16383 POST THIS CARD,NEAR FRONT OF,BUILDING
_. PERMIT NUMBER
CITY OF CUPERTINO ,' 16.383
INSPECTION'DIVISION
JOB INSPECTION RECORD
- PERMIT EXPIRATION
JOB ADDRESS /C) 8°2,, S(I)-NT� LUC�q RD . UNIT# _LOT#
VjjT .PERMIT EXPIRES IF WORK
OWNER / I/tT<C7� �tN CONTRACTOR �� 4,V„� IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.
ANCE.OR 180 DAYS FROM
FOUNDATION O NOTE: LAS7CALLED INSPECTION.
UFER (O ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATOO .
CUPERTINO STANDARDS. ,
GARAGE SLABS -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - Q-/ -•-_` '
UNDERGROUND /SLAB eTi�A � v..
PLUMBING - , ,
ELECTRICAL _ i �. v� ISSUANCI:DATE
MECHANICAL =s' BLDG ELECT. PLG. MECH
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED okltokctvAcW BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION
PLUMBING
MECHANICAL - 6�o-0-0}
PERMIT TO
- ELECTRICAL - - '
FRAMING
INSULATION STORIES TYPE CONSTH,
DEC.GROUP, RES.UNITS
!PR9' CE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
50.FT FLOOR AREA TOTAL ACREAGE
_ ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE_-
+ DIAPHRAGM; ;. THE CONSTRUCTION TAX IS,PAID
ROOF.SHEATHING ewun ON USE
Rrs IND CON PR OIr,
APPLY'NO ROOFING UNTIL ABOVE HAS BEEN ffkgD FINALS DATE I INSP. ❑ ❑ ❑ ❑ 11
ROU H SAN.N
ASSESSORS PARCEL NO
PLUMBING ELECT.ENERGY'
TUBS 8,SHOPA PLUMBING ENERGY TRACT rvo. PARCEL No
MECHANICAL ECH.ENERGY. `
ELECTRICAL - ACC DATE ACC.FILE NO
BUILDING ENERGY
FRAMING - ELECT.FINAL TEST
ZONING ENG.SITE NO.
INSULATION- � � PLUMBING ��
GAS TEST - - GAS' I ” FIRE SPRIEReNERGv r.Za ,
MECHANICAL-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "F] Y "C]
C.'
EXTERIOR SHEAR ELECTRICAL RELEASE ' FLOOD ZO NE A.L.I.
INTERIOR SHEARFIRE DEPT. Y NQ r L+ .NEI
SHEETROCK GRADEFEE SUMMARY,
EXTERIOR LATH , BUILDING ' TN BUILDING
INTERIOR LATH, TEMPORARY APPROVALS
SCRATCH COAT JELECTRIC PLAN CHECK
GAS - FEE '
II
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY , SEISMIC FEE
II OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING•FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
�.
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
`I ONE'WORKING DAY. BEFORE REQUIRED INSPECTION.'
PLUMBING
o-,/ PLEASE GIVE JOB ADDRESS WHEN PHONING.
+ ?
— SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. TOTAL
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
-
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER.16383
ADDDING APPLICATION & PERMIT
ADOREss BUILDING-ELECTRICAL-PLUMBING-MECHANICAL �.
O$ .✓7 - rJG/
1 ",
OWNERS
0 ,!
!�^"YMl AME I
l
QTY. ELECTRIC PERMIT FEE N CHECK VALIDATION
NI
PLA
(,p pTjorvE 2
CONTRACTOR'E
-,I,
OUTLETS-SWITCHES-RECEP 10.0011.00
41• v/"�a'�/'�/ `-�;U's uC.NO. O/ LIGHTING FIXTURES 10.00/1.00
roNTRActoRs PPLIANCES-RESIDENTIAL 4.00
DOREss �fR,r�A+�do Ci .
/ PHONE •� / PANELS 10.00 GATE OF APPLICATION N
ARCHITECT PLAN CHECK FEE P.C.NO.
-
on PANELS (OVER 200 AMP) 20.00
ENGINEER
UC.NO. 'SIGNS TRANS. 3.00 '
ADDRESS ENG' SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APPLI
CAS s MOTORS 'SEE FEE SCH.
