14486 i
POST THIS CARD NEAR FRONT OF BUILDING PERMIT N6%lBER
'CITY' :OF CUPERTINO 14486
INSPECTION DIVISION
JOBiNSPEC'iION RECORD.. '
PERMIT EXPIRATION j
7524 LEEDS 'AVE
JOB ADDRESS UNIT# _LOT# PERMIT EXPIRES IF WORK
OWNER
. .ROSENTHAL CONTRACTOR G.C. GUSTAVSON f IS NOT STARTED WITHIN ;
INSPECTION DATE INSPECTOR INSPECTION RECORD .180 DAYS OF,PERMIT ISSU-
• ANCE OR 180 DAYS FROM'
FOUNDATION , - NOTE:
LAST CALLED INSPECTION.
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF - " +A,IDN
CUPERTINO STANDARDS. p
GARAGE SLABS ' - ,�p N "pi
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED fl .� ����'_
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL - . ISSUANCE UAIE <r
MECHANICAL
BLU(i. ELECT. PLG. MECH.
• � � � '
i ❑ ❑. ' ❑ ❑.
DO NOT POUR FLOOR IIRITJ, ABOVE HAS BEEN SIGNED ' BUILDING PERMIT
INFORMATION t.
WOOD FLOOR - VALUATION SIFT.
PLUMBING
MECHANICAL'
ELECTRICAL
- PERMIT TO
E
'i . . , .
FRAMING -
INS CATION ]_ STORIES TYPE CONSTA
OCC.GHOUP RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED .. ,
SO FT.FLOOR AREA ,orAL n6REACEy
'ROOF " NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
�- DIAPHRAGM THE CONSTRUCTION TAX IS PAID'
BUILDING USE
ROOF SHEATHING
DES IND CON Pe. om�r
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALSDATE INSP. ElCl 1:1 El0
ASSESSORS PARCELNO
. . 'ROUGH '.SAN.# `
PLUMBING - - .'ELECT.ENERGY ---�, -
. . TRACT No: PAHwLNo
TUBS&SHOWER PAN PLUMBING ENERGY _
Y �
MECHANICAL MECRENERGY
ELECTRICAL' BUILDING ENERGY yI �-��I 'ACC.DATE ACC,,FILE No.., v
_ _
FRAMING ELECT.FINAL TEST(, - N' Y ? ZONING.- ENc.srte No. ,
INSU CATION ;•' PLUMBING
GASTEST GAS
/ FIRE SPHINK ENERGY i]9
'�
MECHANICAL "Fe '040
COVER NO WORK UNTII,ABOVE HAS BEEN SIGNED HEATING ( If &;3• f1Gfa1• Y'� Nom' ` ❑ N❑
- - PL000 ZONE« n.i.U.C
_ _ .
EXTERIOR SHEAR ELECTRICAL RELEASE _ —�
INTERIOR SHEAR -' FIRE DEPT. v No v L NQ'
SHEETROCK ' GRADE ���� r� FEE SUMMARY
EXTERIOR LATH - "1 - BUI LDINi. - -
—. _—BUILDING ,
INTERIOR LATH- -
T MPORARY APPROVALS
SCRATCH COAT. ' ELECTRIC PLAN CHECK
�_``_ _�.. ,
GAS — — FEE -
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY- — .4. T��'' SEISMIC FEE .
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING F.INALISSIGNED BY BUILDING INSPECTOR' MICROFILM
I
LU ARRANGE FO'R INSPECTION BY PHONING 252-4505, eLecralc
ONE WORKING DAY'BEFORE REQUIRED INSPECTION. PLUMBING
0 PLEASE'GIVE JOB ADDRESS WHEN PHONING'
—.SEE PERMIT FOR EXPIRATION DATE MECHANICAL
IMPORTANT! coNsr.TAX .
. .PLEASE READ REVERSE SIDE BEFORE 'TOTAL .
' CALLING FOR FINALINSPECT.ION.
OFFICE COPY �» -
APPLICANT TO FILL-IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
- BU I LDING PROJECTIDENTIFICATION - PERMITNUMBER
-
BD;nD,NG APPLICATION & PERMIT
ADDRES:i�7sa 14486
.
BUILDING -ELECTRICAL-PLUMBING-.MECHANICAL
OWNER'S PLAN CHECK VALIDATION
"A E _• PHONE QTY. ELECTRIC PERMIT FEE
CONTRACTORS
N me `l� '� OUTLETS-SWITCHES-,RECEP 10.00/1'.00
g�E
•(Vr V-�^S�ryy /G(Ic.No. LIGHTING FIXTURES 10.00/1.00
CONTRACTORS APPLIANCES-RESIDENTIAL 4.00
• A D 55
a/ J 2-
PHONE 311 PANELS 10,00 20 DATEOF APPLICATION
ARLHITECiPLAN CHECK FEE P.C.NO.
OR PANELS (OVER200 AMP) 20.00
ENGINEER
UC.No. SIGNS TRANS. 3.00
ADDRESS E"G SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
EMP. METER OR POLE INS. 20.00 PAID -APPLICANT - •.S: _ MOTORS SEE FEE SCH. ����
ADDRESS
4SUANCETIATE
SERVICE CHANGE 20.00 woO LICENSED CON'.RACTORS DECLARATIONuI hereby affirm that I am licensed underprovisionsof Chapter 9
my (commencing with Section 7000)of Division 3 of the Business and BLDG. I ELECT: PLG. MECH.
