09604 POST THIS CARD NEAR FRONT OF BUILDING
Pf R%IIT NUMBER
CITY OF CUPERTINO 004
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS�O$G Sfi✓�ns IA CL I� UNIT _LOT# PERMIT EXPIRES IF WORK
C
OWNER CONTRACTOR �1erzeke` Ctr IS NOT STARTED WITHIN
I[NSPECTIOW DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
UFER LAST CAL LED INSPECTION.
000
PREGUNITE PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB fp y/py
PLUMBING ,3
ELECTRICAL ISSUANCE DATE
MECHANICAL BLDG, ELECT, PLG. MECH.
❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION SIFT,
PLUMBING
MECHANICAL
ELECTRICAL PERMIT To
FRAMING
STORIES LUPE CONSTR.
INSULATION
OCC.GROUP RES.UNITS
AN PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
$p,FT.GLOOR ANEA iOTPL SLR F.AGE
ROOF
DIAPHRAGM
BUILDING USE
RES IND CON PB Omer
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 11 ❑ ED ❑
ASSESSORS PARCEL NO.
ROUGH
PLUMBING
TRACT N0, PARCEL N0.
GAS TEST
MECHANICAL
ELECTRICAL {-� �j. ,P% FINALS DATE INSP. ACC.DATE ACC,FILE No.
FRAMING SAN # ZONING ENG.SITE NO.
INSULATION PLUMBING
GAS
FIRE SPRINKENERGYLEO '
MECHANICAL ;/ v ❑ N ♦ ❑ N[D
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD ZONE A.L.0 c.
LATH-INTERIOR ELECTRICAL
LATH-EXTERIOR FIRE DEPT. +8".-Rs Y ❑ NE] v ❑ N❑
SHEETROCK GRADEFEE SUMMARY
SHEAR INTERIOR BUILDING L Q -f
SHEAR EXTERIOR TEMP ARY APPROVALS BUILDING
FIREWALLS ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
UCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC _ -
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUM91OG
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
BU LOI NG PROJECT I DENTI FICATI ON PERMIT NUMBER
aVILOING APPLICATION & PERMIT 09604
AGGRESS
20-e63 �T7�. E�f. ��/ BUILDING-ELECTRICAL-PLUMBING-MECHANICA
OWNER'a �-�►��i/ _ PLAN CHECK VALIDATION
N°"' OTV• � ELECTRIC PERMIT ' - .�'`,FEEI?" /�y3 9,�-•/?-v� /,y��
�+YJ C• v ONE v
mo"MERAcioR's OUTLETS-SWITCHES-RECEP 10.00/1.00 I
LIC.NO. LIGHTING FIXTURES 10.00/1.00 0
roN ACT s
APPLIANCES-RESIDENTIAL 4.00
Ao E
PHONE PANELS 10.00 DATE OF APPLICATION
R HITECiPANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
OR
ENGINEER
LIC.No. SIGNS TRANS. 3.00
ADDRESS ENG. PERMIT 5,00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INFAID20.00 PA�D
AvvucANrFs MOTORS SEE FEE SCH. CLTh,(�/
ADDRESS
SERVICE CHANGE . ,_ 0 JG�
O o LICENSED CON TRACTORS DECLARATION TEMP.POLE 30.00
City
((11 ��pp(IC
a u I hereby affirm that I am licensed under provisions of Chapter 9 T Cu6ft1R0 Clt% 0tS UAW��ME
H < H (commencing with Section 7000)of Division 3 of the Business and -rWG ELECT. PLG. MECH.
r H z Professions Code,and my license is in full force and effect. ❑ ❑ ❑
o m - License Class Lic•Numher
v,r
w Date Cumrictnr
Y c, a OWNER-BUILDER DECLARATION - BUILDING PERMIT
0 v+ v INFORMATION
i °; LL H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
u O J Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 d VALUATION 5/FT.
Code:Any city or county which requires permit to construct,alter. rn OO O
a, a improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIG N0. ELEC.
K G¢
K
requires the applicant for such permit In file a signed statement that TOTAL rO pZ PERMIT TO
! m he is licensed pursuant to the provisions of the Contractor's License
r z i Law(Chapter 9(commencing with Section 70000of Division 3 ofthe /r(/'7Z Rl O.Q 7✓ IF
/DQE
f 4 o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE
M ,-S the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
n ; . by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not more than five hundred dollars(5500).):
❑ h as owner of the property,or my employees with wages as BACK F LOW 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,AR EA,CONO. 5.00
Coderhe 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-
ments are not intended oroffered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6,00
or improvement is sold within one year Of completion,the owner- GAS-EASYSTEM OVER 4 IEA.) 200
builder will have the burden of proving that he did not build or int. . -
. . BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND 0 PB Oma
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSO 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 contmcmRs)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contract pS cdhse Law. TRACT NO. PARCEL NO.
