14665POST THIS CARD NEAR FRONT OF BUILDING
' CITY OF CUPERTINO
INSPECTION DIVISION w
JOB INSPECTION RECORD
•
JOB ADDRESS '1120 1-70 jl'd� UNIT# _LOT#
-
OWNER U fKq-Te'C.,,$ .. CONTRACTOR - -
PERMIT NUMBER
14665
EiI.
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
-r IS NOT STARTED WITHIN
180 DAYS'OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
LASTCALLEDINSPECTION.
INSPECTION DATE INSPECTOR
INSPECTION RECORD
FOUNDATION
NOTE:
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS.
LIFER
PREGUNITE -
-
PERMIT VAuoAtION
bl
���
IssUANCE DATE
GARAGE SLABS I"
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
(a-a2
UNDERGROUND/SLAB
PLUMBING
-
I `'_ �•-� ``lt �Q
ELECTRICAL
MECHANICAL
-
e Oc ELECT
PLG. MECH.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
X
BUILDING PERMIT
INFORMATION
' WOOD FLOOR -
PLUMBING �
..
VALUATIONSIFT.
MECHANICAL
ELECTRICAL
...
PeRMIT To '
','x.,, •. rr+�T, ?:... „�.�
FRAMING
INSULATION
STORIES
"TYPE CONSTR.
OCC CROUP
RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED-
• ROOF-
NOTE: NO FINAL INSP. SHALL BE'MADE BEFORE
THE CONSTRUCTION TAX IS PAID
-
SO' `r `°oR AREA
TOTAL, ncB EAce
DIAPHRAGM -
-
ROOFSHEATHING
BUILDING USE
NES IND • CON PB urnr.
❑ [I El ❑
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED1HENEROG
FINALS DATE INSP.
. ROUGH -
-
ASSESSORSPARCEL NO
PLUMBING
.'ENERGY rTUBS
&SHOWER PAN �
ING ENERGY'
TRACT No.
PARceL No
MECHANICAL --
.ENERGYELECTRICAL
ING ENERGY
A". DATE
.ACCFRAMING
. FINAL TEST
INSULATION
ING -
zoNlrvG
ENC. sr re NO:
GAS TEST
-J
NICAL
FIRE SPRINK
❑ N'❑
ENeRGv r.7aCOVER
1❑N❑
NO WORK UNTIL ABOVE HAS BEEN SIGNED
NG
EXTERIOR SHEAR -
RICAL RELEASE
FLOOD ZONE
v ❑ N❑
A.L UcINTERIOR
01 NEI
SHEAR
EPT.
SHEETROCK
-
FEE SUMMARY
EXTERIOR LATH
BUILDING
INTERIOR LATH'-
- TEMPORARY APPROVAL
BUILDING
SCRATCH COAT• - -
ELECTRIC.
PLAN CHECK
FEE
'
'
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY
SEISMIC FEE
.�....-
OCCUPANCY-OF BUILDING ISNOTPERMI TT EDUNTIL BUILDING FINAL ISSIGNED13Y BUILDING INSPECTOR.
ARRANGE FOR INSPECTION BY PHONING 252-4505,:
Z�. ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLEASE GIVE JOB ADDRESS WHEN PHONING.:
-SEE PERMIT FOR EXPIRATION DATE'-
'
MICROFILM
ELECTRIC
PLUMBING
MECHANICAL
IMPORTANT!,
PLEASE'READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
CONST. TAX
TOT
AL
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
V BUILDING PROJECT IDENTIFICATION
APPLICATION & PERMIT
BUILDING -ELECTRICAL- PLUMBING - MECHANICAL
PERMIT NUMBER
//II��
1 A^
4 0 6
I Nc
ROIL. /'�
((JOKES$_ ('
OWNER'S
N
PH N 70 3
CITY. ELECTRIC PERMIT FEES
PLAN CHECK VALI TION
-
iJ
,
DATE OF APPLICATION,
mERAc.oas jj �I .�J
j' LIC.No-I `xI 2-7
UTLETS -SWITCHES-RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
CONTRACTORS
' ooRFss e{�/I t,�
1 HON' lDI26
PPLIANCES-RESIDENTIAL 4.00
PANELS 10.00
OR
OR IJ�L
GINEF
Yj uC.77&4
PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P, C. NO.
SIGNS TRANS. 3.00
ADDR, SS rvG.
ADDRESS )}�,y� jr `T�
- L &J, A,I rtX zI z3e
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
'
-n
.- /
J/�
/-'p{_p•
ANCE DATE. •
( '
CT. PLG. MECH.
dmgfl DING PERMIT
INFORMATION
TEMP. METER OR POLE INS. 20.00
APPLICANTS
ADDRESS
MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
LICIiNSISD CONTRACTORS DECLARATION
1 hereby affirm that 1 am licensid under Provisions of Chapter')
(commencing with Sc tion 7 007 of Division 3 OC tlru Bu ire
Professions C is in full force •iLfll
License lass_ 4I broiler
D. e� onlmclor OWN ;R DECL n
I Irereby affirm that I am exempt from the Contractor's License
Law for the following reason, (Ste, 7031.5, Rusinessand Professions
Code: An cit or count
Any y county icy requitusap tloconsuance.l4q also
improve, demolish,Orrepairanyrmit to tile prior t0dsts iatement that
for such revisit to file a signed actor's nl that
requires the dp pursuant
he is licensed pursuant RI the provisions of the Contractor's License
Law (Chapter 9/cosions Codeng with that is 00) exempt therefion oofthe
Business and Professions xemp) or that hu is tion of therefrom and
by anyasis the foradexonPsion. Any violation o tell cion 703L$
pindrermil dollars tire applicant and IOaCMIpL'nally
by a ny Do. Carl f five
of not more thm�Nvc bawled dollars (S500).):
❑ 1, as owner of the property, or my employees with wages as
their sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors License Law does not apply to an owner of
properly who builds Or improves thereon, and who does such work
himself or through his own employees, provided that such improve-
Dentsarenot intended or offered for Sala If. however, the building
or improvement is sold within one year of consplelion, the owner-
builder will have the burden of proving that he did not build or im-
prove for purpose of sale.).