H w z Professions Code,' Wmy license is in full f'orc.un `feet
License lass _ Lic Number
Date_S - 'Contractor
H a p - - - BUILDING PERMIT
rc Q w a I WNER-P UILDER DECLARATIO INFORMATION
A o a ° MISC. REFER TO ORD
w ;LL H 1 herby affirm that I am exempt from 0m Contractor's LicenseREFER
$/FT-
rseo¢ Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00
Code:Any city or county which req vires a permit to construct,alte', 0� �-
2a Q Q improve,demolish,or repair any struCILIM,prior to its issuance,also E C.CONT LIC.NO. ELEC.
n w m M requires the applicant for Stich permit to file a signed statement That TOTAL PERMIT TO
he is licensed pursuant to the provisions of the Contractor's Liven
F z a Law(Chapter 9(commencingwlth Section 7000)of Division 3 ofthe -
Business and Professions Code)or that he ie exempt therefrom and QTY. PLUMBING PERMIT FEE C
ac F D the basis for the alleged exemption.Any violation ,fStction 7031.5 STORIES TVP CONSTR,
s3 � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00
Of not mor.than five hundred dollars(S500)J:
-❑ 1,asowner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 400 OCC.GROUP RES.UNITS
their sole cora pcn,,Ium,will do the work(amd the structure . .
is not _
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA;COND. 5.00
Code:The Contraclor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 So,IT,FLOOR AREA TOTAL ACREAGE
himself or through his own employe..,....tried that Such improve-
mentsarenotintendedorofferedforsale.If,however,the building GAS-EA.SYSTEM-b INC.4 OUTLETS 6.00 I
or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 IEA) 200 BUILDING USE
builder will have the burden of moving that he did not buil)or 1111- . . .
: RES IND CON PB Omer
Prove for Purpose of,idc.). - INDUSTRIAL WASTEINTER.
,30.00 ❑ 11 .❑ ❑ 13❑ I,as owner of the property,am exclusively contracting with
licensed wretractors to construct the project(Sec. 7044,Rus ncss LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law docs mat apply
to an owner of property who builds'or improves thereon,and who LAWN SPRINKLERS-,OVER 5(EA.) 1.00
contracts for such projects with a contractor(s)licensed pursuant to
' the Coniractmr's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exempt under Sec. ,B.&P.C.to,fills WATER HEATER W/VENT 6.00 _
reason
Owner Date WATER SYSTEM - 5.00 ACC.OATE ACC.FILE NO. t
WORKERS'COMPENSA1lON DECLARATION - WATER TREATING EQUIP. 5.00
I.hereby affirm that I have a certiticalcof convent to self-insure. - ZONING
c. or a certificate of Worker.''Cu
m nsation Insurance or a certified ENG.SITE NO.
copy Ill reof(Scc.3800, ab.C.
Policy No�ny.
❑ Cer die opY'Is m eby'furnished - FIRE SPRINK ENERGY T@4
z ZO `g Certified a ed .with the city' inspection division. MISC.- REFER TO ORD, [:] N❑ V ❑ N
❑
A/bean[ a i
V
n PERMIT ISSUANCE - 10.00 FLOOD ZONE A.L.uc.
LU - CE TIFICATE OF EXEMPT I IN FROM WORKERS'
W ? C0141-.NSATION INSURANCE PLG.CONTR. LIC.NO. PLG. '
CL 0 ILL his seitiorl need not be completed if the permit is fur one - TOTAL v❑ N❑ y ❑ N❑
::) Z . hundred dollar.(8100)or ks,.)
U O I certify that in the perhormance of the work for which this per- QTY. MECHANICAL PERMIT 'FEE FEE SUMMARY
U_ F- mitis issued, I shall not comic,ay Person in airy mammi so as to
U become subject to the Workers'Compensation Laws of California.
' 0 n. Date' Applicant - ALTER OR ADD TO MECH. - ,5.00 BUILDING
>_ NOTICE'1'0 APPLICANT: It,-ailer making this Certil'icate'o Gx-
F ? emptiun.you should become subject to the Workers'Compensation 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 l0XMC.F.N0. 4.00
CONSTRUCTION LIEN DING AC 17NCY . AIR HANDLING UNIT(OVER 10,000C.P,M.) 6.00 SEISMIO,FEE' ,
I hereby affirm'that there is a construction lending agency forEXHAUST HOOD (WITH DUCT) 5.00
the .CCiance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 - MICROFILM
3097,Ci,.C.)^
Lender's Name • 'HEATING UNIT(OVER 100,000 B.T:U.)9.50 ELECTRIC
Lender's Address
I se,hp,that 1 love Head th s application and fale that the above VENTILATION FAN(SINGLE) 4.00 - -ordinances
is erre 11 ogre.t comply with Ic cityand county and PLUMBING -
.rdman es and stele laws relating I building construction, and BOILER-CUMPI3 H.P.or 100,0008.T.U.) 6.00
hereby authurl.e repr sentat 'es of the city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for Inspection purposes.
(We) agree 1. save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and ex coxes which - CONST.TAX
•
may in,any way accrue against said City in copse ence- the PERMIT ISSUANCE 10.00 --
granting ufthis permit. MECH.CONT. LIC.NO.
TOTAL
� �lJ
Signature fApplicahllConlractor etc �- � v'3 TOTALt 5•'
OFFICE COPY �-