18878APPLICANT TA FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DENTI FICATI ON
_
APPLICATION & PERMIT
BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
.PERMIT NUMBER
111 �7
;>, I r
BUILDING
ADDRESS
OwN
"AM `
ONE
QTY. ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
--•'�~/J
DATE OF APPLICATION
DONTRA.TDRs A/ uc. ND,
UTLETS-SWITCHES -RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
CONTRACTORS
(J PHONE
APPLIANCES - RESIDENTIAL 4.00
PANELS 10.00
ARCHITECT
DR
ENGINEER
LIC. NO.
PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
ARCH, OR ENG.PERMIT
ADDRESSo
zIP
SPECIAL CIRCUIT 5.00
VALIDATIO
/-„•R,//.q/,1.61.✓
-
ISSUANCE DATE
BLDGELECT. PLG. MECH.
.
❑ Ell ❑
EMP. METER OR POLE INS. 20.00
APPLICANT'S •
AD Ess
•
MOTORS ,SEE FEE SCH.
- SERVICE CHANGE 20.00
LICENSED CON IRACTO DECLARATION
1 hereby attire Ilml I am lice d under provisions of Chapter 9
(commencing with Section 70 ) of Division 3 of the Business and
Professions Co C,: an
my license is in full force d effect.
Liccnsc Class _ Lie Number
Date_!/�/V_ Conlractor.5'7G�
/�" 1
OWN it I am exempt
t fromDECLRATION
I hereby affirm that 1 am exempt from the Contractor's License
Law for the following reason. (Site 7031.5. Business and Professions
Code: Any city or county' which requiresa permit to construct, alter,
improve, demolish, or repair any StruCtme, prior to its issuance, also
requires the applicant fol -such permit to file a signed stat Cn,enl that
he is licensed pursuant to Lite provisions of the Contractor's License
Law(Chapter (Commencingwith Section 7000)of D ivisionJ of the
Business and Professions Code) or that he is exempt therefrom and
the basis for the alleged exemption. Any violation of Scdion 7031.5
by any applicant for a permit subjects the applicant to a civil penalty-
ofnolmore than five hundred dollsfs(S500).):
❑ I, as owner of the property, or my employees with wages aspe
their sole comnsmiun, will do the work, and the structure is not
intended or offered for sale (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 docs such work
himself or through his own employees, provided that such improve -
ments are not intended or offered for sale, If, however, the building
or improvement is sold within one year of completion, tire owner-
builder will have the burden of Proving that he did not build or on-
prove for purpose of sale.).
O 1, as owner of the property, an, exclusively contracting wily
licensed contractors to construct the project (Seo. 7044, Bminess
and Professions Code: The Contractor's License Law does not apply
to an owner of properly who builds or improves Ihercon, and who
contracts for solely projects will, n Contractor(.) licensed pursuant to
theConlractor'sLicenseLaw,
❑ I am exempt under Sec. 1B.&P.C. for this
reason
PAIC
-NOV141989
BUILDING PERMIT
INFORMATION
MISC. - •y,r rf n,RE TO ORD
PERMIT ISSUAN E' - 10.00
VALUATION
CY^�� •+ O
S/FT.
ELEC. CONTE. LIC. N0.
-
ELEC.
TOTAL
/I
/j('J�r�//iL
PER IT TO
QTY. PLUMBING PERMIT FEE
ALTER -DRAIN -WATER IEA.) 5.00
STORIES
TYPE CONSTR.
BACK FLOW PROTECT. DEVICE 4.00
Oce. DEOUP
RE6. u"Yrs
DRAINS -FLOOR, ROOF, AREA, COND. 5.00
FIXTURES - PER TRAP 5.00
GAS-EA.SYSTEM-11NC.40UTLETS 6.00
GAS - EA. SYSTEM -OVER 4 IEA.) 2.00
SO. Fr. FLOOR AREA
TOTAL ACREAGE
BUILDING USE
RES IND CON Pa Other
❑ ❑ 0 0 ❑
INDUSTRIAL WASTE INTER. 30.00
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00
ASSESSORS PARCEL NO,
'
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
-
SEWER -SA NITAR V -STORM EA. 200ft/10.00
TRACT NO.
