15239 (2) POST THISCARD'NEAR F'RONT. OF 'BUILDING'
, � , 'PERMIT NUMBER" '
CITY- OF CUPERTINO.' . 15239
INSPECTION DIVISION
'JOB INSPECTION RECORD l
PERMIT EXPIRATION
10895 'Sweet Oak Street
JOB ADDRESS UNIT# '_COT-#k
LL,, y PERMIT-EXPIRES IF WORKOWNER'..£.Ke]-.th Roberts .CONTRACTOR i • IS NOT. STARTED•WI THIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 186.DAYS OF PERMIT ISSU
FOUNDATION ,NOTE: r'
` ANCE OR 180 DAYS FROM
- -
UFER, ., ALL GRADING',AND DRAINAGE SHALL,BE INSTALLED LAST.CALLED'INSPECTION.
TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION i
- PR EGUNITE - i' - CUPERTINO STANDARDS.' - "
' GARAGE SLABS .' ,.. - --
4•
POUR NO CONCRETE UNTIL ABOVE.HAS BEEN SIGNEDXf
UNDERGROUND./.SLAB.. /. f ICI_4
PLUMBING
'
.. Is din Ar
ELECTRICAL, .,.s� rvcl:u c
„ ,, bLOQ tE LE Ci. 'PLf. 'MECH.
MECHANICAL ,I
w
OO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ' _ BUILDING PERMIT
E' Z 77P WOOD FLOOR, _.1� .'c INFORMATION'
vA uUnnoN SIFT
PLUMBING .
v.
_ MECHANICAL,
-. YERMIT TO
ELECTRICAL
i
FRAMING -
INSULATION " - sroRlEs• ?SPE CONSTR. '
,
•' - , I - OCC GNOUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.vl.FEonR'nIIEA TOTAI ncRIArE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID : . '•�
`
ROOFSHEATHING - - ° '.•� .Res INo BUILDING USE,PB o,e,.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - `FINALS DATE' ^` "'INSP:' El
11, ASSESSORS PARCEL NO
.ROUGH - - SAN.a
PLUMBING ' ELECT.ENERGY' i. ,r,' '
TUBS 8 SHOWER PAN PLUMBING-ENERGY, ' rRgci No. PARCEL NO
MECHANICAL • , . MECH.ENERGY
ELECTRICAL "BUILDING ENERGY" Arc.,unre Acc.FILE No.
FRAMING �2 ELECT.FINAL TEST',
INSULATION PLUMBING - zoNING 1' ENG.SITENO.•�
.E GAS TEST. GAS - • `-
MECHANICAL FIRE SPRINK ENERGY i]G.
' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING':.. ° " N.
' EXTERIOR SHEAR - ELECTRICAL RELEASE ,. •'FLooD ZONE A.L.0
.;Y� -N YL .; ��1
INTERIOR SHEAR, - - FIRE DEPT. a ^ L:
. SHEETROCK' , - • GRADE FEE SUMMARY
EXTERIOR',LATH BUILDING -1
,INTERIOR LATH - TEMPORARY APPR AL BUILDING,.' /
SCRATCHCOAT • ELECTRIC PLAN CHECK '
? FEE
.. GAS . .' -.
NO TAPE OR`PCASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE K, '
Jam'•
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
- •MICROFILM'
uJ ARRANGE FORANSPECTION`BY PHONING 252-4505, ELECTRIC
Lu ONE WORKING DAY-BEFORE REQUIRED INSPECTION:' I PLUMBING'
O� PLEASE GIVE JOB ADDRESS WHEN.PHONING.., ,
Z — SEE PERMIT,FOR EXPIRATION.DATE ' MECHANICAL
-IMPORTANT! m CONST.TAX
" PLEASE'REA.D'REVERSES IDE BEFORE
• . " . CALLING'FOR FINAL INSPECTION. , TOTAL /S , ff
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN REDLINES — USE BALLPOINT. PEN ONLY
BU LDI NG PROJECT I DENTI FICATI ON s PERMIT NUMBER
3s I' APPLICATION.&.PERMIT ,,,:' ,; - ,�}]
IO ySScv D,K ST BUILDING —ELECTRICAL—PLUMBING—MECHANICAL' �' ��,"9
_ NAME (�w �Z�7J-T—// �/OWNERS PLAN CHECK VALIDATION
V15) (4 QpEp �$ S CITY. ELECTRIC PERMIT, FEE
CONTRACTOR S
NAME - OUTLETS-SWITCHES-RECEP 10.00/1.00 VVV
LIC.No. LIGHTING FIXTURES 10.00/1.00 `
ADDRESSTORs - APPLIANCES.-RESIDENTIAL 4.00 i.
