15945POST THIS CARD NEAR FRONT OF BUILDING
•
CITY OF, CUPERTINO
INSPECTION DIVISION `
JOB INSPECTION RECORD..
- �J � -
JOB ADDRESS a•dci�7� c•P L:r^ �I/d UNIT# _LOT#'
• ('� / � -
OWNER .•!/i-✓%) AzC— - CONTRACTOR..: ]'0 "V IS -e— Cyd L.'s
PERMIT NUMBER 'I
15945;.,
!
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK '
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU- -
ANCE OR 180 DAYS FROM
LAST CALLED INSPECTION.
" INSPECTION DATE .INSPECTOR
INSPECTION RECORD
FOUNDATION PAPI : Q
NOTE: "�
ALL GRADING. AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS.
-
UFER
yy
PR EGUNITE , 9ffJ •
PERMIT VALIDATION
t' .•��'' •. -
, „ ' •- - ,
10 ISSUANCE RATEc "
GARAGE SLABS - -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
" UNDERGROUND/SLAB
PLUMBING
O
• ELECTRICAL
MECHANICAL -Rc.
LP"cr.
tvLr,. MecR
00 NOT.POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
J
,
BUILDING PERMIT 'Ptv
INFORMATION
WOOD FLOOR
VALUATION
t^�O
J
SIFT.
PLUMBING � � -' -
-
-
MECHANICAL
ELECTRICAL -T ,.
PEIIMI
ru0 ---
FRAMING - - -
INSULATION - F.
STORIES
TYPE CONSTR
'
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
OCC. GROUP
RES UNITS
'
ROOF-
NOTE: NO FNALNSP. SHALL BE MADE BEFORE
THE CONSTRUCTION TAX IS PAID -
'
SOi FT FI,U.1 AREA
TOTAL ALRFAGf
DIAPHRAGM
ROOF SHEATHING
BUILDING USE
RES' IND CON PB om.
❑ ❑ ❑ ❑ ❑
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED,.
FINALS DATE INSP..
_ROUGH'
SAN:»
ASSESSORS PgRCfi L NO
PLUMBING - �9
ELECT. ENERGY
-TRACT
TUBS 8SHOWER PAN " �
PLUMBING ENERGY
No.
PARCEL NO.
MECHANICAL •. _
MECH: ENERGY - - -
ELECTRICAL _ —OUILDINGENERGY
ACC DATE
ACC. FILE No
FRAMING ,ELECT:
FINAL TEST
INSULATION --
PLUMBING
zowmr,
ENc, SITE No. .
GAS TEST -
GAS
'
MECHANICAL -�J'
FIRE SPRINK
Y P . N❑
ENERGY T"7Ct
Y ❑ No
COVER NO WORK UNTIL ABOVE HAS BEENlIGNED
HEATING -
EXTERIOR -SHEAR '1 -
ELECTRICAL RELEASE
FLOOD TONE
Y❑ N❑
46UC.
`❑ No
INTERIOR SHEAR
FIRE DEPT.
SHEETROCK -
GRADE _
FEE SUMMARY
EXTERIOR LATH
BUILDING
BUILDING
INTERIOR LATH -
TEMPORARY APPROVAL -
SCRATCH COAT- -
ELECTRIC
PLAN CHECK
FEE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY'
SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING'EINAL IS SIGNED BY BUILDING INSPECTOR.
MICROFILM_-
ARRANGE FOR INSPECTION BY PHONING 252-4505,
o�: ONE'WORKING DAY BEFORE REQUIRED INSPECTION.
PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE -
(1��
ELECTRIC
PLUMBING CZ0 —
MECHANICAL
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION..
TOTAL. �l
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .
PROJECT IDENTIFICATION
PERMITNUMBER -„
1 BU I LOING
9UIDING
ADOREss
2'LzlS ^cr, Li,
APPLICATION & PERMIT
BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
15945.
OWNER'S (-� - -
x`O ft�t„ , G . L.Z2p
NJ{�ICJ 1 tcllL PHONE 00
DTY. ELECTRIC PERMIT FEE
PLAN CHECK VAL DATION
S�
7(
'
DATE OF APPO CATION
CO ACTOR'S
N M ,,,,{{ ^^`'1QQ ^^�1
f'L , 400.5 LIC. No.1.'CJOS_(„
OUTLETS -SWITCHES -RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
CONTRACT R's
ADORES--s��Qp�
2LJV HorvE7 000
APPLIANCES - RESIDENTIAL 4.00
, PANELS 10.00
ARRCHITECT
ENGINEER
LIC. NO,
PANELS (OVER 200 AMPI 20,00
PLAN CHECK FEE
'
SIGNS TRANS. 3.00
moo esu E.G.
CIRCUIT 5.OQ
PERMIT
PERMIT VALIDATION
'nP
KVy/j{/-ems ,
TEMP. METER OR POLE INS. 20.00
AOREss
ADDRESS
MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
q
Y/
p/� g 19 V
IS CE DATE
BLOrr��� PLG. MECH.
LICENSED CONTRACTORS DECLARATION
I hereby afOrm sir I a��HiuI�. sed under provisions of Chapter 9
(commencing with ctiox�OQ�tf Division 3 of the Business and
ss
Profe' n o ,' n i II m full fo t ft�
Llmnse c Nuntbur
Date - _ ContrBelpL
E(�_
C�
V
BUILDING PERMIT
INFORMATION
OWNER -BUILDER rn:cLnRnTI N
I hereby Minn that I am exempt from the Contractors License
a,&Isin essand Professions
Law forthefollrrea reason(Sec, requires
Any city Dreamily which requirese permit to construct,,alter,also
M ISC.- REFER TO ORD
PERMIT ISSUANCE 40;00 e1 ;1-
VALUATION
/
$/FT.
