15635 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
PERMIT NUMBER
- BUILDING PROJECT lDENTIFICATION - � PE '
BUILDING APPLICATION & PERMIT
?Es
-7 AS owASCT BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 15635
LOO$
OWNER'S _ PLAN CHECK VALIDATION -'
NAME /� (y/�J l� �f ^J OTV. ELECTRIC PERMIT FEE G��,///yJ�P �(I
M�K ' RfTTfIr""'Iu'""I PHONE 57-*S� 1 % F • Gti.`. _
croRs
NAME 'OUTLETS SWITCHES-RECEP 10.00/1.00 3,
NAME
-- LIC.No. j_Q LIGHTING FIXTURES. - 10.00/1.00 •'
ADDRESS oRs APPLIANCES-RESIDENTIAL 4.00 -
CONTRA '
PHONE PANELS 10.00 DATE OF APPLICATION
ARCHITECT - - PLAN CHECK FEE P.C.NO.
OR - PANELS (OVER 200 AMP) 20.00
ENGINEER
LIC.NO, SIGNS TRANS.' - '•3.00
ADD ESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS: 20.00
Ars MOTORS - SEE FEE BCH.
ADDRESS
Ess 1
SERVICE CHANGE 20.00 t
� oo LICENSED CONTRACTORS DECLARATION 8I�
U U . 1 hereby affirm (net 1 x111 licensed under provisions of Chapter 9 - - ISSUANCE DATE
fcommrncing with Section 70001 of Uivision'3 0(the Rosiness and LDp. M�.
N Z w BELECT. PLG.
F m z Professions Code,and my license is in full force and effect. - ❑
z O m - License Class Lic.\umber
9 Y 0, Dale - Contractor s ,y
ost: ic ¢ OWNER-BUII.DF.R UECLA RATION city OIC PiI IIOO BUILDING PERMIT
- R w U INFORMATION
w3 A w I hereby affirm that 1 am exempt from the Contractor's License - MISC.- REFER TO ORD -
u• 6oj
POST THIS CARD NEAR FRONT OF BU LDI'yG
S - 1 PERMIT NUMBER
: . CITY OF CUPERTINO` 15635
INSPECTION DIVISION
JOB INSPECTION RECORD
a v"'- E/� `N'�"I IMAc.J PERMIT EXPIRATION
JOB ADDRESS
UNIT _LOT#
PERMIT EXPIRES IF WORK:a
OWNER I1� IV"!VI"_I I/ CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT.ISSU-
FOUNDATION
- ANCE OR 180 DAYS FROM
NOTE: .
LAST CALLED INSPECTION.-
'
LIFER ALL-GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED_ - T
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL ISSUANCE DATE
MECHANICAL BLDG. ELECT. PI,G. MEC..
xo . El ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 'BUIL 0ING PERMIT
.�- INFORMATION
WOOD FLOOR < LUATION SIFT
PLUMBING
MECHANICAL !� r. }
ELECTRICAL
' FRAMING
1
INSULATION
.STORIES " TYPE CONSTR. ,
r'
DEC.GROUP. RES,UNITS
leoc,r/ scicaw FAMTc Y /loin
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED A/1 v
j . .
- ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SOPL FLOOR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID`
BUILDING USE
ROOF,SHEATHING _ HES : IND CON ' Pe 0'1,"
+'-'^'• -APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED -FINALS DATE INSP.
ASSE.SSORS PARCEL NO.
ROUGH ,SAN.#.-
PLUMBING ELECT.-ENERGY
TRACT No. PARCEL No
TUBS&SHOWER PAN PLUMBING ENERGY -
MECHANICAL MECKENERGY
ELECTRICAL BUILDING ENERGY - ACC DATE Acc.FILE No,
FRAMING ELECT.FINAL TEST- -
_ ZONING .ENG.SITE NO.
INSULATION- y�/ PLUMBING - 49
GAS TEST GAS '
MECHANICAL
FIRE SPRINK ENERGY T,2e
� . 2 •
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' - Y E NE ♦ ED N❑
EXTERIOR SHEAR 10A ELECTRICAL RELEASE ` ELooDmNE AL.u.c.
INTERIOR,SHEAR FIRE DEPT. v� N� � L N11
SHEETROCK GRADE FEESUMMARY
EXTERIOR LATH' BUILDING
INTERIOR LATH - TEMPORARY APPROVAL BUILDING
I SCRATCHCOAT - _ ELECTRIC - PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE I �I'::I
OCCUPANCY OF BUILDING IS NOT PERMITTEDUNTI L BUILDING FINAL.IS SIGNED BY BUILDING INSPECTOR. MICROFILM -
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
l�
U.1 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
OZ PLEASE GIVE JOB ADDRESS WHEN PHONING.
-SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
I c1
IMPORTANT! CONST.TAX -
: '
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY