18036 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
CITY OF CUPERTINO PAID 18036
INSPECTION DIVISION OCT 91999
JOB INSPECTION RECORD
7-516r
u/ Cl' _ Ciel Of Punnrt!Rp PERMIT EXPIRATION
JOB ADDRESS�/5 1V r C •/de.�/�'-On'h UNIT# _LOT#
PERMIT EXPIRES IF WORK
OWNER CONTRACTOR IS NOT STARTED WITHIN
EC
INSPION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION - I ANCE OR 180 DAYS FROM
NOTE: LAST CALLED INSPECTION:
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
P.REGUNITE TO COMPLY WITH THE APPROVED,PLANS AND CITY OF PERMFT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS <�/-(' �e—
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED �T�tiCiGL J ��
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL - ISSUANCE DATE
MECHANICAL - BLDG ELECT pLG E
❑ 11: El
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION S/ET.
PLUMBING
MECHANICAL
ELECTRICAL - PERMIT To
FRAMING -
INSULATION STORIES TYPE CONSTR.
OCC GROUP RES UNITS.
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO.FT FLOOR ARTA TOTAL ACREAGE
• ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE
DIAPHRAGM- THE CONSTRUCTION TAX IS PAID
BUILDING usE
ROOF SHEATHING Res INO CDN PE ow,q
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
ROUGH SAN.N ASSESSORS PARCEL NO
PLUMBING . - ELECT,ENERGY
' •TUBS BSHOWER•PAN PLUMBING ENERGY TRACT NO. PARCEL NO
MECHANICAL MECH,ENERGY
ELECTRICAL BUILDING ENERGY ACG DATE ACC FILE NO
FRAMING' ' ELECT.FINAL TEST
INSULATION PLUMBING ZONING ENG.SITE.NO.
GAS TEST. - GAS
FIRESPRINK ENERGY T 2
MECHANICAL
Y ❑ No Y ❑ N❑
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
EXTERIOR SHEAR' - - ELECTRICAL RELEASE FLOOD mNI: A.Luc.
INTERIOR SHEAR FIRE DEPT. v❑ N� v ❑ N❑
' SHEETROCK - GRADE - FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH - TEMPORARY APPROVALS - BUILDING
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
_ OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL IS SIGNED BY BUI LDING INSPECTOR, MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
z°� PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL t' -
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES'- USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION -PERMIT NUMBER -
awLo,.c APPLICATION & PERMIT F� �O f�
A°°RE5, BUILDING - ELECTRICAL-PLUMBING-MECHANICAL p„ I J
-f/-✓p^`
OWNERS PLAN CHECK VALIDATION
ME
N
h JDo 46-7--Zb OT ELECTRIC PERMIT FEE ?WKS
PHONE
NAMQRA oRs LETS-SWITCHES-RECEP - 10,00/1.00
LI4NO.�w'� � LIG NG FIXTURES 10.00/1.00 OCT 91989
AOFRE
CONTRACTORS APPLIA ES-RESIDENTIAL 4.00 City of Cupertino(w A°°REss //•fes / � �^�/�
V �_4_ YnL.f'' PHONE ✓/ PANELS 10.00 y o C APPLICATION
�,.. ARCHITECT PLAN CHECK FEE P,C.NO.
oR PANELS IOVE 200 AMP) 20.00
ENGINEER
.No. SIGNSTRANS. 3.00
ARCH.OR ENG. PERMIT VALIDATION
I AooREss SPECIAL CIRCUIT 5.00
Z TEMP.METER OR POL INS. 20.00 ✓� �- /
ADDRESS (�,� MOTORS SEE FEE SCH. /4N/7�.vfJGGr
AOORESS ' J I ,
CC..11/ SERVICE CHANGE 20.00
'02 LICENSED CONTRACTORS DECLARATION
<u U I hereby affirm that I no licensed under provisions of Chaplet 9 ISSUANCE DATE
,HA Q m (commorning with Section 7000)of Division 3 of the Business and BLDG. ELECT. PI- MECH.
H m Z Professions Cod• nd'1?license is in full force' Cfe I ❑ ❑ ❑
z o m- License Class Lic.Number L
O_ m r w Date (� Le. Commctor�
er y E , 7 �6 , BUILDING PERMIT
In S, re¢ WNEILBUILDF.It DECLA ItA1'ION INFORMATION
MISC.- REFER TO ORD
w ;a- y 1 hereby affirm that I am exempt from the Contractor's License VALUATION $/FT.
