18565 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO 18565
INSPECTION DIVISION
JOB INSPECTION RECORD
Q(00 f}�D 102CXJ hr rt�17t�r U - !' 1
� ''EPERMITIEXPIRATION
JOB ADDRESSy ( � UNIT# -LOT# II L, I
PERMIT EXPIRES IF WORK
OWNER Q - CONTHAcroR Q f •B Y)'l__ IS NOT STARTED WITHIN - )
NSPECTION D TE INSPECTOR INSPECTION RECORD AN DAYS OF PERMIT
FOUNDATION - CE OR 180 DAYS FROM
NOTE: I LASTICALLED.INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED ! '
PREGUNITE - TO COMPLY WITH THE APPFPVFD,P,LQNS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS. �+/{y�,J
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED JAN 17 'MIU , � �. � 7
UNDERGROUND/SLAB - i, �,•`1G1_, I
PLUMBING Cjhl
ELECTRICAL ISSUANCE DATE -'�",�r
BLDG.• FILE PLG. MECH.
MECHANICAL
❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR -
VALUATION SIFT'
PLUMBING
MECHANICAL- UU
EHMIT TO
ELECTRICAL -
FRAMING
INSULATION $jeR I ES Tv E.VNSTR. '
k LIV
OC®.0 OUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL B ADE BEFORE sJu(�F r,�jF��oo-IAREA TOTAL Acacncs
ry
DIAPHRAGM k, THE CONSTRUCTION TAX IS I -
RUILDING USE
ROOF SHEATHING -RES IND CON 'PB ow"
APPLY NO,ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DA E INSP.
n55 SSOHS PAN L NO
ROUGH ' SAN.a / 3(J � r�
PLUMBING ELECT.ENERGY '� l if
- THACI N0', PARCEL NO
TUBS 8 SHOWER PAN PLUMBING ENERGY -
MECHANICAL MECH.'ENERGY
ACL.GATE ACC.FILE NO
ELECTRICAL - BUILDING ENERGY _
FRAMING • ELECT.FINAL TESTowrlc Erva SITE No.
INSULATION - PLUMBING V _
GAS TEST GAS
MECHANICAL-
FIRE SPRINK ENERGY T2
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING r N❑ v ❑' N�
FLOOD ZONE A.L.V.C.
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT. - Y E NE ?' ❑ NE]
SHEETROCK - GRADE FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH I TEMPORA P OVALS BUILDING 1�
SCRATCH COAT ELECTRIC PLAN CHECK •1 �F
. GAS FEE .
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE U�
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEO BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING '
Qft 0� PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z — SEE-PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT!
to
CONST.TAX
PLEASE READ REVERSE SIDE BEFORE ` a L' TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN,INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
L
DING PERMIT NUMBER
BUILDING DING PROJECT APPLICATION &'PERMIT
- I �J'
• ADDRESS 10010 N,TAAr{'/{ /I BUILDING -ELECTRICAL-PLUMBING-MECHANICAL , 18565
OWNERS I, 1 1'� l/11� PLAN CHECK VALIDATION
NAME 2�•020Q OTY. ELECTRIC PERMIT FEE
rRr�c -,r co cr;��
CONTRACTOR'S. % JI
NA / OUTLETS-SWITCHES-RECEP 10.00/1.00 '1
OO P j IC.NO, R 11,4111 IGHTING FIXTURES 10.00/1.00
COHTRAcrons
ADDRC_;E2`// /� PPLIANCES-RESIDENTIAL 4.00
ESS
e•I'//LL�1✓/•�-C- PIEOsI 6767 7 PANELS 10.00 DATE OF APPLICATION
ARCHITECTpe,11150 PLAN CHECK FEEP.C.NO.
OR F�,(//LL// Iz�4�JVv PANELS (OVER 200 AMPI 20.00 r77
ENGINEER - p
uc.rvo.Ca SIGNS TRANS. 3.00 I� 7 JZ
ARCH.ORE f+� PERMIT VALIDATION
ADDRESS 1,O PINE ST SPECIAL CIRCUIT 5.00
GA P I l 11 J TEMP.METER OR POLE INS. 20.00 / /
APPLICANTS J4 P(NI 5T\ MOTORS SEE FEE SCH. (
ADDRESS b
4A JL111 I SERVICE CHANGE 20.00
wo o LICENSED CONN'RACfORS DECL7RAT ION PAID
c w.w 1 hereby.Hine that am IicenseJ under provisions of Chapter 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3.f the Rusin•ss and BLDG. ELECT. PLG. MECH.
G m i Professions Co de nd n)Y licenw is in full(nice' lit u _ GgI]
Z, i m o Licenm C�ss _ �!_Lic.Number- _ O
Data Conlruclo _ _
y s BUILDING PERMIT
W a OWNER-BUILDER DECL, A'I'ION - .rI1RD INFORMATION
anoa " MISC.- REFER TO ORD
; y I hereby uffunt Ieal I in escaupt born the Contractor's License
LLog- Law forte following rcxv'E.(Sce.703 1.5,Busine,and Profess i�ns , PERMIT ISSUANCE , - 10.00 VALUATION g/FT.
