14725 POST THIS CARD NEAR FRONT OF BUILDING ';
v - #PE '" ,RMIT NUMBER
CITY OF CUPERTINO 1 �7Z5s
INSPECTION DIVISION , »' ?
*^= JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS�_O� ���Ng- T� w UNIT# _LOT ft 1
n PE RMIT'EXPI RES I F WORK
OWNER EfZ cONTRACTOH O p .IS wNOT'STARTED WITHIN 'I
INSPECTION DATE INSPECTOR INSPECTION RECORD 1180.DAYSOF PERMIT ISSU-
FOUNDATION "^ANCEOR-A80:DAYS';FROMj
_ NOTE: ` LAST CALLED INSPECTION
LIFERALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY'OF'. PERMIT VAWDATION
CUPERTINO STANDARDS.
GARAGE'SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED i ,-^•�'
UNDERGROUND /SLAB
PLUMBING'
ELECTRICAL IssuArvcE un�
MECHANICAL ' ` BLDG ELECT. PLG, MECH.
❑ ❑ ❑ .
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
_ •'"h - INF•ORMATION ,i
WOOD FLOOR – VALUATION. s/FT.
PLUMBING '
MECHANICAL - -
ELECTRICAL - PERM Tro
FRAMING
INSULATION STORIES TYPE CONSTR.
. 01CC'GHOUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED '' . . ' • ' -
.ROOF NOTE:NO FINAL INSP.SHALL BE AdE FO aO FT FLOOR ARCA
TOTAL AceeAee
THE CONSTRUCTION TAXIS PAI[�L `��
DIAPHRAGM
`a.An IWVe .:f- .,,UI-OING USE. r
ROOF SHEATHING lWY Hcs IND, CON PS 'Ome' ,
APPLY NTROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE -- INSP. '� `' ❑[
ASSESSORSPARCEL NO
ROUGH SAN.a
PLUMBING - ELECT.ENERGY
1HACI NO PARCEL NO
TUBS 8 SHOWER PAN - PLUMBING ENERGY.
MECHANICAL MECH.ENERGY
ELECTRICAL - ACC.DATE ACC FILE NO,
BUILDING ENERGY
FRAMINGELECT.FINAL TEST .x1 `'
INSULATION ' - PLUMBING - zoNING ENO.SITE,NO.
GAS TEST _ - . GAS
MECHANICAL FIRE STRUNK ENERGY T 24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y E] 'ANO Y 0 No'
-
EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOOZONE A- r d+B.UC.
INTERIOR SHEAR - FIRE DEPT.
vC—,'N❑ Y N�
SHEETROCK GRADE <FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH - TEMPORARYAPPROVALS BUILDING '
SCRATCH COAT ELECTRIC - PLAN CHECK
'- - GAS - FEE . ¢
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY- SEISMIC FEE
OCCUPANCYOF BUILDING ISNOT-PERMITTED UNTILBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM
4
Yi W
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
I- ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLEASE GIVE JOB ADDRESS WHEN PHONING.
I z = SEE PERMIT FOR EXPIRATION DATE - MECHAN(cAL ' T
IMPORTANT! coNST.TAx
PLEASE READ REVERSE SIDE BEFORE 'IT TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
:,( APPLICrTO.FI 9C N-INFORMATION WITHIN RED LINES- USE BALL POINT PEN ONLY
-,BU I LDING PROJECT I DENTIFICATI ON - PERMIT NUMBER
DIN
BUILG - - APPLICATION & PERMIT 4
BU LOONS I
BUILDING -ELECTRICAL-PLUMBING -MECHANICAL 7
i• 25
owry ER's
NAME PLAN CHECK VALIDATION
'�4;,r V. ELECTRIC PERMIT FEE
f� E -
I_ -- NONE Ac>•oHszw� OUTLETS-SWITCHES-RECEP 10:00/1.00
- IQ.N G LIGHTING FIXTURES 10,00/1.00 -
E X � g 41J APPLIANCES-RESIDENTIAL 4.00 '
CA7370 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE _ P.C.NO.
OR \,... PANELS (OVER 200 AMP) 20.00
ENGINEEP
II I( Lm.No, SIGNS TRANS. 3.00
ADD'Ess ENG. - SPECIAL CIRCUIT 5.00 •PERMIT VALIDATION
ZIP TEMP. METER OR POLE INS. 20.00 -
AMOTORS SEE FEE SCH.
