14372l POST TH*ARD NEAR FRONT OF BUILDING •
N,IiN MaEN
CIl Y OF CUPERTINO
14372
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS 10060 PASADENA UNIT# _LOTtt
PERMIT EXPIRES IF WORK
OWNER JAMES SISK CONTRACTOR JAMES SISK
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU
ANCE OR 180 DAYS FROM
INSPECTION DATE I INSPECTOR
INSPECTION RECORD
FOUNDATION
NOTE:
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
LAST CALLED INSPECTION.
UFER
PERNUT VALIDATION
PR EGUNITE
CUPERTINO STANDARDS.
-�/ "T/j.•'E wf' GGt
�,
'
ISSUANCE DATE
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
Sd S:e/
UNDERGROUND /SLAB
PLUMBING
t -16-`e neo -r uak fornT�01V:,.
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ELECTRICAL
MECHANICAL S''t5--3r5{ P—. C-- tC.
0
RLUG
ELECT
PLG. n+ED
�
❑
❑
'A
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED S9��
BUILDING PERMIT
B
INFORMATION
WOOD FLOORZ`o
VALUATION
SIFT.
PLUMBING
MECHANICAL
PERMIT TD
ELECTRICAL
FRAMING
1
STORIES
TYPE CONST N,
INSULATION
UCC GROUP
RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
$O IT FLOOR 4RFA
i0i<L ACREAGE
ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING
RES Irvo CON ory Pa on...
❑ ❑ ❑ ❑ ❑
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.
ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING ELECT. ENERGY
TRACT NO
PARCEL NO
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ACC DATE
ACC FILE NO
ELECTRICAL BUILDING ENERGY
FRAMING ELECT. FINAL TEST
zGRIND
END SITE NO.
INSULATION PLUMBING d'•S -
GAS TEST GAS -.1 -dpor,
FwE SPR INK
ENERGY Taa
MECHANICAL 8_ S
Y ❑ NE]
V ❑ NE]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - 5 -fir!
FLooD ZONE
r ❑ N�
ALuc
r ❑ N❑
EXTERIOR SHEAR -Z CIS ELECTRICAL RELEASE
INTERIOR SHEAR -ZZ- FIRE DEPT.
SHEETROCK GRADE
FEE SUMMARY
EXTERIOR LATH BUILDING 'Z
BUILDING
INTERIOR LATH TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC
PLAN CHECK
FEE
.
GAS - S -
SEISMIC FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY I I
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR,
MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ELECTRIC
PLUMBING
Hw- ONE WORKING DAY BEFORE REQUIRED INSPECTION.
O� PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z
MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
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APPLICANT TO FILL IN INW,MATION WITHIN RED LINES - LISMALL POINT PEN ONLY
BUI LDI NG PROJECT I DENTI FI -ION
IIIPERMIT
APPLICATION & PERMIT
BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
NUMBER
14372
1BUILDINGI
10NE"0 T D A,5AVE A
OWNER'5
NAME f1.14A` c
J&M E. C, I,. SI�,K PHONE 7-55. 4'6515
CITY. ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
DATE APPLICATIpNC.
CONTRACTORS
NAME �/�/J c
ES �I IS Ile- LIC. No.,Xr[,. 5
UTLETS-SWITCHES -RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
DDREACTOR's
ADDRESS
100¢1
APPLIANCES - RESIDENTIAL 4.00
PANELS IOOD
ARCHITECT
OR
ENGINEER
LIC. No.
PANELS (OVER 200 AMP) 20.00
PLAN CHECKOF
NO.
SIGNS TRANS. 3.00
ARCH.OR ENL.
ADDRESS
SPECIAL CIRCUIT 5.00PERMIT
VALIDATION
TEMP. METER OR POLE INS. 20.00
ZIP
/Z///
ANTS
ADDRESS
MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
hKkE ZS
�1
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9
ISSUANCE DATE
(commencing with Section 7000) of Division 3 of the Business andBLOC.
Professions Co4uVy..�nd my license is in full fa r effe
License Class_^' . Lic. N'w er-�
ELECT.
krT ❑
PLG, MECH.
❑ ❑
Date h - 1I- $i Cmnrvn
BUILDING PERMIT
OWNER-BUILDIiR DECL ATION
I hereby affirm that I am exempt front the Contractor's License
Law for the following reason. IS". 703 1.5, Business and Professions
Code: Any city or county which requires a permit to construct. alter.
improve, demolish, of repair any structure, prior to its issuance, also
INFORMATION
MISC.- REFER TO ORD
VALUATION
S/FT.
PERMIT ISSUANCE 10.00
ELEC. CONTR. LIC. NO.
