C8157 APPLICANT TO FILL-IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
13U LDING PROJECT I DENT[FICATION APPLICATION & PERMIT PERMIT NUMBER
BUILDING .
'ADDRESS 2o�oS LAz ,�. _ _ 815 7
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
1_-' NER(S PLAN CHECK VALIDATION
.NAME Lir/ O/✓ S' OTY. ELECTRIC PERMIT FEE
- /� NCL•�
PHONE
oMERAc.oRs UTLETS-SWITCHES-RECEP 10,00/1.00
i
uc.rvo. LIGHTING FIXTURES 10.00/1.00
C0141'FACTORA I PPLIANCES-RESIDENTIAL 4.00
_ s �/-�(�'
T PHO Yw V PANELS 10.00 GATE OF APPLICATION
ORCHIECTct H PANELS (OVER 200 AMP) ' 20.00 PLAN CHECK FEE PG.NO.
GINEER // �r /_
Ue.N., C-(o�J SIGNS TRANS. 3.00
ARCH,OR ENG. SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
-pAGLO Alc:m EMP.
METER OR POLE INS. 20.00
ADDRESS rs
ADORES
MOTORS SEE FEE SCH. X
r
SERVICE CHANGE 20.00
a o LICENSED CONTRACTORS DECLARATION L TEMP.POLE 30.00
u v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Business and
a Q y BLOC. ELECT. MECH.
F w z Professions Co �d y license is in full for quid L)' ❑ ❑ ❑
2 D m Liccnsc Class Lia Ncu3c `�
mw Dalc Contracto
o wr y�p�I�1 �+ 1J��iC
OWNER-BUILDER R-BUILDER DECLARATION - B IN�61►MbITTOId"r S
X g y I hereby affirm that I um exempt from the Contractor's License MISC.- REFER TO ORD
PERMIT ISSUANCE - 10.00 VALUATION FT.
H u O j Law for the following reason.(Sec.]031.5.Buiiness and Professions ` { {
Code:Any city orcounly which requires a permit to construct,alter, 3,f( gIlycofC Pe IIID
Q Q Q Q Improve,demolish,or repair any Structure,prior to Its Issuance,aISO ELEC.CONTR. LIC.NO. ELEC.
DLL requires the applicant for such permit to file a signed statement that - TOTAL
PERMIT T
n w m he is licensed pursuant to the provisions of the Contractor's License -
H z i
POST THIS CARD NEAR FRONT OF'BUILDING . '
_ PERMIT NUMBER ; •,
CITY 'OF CUPERTINO {�9
INSPECTION DIVISION,.0
JOB INSPECTION RECORD %�'�'! •
/ - PERMIT EXPIRATION "+
JOB ADDRESS O - UNIT#. "LOT PERMIT EXPIRES IF WORK ^
OWNEa CONTRACTOR NOT STARTED WITHIN
INSPECT DATE •INSPECTOR INSPECTIONRECORD > 180 DAYS OF PERMITISSU-'
ZJ.CO ucr- L'S_Ede ANCE'OR 180 DAYS FROM ..
FOUNDATION yA•G?, Olt LASTCALLED INSPECTION.
UFERCJ�tCi .' y.'FE� -
PREGUNITE
. fPERMIT VALIDATION ;
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED d
UNDERGROUND /SLAB .
PLUMBING
_ r
ELECTRICAL _ ISSUANCE uaiE
MECHANICAL C��A / BLDG. ELECT. PLG. MECH.
I .
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED _;7Lo r BUILDING PERMIT
IMRMATION
'WOOD FLOOR _
PLUMBING ♦ T I,' - vA • _. 5/FT
. ' BL�r.'� ids-u+•�c� J%'
MECHANICAL •rrv-�� jC7 Yb
ELECTRICAL ', - PERMIT TO
FRAMING - pb77i.....- ,•„..�.5., t//i;
STORIES 'TYPE CONSTR.
INSULATION -
OCC.GROUP .RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ..
TOTAL ACREAGE
SO.FT FLOOR AREA
. ROOF . . ,
•�, DIAPHRAGM ` BUILDING USE
RES IND CON PB O,he,
APPLY NO ROOFING UNTIL ABOVE HAS.BEEN SIGNED 'E 0. El El F-1
ROUGH ASSESS ORS PARCEL N O.
PLUMBING
TRACT NO ^• PARCEL NO.
GAS TEST - - -
MECHANICAL - ..
ELECTRICAL .FINALS DATEINSP. ACC.OATe ACC.FILE NOa
' �i
FRAMING -I - SAN # '
,' ONING ,ENO.SITE NO.
INSULATION < - - PLUMBING
GAS
- FIRE SPRINK ENERGY T$A.
MECHANICAL -y.S- -' • � '
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEAT YE]. N-E] v � NE]
t '
ROODZONE A.L.0 C.,. L ,
LATH-INTERIOR ECE T ICAL. ��S w� N[:) Y ]. NQ
LATH-EXTERIOR FIR DEPT.
SHEETROCKGRA E FEE SUMMARY '
SHEAR INTERIOR BUIL - S
SHEAR EXTERIOR TEMPOR Y,APPROVALS BUILDING
FIREWALLS ELECTRIC - ( 'PLAN CHECK
GAS _ ,FEE
l
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. - - .SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING'FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE•FOR INSPECTION BY PHONING 252-4505, ELECTRIC
o� ONE WORKING DAY BEFORE REQUIRED INSPECTION PLUMBING.
Z. PLEASE GIVE JOB ADDRESS WHEN PHONING.
1.- SEE PERMIT FOR EXP.. IRATION DATE - " MECHANicAL
'CONST.TAX
.. IMI?ORTANT! '
PLEASE READ.REVERSE.:SIDE BEFORE TOTAL''
CALLING*FOR FINALANSPECTION.
OFFICE COPY ''