_ ❑ la Imtunder I.-,B.&P.0 for this WATER HEATER WENT 6.00
reason
P
OwnerAuDat WATER SYSTEM 5.00
ACC.DATE ACC.FILE N0.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent t0 self-insure. ZONING
or 4 certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO.
copy thereoftSec.3800,Lab.C.).
Policy No. Company
C Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z Z ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD.
O Applicant Y ❑ N❑ Y ❑ No
CC tw CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10,00 FLOODZONE A.L.U.C.
LU > COMPENSATION INSURANCE PLG.CONTR, LIC.N0, PLG. V❑ N C] Y C] N❑
CL 0 (This section need not be completed if the permit is for one TOTAL
=) Z hundred dollars(S 100)or less.)
U O 1 certify that in the performance of the work for which this per- OTY MECHANICAL PERMIT 'FEEtt - "FEE SUMMARY• '
LL h- (nit is issued. I shall not employ any person in any manner so as to _
OW become subject to the Workers'Compensation Laws of California. �y
o. Date Applicant BUILDING
>_ N NOTICE TO APPLICANT: IL after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 x
F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=r-F.M.
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000GF. SEISMIC FEE
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) .0
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 5.btKr
Lender's Name HEATING UNIT IDV ER 100,000 B.T.U.) Q�
Lender's Address ELECTRIC
I cenify that I have read this application and state that the above VENTILATION FAN (SINGLE) 1
information is correct. 1 agree t0 comply with all city and county PLUMBING
ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives ec this city to enter upon the BOI LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
hereby authorize
property forinsp of
purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 Q CONST.TAX
m n a4(hisit.
e against said City in cons uenee of the
ng MECH.CONT. LIC.NO. MECH.
11
TOTAL TOTALa ontrac[or Date
OFFICE COPY
POST THIS CARD NEAR,'FRONT OF BUILDING .
- PFRMIT NUMBER
CITY OF CUPERTINO
INSPECTION DIVISION 9 96,0
JOB INSPECTION RECORD
/.
PERMIT EXPIRATION'
JOB,ADDRESS�OBG^� SI'BVC.LS IA CLIA UNIT# LOT#k `
,PERMIT EXPIRES IF WORK'
5�
OWNER � .CONTRACTOR Mee, Ca- IS NOT STARTED WITHIN:
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU
FOUNDATION /01-3A-gJ' ANCE OR 180 DAYS FROM.
LASTCALLED INSPECTION:
LIFER,
PREGUNITE - PERMIT VALIOAT'ON
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
- PLUMBING - 7
ELECTRICAL - - -
ISSUANCE DATE
MECHANICAL ELECT. PLG. I,MECH.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR - .. INFORMATION
PLUMBING
VALUATION $IF,T.-
� _ '
MECHANICAL ,
ELECTRICAL 'PERMIT TO
FRAMING - :/ •'�' I
INSULATION - _ STORIES TYPE CONSTR.
. OCC.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF SO FT.FLOOR AREA TOTAL ACREAGE
DIAPHRAGM
USE,
u U ILDON
RES IND CON PO Otner
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ FNI/ ❑ ❑
ASSESSORS PARCEL NO.
'ROUGH
PLUMBING -
TRACT NO. PARCEL NO.
GAS TEST � � � � � '
MECHANICAL
ACG DATE ACO.FILE NO,
ELECTRICAL FINALS DATE ,INSP.
FRAMING SAN #
INSULATION PLUMBING zorvwc ENG.SITENO.-
IGAS
MECHANICAL •FIRE SPHINK4 ENERGY T24'
Y ❑ N❑ - v ❑ N[3COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING pp
�O�3G Apr L .C.
LATH—INTERIOR ELECTRICAL FOOD ZONE A.L.0C '
LATH—EXTERIOR - FIRE DEPT. Y❑ I N❑ Y❑ No
SHEETROCK . GRADEFEE SUMMARY
SHEAR INTERIOR BUILDING L
SHEAR EXTERIOR _ TEMP ARY.APPROVALS sulLnwG•
` FIREWALLSELECTRIC PLAN CHECK
GAS .FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR. MICROFILM
I
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
Iw—� ONE WORKING DAY BEFOREREQUIRED INSPECTION. PLUM91 c
z PLEASE GIVE JOB ADDRESS WHEN PHONING, a
= SEE PERMIT FOR EXPIRATION DATE — MECHANICAL , :..-
IMPORTANT!
CONST.TAX,
PLEASE READ REVERSE.SIDE BEFORE' TOTAL J ?
CALLING FOR FINAL INSPECTION.
` OFFICE COPY " —