PARCEL NO.
WATER HEATER W/VENT 6.00
Owner Dace
WATER SYSTEM 5.00
WORKEiRS'CO.MPENSATION DECLARATION
I hereby affirm that I have a ceriifniltc of consent to selG' sure.
or a certificate of Work • s' C ...anion Ill or or When
Policy w1i
o
PlAic, N , vn
ACC. DATE
ACC. FILE NO.
WATER TREATING EQUIP, 5.00
ZONING
ENG. SITE NO.
_ Certified yis hereby forms hFIRE
Cerlihc copy is Filed wit
Applicant
c city in tio
-n isi m.
SPRINK
Y[:] NEI
ENERGY 1.24
YE] NC]
MISC.- REFER TO ORD.
_
CERT FICATE OF i -xi :NIT )N PROM WORKERS'
COMPFNSATTO INSURANCE
lie section need not be completed if the permit is for one
hundred dollars IS 100) Pe form work for which this per-
I certify that in the to employ
of person
mit is issued, I to the W employ any person in any manner co is to
hecomc subject to lire Workers' Campensal ion Laws oC Culilbrniu.
DatNO ICAN1:art
NOTICE '1'O API'LICAN'I : If. alter making This Certificate of lix-
emption, you should become subject the workeri Co,npensation
of the Labor Code, you must forthwith Comply with such provisions or this permit shall he deemed revoked,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
lire perforn am, of the work for which this permit is issued (Sec.
3097, Civ C.).
Lender's Name
Lender's Address
I certify that 1 have read this application and stale that the aboveLATION
is correct. I agree to comply with all cit ad countyPLUMBING
ordinances and stale laws relating to building co truce t, and-
amhuriec represenlalives oC this city t .ter on theabove-mentioned properly for inspection purpo
(W.) a• ': r,indem y nd keep arm] he City ofREFER
against hdi ties, dgn arts, c s an peroses whichCONST.
ayany w crue Starts, aid C' in c e luence of the
ol'IhispennlL
PERMIT ISSUANCE 10.00
FLOOD ZONE
V N�
A.L.U.C.
v N�
PLG. CONTE. LIC. NO:
PLG.
TOTAL
QTY MECHANICAL PERMIT FEE
FEE SUMMARY
BUILDINGg7O
ALTER OR ADD TO MECH. 5.00
APPLIANCE 5.00
AIR HANDLING UNIT (TO 10=CF.NL) 4.00
PLAN CHECKprovisions
FEE
AIR HANDLING UNIT(OVER 10=CF.M.) 6.00
SEISMIC FEE
EXHAUST HOOD (WITH DUCT) 5.00
MICROFILM
ELECTRIC
G U NIT (TO 100,000 B. T. U.) 8.00
NG UNIT(OVER 100,000 B.T.U.)9.50
FAN (SINGLE) 4.00nomination
COMP(3 H. P. of 100,0008.T.U.) 6.00hereby
-COMP (Over 100,000 BTU) SEE FEE SCH.
W
MECHANICAL
TO ORD.uperti
ISSUANCE 10.00mntit
TAX
LIC. N0
MECH.
TOTAL
TOTAL
Si are of Apph rn/C In for LVtc
OFFICE COPY
POST THIS 'CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO
INSPECTION DIVISION
JOB INSPECTION RECORD
-
JOB ADORES (p ( G`V/ GES T _LOT#
U�N�{
OWNER CONTRACTOR y�
PERMIT NUMBER
1887 8;
PERMIT EXPIRATION
--'}%'rr'//
PERMIT EXRFRES IF WORK
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU.
ANCE OR 180 DAYS FROM
LAST CALLED INSPECTION.
INSPECTION DATE
INSPECTION RECORD
INSPECTOR
FOUNDATION
"
NOTE:
ALL GRADING AND. DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
STANDARDS.
-
LIFER
PR EG UNITE
P RnRT OVIR kOUCUPERTINO
ISSUANCE DATE
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDUNDERGROUND/SLAB
PLUMBING,._
ELECTRICAL
MECHANICAL
IVUV .; W�_
B�LyDSc/
ICJ
ELEc r,
: ❑ -
Pu.. mecR
• ❑ ❑
'
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
�jt^ !" -"' ' ' °" -
BUILDING PERMIT
INFORMATION
WOOD FLOOR
PLUMBING
VALUATION
SIFT.
- MECHANICAL
ELECTRICAL
- PER n To
FRAMING
INSULATION
I
STORIEB
TVPE¢oNsrr�
•
OCC. GROUP
'
RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
NO FINAL . SHALL BE MADE BEFORE
THE CONSTRUC ON TAX IS PAID
L -
SO. Er. FLOOR AREA
TOTAL ACREAGE
DIAPHRAGM
ROOF SHEATHING'
BUILOIrvG USE
RES" IND CON PB 00",
❑ ❑ ❑ ❑ ❑
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
FINALS DATE INSP.
ROUGHSAN.k
ASSESSORSPARCEL NO.
PLUMBING
ELECT. ENERGY
TUBS B SHOWER PAN
PLUMBING ENERGY
THACT NO
PARceL NO
MECHANICAL
MECH.ENERGY
ELECTRICAL
BUILDING ENERGY
Acc onTz
ncc. EILE No
"
FRAMING
ELECT. FINAL TEST
INSULATION
PLUMBING
ZONING
ENG. SITE NO.
GAS TEST
GAS
MECHANICAL
EIRE SPRINK
Y ❑ NE]V
ENERGY T 24
[-]N[]EXTERIOR
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING
SHEAR
ELECTRICAL RELEASE
FLOCOZON'E
v ❑ N❑
A.L Oc
. ❑ N❑
INTERIOR SHEAR -
FIRE DEPT.
SHEETROCK
GRADE - -
FEE SUMMARY
EXTERIOR LATH .
BUILDING
M
BUILDING<! `�
INTERIOR LATH -
TEMPO RARY APP R OVALS
SCRATCH COAT
ELECTRIC
PLAN CHECK
FEE
+
GAS � -
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY
OCCUPANCYOF BUILDING IS-' NO TPERMITTEDUNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR.
SEISMIC FEE "
'
MICROFILM
OARRANGE FOR INSPECTION BY PHONING 252-4505,
� ONE WORKING DAY BEFORE REQUIRED INSPECTION.
z PLEASE GIVE JOB ADDRESS WHEN PHONING.
-SEE PERMIT FOR EXPIRATION DATE -
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX.
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
TOTAL • Q� s
uFFIGe COPY
-m. ill flr4�&� L.
No. 833
AT
%LWrtif traftof o rrit attry
ill014
OZ- . 1 Tity of Tuperfluo
'PrItartm Pitt of Nitilbing �11oppr1i"It
A.
This certificate issued pursuant to the requirements of Section 307 of the
Uniform Building Code certifying that at the time of issuance this structure mu
in compliance with the various ordinances of the City regulating building
construction or use. For the following:
%tfUse Classification Tenant Improvement 18878
Bldg. Permit No.
Group B-2 TYpe Construction III -N -UseZone Planned Development
Ownerof'Building Oasis Laundry Address 20676 Homestead Road
Building Address 20676 Homestead Road Locality Cupprt-ino. California 95014
By: — Joe Attnnuc- - c -i
Date: July 17, 1990
b Building Official
POST IN A CONSPICUOUS P"CE
N, is
,70kVMk Lmim YIWCeR-M-M'\Nf A hml k �MiIARR*�A
101. '.'