15447 (3) POST THI RD NEAR FRONT OF BUILDING'", PERMIT NUMBER,
CI OF' CUPERTINO 15447
INSPECTION DIVISION '
JOB INSPECTION RECORD
I . / PERMIT EXPIRATION
JOB ADDRESS
z.3 /I[�I�O LSE UNIT# - _LOT#
• A • 'n PERMIT EXPIRES IFWORK
OWNER S, A 0 - CONTRAETOFI ;,q r LDK IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR' INSPECTION RECORD 180 DAYS OF PERMIT.ISSU",rt
FOUNDATION . ANCE OR 180 DAYS.FROM
NOTE: LASTCALLED.I NSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED 44''�lii
TO COMPLY WITH THE APPROVED PLANS AND CITY OF - PeHM11 nImATION
PREGUNITE CUPERTINO STANDARDS.
;-..fit GARAGE SLABS M
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED '`,_ 10 • C"`0'r0. - Y'oLmE -
UNDERGROUND /SLAB . !
PLUMBING
ELECTRICAL _ • ISSUANCE DATE `
MECHANICAL. - ELECT. 'PLG. MECR
" o. ❑ ;
DING
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED y sua INFOORMRM PERMIT
. . ,. r ATION
WOOD FLOOR - VALUATION s/FT.
PLUMBING.
MECHANICAL 30,000 '
PERMIT To
ELECTRICAL WMIOR nVR0#104
FRAMING
STORIES TYPECONSTR
INSULATION'
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED TFLDDR AREA TOTALACREAGE
I `ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE ,
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING - RES INC CON PB 00-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El o 71 �`L �` I
AaBESSORSPARCENO
' ROUGH SANA - -
PLUMBING - ELECT.ENERGY '
TRACT NO. PARCEL,NO i
TUBS&SHOWER PAN' PLUMBING ENERGY
MECHANICAL' - MECH.ENERGY
Acc DATE ACC FILE No
-
.ELECTRICAL - BUILDING ENERGY . •.:I
FRAMING - - ELECT.FINAL TEST •I
ZONING ENG SITEiNO.
INSULATION - PLUMBING -�- -
GAS TESTGAS y-Z '
FIRE$PRINK ENERGY T•]4'
4 - MECHANICAL _
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED ' HEATING ❑ N❑ N❑.
FLOOD ZONE A.L U C.
EXTERIOR SHEAR - ELECTRICAL RELEASE - ' -''
FIRE DEPT. - 'Y❑ _N❑: r ❑ NE]
SHEAR'
SHEETROCK GRADE FEE SUMMARY .
EXTERIOR LATH BUILDING ' BUILDING
INTERIOR LATH TEMPORARY APPROVALS
• 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. MICROFILM '
ARRANGE FOR INSPECTION BYRHON'ING 252-4505, ELECTRIC
LU , ONE WORKING DAY BEFORE REQUIRED INSPECTION., PLUMBING
O PLEASE GIVE JOB ADDRESS WHEN PHONING. •
Z MECHANICAL '
- SEE PERMIT FOR EXPIRATIONDATE -
' IMPORTANT! "
CONST.TAX
PLEASE READ REVERSE SIDE BEFORE,' TOTAL - 7
CALLING FOR FINAL INSPECTION.
OFFICE COPY-
1,
+4%1, APPLICANT TO FILL IN IN ATION WITHIN RED LINES - USER LL POINT PEN ONLY
+ 'UUILDING PROJECT IDENTI FIC - -PERMIT NUMBER - -+
a1,I1-0ING APPLICATION & PE .IT 15447. 40DREYO 123 N. Wolfe Rd. , Sp. �tBUILDING-ELECTRICAL-PLUMBING-MECHANICAL °`'
OWNER'S PLAN CHECK VALIDATION
NAME SBARRO, TV. ELECTRIC PERMIT FEE
SIt6-'864-024
PNONE
t CONTRACTOR'S
NAM �y OUTLETS-SWITCHES-
RECEP 10.00/1.00 -
�, N���-( LIGHTING FIXTURES 10.00/1.00
CONTRACTOR ,,. APPLIANCES-RESIDENTIAL 4.00 '
37CY PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
OR _ p
ENGINECRKen Butts , - 27p75
ISIGNS TRANS. 3.00
ARCH.
