18803 r POST THIS CARD NEAR FRONT.OF BUILID ING'
• PER\11T NUMBER
CITY SOFTCUPE�RTINO � 18803
INION
JOB INSPECTION RECORD G
/ �/�O �(' }'� O PERMIT EXPIFJATION
JOBADDRESS_C=L 67 L7 des `C �� jJ UNIT# _LOT# �<l_l /' ,
PERMIT EXPIRES IF WORK
OWNER s✓T(r� � ��S (� CONTRaCTOR ------` IS NOT STARTED WITHIN
INSPECTION ATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE ; TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAI.IUAT ION
CUPERTINO STANDARDS.,
GARAGESLABS - PAID !__ �- �-�•�
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ �IV tf o
UNDERGROUND /SLAB A, + '1 10 !' '
PLUMBING . - „} �'-lt-
ELECTRICAL. -Cit" ^0 "^OIt!RO
ISSUANCE UATE
MECHANICAL - BLDG ELECT. PEG. MEC.
% ❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS.BEEN SIGNE BUILDING PERMIT
WOOD FLOOR �rC �.2 — INFORMATION
PLUMBING - vnWNlOT5p $IFT.
MECHANICAL �•�— �C `
ELECTRICAL �J/nl vERMIT/To
FRAMING ."'�L. r
INSULATION f
sTONIes rwEcoN
' OCC,GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED '
ROOF - NOTE:NO FINAL INSP,SHALL BE MADE BEFORE SOLFTr✓LJL O"AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
ROOF SHEATHINGBUILDINCUBE
RES IND CON PB ONrr
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑' ❑ ❑
ROUGHSAN.N - n9s9SSOHS PARCEL NO.
PLUMBING ' I
.ENERGY -
TUBS BSHOWER PAN ING ENERGY TRACTNo. PARCEL NO.
MECHANICAL ENERGY t
ELECTRICAL NG ENERGY ncc unre ACC.PILE No.
FRAMING .FINAL TEST
INSULATION ING zoA AC ENG.SITE NO.
GAS TEST -
NICAL, FIRE SPRINK ENERGY T.za
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED NG - Y ❑ N❑ Y ❑ N❑EXTERIOR SHEAR RICAL RELEASE FLOODZONE AL UCINTERIOR SHEAR EPT. Y❑ N❑ ❑ N❑
SHEETROCK FEE SUMMARV .
EXTERIOR LATH � I � � � �2. — ,O
INTERIOR LATH MPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE E.$`0 .
OCCUPANCY U F BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED By BUILDING INSPECTOR. MICROFILM �—
ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC
o�. ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. TOTAL S;; (�•
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
qWi LDING PROJECT IDENTIFICATION PERMIT NUMBER
S ft-DINGAPPLICATION & PERMIT 18803
ADDRESS V _`\� l
QO `` UILDING-ELECTRICAL-PLUMBING-MECHANICAL
OESyov Y. 1(•-OWNERS PLAN CHECK VALIDATION
T PTY. ELECTRIC PERMIT FEE
7�
CONTRACTOR'S' - I
NAMEUTLETS-SWITCHES-RECEP 10.00/1.00
LIc.No. LIGHTING FIXTURES 10.00/1.00 t
ADDRESS tons APPLIANCES-RESIDENTIAL 4.00
PHONE - PANELS 10.00 DATE OF APPLICATION
OARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.c.No.
NGINEER
uc.No. - SIGNS TRANS. 3.00
ARCHOR
A DURESS ENG SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
ZIP EMP.METER OR POLE INS. 20.00 ,
ADORESsrS MOTORS • SEE FEE SCH. S:,
/
.s 9p S - SERVICE CHANGE 20.00
O o LICENSED CONTRACTORS DECLARATION
au I hereby affirm that 1 am licensed under provisions of Chapter 9
zw - nr�e .� �. ISSUANCE DATE
as a `w (commencing with Section 7000)of Division 3 of the Business and
°z Professions Code,and my license i5 in full form ly u 4 and effect. 4 (J IJe J BLDG. ELEGL PLO. MECH.
z ° - License Class Lie.Number ❑
o m t o Date Contractor
ams rile, ^s "n-rth 0 BUILDING PERMIT
Ir: w a OWNER-BUILDER DF.CLARA'I-ION
°' °w MISC.- REFER TO ORD INFORMATION,
X ; I hereby off rm that 1 am exempt from the Contractor's License
b rens.....(Sec 7031.5,Businessand Professions �VALU+ATION $/FT.
u o ¢ Law I'or the following 10.00 v n Q 0
- PERMIT ISSUANCE V
wu, Code:Any my or county which struiture,p emit toconstruct.alter.