� - Code Any.try Or county which requirsul>Lrntit loconslruul,altcq - '
Q ¢ ¢ 0O Improv, den Ir.a 1' a y 1 e h r prior I is L:amu'L also ELEC.CONTR. LIC.NO. ELEC to
s
D Q requires the applicant ft r such p mut In fit a igned Maho
Rent teal TOTAL• P RMITTO
w $ he Is licensed paminnit to the provisions ns f the C 1 tor's License
z i Law(Chapter 9(commencing with Section 7000)ot'Division3oftec
a Business and Professions Code)or that lie is"Left lhentrom and OTY. PLUMBING PERMIT FEE
it the hasis for the alleged exempt ion.Any vuHat into of Section 7031.5 STORIES" TYPE CONSTR.
by any applicant Or apermit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 /,,,,, N
cfnot Rona than five handfed doll...155001.1:'
❑ I,as owner of the properly,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 C.GROUP REs.urvITS
their sole compensation,will do the work,and the structure is not
intended or 0lfeord for sale (Sec. 7044, an
Business d Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 B/2 AFaj 0'-
Code:The COntractoe Lo
i's Licensw dos not apply to an owner of r
properly who builds or he proves thereon,and who does such work FIXTURES-PER TRAP 5.00 S151,500
a FT,FLOOR AREA TOTAL ACREAGE
I� Dents(re through his own employes.Provided that such improve- 15q 500
mmselfo not through
hiss or offered ess.or p,.ILhowevesuhe..i.ding GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 'I
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 that he did not build or im- RES IND CON PB Omv
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ h as owner of the property,am esclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7144,Business LAWN SPRINKLERS- 1 INC 5 V.B.' 6.00 ASSESSORS PARCEL NO.
and Professions Coda:The Contractor's License Law dos not apply ' 'q
to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) -1.00
nt ry �� j
contracts for such projects with a contractor(s)licensed puuato SEWER-SANITARY-STORM EA.ZOOft/10.00
the Contractors License Law, TRACT NO. PARCEL NO.
❑ I am exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00
reason
Owner Uuln WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKERS'CU.NPENSATION DECLSRATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a eertilicme ofconwat to self-insure. ZONING ENG.SITE NO.
or n certificate of Workers'ComptmebumE I s.Rmcc,or o certifrcd -
copy thereof(Sea.3810,UbU.f ,
Policy No-
0
oO ❑ CeRiliede. It,, yfor e.e FIRESPRINK ENERGY T24
Z ZCera( py ction division. MISC.- REFER TO ORD.
plicae /16 - _ Y C] NE] Y [:J NEI
~vaPERMIT ISSUANCE 10.00
� - CIiR' IPICA'1'li UE P Ii PITON FROM WORKERS' FLOOD ZOrvE A.L.U.C.
W MP
Y COIiNS ON INSURANCE PLG.CONTR. LIG.No. PLG.
(Chis .slide Recd not be Completed if the Permil is for one TOTAL Y[DN❑ Y ❑ .N 1:1Z
hundred do11.rR IS I(IU)Or lino)
U O 1 certify that in the rertonhmnce of the work for which this per- QTY. MECHANICAL PERMIT FEE' FEE SUMMARY
EL I- Lou is iss.ml,1 '11.11 nal mnploy any PcrGm in any neon.......to
U become subject to the Works$congcnsmion lyws Of CLIME.U..
LU Datc Applicam ALTER OR ADD TO Pd MECH. 5.00 BUILDING 21
} m NOTICE TO APPLICAN 1': 11,Mier making III,Ccflificalc of Ex-
? emptinn,you should become subject to the Worked Conhpensatiun APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE"
C..) such provisions ur this pernhit shall be dcened rc,ukLd. AIR HANDLING UNIT(TO 10=CF.M.) . 4.00
AIR HANDLING UNIT(OVER 10.0WC.FM.) 6.00 SEISMIC FEE OO
CONSTRUCTION LENDING AGENCY 1 ,I
I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work lot which this permit is issued(Sec. MICROFILM 1
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.)- '8.00 _
Lenders Name
Lenders Address HEATING UNIT(OVER 100,000 B.T.1.119.50 ELECTRIC
I certify that I have read 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 scute laws relating to building construction, and BOILER-CONDO H.P.or 100,000 B.T.U.) 6.00
hereby authorize reprsentalives of this city to enter upon the BOILER-COMP (O'er 100,000 BTU)SEE FEE SCH. ' MECHANICAL
abuse-mentioned property for inspection .us.
i (We) agrtt to 'sc, indemnify and ep harmless the City of MISC.- REFER TO ORD.
upertio.again told ics, ' Jgme costs and expenses which PERMIT ISSUANCE 10,00 CONST.TAX
ay in any y accrue ag Est City in consequence of the
rantin f IS Pen MECH.CONT. - LIC.NO. MECH.
�7_Gn TOTAL TOTAL 3�I
uIrign. reef Applicant 54
..tor Uea
OFFICE COPY 11