16466 (2) POST.-THIS CARD NEAR FRONT:OF BUILDING
PERMIT NUN14
.CITY 'OF CUPERTINO 16466
INSPECTION DIVISION'
JOB INSPECTION RECORD
• . d I�' , PERMIT EXPIRATION
JOB ADDRESS IIIdO �1 C/7/ IC- ' ! -
UNIT#' =LOT#
,,// f ^• PERMIT EXPIRES IF WORK.:
OWNER Cj-p U.Q 2Y- CONTRACTORS;•��pO.y•gz9 L,8 IS NOT STARTED WITHIN 1 "
INSPECTION DATE INSPECTOR INSPECTION RECORD .IUU UAY5OF PERMIT ISSU. .
- ANCE OR 180,DAYS"FROM;., �,
FOUNDATION NOTE: ,"
CASTCALLEDINSPECTION:I;F
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE. r - TO COMPLY WITH.THE APPROVED PLANS AND CITY OF .PE MIT VALIDATION,'
CUPERTINO STANDARDS,
GARAGE SLABS , .._•/
POUR NO CONCRETE'UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING - "•" r '
ELECTRICAL ISSUANCE DATE
MECHANICAL- BLUG EyecT Pu;:I MccR,
DO NOT POUR FLOOR UNTILABOVEHAS BEEN SIGNED _ "•'�•- BUILDING PERMIT
WOOD FLOOR ' . INFORMATION
PLUMBING . . VA�uATION .p STET..
,MECHANICAL: -
PERMIT TO. -
ELECTRICAL -
FRAMING
INSULATION - GSTORIES TYPE CONSTR
-
OCC,GROUP RESIUNITS,-
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF -' - NOTE:NO FINAL INSP.SHALLBE MADTIlffFORE, .sso.vr.F�opRAREA - turn L.AcaeneE
DIAPHRAGM -
THE CONSTRUCTION TAXIS PAID
11 1 BUIL, NG uSE
ROOFSHEATHING .Q its IND -,TON PB Onu• '
u APPLY NO.ROOFINGyUNTIL-ABOVE HAS'.BEEN SIGNED - .FINALSDATE'' , .'1 p
ASSESSORS PARCEL ND
• ..ROUGH SAN.q .' .'.1 . .
PLUMBING , ELECT.ENERGY
TUBS B SHOWER PANPLUMBING ENERGY - TRACT Oil,, PARCEL NO
MECHANICAL - - MECH..ENERGY -
ELECTRICAL ACC GATE ,I'acr..Fu.e No.
BUILDING ENERGY '
FRAMING - - ELECT.FINAL TEST , - ZONING ENG,SITE NO. ,
INSU LATI O_N , - PLUMBING Q-
GAS TEST GAS' _
MECHANICAL'•
•FIRE SPRINK ENERGY T'14
'- r .,
'COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - '.Y N❑ ,Y E]. No
EXTERIOR SHEAR' - ELECTRICAL RELEASE - FLOOD ZONE A.L IO
Y�.; � J
INTERIOR SHEAR ! FIRE DEPT. ' NY'LN
SHEETROCK ,,, GRADE' - ' - FEE SUMMARY
EXTERIOR LATH ' I - " BUILDING -
INTERIOR LATH TEMPORARY APPROVALS.• BUILDING.
.SCRATCH COAT ELECTRIC 'PLAN CHECK
GAS "FEE.
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY,OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILMLLJ ' I •
ARRANGE'FOR.INSPECTION BY PHONING 252-.4505,`x , ELECTRIC
ONE WORKING:DAY,BEFORE REQUIRED INSPECTION : , PLUMBING .
