17994 (2) POST THIS CARD NEAR FRONT:OF. BUILDING
... ^ PERMiTNUMBER
CITY OF CUPERTINO .
�. . 1 179 4
INSPECTION DIVISION
JOB INSPECTION RECORD
�PERMI EX ION -
JOB ADDRES _N VIED . Ltl • ,UNIT# -I, LOT# ""+ P � , j' +
\ + .. `. .�PEi,M1T�1P�JXPI ES"jP,WORK, �•
' OWNER. �a yL/d, •r CONTRACTOR. , ig, p— 4Q IS M STATED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD ••18oDAYSOFPERMITISSu-
FOUNDATIONANCE:OR 180 DAYS FROM
NOTE: .' •LASTCALLED INSPECTION.
'UFER - - :ALL GRADING AND DRAINAGE SHALL'BE INSTALLED
PREGUNITE TO COMPLY WITH THEA CANS AND CITU OF' • PERMIT VA UDATION
CUPERTINO STANDARDS -
GARAGESLABS (, . '•'�-..� . ,.» /^.�,.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - !
°-UNDERGROUND /SLAB
PLUMBINGr�''I• `-
ELECTRICAL' - - '/ ISSUANCE DATE
MECHANICAL - Loc ELECT. PLG.V1 I
E
-
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - -. - '•BUILDING PERMIT
NF R ON
WOOD FLOOR
PLUMBING OK OhiOY' ,-- y/'
MECHANICAL - /7-`69 .TS W`1"../ul r>`
ELECTRICAL � •e•L . - `Abig�l✓7 .000 PER�^/y/�ro'
. FRAMING �'+.GM-• %U— �6N: '-> ' til'{"?1� 1i-�'„ 1111y�
INSULATION �� �,C STORIES +, .,TYPE CONSTR.t
w �ti _ONICC.GROUP, - RES Emirs
Tu
c., •a.r�•..� IVfrr•s .Qar�.:._, i-w_T.'
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED � ti
ROOF, NOTE:NO FINAL INSP.SHALL BE MADE BEFORE s FT,rcooR A TOTAL ACREAGE
DIAPHRAGM .THE,CONSTRUCTION TAX IS PAID, 3+ _ ,`-
' v BU LDING USE n
ROOF SHEATHING, .�' - .RLS - INCc ry ,PB - 0111- .
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS - DATE INSP. L
ROUGH SAN.k ASSES 5 1.RILL NO.
PLUMBING ELECT,ENERGY " '
H TRACT NO, PARCEL NO:
TUBS S +
S OWER PAN PLUMBING ENERGY • s
MECHANICAU ' - M
ECH.ENERGY _
.
' ELECTRICAL' ' - - - � BUILDACC DATE ACCFILE NO,ING ENERGY - -
FRAMING - ELECT.FINAL TEST ,
CONING ENG.SITE NO.
INSULATION - PLUMBING' _2 ,�
.• 'GAS TEST , ;� GAS
MECHANICAL FIRE SPHINR ENERGY T•]A,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED - HEATING ,u Y •+"0 ° 0 "�
,FLOOD ZONE A,LU,G,
EXTERIOR SHEAR _ ELECTRICAL RELEASE / F
INTERIOR SHEAR FIRE DEPT. -
SHEETROCK • GRADE , FEE SUMMARY -
EXTERIOR LATH BUILDING ' —Q-
INTERIOR LATH - TEMPO RARY•APPROVAL-S BUILDING t
SCRATCH COAT, ELECTRIC _ 'PLAN CHECK' C,
'• - GAS 'FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE '
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BYBUILDING INSPECTOR. MICROFILM
\ ARRANGE FOR INSPECTION BY PHONING 252-4505 ELECTRIC
\ I"-- ONE WORKING DAY BEFORE REQUIRED INSPECTION ,., `
z�. PLEASE GIVE'JOB ADDRESS WHEN PHONING. PLUMBING
—SEE PERMIT FOR EXPIRATION DATE MECHANICAL
E IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL 6 Uv
CALLING FOR FINAL INSPECTION.. -
.OFFICE COPY
"
It APPL'ICANT.TO FILL IN INFORMATION WITHIN REDLINES = USE;BALL POINT PEN-ONLY
i i� , •Bl" DING P OJFC I E TI FICAT ON - '- - _ :PERMIT NUMBER
+ auieO t APPLICATION & PERMIT
R ADP as �,7 g g 4 -
y .L`�".Gh'SrNora ANTI &UILDING ELECTRICAL-PLUMBING`—(MECHANICAL s r„
' OW NER'a•�.