ELEC.
requires the applicant for such permit t0 file a signed statement that
he is licensed pursuant to the provisions of the Contractor's License
TOTAL
PERMIT TO
_
QTY. PLUMBING PERMIT FEE
Law (Chapter 9 ( commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5
ST RIES
TYPE CONSTR.
ALTER -DRAIN & VENT -WATER (EA.) 5.00
by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($50000:
❑ I, as owner of the property, or my employees with wages as
their sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044. Business and Professions
BACK FLOW PROTECT. DEVICE 4.00
OCC. GROUP
RES. UNITS
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 does such work
FIXTURES - PER TRAP 5.00
SO. FT FLOOR AREA
TOTAL ACREAGE
himself or through his own employees, provided that such improve-
mentsarenotintendedoroffered for sale. If. however, the building
GAS-EA.SYSTEM-111NC.4OUTLETS 6.00
or improvement is sold within one year of completion, the owner.
builder will have the burden of proving that he did not build or int-
prove for purpose of sale.).
❑ 1, as owner of the property, am exclusively contracting withLAWN
licensed contractors to construct the project (Sec. 7044. Business
GAS - EA. SYSTEM - OVER 4 (EA.) 2.00
BUILDING USE
RES IND CON Pe Other
ElC1❑ El El
INDUSTRIAL WASTE INTER. 30.00
SPRINKLERS - 1 INC 5 V.B. 6.00
ASSESSORS PARCEL NO.
and Professions Code: The 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 cootrxetons) licensed pursuant to
the Contractor's License Law.
SEWER -SANITARY -STORM EA. 200ft/10.00
TRACT NO,
PARCEL NO.
WATER HEATER W/VENT 6.00
O l am exempt under Sec. .B.&P.C. for this
reason
Owner Dam
WATER SYSTEM 5.00
ACC.DATE
ACC. FILE -NO.
WORKF.RS'COMPENSATION DECLARATION
WATER TREATING EQUIP. 5.00
I hereby affirm that I lase a Certificate ssf consent 10 Sen-msur .
or a certificate of Workers'Compensation Insurance, or a certified
ZONING
ENG. SITE NO.
copy thercofl Sec 3800. Lab.C.).
Policy No. Company
❑ Certified Copyi hereby furnished.
V Ce " d copy is filed,with Ih city inspection division.
Applica
FIRE SPANK
Y ❑ N ❑
ENERGY T 24
Y ❑ N❑
MISC. - REFER TO ORD.
PERMIT ISSUANCE 10.00
FLOOD ZONE
A.L.u.C.
: tTIFICATE 0171 XEMPTION FROM WORKERS'
PLG. CONTR. LIC. NO.
PLG.
TOTAL
COMPENSATION INSURANCE
(This Xm Ctom need nbe completed if one the permit Is for n
Y ❑ N❑
Y ❑ N❑
CITY. MECHANICAL PERMIT FEE
FEE SUMMARY
hundred dollars I S 100) n1 less.)
I certify that in the performance of the work fin which this per
mit is issued. I shall not employ any person in any n a er v, as to
become subject to the Workeri Compensation Laws of California.
Date Appla,aM
BUILDING
ALTER OR ADD TO MECH. 5.00
NOT ICE *1'0 APPLICANT'', It. after making this Certificate of Ex-
emption, you should become subiL,i to the Workers'Compensatton
APPLIANCE 5.00
PLAN CHECK
provisions of the Labor Cade, you most forthwith Comply with
such provisions or this permit shall be dremed revoked.
FEE
AIR HANDLING UNIT (TO 10=C.F.M.) 4.00
AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00
SEISMIC FEE
s
CONSTRUCTION LENDING AGENCY
EXHAUST HOOD (WITH DUCT) 5.00
MICROFILM
1 hereby affirm that there is a construction lending agency for
Ihr Performance of the work for which this permit is issued (Sec.
3097. Civ C.I.
HEATING UNIT (TO 100,000 B.T.U.) 8.00
HEATING UNIT (OV ER 100,000 B.T.U.) 9.50
ELECTRIC
Lender's Name
Lender's Address
I certify that 1 have read this application and state that the above
information is correct. I agree to comply with all city and countyBOILER-COMP
ordinances and stair laws « luting to building construction, and
VENTILATION FAN (SINGLE) 4.00
PLUMBING
(3 H.P. or 100,0008.T.U.} 6.00
BOILER -COMP (Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of
upertino against liabilities, judgments, costs and expenses which
may in any way accrue against said City in consequence of the
MISC. - REFER TO ORD.
CONST. TAX
PERMIT ISSUANCE 10.00
MECH. CONT. LIG. NO.MECH.
TOTAL
TOTAL
rantingof this permit,
Signature of Applicant/Contranor Dale
OFFICE COPY