PLEASE GIVE JOB ADDRESS WHEN PHONING T "
z — SEE.PERMIT FOR EXPIRATION DATE ; ` MecHAwcn
IMPORTANT! consT.rax
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION: TOTAL
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WI,THIN'RED LINES - USE BAL,C.POINT PEN ONLY, y'
BU I LDING PROJECT I DENTIFICATI ON PERMIT.NUMBER
ADDRESS - APPLICATION & PERMIT ' • q n
ADDRESS - '. /'' I b
O BUILDING ELECTRICAL—PLUMBING_MECHANICAL
OWNER'5 .. - + . PLAN CHECK VALIDATION
NAME
,, .• � QTY'. ELECTRICPERMIT ^" FEE
CONTRACTORS
UTLETS-SWITCHES-RECEP, 10.00/1.00 a
LIC. 'Q LIGHTING.FIXTURESq -10.00_/1.00 '
ADDRESSCONTRACTOR APPLIANCES=RESIDENTIAL ` 4.00
17 PHONE ,p PANELS i• 10.00 'DATE OF APPLICATION i
ITECT
-
OR - ')' PANELS (OVER 200 AMP(+ -20.00 PLAN CHECK-FEE P.C.NO.
ENGINEER -
ihc.NO, � SIGNS TRANS.- - - ,3.00RRCH.OR
'
ADDRESS ENG SPECIAL CIRCUIT -" '' 5,00 PERMIT VALIDATION '
' all' EMP. METER OR POLE INS. , .,,.*20.00 /fir!
APPLICANT'S V a
ADDRESS MOTORS SEE FEE SCH.
- '• .. h , SERVICE CHANGE t 20.00 �/Y.7/��
0. o 22, LICENSED CONTRACTORS DECLARATION '
Q'o U 1 hereby alllrm that I am licensed under p"okionsof Charter ISSUANCE DATE
N a w Ieommenemg with Section 7000)of Division 3 of the Business and _ - BLDG. ELECT.• PLG. MECH.
H o Z i'rol ssions Cod I nl 1' enm is in lid)for Tec. - ❑
Z o w icer ass Li,.Number -
o m F w Date�yL CDN ra for - , ,%n ❑. ❑ c
' ¢ m ¢ a OWN(R-BUILD(R DI CLARA'I'IONO BUILDING PERMIT
o i ° - INFORMATION
E
01L,y 1 hereby alfrm that I am exempt I'tom the Contractor;License MISC.r— - REFER TO ORD -
'F 'LOj Lawlor the following reason(Sec.7031.5,Business and Professions - PERMIT ISSUANCE ' 1000 VALUATION ;/FT.
Code:Any city or county which requimsa permit to construct,al vr,
rt ¢Q improve,demolish,or repair any stoma Ure,prioi to its issuance,also ELEC.CONTR. LIC.N0. ELEDf -
oa¢ requires the applicant for such permit to file a signed statement that TOTAL
N w he is licensed pursuant to the provisions of the Contractor's License P �^^y,'PEQRMIT TO
'rZQLaw Chapter 9(commencingwilli Section 7000)ofDivision 3 of the - / ""'kms
�-i D Business and Professions Code)or that he is exempt therefrom and OTU. PLUMBING PERMIT FEE' /
o the basis for tie alleged exemption.Any violation of Section 7031.5 .STORIES TYPE CONSTR.
La ; m by any applicant for a permit Subjects the applicant to a civil penalty -
OfnotmomtanfivehundreddollanI S500).): 't ALTER-DRAIN&'VENT-WATER'(EA.) 5:00
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT'.DEVICE 14.00
their sole compo nition,will do the work,and the structure is not .00C.GROUP RES.UNITS
intended or offered'I'ur sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5,00
Code:The Contractors License Law does not apply to an owner of -
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP: t S0.FT,FLOOR AREA TOTAL ACREAGE
himself or tivaugh,his own employees,Provided that such ingirove. GAS IN
�- mems are not intended or offered for sale.If,however,the building _C.40UTLETS b.00 .
or improvement is sold within one year of completion,the owner.
builder will lave the burden of proving that he did not build or in,- GAS-EA.SYSTEM,-OVER 4 (EA.) BUILDING USE.