OR
ENG. .. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
21133 V+ic':E'yry /Blvd . EMP.METER OR POLE-INS. 20.00 v n
APPLICaNR DgW-ft.. Catl P
ADDRESS MOTORS SEE FEE SCH
- ,
763 Parkfield Rd . Commack N Y. SERVICE CHANGE 20.00 Al 9,4-41�
w o o LICENSED CONTRACTORS DECLARATION
¢u w Thereby affirm that I am licensed under provisions of Chapter 9 r, O ISSUANCE DATE
w< y
(commencing wi 'tion 7000)of Division 3 of the Business and ` G. ELECT. PLG. MECH.
r Z Professions Cod. y license is in full fo r//l)
2 o a License Ch s_ Lie.Number I ❑ ❑ ❑
o r Date4C� Contractor
P: Y E - BUILDING PERMIT
¢ ¢ OWNER-BUILDER DEC RATION INFORMATION
o a G REFER TO ORD
1 hereby affirm that I am exempt from the Contractor's License MISC.- VALUATION S/FT.
u.o¢ Law for the following reason.(Sec.7031.5,1lusinessand Professions PERMIT ISSUANCE 10.00
Code:Any city or county whichnquinesapenn it to construct,altc,, 50,000
Q Q ¢0 Improve,demolish,Or repair any structure,prior to its Issuance,also ELEC.CONTR. LIC.NO. ELEC.
¢ 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
Fzi Law(Chapter9(commencingwithSection700()ol'Dlvision3ofthe INTERIOR 1MPROVEMEN S
¢ Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
iiD
ad I the basis for the alleged exemption.Any violation of Section 7031.$ STORIES TYPE CONSTR.
a; _ by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not more than five hundred dollars(8500).):
O I,us owner of the property,or my employees with wages us BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sale(See. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CONO. 5.00
Code:The Commcrors License Law does not apply to an owner of
property who builds or hnproves thereon,and who does such work FIXTURES-PER TRAP 5.00 50:FT,FLOOR AREA TOTAL ACREAGE
himself or through his awn employees,provided that such improve- GAS-EA.SVSTEM-1 6.00
ments are not intended or offered for sale.If,however,the building
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving than he did not build or int-
' prove for purpose of sale). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB ' omer
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(See. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORSPARCEL NO.
and Professions Code:l'he Contractor's License Law docs not apply
to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00
contracts for such projects with a contractor(%)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractors License Law. TRACT NO, PARCEL NO.
❑ IamexenlptundeB.&P.C.for this WATER HEATER W/VENT 6.00
reason- wlA7
Owner - Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO.
�l¢WORKERS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00
hercby al lirm that I have a Certificate of consent to self-insure, TONING ENG.SITE N0.
lificale of Workers Compensation Insurance,or a certified
l of(Sec.3 CooHno.C.)..pe��L^.p0 ¢
PDllcy No._ _Company_ (��
0 1�(Certified Copy la l ereby furnished. FIRE SPANK ENERGY T-24
Z Z TJ'Cc bfi, r py filed wink the city inspection division. - REFER TO ORD.
O Applicant - MISC. Y E] N❑ V ❑ NE]to CERTI PICATF.OPE EMI'TION FROM WORK CRS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C.
UJ COMPENS TION INSURANCE PLG.CONTR. UC NO. I.G.P
(This section need riot be completed if the permit is for one TOTAL V❑ N E] Y F] N❑
Z hundred dollars(S 100)or less.)
0 0 I certify that in the performance of the work for,whlch this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY
IL E- min is issued,I shall not employ any person in any numner so as to
U become subject to the Workers Compensation Laws of California. 3�
W Date Applicam ALTER OR ADD TO MECH. 5.00 BUILDING
>- m NOTICE TO APPLICANT:.H,after making this Cenificale nlEx-
Fz emption,you should become subject to the Workers'Compeasalion APPLIANCE 5.00 PLAN CHECK .,
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10p00C.F.M.) 4.00
CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10PMC.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+;r,work for which this permit is issued(Sec. MICROFILM
3097,CN.C.). 1111Y-fJ HEATING UNIT(TO 100,0008.T.U.) 8.00
Lender's N. ••R HEATING UNIT I0 VER 100,000 B.T.U.)9.50 ELECTRIC
Lender's Address
1 certify that I have reed this application and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
. ordinances and state laws relating no building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes.
(We) agrcc to Save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against HaWNies,judgments, costs and expenses which CONST.TAX
ma in'�anf�y way an, ru against said City in coney rice of the PERMIT ISSUANCE 10.00
m s4 E)I MECN.CONT.' LIG NO. MECH.
Q7� TOTAL TOTAL SC,Z Dfl
Signa re F pplicant/Cont ctor • e
OFFICE COPY