PHONE PANELS - 10.00 " DATE OF APPLICATION
ARCHITECT ,- .PLgry CHECK EEE n,' P.C:NO.
oR PANELS (OVER 200 AMP) '. :`/ti'2.0!00 i7 - -
- ENGINEER LIC,No. SI GNS TRANS. 3,00
ADDRESS C. OR ENG, $PEQIAL QIRCUIT -5.00 . " '•1 PERMIT VALIDATION
EMP.METER OR POLE INS. ,20.00 /1
moo ssTs - MOTORS SEE'FEE SCH. /U--'�CjA,t-.�`
^.: SERVICE CHANGE " ,'20:00 'P
Foo 'LICENSED CONTRACTORS DECLARATION
< I hereby ultinn
that 1 am licensed under pr rvisimex of Chapter 9 r - ISSUANCE DATE
a 1 w (commememg w th Section 7000)of Division 3 of the Business and _ - BLDG, ELECT. PLG_ MECH.
w z Professions Code,and my license Is In full force and effect., +
iu,o License Class Cic:Number , ❑C
m L Dalc Contractor
sty E -a
¢ ¢ w 4 OWNER-BUILDER UECLARA'I'ION - BUILDING PERMIT
O -
X ;LL y I hereby affirm that I am exempt from the Contractor's License MISC ' REFER TO ORD' INFORMATION.
u O 4 Law let the following Hason.(Sec.7031.5;Business and Professions VALUATION $/FT.
I- -
PERMIT ISSUANCE
10.00
Code. e,d city or county which structur e Permit priorto construct,uce,alter,
¢ <o Improve,demolish or repair any structure,poor to❑s Issuance,also ELEC.CONTR. LIC.NO. ELE
i O ¢ Requires las theapplicant for xrich rni t m I'He a si
1I elud SlalemmV[Inti' TOTAL TT
w m he is licensed pursuant to the provisions of the Contnmtor's License -- - ,' -PERMI O
Law(Chapttr9(commencmgw'th Sectinn7000)ofDivision3ofthe 19
BusinessQ o-Tpp
¢ o and Professions Code)or that he is exempt therefrmn and QTY. . PLUMBING PERMIT J 11,, 11 R(?LV _
¢I- o the basis for the alleged exemption.Any violation of Section 7031.5' R t I STORIES .TYPE CONSTR
u ; m by any applicant for a permit subjects the applicant to a civil penalty
of not more t ' ALTER-DRAIN
han five hundred dollms($500).): .. -
❑ I,as owner of the property,or my employees with wages as BACK'FLOW,PROTECT. DEVICE' 4.00 .I• OCC.GROUP RES.UNITS
their sole compensation,will do tire work,and the structure is not
intended or offered for sale (Sur. 7044, Business and Professions DRAINS-FLOOR,ROOF„AR EA,COND.. 5:00
Code:The Contractor's License Law does not apply to an owner of -
property who build,Or imPTOseS thereon and who does such work FIXTURES-.'PER TRAP _ 5.0.0 SO.+FT.FLOOR ARFA TOTAL ACREAGE
1 himself re through his own employees Provided that such inn Prove-' - - - -
i
Trendsare notis old or withifien
on years if,
ompletio ilic theo nes- GAS=EA.SV.STEM-1INC.4OUTLETS '6.00
or,der will have
Is sold wuhp one year of completion,the owner-
builder will rpos the burden of proving that he did not build or int- GAS-EA.SYSTEM'-OVER 4 (EA.) 2.00 BUILDING ON USE
Prove for 1,as owner
off the.1. ., RES IND CON PB Other
❑ 1,as owner of the property,um exclusively contracting with INDUSTRIAL WASTE'INTER. 30.00 ❑ ❑ _ ❑ ❑ ❑
- licensed contractors to construct the project(Sea 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 , ASSESSORS PARCEL NO.