prove for 1,.po nee of sale.). INDUSTRIALWASTE INTER. .00 - (1�S .I❑ -❑N ❑ Other❑
❑ I,as owner of ale Proper;Y,um exclusively.contracting with _ '
v licensed contractors to construct the project (Sec 7044, lhioness LAWN'SPRINKLERS- 1 INC 5 V.B. ' ASSESSORS PARCEL NO.
and Professions Code:'I'lie Contractors License Law does not apply
loan owner o1'property who builds or improves thereon.and who LAWN SPRINKLERS.-OVER 5 (EA.)cootract '
- the Cort for such Licensets
contruaor(s]licenced Pois"Int to SEWER-SANITARYV-STORM EA:200ft/10.00
- - ' the Coniraclars License Law. - ' TRACT NO. PARCELNO.
❑ tum exempt under Sec. ,li.&Y.C.I'or this
reason WATER HEATER W/VENT 6.00
Owner
One - WATER SYSTEM '" -500
P99 ACC.DATE ACC.F ILE NO.
-
WORKIiRS'COMPIiNSA'I'IONDI:CI-ARATION WATER TREATING EQUIP. 5,00
Lberchy affivn that ( have a cerltlicate nl'consent toself-ileum, w
or a certificate of Workers:Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec 3800,Lab.CJ.
Policy No - Company • .
O ❑ Cenified yls ltetthy le . FIRE SPRINK ENERGY T-24
rz Z.v a/Certifies py isfil nit ie city ms .
-F O' APphc int - - MISC. REFER.TO ORD • v []. IN v ❑ N❑
PERMIT ISSUANCE
LU y CBRTII°ICCO6Pl NiWJON EXEMPTION N WORKERS' �ta�--' „'FL000 ZONE A.L.U.G.
W COMI'IiNSA'I'ION INSURANCE. " PLG.CONTR. LIC.NO, .,` PLG.
CL 0 !This scoi<in oeeA'net be completed if the permit is for one '- TOTAL '�- Y❑ N❑ Y❑ ^,N❑
hundred dollars IS 100)or less.)
U O , 1 certify that in the performance of the work for which this per. DTV. - MECHANICAL PERMIT FEE . FEE SUMMARY,
jt. H-: mit is issued,I shall not employ any'person in any nanner so as to
UW become subject to tireor
Worker;Compensation Laws of California.
y DutcApplicant ALTER OR ADD TOMECH. 5.00 BUILDING
}'W • NOTICE; TO APPLICANT: II;after nit akin,this Certificate of Bx-
F Z ' empti in,you should become subject In the Workers'Compensation APPLIANCE - 5,00 PLAN CHECK
provisions of the Labor Code, you most forthwith comply with r FEE '
U such provisions or this permit situ)]he deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) , 4,00
CONSTRUCI]ON LENDING AG17NCY + AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 - SEISMIC FEE•
I hercby'nifir tlmt them is a uonstruction lending a vie,, for EXHAUST HOOD(WITH DUCT) 5:00 -
the performance of lire work for which this permit is issued(Sec. - - MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lenders Nome HEATING UNIT 100,000 B.T.W9.50
Lender's Address ELECTRIC
I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 -
infounation is correct. I agnro It,comply with all city and County PLUMBING "
�--=
ordinances and state'luws BOILER-COMP(3 Hrelating In building construction, and H.P.or 100,000 B.T.U:) 6.00
•
hereby authorize representatives of this city to enter upon the BOILER-COMP.(Over 100,004BTUI'SEE.FEESCH. _ MECHANICAL
above-mentioned ve-mtioned property for inspection PurPOses. -
(We) agree to Save, indemnify and keep harmless the City of - MISC.- -(REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE - 10.00 ;. CONST.TAX
May
lin It way accrue amst said City in consequence of the -
rzontni his Penn MECLCONT. LIC.NO. MECH,
�'cj TOTAL TOTAL
Signature of Applicant/Contractor Dart'
OFFICE COPY,' . . ,.