Fu0¢ Law forthe followingrcason.(Sec.703L5,Business and Professions PERMIT ISSUANCE 10.00
Code:Any city orcounty which requires"permit o construct,alter,
ce ¢a 2 improve,demolish,or repair uny structure,prior to its issuance,also ELEC.CONTR. UC.NO. ELEC.
n x0 u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
m he is licensed pursuant to the provisions of the Contractor's License
t z r
Law(Chapter 9(co.mencing with Section 7000)of Division 3 oftta _
¢ (fastness ural Professions Code)or that he is exempt therefrom and V. PLUMBING PERMIT FEE
¢ $ the hasis for the lilies"]exemption.Any violation of5ect ion 7031.5 STORIES TYPE CONSTR.
by any applicant for a pemhit subjects the applicant to a civil penally
of not more than five hundred dollars($5001): LTER-DRAIN& VENT-WATER (EA.) 5.00
❑ I,as..net of the property,or my employees with wages as NEA..
ROTECT.DEVICE 4.00 OCC.caouP RES.uwTs
their sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions R,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work R TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve
.Cuts are not intended oroffered for sale.If,however.the building EM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,the owner. TEM-OVER 4 (EA.) 2.00
builder will have the burden ofproving that he did not build or im. BUILDING USE
prove for purpose of sale.). INDUSTRIAL STE INTER. 30.00 RES IND CON PS Other
❑ I,as owner of the properly,am exclusively contracting with
licensed contractors to.construct Ole project(See.1044,Business LAWN SPRINKLE S-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractors License Law does not upply
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 contractions)licensed Pllrsaanl to SEWER-SANITARY-ST MEA.200ft/10.00 .
the Contractors License Law. TRACT NO. PARCEL NO.
❑ I am exempt under Sec..,H.&P.C.for this WATER HEATER W/VEN 6.00
reason
Ow"cr Dace WATER SYSTEM 5.00
ACC.GATE ACC.FILE N0.
WORK FRS'COMPIiNSAT10N DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that 1 have a certificate of consent to sel Finsere,
or a certificate of Workers'Comp nsation Insurance,or a certifi ZONING ENG.SITE NO.
copy llrnrys��,�(($$yyyy��338 Lah.C.).f`� " �x'/��
Policy No.G_I_0?"tnpany.>.L � ••^-" I
O ❑ Certiliedcopyis h erebyfumishe FIRE SPRINK ENERGY T-24
Z 0 Apr./Certified copy is ilC wlllhe city inspection division. MISC.- %REFER TOO Y ❑ N Y E] N❑
W CER'TIFICATI:01;EX EMPI'ION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 C.
W > COMPENSATION INSURANCE. PLG.CONTR. LIC.NO. PLG.
CL 0 ("this section need not he complelml if the permit is for one TOTAL Y 0 N� Y [] N�
hundred dollars IS 100)or less.)
U O I certify final in the performance of the work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued,I shall not employ any person in any manner so as to
become subject to the Workers'Compensation Laws of California.
O i Date Applicint - ALTER OR ADD TO MECH. 5,00 BUILDING
} m NOTICE. TO APPLICANT: If,after making this Certificate of Ex
F Z coalition,you should become subject to the Workers'Co alculatimh 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=CF.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANCLING 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 this permit is issued(Sec. MICROFILM
3097,Co.C.). IIIHEATING UNIT(TO 100,000B.T.U.) '&00 • b0
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I certify that l have read this application and state that Due above VENTILATION FAN (SINGLE) 4.00
. information is correct. I agree to comply with 411 city and county PLUMBING
°rdlnances•and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 ,�,�••�a,,
hereby authorize representatives of this city to enter upon the
rvementioiz property for inspection purposes. 801 LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
(WC) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE ig,QD ,lib CONST.TAX
may any way accrue against said City in con quIp nce or the
nC f this permit. / { `-" MECH.CONT. LIC.NO. MECH.
VT ryrt•'n-'4"�-a___ n /, _2/ TTA a/ 0� TOTAL
Signa ure of Applicant/Contractor ate /'(`-�'/Q„Q �`k-�Trt LTf(�•^`" (P
OFFIC COPY