15878 (2) POST THISCAR D NEAR FRONT.OF BUILDING
PERMIT NUMBER
' CITY OF CUPERTINO5 8
INSPECTION DIVISION a ��
JOB INSPECTION RECORD.
c/ /l-� PERMIT EXPIRATION
JOB ADDRESS J f�l.JCi-fA)Ll I Sp2(A ^ l ;T# _l0T#
/' PERMIT EXPIRES IF WORK
OWNER . (,7 CONTRACTOR IS NOT STARTED'WITHIN
INSPEtTIONL D TE INSPECTOR INSPECTION REC RD P 1 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION. '
LIFER , ALL GRADING AND DRAINAGE SHALL BE INSTALLED 0 -
TO COMPLY WITH 7HE APPROVED PLANS AND CITY OF .A.PLH IT VALIDATION
PREGUNITE CUPERTINO STANDARDS.
GARAGE SLABS '
POUR NO CONCRETEUNDERGROUND /SLAB E HAS BEEN SIGNED DEC1 3 1988
PLUMBING UG4 '
ELECTRICAL City Of CDpBfIIRD ISSUANCE DATE
MECHANICAL BLDG ELECT. PLG. MecR
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING VALUATION SIFT,
MECHANICAL �78
ELECTRICAL . PERMIT TO
- T
FRAMING Iml
INSULATION STORIES- TYPE CONSTR,
OCC.GROUP Rims
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED '3
SO FT.FLOOR AREA TOTAL ACRFAGE
ROOF NOTE:NO FINAL INS°.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
_ ROOF SHEATHING REs mu CON Pa ou...
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SI NED FINALS DATE INSP. ❑ 0 1:1 E] O
ASSESSORS PAHCEL NO,
ROUGH
PLUMBING ELECT.ENERGY
TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO
MECHANICAL '"Z MECH.ENERGY r ()-/[y I
ELECTRICAL2 BUILDING ENERGY ACC DATE ACC FILE NO
FRAMING ELECT,FINAL TEST
ZONING ENG.SITE NO.
INSULATION PLUMBING
GAS TEST GAS .
MECHANICAL FIRE SPRINK ENERGY LZn
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y " Y "�
FLOOD LONE A L C.
EXTERIOR SHEAR' ELECTRICAL RELEASE �1
'YO NO YID N[]
INTERIOR SHEAR �� FIRE DEPT. - LJ
SHEETROCK fp'•j0�. USIGNED
FEE SUMMARY
EXTERIOR LATH 0G
INTERIOR LATH D' TEMPORAR AAPPROVALS BUILDSCRATCHCOAT - IC PLAN CHECK �sa�NO TAPE OR PLASTER UNTIL ABOVE HAS BNCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
Uj ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC RLAA
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
o PLEASE GIVE JOB ADDRESS WHEN PHONING. 68.58
Z MECHANICAL
- SEE PERMIT FOR EXPIRATION DATE -
CONST.TAX
IMPORTANT! 297.08
PLEASE READ REVERSE SIDE BEFORE L
CALLING FOR FINAL INSPECTION. TOTAL !I ' -
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION -PERMITNUMBER
BUILDING 11695 Walnut Spring 0ourt , APPLICATION & PERMIT 15878
ADDRESS
EA`NE
Lot 23/ 2,C� (� y BUILDING -ELECTRICAL-PLUMBING -MECHANICAL
NAME
(3 Ego J .Q raft Inc• PLAN CHECK VALIDATION
k.M,.. r� TY. ELECTRIC PERMIT FEE
All lan.S(� UGv. PHONE 4151595-21
NACONTRACTORS f�.,�,,I,I,Pn, UTLETS-SWITCHES-RECEP 10.00/1.00
Gregory &soup, Inc. LIC.NO.B-4M/ LIGHTING FIXTURES 10.00/1.00
CONTRACTORS.2ZO.0IWIn Dolphin APPLIANCES-RESIDENTIAL 4.00
ADOORE55(��/�[
RWCJ`ILA/
5 PHONE 415/595-210(F-PANELS 10.00 DATE OF APPLICATION
ORRCRITECT � Ssenlan, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER Associate$ 'LIC.NO.
