16360 .:POST THIS CARD NEAR FRONT OF BUILDING
' i PERMIT NUMBER
�- CITY OF, CUPERTIIVO 416360
aI NSPECTION,DI V ISI ON
JOB INSPECTION RECORD
PERMIT^E XPIRA-n N _
JOB ADDRESS • L. G9 � `e��-G�', •�(V� UNIT# LOT 41: E -
_ /� , " ;PERMIT EXPIRES IF WORK
ow"BR ..A' .e..( ` • (/ C9 .CONTRACTOR 'P e ' . C.D"Zr','• :.IS NOT, STARTED,WITHIN
"• INSPECTION DATE INSPECTOR• - INSPECTION RECORD 180 DAYS.OFPERMIT ISSU
:ANCE OR 180 DAYS'FROM •'
FOUNDATION � NOTE: ' " = � • � �- '+' `� '
LAST CALLED INSPECTION.` •
LIFER ALL GRADING AND`DRAINAGE SHALLBEINSTALLED "A.
PREGUNITE ' TO COMPLY WITH THE APPROVED PLANS AND CITY OF. PERMIT VAI.IDAT,ION
.yCUPERTINO STANDARDS..
GARAGE SLABSZan. 4'
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB '
PLUMBING G �Z ',/I �•'•�
h ELECTRICAL,. .- _ T '• "
_ T ISSUANCE UATIE
MECHANICAL _ -s ,RYDC •ELECr PLC, MECR .
�• O Q ❑
.. DO NOT POURFLOORUNTIL ABOVE HAS BEEN SIGNED " : 1. BUILDING PERMIT
INFORMATION
WOOD FLOOR - '
VALUATION $IFT'
. .t, PLUMBING __
MECHANICAL
. ELECTRICALPERMIT TO
FRAMING- 2-\AA PI
INSULATION,' DEC STORIES rvPECONSTRI 1�
.• - , .. '� pe IDD UCC GHOUP :Res.UNITS, :
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
'
ROOF ID IT FLOOR AREA TOTAL CREAGL -
�. NOTE'NO FINAL INSP.SHALL BE MADE BEFORE - . .
THE CONSTRUCTION TAX IS PAID .
DIAPHRAGM. - - - - _ BUILDING USE 1
ROOF SHEATHING TTS• IND CON- PR O n„
"APPLY NO^ROOFING UNTIL ABOVE HAS BEEN SIGNED �. FINALSA,, ;.. DATE,, . ' 'INSP. " 0' 1- c- ❑ ❑
ASSeSSOHS PARCEL Na;
ROUGH AN.#
PLUMBING. ZZ ELECT.ENERGY
TRACT NLI — IARCt NO.
- TUBS&SHOWE AN - PLUMBING ENERGY '
MECHANICAL - - J MECR.ENERGY - 'I
'ELECTRICAL - - BUILDING ENERGY - acc.DATE. ACC.FILE No.
FRAMING '< ELECT.FINAL TEST - -
ZONINI, , ENC.SITE NO
INSULATION• - +. PLUMBING '; -C�
GAS TEST - GAS
- +FIRE SPRINK ENERGVTr?C
' MECHANICAL• ya
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 'y "� ° ❑- "�'
.EXTERIOR SHEAR - +" ELECTRICAL RELEASE 'FLOOD ZONE A.L.U.Cl
INTERIOR SHEAR' FIRE DEPT. �� ' "❑ P .7. i. N❑
-- SHEETROCK • " ' t GRADE .,.,,.. FEE SUMMARY I
EXTERIOR LATH BUILDING• ' -
INTERIOR, LATHBUILDING
TEMPORARY.APPROVALS ' +�
SCRATCH-COAT j. ELECTRIC PLAN CHECK
'. GAS ' FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY O F BUILDING IS NOT PERMITTED UNTI L BUI LDING FINACIS SIGNED BY BUI LDING INSPECTOR. MICROFILM
ARRANGE''FOR INSPECTION BY PHONING 252-4505; ELECTRIC'
r 1 UJI 'ONE WORKING DAY BEFORE REQUIRED INSPECTION:: + .