, ' NAME _ •. 1P C C L 1
QTY. ELECTRIC PERMIT. FEE t
"j..2, •.'-'ZO
NAWE OUTLETS SWITCHES=RECEP: 10.00/1.00
' • ud rvo LIGHTING FIXTURES `"'10.00/1.00 (' /
CONTRACTORS
ADDRESS PPCIANCES-RESIDENTIAL ' 4.00 n 1
PAN ''10.00 J: DATE OF APPLICATION E'
ARCHITECT , PLAN CHECK FEE P.C." NO.'�
GR - ,' 1 +� PANELS (OVER200 AMP) 20.00 -
a y ENGIrvEER A.�L, ��;�l.�e_,�,`,Q� ..;C,� " SIGNS,TRANS• . - 3.00
ARCH,OR ENG t P - • 'PERMIT VALIDATION
ADDRESS' 3CiQC S'4�.1 R9b Or'�.'+�. iRD SPECIALCIRCUIT - 500
p ✓
S0+3(L/�-why' ..,pip-{.Y(9� 'EMP.METEROR POLEINS,, 2000
APPLI CAN
ADDRESS
DDRESS MOTORS ' FEESCH
= ) 1
PfSCk71Q0 S4n).SoS6 SERVICE CHANGE ' 2000 /
O o `'LICENSED,CONTRACTORS DECLARATION - ? ^-
Qu,G_ , Thereby afTim'thm,I am licensed'undeiprovisioos of Chapter — .- o '�.,.,ISSUANCE DATE ir. -
r z ` (commencing with Section 7000)of Division 3 of the Rosiness and 'DG.k CECT. PLG.
; Professions Code,and my license is in full force'sno effect. - .N " 1 _
z z z n o Liceme;Class Gc Number' pi� _
4 ,",r w Date - - Contractor a" 1
- :`_� 'BUILDING PERMIT
w c¢ii - •OWNER-BUILDER DECLARATION - t - - NFOR TION
w ;LL H •I hereby affvm that I am exemption. the Contractor's Li ense MISC - ' REFER TO ORD
LL o¢ ' Law for the following reason.(Sec.703 L5,Business and Professions TI $/FT."
PERMIT ISSUANCE „ 10.00 /
Cade Any city or county which requlresa permit to Construct,alter, -
Q'Q Improve;deme ish,or repair any structure;prior to its issuance,also ELEC.CONTIR - LIC.NO. +ELEC
i DLL requires HIe applicant for such permit to file a signed statement that 4 - TOTAL I - PERMIT TO
x$ he Is licensed,pursuant to the provisions of the Contr'mtor's�License ,e _ -
't �•Z.s- Law(Chapter 9(commencing with Section 7000)of Divisioo 3 ofthe ,
t i c ' Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE '
IL E_$ the basis for the alleged exemption.Any violation ofSection 7031.5 --• _ _ # STORIES TYPE CONSTR_
U. 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($500).). -
❑ =1s as owner of the property,or my employees with wages as.•_
their sole compensation,will do the work;and,the structure is not BACKFLOW.PROTECT:DEVICE. 4.00 I OCC.GROUPRES.UNITS
intended or offered,'for sale (Sec..7044, Business and-Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 -`
Code:The Contmetor's'License Law.does not apply to an owner of -
,' propea,Y'who:builds or improves thereon,and who does net,work FIXTURES,PER TRAP r5 00 LD.FT.FLOOR AREA TOTAL ACREAGE
himself or[hiough his own employees,provided that such improve- - - -
menuare notintended orofferedCorsale If,however,the budding GAS-EA.SVSTEM-'1 600
or.improvement is sold within one year of completion,the owner.
builder will have the burden of provm5 that he didnot build or Im- GAS-EA.SYSTEM OVER 4 (EA.) - 2.00 —BUILDING USE
prove far,purpose ofs.1e.). r ' INDUSTRIAL WASTEINTER. _30.00RES' - IND Co Pe Other
❑ I,
as owner of the properly,am exclusively contracting with j
❑ ❑ ❑ Ellicensed contractors to construct file prgiced(Sec. 7044;'Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESS S ARCEL NO. -
and Professions Code:The Contractor's License Law docs not apply -
i to an owner of Property who builds or improves thereon,and who LAWN SPRINKLERS'-'OVER 5(EA.). 1.00
contracts for such projects with u contractoi(s)Ilcensedpursuonl to - SEWER'SANITARV-STORM EA.200ft/10.00 "
the COnhse[or9 License Law. •�j' _ TRACT NO. - PARCELNO. .
