18466 POST THIS CARD NEAR FRONT OF BUILDING PERMITNUMBER
PITY .OF CUPERTINO ' 18466 .
INSPECTION DIVISION-'','
JOB INSPECTION RECORD'
(-- PERMIT EXPIRATION
JOB ADDRESS_ V ` -P INL �+, ��—UNIT# - _LOT# PERMIT EXPIRES IF WORK
OWNER .G CONTRACTOR / IS NOT STARTED WITHIN
.INSPECTION DATE INSPECTOR INSPECTION R ORD 180 DAYS OF PERMIT ISSU.
FOUNDATION - ANCE OR 180 DAYS FROM
NOTE: '
LIFER � � - � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.-
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF, PERMIT VALIDATION
CUPERTINO STANDARDS. PAI �/ l
GARAGESLABS D'
;�` -' e.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED i
UNDERGROUND /SLAB AUG 161989
PLUMBING ` ! ', ^��"
ELECTRICAL „ �
ISSUANCE DATE
MECHANICAL Y uc ELECT PLO, mEw
r ❑ ❑ ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING vwwan TNPb SIFT.
MECHANICAL
ELECTRICAL �,�//J' f,`+T To
FRAMING
INSULATION STORIES TYPECONST R.
OCC GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE ' SO FT FLOOR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID T;
BUILDING USE
ROOFSHEATHING HES IND . CON PB Om..
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. �' E ❑' E]
ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING - ELECT.ENERGY -
TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO.
MECHANICAL MECH.ENERGY -
ELECTRICAL - BUILDING ENERGY ACC.DATE ACC.FILE NO
FRAMING ELECT.FINAL TEST ZONING ENG.1.SITE NO.
INSULATION PLUMBING -
A'
GAS TEST - GAS -
FIRESPRMK 'ENERGY T 24
MECHANICAL NQ
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
.
EXTERIOR SHEAR ELECTRICAL RELEASE ' FLOOD ZONE AL C.
❑
INTERIOR Y� N YI N
SHEAR FIRE DEPT. L�
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING '
INTERIOR LATH - TEMPORARY APPROVAL BUILDING
SCRATCH COAT ELECTRIC PLAN CHECK.
GAS FEE .3 D
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE " f
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, T eLEcrRic ' . a.-lea
-1 F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING '
0 PLEASE GIVE JOB ADDRESS WHEN PHONING. . .
z MECHANICAL'
/
- SEE PERMIT FOR EXPIRATION DATE -
IMPORTANT!
CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DEIyTIJPERMIT NUMBER'ICAYION r
BUILDING (7 /��
APPLICATION & PERMIT
ADURISS -
�oS�� 14 / a7 BUILDING-ELECTRICAL-PLUMBING -MECHANICAL k.
18466
OWNER'$ [ PLAN CHECK VALIDATION
NAME _3C' TY"� TV. ELECTRIC PERMIT FEE
ACT.RvHONEIj�S--�T
cG MfRAcrons OUTLETS-SWITCHES-RECEP 10.00/1,00
I "L G�S1 1141,.No. LIGHTING FIXTURES 10.00/1.00
- rDN
ADDRESS cTorys�„ I r/X-LI S�'lfl 'Le�4'l�
�-v APPLIANCES-RESIDENTIAL 4.00
(1` IQ aHONE PANELS 10.00 PATE OF APPLICATION /
0gcnrrscT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C:NO.
ENGINEER
uc.No. SIGNS TRANS. 3.00 70.00
ARCH.0S ENG. SPECIAL CIRCUIT S.QQ PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APP4CANT' Yom'^,Q J
AOURE55 - MOTORS SEE FEE SCH. l
T
q SERVICE CHANGE 20.00
Dai
, 00 LICENSED CONTRACTORS DECLARATION "
R U u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
N G w (Commencing with Section 7000)of Division 3 of the Business and 1989 DG. ELECT. PLG. MECH.
F, N z Professions Co gal it cense is in full for •H
Z D H - Licen Class_ Lic.Number Cl 'QID
9 m r Dal• Contra C1tJ 11l Cape
a x f -Ji Y �if�11(Q I UILDING PERMIT
rc
IS ¢ OWNER-BUILDS iCLA TIO
A o d v INFORMATION
is I hereby affirm that I am exempt from the Con s Li ease MISC.- REFER TO ORD
u O a Law for the following reason.(Sec.7031,5,Business and Professions VALUATFI1lON S/FT.