PLEASE GIVE JOB ADDRESS WHEN..PHONING:. PLUMBING
P Z •`
-MECHANICAL"
- SEE PERMIT FOR EXPIRATION DATE
CONST. TAX I
IMPORTANT!,
PLEASE READ REVERSE SIDE BEFORE ' TOTAL g�.
CALLING•FOR FINAL INSPECTION: '
OFFICE COPY ,
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES _USE BALL POINT PEN ONLY
BUI LD1 NO PROJECT I DENTI FICATION - - .PERMIT NUMBER
BDIeDING APPLICATION &PERMIT'
'• ,� A DP ssQ 1 r63.�6 R
10 C„t.���, C BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 1
OwNER'b 1 d I/•U `/ _ - - PLAN CHECK VALIDATION "
NAME \E ��/� • ..
• I, �.OTY,. ELECTRIC PERMIT • FEE
I�� ;
) s e o• � Cb PNDNE Sa- 2
NOME ActDRs _ * OUTLETS-SWITCHES'-RECEP .10.00/1.00 l! '
LIC.NO. . LIGHTING FIXTURES . " . 10.00/1.00. _
CONTRACTOR'S - PPLIANCES-RESIDENTIAL 4.00 e
ADDRESS
PRONE, PANELS - - -10.001
DATE OF APPLICATION' .
Q - ARCRITECT -. - ,. - PLAN CHECK FEE P.C.NO.. -
OR �� Q x , ( PANELS'IOVER 200 AMP) 20.00 .
ENGINEER
uc.rvO. SIGNS TRANS. 3.00
�,. ARCH.OR ENG. PERMIT VALIDATION
: (• ADDREss j ' SPECIAL CIRCUIT ' 5.00
)'!
M4-YfRTEMP.METER ORPOLE IN20.00 2-
APPLICANTS - - MOTORS SEE FEE SCH.
ADDRESS
s' SERVICE CHANGE: 20.00 -
o O LICENSED CONTRACTORS DECLARATION . -
G V U I hereby affirm that I am licensed under provisions of Chapter 9 �� - s.ISSUANCEs�DATE t
G (commencing with Section 7000)of Division 3 of the 1114 iness and -�--•� pG. ELECT. PLG. -'MECH.
- H 4 z Professions Cod d my license is in full foy-y-�1 rr99 DEC'j. N 1�
.i
Oz m - License Cla s Lie.Number'y '�O 'o -
19H al Uate1.] y Contractor t .•.r�.�'`
ams uty 1t cuptM BUILDING PERMIT
le w a
6WNI3 R-[I UI LD 17R DECLARATION ,
a a O - - INFORMATION
o S'
w ; 0 y I hereby aft it wing I am exempt from the Cesar tor'.License MISC.- REFER -
VALUATION •$/FT.
ru. OJ Lawforlyefollowingreason.(See.7 03 uiresa,llusil tocodProfessions EERMIT ISSUANCE 10.00
Cade: e,y molsf cm m,an,nty h ny r tincture p Prior
to t,mlrn ulteq
I. rt M Q O Improve,demolish,nr repair any tincture,prior to its issuance,also ELEC.CONTR. LIC.NOy ELEC. (/e•� "
.� wO d requires the applicant for such pernit to file a Signed stalclnen11hat - .Y TOTAL PERMIT TO -•••
$m he is licensed pursuant to the provisions of the Contractor's License _
- 'H z aLaw(Chapter9(commencing with Section 7000)of Division 3 of the r `-,
E i o Ihisiness and Professions Cede)or that bMe is exempt therefrom and OTY. PLUMBING PERMIT .FEE I le g
M H $ the basis for the alleged exemption.Any violation of Section 7031,5 '• _ STORIES TYPE CONSTR.
w 3 .- by any applicant for u permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.15.00
of not more than five hundred dollars(S500).1: .