_ and Professions Coda:The Contractors License Law docs not apply
to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OV EFL5(EA.) 1.00
contracts Ron such projects with u contraclons)licensed pursuant to - -
theCnmmctor's'LicenseLaw. - SEW ER-SAN ITARY-STOR M EA.200fU 10.00TRACT NO. .. PARCEENO.
❑ I am exempt under Sec ,B.&P.C.l its WATER HEATER W/VENT,'' 6.00
_
ease.
Owner Dm WATER SYSTEM . 5.00
ACC.DATE ACC.FILE NO.
WORKITRS'COMPENSA'FION DECLARAHON WATER TREATING EQUIP, 5.00
1 hereby affirm that I have a certificate ofconsent to sell-insure.
or a certificate of Workers'Compensation Insurance,or a certified - ZONING ENG.SITE NO.
copy Ihereol'(See.3800,Lah.C.).”
policy No. Company - -
O ❑ Certified Copy is hereby famished. FIRE SPRINK ENERGY T-24
"Z Z ❑ Certified copy is filed will,the city insp ,tion division. - -
F, O Applicant - MISC.- REFER TO ORD. v❑ N❑ - ,Y ❑ N❑
y' CE MI'I F I CA'I'F 01'17 XE M PTI ON PROM WORKERS', PERMIT ISSUANCE. ; 10.00 ..FLOOD ZONE i A.L.U.C.
Lu > . COAIPF-NSATION INSURANCE PLG.CONTR.
Q. Z ('Phro
is section need not be completed if tine permit is for '. - TOTAL Y❑ N ❑
❑ Y❑ N
- hundred dollars 1$100)or less., I -
V O 1 certify that in the performance of the,work for which this per CITY. , MECHANICAL PERMIT FEE, D FEE SUMMARY
LL I- mitis issued,1 shall not employ any person in any manner so as to -
U become subject to the Workers'Compensation Lows of California. - + r
y Date; Applicant - - BUILDING 3�
} m NOTICE TO APPLICANT: If,after making this Certificate of Ex. ALTER OR ADD TO MECH.. 5.00
F Z emptiou,ymfshould become subject to the Workers'Compensation - APPLIANCE '•a 5.00 - PLAN CHECK, "
Provisions of the labor Code, you muse forthwith comply will - FEE
V such provisions or this permit shall be deemed revoker,. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
I hereby affirm that there is it construction lending agency for 'EXHAUST HOOD(WITH DUCT)., '5.00
the performance of,ihe work for which this permit is issued(See.- - - MICROFILM
• 3097,Civ.C.E HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9,50
Lender's Addinss ,ELECTRIC
1'certify that I have read this application and state that rhe above VENTILATION FAN (SINGLE) 4.00 -
information-i, correct. 1 agree IO comply with all city aiid county. - PLUM BING�
ordinances and-slate laws relating to building construction,and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) '6.00
~ hereby aulhorim representatives of this city to enter upon the
above-mentioned properly for inspection purposes. BAILER-COMP(Over 100,000 BTUI SEE FEE SCH. MECHANICAL
(We) agree to Save, indemnify,and keep harmless the City of MISC.- REFER.-TO ORD.
Cupertino against liabilities,judgments, casts acid expenses which - - CONST.TAX
ay In any way:accrue agou id City in cdnsequenec of the PERMIT ISSUANCE - 10:00
nliit6 gY,`i / � MECH.CONT. LIC NO. TOTAL
TOTAL 3� V
Signature of Applicant/Contractor -- Uat ,
_OFFICECOPY .'