ADDRESS
SERVICE CHANGE 20.00 /jPGe/
O ¢ Z Plr; V /�j/W
r
02. LICENSED CONTRACTORS Uf:CLARATION / T/o
¢ i w I hereby uffrnr that I am licensed under provisions of Chapter 9 �� ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Businessent L G. ELECT. PLG. MECH.
0 N- Professions Code, rid my license is in full force and effect ❑ ❑
Ozo„- License Cie s - Lia Number n
9 z wt Date q�Contrucmr 4,{T
J C¢ BUILDING PERMIT w a OWNER-Bl1ILDER DECLARATION - t
X ; LL R I hereby Rollo that I am exempt from the Contractor's License
MISC.- - REFER TO ORD INFORMATION
FUOJ Law for the following reason.(Sec.7071.5,Business Professions PERMIT ISSUANCE 1000 VALUATION $/FT.
fi40E Code Any city or county Whichreyuireso permit toconstruct alter,
ac 2 Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
i
D¢ requires the applicant for such permit la file a signet smlemenf Ihnl TOTAL
W m LL he is licensed pursuant to file provisions of lite Contractors License j� PERMIT TO
H r, Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe ',Gyle-rr
i o Business and Professions Code)or that h (_
e is exempt therefrom and QTY. PLUMBING PERMIT FEE W
¢r lire basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
by any applicantfor a pennit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not mom dull five hundmd dollars($500).):
❑ I,as owner of file property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 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:Tire Contractor's License Law docs not apply to an owner of
1 property who builds Or iliquoves thereon,and who tines inch Werk FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
r s- ments are not intended or offered for sale.If,howeveq the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 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 im. GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
�fp prove for purpose Of sale.), RES IND CON PB Other
'❑ 1,as owner of the property,am exclusively conlrxeting with INDUSTRIAL WASTE INTER. 30.00
licensed contractors to construct the project(Sec.7044,BusinessLAWN SPRINKLERS-1 INC 5 V.B. 600 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law does riot 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 contractor(s)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exempt under Sec..,If&P.C.for this
reason WATER HEATER W/VENT 6.00 '
Owner Dam WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO,
WORK ERS'COMPFNSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hemby affirm that I,huve a certificate ul corwrl to self-insure,
or a certificate of Workers'Compensation Insurance,or u certified ZONING ENG.SITE NO,
copy thereof(Sec.38 Co Labpon _.�T���
Policy er Company
Q ❑ Certif ie 'op 's hereby�fs rr fished.
Z Z -�((YY Cerfifie Bid Lith t e oily inSpeclion division. FIRESPRINK ENERGY T-24
FO , AFpliI I MISC.- REFER TO ORD, v ❑ N❑ I Y ❑ N[]
CCN CER' IP ATE:OP EXE.M ION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOOZONE ALU.C.
LU > COMPENSATION INSURANCE PLG CONTR. LIC.NO. PLG.
(^ O ('this sectidn need not he completed if the permit Is for one _ TOTAL v[:] N y 1:1, No
D Z hundred dollars IS 100)or Icss.l
U O I certify that in the performance Of the work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued, I shall not employ any person in any manner so as lo
O W become subject to the Workers'Compensation Laws of California.
a lyase Appllr nt ALTER OR ADD TO MECH. 5.00 BUILDING
} W NOTICE TO APPLICAN11 Ih after nmking this Certificate of Ex-
H ? enmtion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
PDwkions.of the Labor Code, you most fmflovitli comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000CEM.) 6.00 SEISMIC FEE �f
I hereby'atfinn.fat there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this peril is issued(Sec. MICROFILM
3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OV 1100,000 B.T.U.19.50
' Lender's AA ELECTRIC
I certify that
6l(have read
agreis to co ply it,,
allstatec that and
county VENTILATION FAN (SINGLE)
information n correct I agree to comply with all oily and county PLUMBING
ordinances and state laws relating to building rnnstermuon, and BOILER-COMP(3 H.P.Dr 100,000 B.T.U.) 8.00
hemby authentiorixe representativesoertec this city to enter upon the 801 LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned properly for inspection purposes.
(We) al to save, Indemnify and keep Iranuless the City of MISC. REFER TO ORD.
-- -ICuperti Pit,ago ut liabilities,judgments, costs and expenses which CONST.TAX
Is
git
accrue against said City or cmosect I ce o the PERMIT ISSUANCE 10.00rmiL i MECH.CONT. LIG NO. MECH.
TOTALTOTAL onto for ale
OFFICECOPY