❑ I,as owner of the property,or my employees with wages as
BACK FLOW PROTECT. DEVICE 'iq.00 •-
their Sole count will do Idle work,and tiro structure is not OCG GROUP REb,UNIT3
p
intended or offered for Nadi,(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 -
properlywhobuiddsorimprovesthereon,and who does such work FIXTURES-PER TRAP _ 5;00
SQ.PT.FLOOR AREA TOTALACREAGE
himself or through his own employees,provided that such improve- -
' Ioants are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-I1NC:40UTLETS 6.00 -
-' or improvement is sold within one year of completion,the owner- -
builder will have tile GAS-EA.SYSTEM-OVER 4 (EA.1 2.00 e burden of proving that he did not build or im- BUILDING'USE
'
prove'I'or purpose of sale). INDUSTRIAL WASTEINTER. 30100 RES IND CON 'PB Omer
LII,as owner of the properly,am exclusively contracting with ❑,' ❑ ,❑ 1 ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. -6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not applyQ -
to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 3 6'?
7 Q77
contracts for such oojecls with a ci aractor(s)licensed Pursuant to C V
the Contmetor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. „' PARCELNO.
❑ I am exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 - -
eason
! Owner nam WATER SYSTEM 5.00 ACC.DATE -ACC.FILE NO.
woRKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 -
I hereby affirm that have a certificate ofe.....I to self-imum,
` or a certificate of Workers'Compens:dlori Insurdnc or a certifiedZONING .. ENG.SITE NO.
copy Cher Se ]800 Lab.C) '
' Policy NtQrJJ Company ' tl1 t
O ' ❑ Certified py is hereby furnished FIRE SPRINK ENERGY T24
Z Z ❑ Certl copy h•e`fYth the citmspection division. - MISC.- REFER TO ORD.
O Applicant Wk• Y ❑ N❑. y ❑ N❑,
CC w � PERMIT ISSUANCE 10.00
�.- CIi R'I'I I'IG1 .Op EXEMPTION FROM WORKIiRS' 'FLOOD 20NE" A.L.0 c.
W > COMI'ENSA'I'ION INSURAN617 ;' PLG.CONTE. •LIC.N0. PLG. r
CL 0 This section need net be completed if,the permit is for one TOTAL V❑•.r,N❑ Y❑ N❑
hundred dollars IS 100)or less.) - - -,
U O I certify that in the performanceof the work for which this per DTV. . MECHANICAL PERMIT FEE FEESUMMARY -
W I- ..tit is issued,I shall not employ any person in any manner so as to
O L) become subject to the Workers Compensxlion Laws of California.
D- Date Applicant - BUILDING 1. �qar,� �
> m - NOTICE TO APPLICANT: IL after making fills Certificate nl'F. ALTER OR ADD TO MECH. . 5.00
f- ? emption,you should become subject to the Worker,'Compensation APPLIANCE •5.00 PLAN CHECK '.
Provisions of the Labor Code, you roust forthwith comply with FEE
C.1 such provisioDs or this permit.Inuit be deenmd revoked. AIR HANDLING UNIT(TO 0=C;F.M.) ,4.00 _
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10p00C.F.M.) 6.00 SEISMIC FEE - 17, 2-S!
1 hereby'affiro-that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
• the performance of the work for which this permit is issued(Sec. MICROFILM '
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 -
Lender s Address
HEATING UNIT(OVER 100,000 B.T.U.)9.50 t
Lenders AAAmss ELECTRIC -
1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 -
'qinformation nd:st r, l agree to comply with all city and county PLUMBING
- �� ordinances und�;stale lows relating to building construction, and BOILER-COMPI3 H.P._ Or,i 00,000 B.T.U.),.6.00 '
hereby authorian representatives of this city to enter open the s --
above.inentioned property for inspection purposes.., .. BOILER-COMP (Dver 100,000 BTU(SEE FEE SCH. MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cuperlino,ugainst liabilities,judgments, casts and'ex pens. which CONST.TAX
..hay in any way accrue against said City in consequence of the 'PERMIT ISSUANCE' 10.00
, tingofthisper 't. - MECH.CONT.: LIC.NO. ' MECH.
% .1l i /01V t;.'.r OTAL ' TOTAL
Signature o' p icnnt/Can motor ate 0
OFFICE COPY