We) nee save, inde reify and keep,hmmless the City of MISC.- REFER TO ORD.
Cu it, aja' t liab'lure dgments, costs and expenses which CONST.TAX
sea in a rue ainst said Cit -PERMIT ISSUANCE 10.00
y yin consequence of the
granti isp it. MELH.CONT. LIG NO. MECH.
7f1 Jp / 'Jo 7,
TOTAL TOTAL 3 S O
i Apple nt/Contractor 'Uat '
OFFICE COPY ..
.. , 4 , . e -