ADDDRESSDRESS
SERVICE CHANGE 20.00
02 -LICENSED CONTRACTORS DECLARATION
a u u I hereby affirm that 1 am licensed under provisions of Chapter9
Z4
w ISSUANCE DATE
¢ (comnu•neing with Secl ion 7000)of Division 3 of the Bueiwss and
r D i BLDG. ELECT. PLG. MECH.
le, I n li- is in full to f ❑ ❑ ❑
z O vii- Numb r
O z r O Date - ontracts _
+ Q Y Z
rc ¢ OWNER+BUILDER DECLARATION - BUILDING PERMIT
A o d D INFORMATION
X g w I hereby affirm that I am exempt from the Contractors License MISC.- REFER TO ORD
u O¢ Law for the following ruuson.(Sec.7031.5,Businpsand Professions VALUATION /FT.
- .; PERMIT ISSUANCE - 10.00
Code Any city orcounty which reyuiresa permit to construct alter,
QQ ¢Q Improve,denimlis 1,or repair any Structure,prior to its Issuance,also ELEE.CONTR. LIC.NO. EIEC.
DLL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
w m be is licensed pursuant to the provisions of the Contractor's I....
HV`
I rzi
Law(Chapter 9(eommencing with Section 7000)ol'Division 3 crone ��
4 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE
XIp thebasisforthe alleged exemption.Any violation ofSection7031.5 STORIES TYPE CONSTR.
T;m- by any applicant for a permit subjects the applicant to a civil penalty -
ofnot mom than five Hundred dollars(4500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00
❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
intended or offered In,sale (Sec. 7044,13usiness and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 5.00 '
Code:The Contractor's License Law does not apply to an owner of
Property who builds or improves thereon,and who does such work FIXTURES,PER TRAP 5.00 SD.FT.FLOOR AREA TOTALACREAGE
himself or through his own.employees,provided that such improve-
d' mems are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00
builder will have the burden of proving that he did not build or im- BUILDING USE
prove fol purpose of sale,). RES IND CON PB Other
❑ 1,as owner of the property,um exclusively conlrucling with INDUSTRIAL WASTE'INTE R. 30.00 1:1 1:1 1:1 El licensed contractors toonstruct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:1h Contractor's License Law does 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 contruclor(s)licensed pursuant to
the Contractor's License Law. " SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exempt under Sec. ',B.&PC.for this WATER HEATER W/VENT 6.00
reason
Owner [)at; WATER SYSTEM 5.00 ACC.DATE ACG FILE NO.
WORK IiRS'COMPENSAT ION DECLARATION WATER TREATING EQUIP, 5.00
I hereby affirm that I haven certificate orcon,cm to sell-in...c, -or a certificate of Workers'Compe n sur ce,. certified ZONING ENG.SITE NO.
Wo gg�h�e�Je Its• 0 C.1...,,)
-Ce c n n£f t
❑ rtifie ops is rerehy f nl,t FIRE SPRINK ENERGY T 24
z Z `lam Ce fied op I 'tl c'Y ..to 'it 's
� O Appian MISC- - REFER TO ORD, Y ❑ N❑ Y ❑ No
CC 1
LO CERTIFICATE 017 EXEMPTION PROM WEPERMIT ISSUANCE
FLOOD 20NE A.L.U.C.
111 COMPIiNSATION INSURANCE PLG.coNTR. LIC.rv0. pt16
C- D (This section need not be completed if the permit is for one TOTAL a Y❑ N❑ Y❑ N❑
:D Z hundred dollars(S 100)or less.) -
U 0 1 certify that io the performance of the work for which this per- OTY. MECNANICAL PERMIT �� FEE 0 FEE SUMMARY
LL I- mit is issued,I shall not employ any person in any manner so as to
OU become subject to the Wnrkers'Compensation Laws of Califorria. r
UJ
Q. Lam Applicant ALTER OR ADD TO MECH. - BUILDING
} N NOTICE TO AITLICAN'I': It allot making this Ccrtifics'tc of -
2 emption,you should become subject to the Workers Compensation APPLIANCE .00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with - FEE
V such provisions or this permit shall he deemed(evoked. AIR HANDLING UNIT(TO iQ000C.F.M.1 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT). 5.00
the performance of the work or which this permit is issued(Sec.' MICROFILM
3097,r'sN ). / /n��y-1 HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lenderi Name (,�LLJ L--C�
Lender's Address HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I certify that l hio,cmad this application andstate that the above VENTILATION FAN (SINGLE) 4.00
nfornmtion is correct, I agree to comply with all city and county PLUMBING
ordinances and state laws relating to building construction, and BOILER-COMPOH.P.Or 100,000B.T.U.) 6.00
hereby cmIHmize representatives ins inspection
city es enter upon the BOILER-COMP (Give,100,000 BTU)SEE FEE SCH. MECHANICAL
uerebyn authorize
property forinsp of this
purposes.
(We) agree to sncc, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which pERM1T ISSUANCE 10.00 CONST.TAX
may way accrue against said City in consequene���e 111 the
t IBg of this pCOnit. / E .CONT. LIC.NO. MECH.
to °TA TOTAL
S' a re or Applicant Contmc r Dom
OFFICE COPY.