❑,I)um exempt,under Sec. •B:&P.C.I'or This- - _
w• � ' reason= WATER HEATER W/VENT'. •6.00 a ,
Owner - Date WATERSYSTEM * 5.00
.. ACC.OATE ACC.FILE NO.
.: WORKERS:COMPENSATION DECLARATION WATER TREATING EQUIP 5.00 I. - I
hereby afCrm that I have a certiNcate of wnsen[to self-inesum,
1. '
or a certificate of Workers'Compensation',I dsuranev,or a ccrtdicd "'+ 'ZONING ENG SITE NO.'s•
.2. Copy theroaf(Sea,3800,'Lob.C.):,
Policy N '-Cronin
','O ❑ Citified PY rsh Led'.' - 'FIRE SPRINK •ENERGY T-24 � ,
Z'Z ❑ ertified spy is Ileo 1.• . .ty inspection dm,iml, - MISC..- - .'REFER TO ORD
O. APP(uI 'y ❑ 'N❑ V ❑ ,N❑
PERMIT ISSUANCE-,' i yr. ' 10:00
' Cr CIIRTIEICA E ECEM PTION FROM WORKERS' ,F LOOD ZONE A L.0 C.,•
LLI + ='C EN TION INSURANCE, - PLG.CONTR.� �a LIC NO. PLG. _
O'`O lThisse"coon'need viol ba completcd`if the permit is`fO,r'one TOTAL Y❑ 'N❑ Y❑ N❑�
Z hundred dollars IS
-Iv _-
U^O,' I certify that in the performance:i>f the work for which'Ihi,peri CITY: ` MECHANICAL PERMIT FEE FEE SUMMARY
Il U, and is issued,I sh iihnol employ any person in any manner so as to 4
become subject to the Workers Compensation Laws of California
O y',•
Data - 'Applicant - - - ALTER OR ADD TO MECH.• i 5,00 ;_.. _ BUILDING
} N NOTICE TOIAPPLICANT: If,after,maknig this Certificate of Ex - '
r
F? £, ealpbon,you should become subject to the Workers'Compensation 4' APPLIANCE .•E _ 'e' '. 5.00 PLAN CHECK, •"�
" provison
is of the-Labor Code, you must forthwith comply with' 'FEE^ "
Vlb : such provisions or this permit shall be deemed revoked. AIR;HANDLING,UNIT(TO 10000C.F.M.) 4.00
11 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10)0WC.F.M.)-6.00 SEISMIC,FEE
: .3..
herfori ance ,that there s a construction Ending agency for „EXHAUST HOOD(WITH DUCT) "' '5.00 R
the.performance of.the work for which,this permit Is issued(See -MICROFILM
3097,ciY.c.) -�' - ',Ix •'• , . - a HEATING (TO 100;000 B:T.U.) .8.00 '
a;a _ ..
Lende,r'sName HEATING UNIT(OVER100,000 B:T.U.)$.50 .,
Lenders Addr ss 'ELECTRIC
�. - - - •�
formation is
l have et."I agree appheotion and all c thatyand
county VENTICATIONIFAN.(SINGLE) ,' " 400
information n estate( I agree ti comply doing lccity and county - PLUMBING '
- ordinances and state lows relating t building.construction and 'BOILER-COMPy13 H.P,'oa 1000008T.U.). 6.00,
.
hereby'authorize represcntativa,mi this city to en tur'upon 1t, BOILER-COMP 10'er 11)U,000 BTU)SEE FEE SCH. MECHANICAL - a
above-mentioned property fo'r inspection purposes.
/ - (WOf agree bi save, indemnify end`�kecp harmless the City,Of' MISC.- „ p�' y' ;'tF'REFER TO ORD
'} !I ' upeitino against liabilities,judgments costs end expenses which PERMIT ISSUANCE - - � 10 00 _ CONST.TAX Ian
may in Ill, way accrue against said City in consequence of the
Y ranting fthis ermit Lon, - MECH.CONT - LIC NO, MECH
' G TOTAL
` Sig ore f tic Contractor
k
OFFICE COPY- w