¢ a p improve,demolish,or repair any sl mcture,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
° m requires the applicant for such permit to)ilea signed statement that
A w om u TOTAL the PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License R
F Z Q
Law(ChapterProcosion$Codeog with Section is 00)of exempt Division and
m 4° 'he Business and Professions amp ion that he is exempt therefrom and OTV. PLUMBING PERMIT FEE
w H o the basis for the alleged enemption.Any violation of Sectio..7031.5 STORIES TYPE CONSTR.
a ;� by any applicant for a permit subjects the applicantto a civil penalty ALTER'-DRAIN -WATER IEA.) 5.00
s t'not more than five hundred doHm s($500).):
24C I,as owner of the properly,or my employees with wages as BACK FLOW PROTECTDEVICE 400
t ar sole compensation,will do the work,and the sVuqurc is not . .
OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,GOND. 5.00
Code:The Contractor's License Law does not apply to an owner of
properly Who bu1h h or improves employees,
pr and who t suc ice work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE
himself or who
buil his ownro es there n,..it
that such improve-
mentsarenotintendedorofferedforsalelf,however,the building GAS-EA.SYSTEM-1 INC.4OUTLETS 6.00 2�oi
or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 (EA.) 2.00
builder will have the harden of proving Ilmt he did not build o - .r im- BUILDING USE
move 1,as ownerose
of the.). RES INDUSTRIAL WASTE INTER. 30.00 1:1
I❑ ❑N ❑ ' ❑
❑ d as owner of the property,con exclusively cont ractimg with
licensed contractors : construct the project(Sec. does Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Profession Code:The Contractor's License Law docs not 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 contmctnr(s)licensed pursuant to -
theContraerm'sLicenseLaw. SEWER-SANITARY-STORM EA.200ft/10.00TRACT NO. :, PARCEL NO.
o'❑ la ex mpt under Sm. ,B.&P.C.for this WATER HEATER W/VENT 6.00 ,
n
Owner Date WATER SYSTEM 5.00
ACC.DATE ACC.FILE N0.
WORK ERS'COM iNSA'I'ION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm thin I have a certificate of consent mself-insure,
or a cerlificale of Workers'Compcnsatmii Insurance,or a cerliticd - ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.CJ.
Policy No. Company
O ❑ Certitiml copy is hereby furnished.
Z Z ❑ Certified copy is fled will, the city inspection division. FIRE SPRINK ENERGY T 24
Applicant MISC.- REFER TO ORD. Y N Y ❑ No
~ O PERMIT ISSUANCE
LU - CIiRT'IIIC'AI'B OF:EAI FINPROM WORKIiRS' 10.00 FLOOD ZONE A.L.U.C.
W COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL1'f his evctiun need not be completed if the pant it is for one TOTAL Y N❑ Y ❑ NEI
Z hundred dollars IS 100)or less.)
U Z) O 1 certity that in the performance of the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY
LL U mitis issued, m
I shall ol employ any person in any manner on as'to
O w become subject to the Workers'Compensation Laws of California.
S. Dal` APPLICANT:
ALTER OR ADD TO MECH: 5.00 BUILDING I51Jb
} S. NOTICE TO AI'I AppliT: If,alter making this Certificate of fix- -.
? eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Cade, you must forthwith comply with
CJ such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 FEE
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE
'I hereby affirm that there is'a Construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec.
3097,Civ.C). N
UNIT(TOMR B.T.U.) 8.00 MICROFILM
Lender's Name
Lender's Address NIT IO0 B.T.U.)9.50 ELECTRIC
) certify thatlhavcrcatllhisapplicaonand stale ihm lhuabove ION FA ) 4.00information is correct. I agree to comply with all city and countyPLUMBING
ordinances and state laws relating to building construction, and P(3H.P0B.T.U.) 6.00hereby authorise represenLtlives of this city to enter upon the MP(OveU15EE FEE$CH.above-mentioned property for inspection purposes. MECHANICAL'(We) agree to save, indemnify and keep harmless tIm City of FER TO ORD.upertino against liabilities,jutlgments,.costs andexpenses whichCONST.TAX
my i any way accrue against said City in consequence of the UANCE10.00
rami g f th' arm'.
_J MECH.CONT. LMECH.
Sigt u e o p an onlm<tor
ate TOTAL TOTAL
OFFICE COPY