0-8395 ISIGNS TRANS. 3.00
AAD KOR
DDRESS ENG,2031 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
Santa Ana Ht$. CA 92707 ZIP TEMP.METER OR POLE INS. 20.00
APPUCANr'a MOTORS SEE FEE SCH.
ADDRESS
z2U-C Twin ,.Dol in Or. RWC 94065 SERVICE CHANGE • 20.00 (DEC 13 19EU
D o o LICENSED CONTRACTORS DECLARATION
a w I hereby affirm[hat I am licensed under provisions of Chapter 9 ISSUANCE DATE
vHi (commencing with Section 7000)of Division 3 of the Businessand
BLDG. ELECT. PLG. MECH.
H o i Professions Codcond my license Is In full force4 t. p
z o y- License Class Lic.Number'
umber City Uf
9 m r w
Date_Contractor_ _
a x f BUILDING PERMIT
a, as
OWNER-BUILDER DECLARATION
o a v INFORMATION
K
; r I hereby al firm thin 1 am exempt from the Contractor's License MISC.-' REFER TO ORD
uo¢ Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 VALUATION SIFT.
� - Code:Any city or county which requires a permit to construct,alter, --rzpp �p
¢Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. 178,281
wo LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
w he is licensed pursuant to the provisions of the Contractor's License
Fz> Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe
a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE SFW
it r $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
ate _ by any applicant for It permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars($500).): 2 5W❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RE5.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sate(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law docs not apply to an owner of R-3 1
property wIm builds In improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 S0.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve.
ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-I1NC.4OUTLETS 6.00 2726
or improvement is sold within one year of completion, the owne
- builder will huve,the burden of proving that he did not build or intr- GAS-- EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other
CII,as owner of[he property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
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 Contractors License Law does not apply
to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1,00 3�C- 3371- ,fj
contracts for such projects with a contractors)licensed pursuadt to SEWER-SANITARY-STORM EA.200ft/10.00 /
the Contractors License Law. TRACT NO. PARCEL NO.
❑ l am exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 �0
reason
Owner Date WATER SYSTEM 5.00 ACC.-DATE ACC.FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00
1 hereby affirm that 1 have a certificate of consent to self-insure' ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(See.3800,Lah.C.). Wited PdC1f1C
Policy No. Company _
0 O Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z Z ❑ Certified copy ed ith the city inspection division.
~ � Applicant '! Misc.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑
_ PERMIT ISSUANCE 10.00
� CER'I'IPICATIi OP IiX1ih1PTION FROM WORKERS' FLOOD 20NEA.L.U.L.
LU > COMPENSWION INSURANCE PLG.CONTR. Lic.NO. PLG.
CL Z fl' his Section need not be completed if the permit is for one TOTAL Y❑ N❑ v❑ N❑
hundred dollars($100)or less.)
U O 1 certify that in the performance of the work for which this per. OTY. MECHANICAL PERMIT FEE FEE SUMMARY
U. F mit is issued,I shad[not employ any person in any mariner so as to
0 ED become subject to the Workers'Compensation Laws of Cabl'arniu.
0. Dam Applicant BUILDING
} N NOTICE:.TO APPLICANT: If.after making this Cerlificute of lix� ALTER OR ADD TO MECH. 5.00 - 916.00
F. Z emp[ion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 15.r5y0y
provisions of the Labor Code, you must forthwith comply with FEE 62.00
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MCF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=0CEM.) 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,CIv.C.). Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name�- HEATING UNIT(OVER 100,000B.T.U.)8.50
Looter's AddrelsJJtaB1-L.a �th�lr- • 941 ELECTRIC68.58
Icertify 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 city and county BAILER-COMP13 H.P.or 100,000 B.T.U.) 6.00 PLUMBING C�
ordinances and state laws relating to comply
with
l city and c, and my
hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes. BOILER-COMP IOver 100,000 BTU)SEE FEE SCH. MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX 297.03
Day in any way accrue again t said City in con aqua tee of the
ranting of this permit, MECH.CONT. LIC.NO. MECH.
as g TOTAL TOTAL I15o8�B0
Signature of Applicant/Corter ctor Date
OFFICE COPY