❑ I, as owner of the property, aesclmivcly c.ntniclin, with
m
licensed contractors to construfl the project (Sec. 7044, Business
and Professions Code The Contractor's License Law does not apply
to an Owner of property who builds or improves thereon. and who
s with a contractors)ensed pursuant to
the CmLaw.
❑ t Se' ,B.&P.C. for this
reason
contra4WORK9ERS'
Owner Dane
MPENSATION
1 hereby affirm thus 1 have a cendr,me of consent m lijjsts=insure.
or o certificate je of W is lie nsyrq r c
or a Cher b J.
Policy Nq
o Le ti ie col uhereb lu s';hcJ,
❑ Certif c t is fit the c y ins wIeCT t dNision.
Applicant-
CERTIFICA'I'F: OF EXEMPT ION FROM WORKERS'
CO.MPENSATIONINSURANCE
(Phis section sed not be completed if the permit is for one
hundred dollars ($100) or leo, I
I certify that in the performance of the work 1'or which this per.
mit is issued, I shall not employ, any person in any manner so as b
become subject to lire Workers Compensation Laws of California.
Date ApplicantALTER
- ,El
MISC. - REFER TO ORD
PERMIT ISSUANCE 10.00
VALUATION
s(f O'B-O
$/FT.
ELEC.CONTR. LIC. NO.
ELEQ
TOTAL
-
PERMIT TO
CITU. PLUMBING PERMIT FEE
STORIES
TYPE CONSTR.
ALTER -DRAIN & VENT -WATER (EA.) 5.00
_ BACK F LOW PROTECT. DEVICE 4.00
OCC. GROUP
RES. UNITS
DRAINS -FLOOR, ROOF, AREA, COND. 5.00
FIXTURES - PER TRAP 5.00
SQ FT. FLOOR AREA
TOTAL ACREAGE
GAS -EA. SYSTEM -11NC.40UTLETS 6.00
GAS - EA. SYSTEM - OVER 4 (EA.) . 2.00
BUILDING USE
RES IND CON PB Omer
El El ❑ 1:1 ❑
INDUSTRIAL WASTE INTER3000
. .
ILAWN SPRINKLERS- 1 INC 5 V.B. 6.00
ASSESSORS PARCEL NO.
'
LAWN SPRINKLERS L OVER 5 (EA.) 1.00
SEWER -SANITARY -STORM EA. 200ft/10.00
TRACT NO.
PARCEL NO.
WATER HEATER W/VENT 6.00
WATER SYSTEM 5.00
ACC:DATE
"
ACC. FILE NO.
WATER TREATING EQUIP. 5.00
ZONING
ENG. SITE NO.
FIRE SPRINK
v N❑
ENERGY T44
Y 0 N�
MISC. - REFER TO ORD.
PERMIT ISSUANCE 10.00
FLOOD zoNE
'
Y[] N ❑ 1
A.L. u.c.
-Y[3 NE]
PLG. CONTR, LIC. NO.
PLG,
TOTAL
CITY MECHANICAL PERMIT - FEE
FEE SUMMARY
BUILDING
a�9 BQ
J
OR ADD TO MECH. 5.00
M1'OTICn, ' 10 API'LICAN'1': It, after making This Certificate OI six-
cmPtio, you should become subject to the Workers Compensation
provisions of the Labor Code, yon most forlhwilh comply with
such provisions or this permit shall be deemed revoked.
CONST RUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency Iia
the performance of the work for which this Permit is issued ISee
3097, Cu.C.).
Lenders Name
Lender's Address
I certify that I have read this applifat ion and stale that tire above
information is C. t. I cc to comply with all city and county
ordinances and stole t s relating to building construction and
hereb doors c rebs en lives of this city m enter upon the
aro -mer Boned proper y r inspection Purposes.
e) a ree tos e, n comely and keep harmless the City of
er o gains) r bili[ , jml icf ts, cost and expenses which
y n a way clue guinsf said Cit n Consequence of the
g Ingo is Pe i
Si e m of Ap ica c 0 Date
APPLIANCE 5.00
PLAN CHECK
FEE
--
AIR HANDLING UNIT (TO 10=C.F.M.) 4.00
AIR HANDLING UNIT (OVER 10,000GEM.)6.00
SEISMIC FEE
EXHAUST HOOD (WITH DUCT) 5.00
MICROFILM
ELECTRIC
HEATING UNIT (TO 100,000 B.T.U.) 8.00
HEATI NG UN IT (OV ER 100,000 B.T.U.) 9.50
VENTILATION FAN (SINGLE) 4.00
PLUMBING
BOILER- COMP H.P. or 100,000 B.T.U.) 6.00
801 LER-COMP Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
MISC. - REFER TO ORD. s
PERMIT ISSUANCE 10.00
-
CONST. TAX
MECH. CONT. LIC. NO.
MECH.
DTAL
TOTAL
�(P�°
OFFICE COPY