ELEC. CONTR. LIC. NO. ELEC. '-1 -
TOTAL v�+-
imCodeprove,
Im mires the n statement also
Or repair h p structure, to file a signed
requires the dp u applicant for such permit In file a signed statement that
he is licensed pursuant ton the provisions of the Contractor's License
Law (Chapter 9 (commencing with Section 7000) Division 3 of the
,�
r
PERMIT TO
�W/.LJ/L///�/(� %�U
Business and Professions Code) or that he is"exempt therefrom and
m
QTY. PLUMBING PERMIT FEE
o
the any
basis for Nu alleged exemption. Any violation of Rection malty
by any applicant fora permit subjectstile (S500plicant toacivil penally
of not more than five hundred dollars (5500).):'
.1 STORIES
TYPE CONSTR.
//''
B'V/V / / C
ALTER -DRAIN 5.00
❑ I, as owner of the property, or by employees with wages as
their sole compensation, will do the work, and the structure is not
BACK FLOW PROTECT. DEVICE 4.00 2-
OCC. GROUP
RES. UNITS
DRAINS -FLOOR, ROOF, AREA, COND. 5.00 2 -
intended or offered for sale (Sec. 7044, Business and Professions
Code The Contractor's License Law does not apply to an owner of
FIXTURES - PER TRAP 5.00
-
GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00
50. FT. FLOOR AREA
TOTAL ACREAGE
property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improve-
mentsarenotintendedor offered l'or sole. If, however, the building
or improvement is sold within one ye:n of completion, the owner-
builder will have the burden of proving that he did not build or ins-
prove for purpose of sale.).INDUSTRIAL
❑ I, as owner of the property, am exclusively.
contracting with
GAS - EA. SYSTEM -OVER 4 (EA.) 2.00
BUILDING USE
RES IND CON PB Ono,
❑ ❑ ❑ El
WASTE INTER3000
.
licensed contractors m construct the project (Sec. 7044, Business
and Professions Code: The Contractai s License Law does not apply
to an owner of property who builds or improves thereon, and who
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00
LAWN SPRINKLERS - OVER 5 IEA.) 1.00
ASSESSORS PARCEL NO.
,
contracts for such projects with a contractor(,) licensed pursuant 10
the Contractor's License Law.
❑ lam exempt under Sea ,e.&P.C. Ibrlhls
reason
SEWER -SAN V -STORM EA. 200ft/10.00
TRACT NO.
PARCEL NO.
WATER HEATER W/VENT 6.00
Owner Date
WATER SYSTEM 5.00 T" �
ACC. DATE
ACC. FILE NO.
WATER TREATING EQUIP. 5.00 '
WORK F,RS'COMPENSA'I ION DECLARATION
1 hereby affirm that I have a certificate of consent 10 sell=insrue,
ZONING
ENG. SITE NO.
or ehri��Ncale m nsation Insdrunc r u certified
�etlil'ieA oryia he[ehy fu/�vhu�.
Cetlificty is IjlEd NiLL Willy chy mspeclion division.
ApplicamJ(��{-(-�'�WOW
FIRE SPRINK
YE] NEI
ENERGY 24
Y[3 NEI.
MISC.- REFER TO ORD.
CERTIFICATECIF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE.
(This section need not be completed if the permit is for one
PERMIT ISSUANCE 4ebeee%.
FLOOD ZONE
Y ❑ N ❑
A.LU.C.
Y ❑ N
PLG.CONTH. LIC. NO.PLG.
CIL
TOTAL
hundred dollars (S 100) or IcS,.)
I certify that in the performance of the work for which this per-
mit is issued, I %hall not employ any person in any manner so as to
OTY. MECHANICAL PERMIT FEE
FEE SUMMARY
BUILDING
become subject to the Workers' Compensal ion Laws o' Calih,rniu.
Date Applicant
ALTER OR ADD TO MECH. - 5.00
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
APPLIANCE 5.00
AIR HANDLING UNIT (TO 10=C.F.M.) 4.00
PLAN CHECK
FEE
emption, you should become subject to lire Workers'Compensation
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT (OVER I0,000QRM.) 6.00
SEISMIC FEE
l Z
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
the Performance of the work (or which this permit is issued (Sec.
3097,C ,.CA
EXHAUST HOOD (WITH DUCT) 5.00
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Name
Lender's Name
HEATING UNIT (OVER 100,000 B.T.U.) ,p _
ELECTRIC
�-z Od
VENTILATION FAN (SINGLE) 4.00 -
I certify that I have read this application and slate that the above
information is emUcet. I agree to comply with all city and county
ordinances and state laws relating to building construction, and
PLUMBING
gO1LER-COh2fl (3 H.P. Or 100,000 B.T.U.) 6.00
hereby
hereby enthorire representatives of This city to enter upon the
above-mentioned property forinsp of inn �uity to
BOILER -COMP (Over 100,000 BTUYSEE FEE SCH.
MECHANICAL
�'sa
W 3'1agree to save, indemnify and oulf.harmless file City of
- MISC. - REFER TO ORD.
I in against hand 't14s, judg lents, costs and expenses which
ma in a y sre arc a ainst aid City in consequence of the
PERMIT ISSUANCE ig0g. � -
CONST. TAX
ran man f rout ^ e
/ - Q'1
Sit)
MECH. CONT. UC. NO.
f
TOTALMECH.
S'
TOTAL
4 9
ignature Applicant actor
'Date
OFFICE COPY
)L ,.