H _ k PERMIT ISSUANCE 10.00 2,� I/ d
was Code:Any City or county which requires a permit to construct,alter,
¢ ¢ ¢ p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
n w m¢ requires the applicant for such permit to file a signed statement that TOTAL PERM( TO
he is licensed pursuant to the provisions of the Contractor's License
r z Q
Law(Chapter 9 f commencingwith Section 7000)of Division 3 ofthe w�L �� !.
F 4 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FK
EE -
¢ r $ the basis for Ole alleged exemption.Any violation of Section 703 L5 STORIES TYPE CONSTR.
u ; _ by any applicant for a permit subjects the applicant ma civil penalty ALTER -WATER (EA.) 5.00
of not mom than five hundred dollars(S500)J:
Cl I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 7 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:'The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who doe,such work FIXTURES-PER TRAP 5,00 SO.FT.FLOOR AREA TOTALACREAGE
himself or through his own employees,provided that such lnlprzmve-
meals an not intended or offered for sale.If,however,the building GAS-EA.SVSTEM-I INC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
builder will have the burden of proving that h - .e did not build or im- - REB IND CON Pe Omer
prove lot purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
O I,as owner of the property,am exclusively contracting with 13 El ❑ ❑ ❑
licensed contractors to construct the project(Seo.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 gBBEBSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not apply
to an owner of property who hands or improves(hereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1,00
contracts for such projects with a contractorts)licensed pulsuam to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑ I um exempt under Sea ,B.&P.C.for this WATER HEATER WIVENT 6.00
reason
Owner Dam WATER SYSTEM 5.00
PCL.DATE ACC.FILE N0.
.WORK BRS'COMPENSATION DECLARATION - WATER TREATING EQUIP. 5.00
I hereby xffrn that I have a certificate ofconsent to self-insure, ZONING ENG.SITE N0.
or a certificate of Workers'Compensation smaller n a certified -
copy Bycref3e'. 0,j� .C.,.• -
PGlic dhi O d(1'jlyen P
O Certified, y is hereby y lot. FIRE SPRINK ENERGY T-24
Z 0 dicin ti ' is til with the ci nspe lion division. MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑
rnPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. -
LU CB 'ICA'(' . IiXEM TIO PROM WORKERS'
W � MP, NINSURANCF: PLG.CONTR. LIC.NO. PLG.
CL Z (This section need not be completed if the permit is I'or one TOTAL Y❑, N❑ Y❑ N
hundred dollars($100)or less.)
U O s I certify that in the performance of the work for which this per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL l- mn is issued,I shall not employ any person in any manner so as to
U become subject to the Workers'Com nation Laws of California.
O w ) �e BUILDING -�
y Dale Applicant ALTER OR ADD,TO MECH. 5.00
} N NOTICE TO APPLICANT: If,after making this Certificate of Ex-
F.. ? enlption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK h
provisions of the Labor Code, you must forthwith comply with FEE A,3a
C.1 such•provisions or this permit shall be demced revoked AIR HANDLING UNIT(TO 10=C.F.W 4.00 (
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 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 Ibis permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) . 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 2-ao
Lendcr i Address
I certify that l hevercad thisapplication andomelhattheabove VENTILATION FAN (SINGLE) 4.00
information is Correct. I agree to comply with all city and county PLUMBING
ordinances and stale laws relating to building construction, and BOILER-COMPH.P.or100,000B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOI LER-COMP((3Over 100,000 BTU)SEE FEE SCH. MECHANICAL
I above-mentioned property for inspection purposes,
V (We) agree m.save, i 'fy and keep harmless the City of MISC.- REFER TO ORD.
upertin against les,In ents, costs and expenses which CONST.TAX '
ay in Y accrue against C, It in consequence of the PERMIT ISSUANCE '10.00
m in 1Is permit. MECH.CONT. LIC.NO. - MECH.
8�I o TOTAL TOTAL (�.saw
ignature o p ca actor UaIC
OFFICE COPY