15365 'C'ST THIS 3L11LU1I4G - - - -----
C9 i OF ft;UPEINQ p�Ii orae
INSPECTION DIVISION �® 15365
JOB INSPECTION RECORD l�
�Q 3/ tZeC �Jy PERM I EXPIRA-i
JIB ADDRESSuNrf JA ----_LOT 91 __ .
PERMIT EXPIRES II
osrvrn ._ cary uu.ra uu i(�!J :-. .? - _+ IS NOT STARTED
Ir1SPECT101J- DATE. iNSPECTOR INSPECTION RECORD lso ogva OF Pr,r....
'FOUNDATION ANCE OR 100 DAYS I
UFER � ALLLTGRADING AND DRAINAGE SHALL Bk INSTALLED LASTCALLED INSPECT
PREGUNFTE TO COMPLY WITH THE APPROVED PLANS AND CITY OF - rr lW,11.11.11.111 .
CUPERTINO STANDARDS.
GARAGE SLAF3--- .-�" �' c'-: f,
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEU 8��r}�1e--
UNDERGROUND /SLAB
P L U M S I NG --- /2-i-f, 49)6b /�' G'>'Yti2FC✓h.
ELc'CTIiI CAL P-� Cy, Cfij 'l=-�
cIDu^mCI nnn
MECHANICAL (•Itt(�1:-: rr.c�:� �'�°'
y(`.1'��B L_1.0 AD`S l�ta� O� ❑ ❑ I
04 NOT POUR F100H UNTIL A80_1J F. HAS BEEN SIGNED P
BUILDING PERI:I.
I_ WOOD FLOOR YW,0 INFORMATION
PLUMB;NG _ -l-�t� C. r, 6,�,1Lbl!u v^���niu.ru
n �;J FZ7 L'-¢(,TL.JR�t/ a�t.fL T
MECHANICAL .1r i2�•�_y'u rl'� -
ELECTRICAL INIP VZOCIF
-rmw r')
)FRAMING "Vc -f_ Cly Ih IF -"5?r r 4.,-LumW5
)NSU IATION -t iea siu�.n:: rmr
PLACE NO WOFLCOR UNTIL R80V HAS BEEN SIGNED _ _ .
ROOF _ _NOTE:NO FINAL INSP.SHALL BE MADE BEFORE :.'% !,.1
DIAPHRAGM I'HE CON:iI I'IUCI ION l AY, IS PAID
ROU.-SHEAT I-IING �-(�'6 Li 1 qLj wai II"I
APPLY NO RGOFING UNTIL A80'✓E HAS BEEN SIGNEC FINALS CATiE INSP.
I ROUGH c
TUBS. SAID �j�1G-Q ELECLPNERGY
Tub^P.SIIOe'JEH PAN PLUMBING CNERGY - rani >. • ,
MECHANICAL —_— -- MECH.I:;JERGY
ELECTRICAL -�}�{ X119 rj I BUILDING ENERGY ^[c i.•:rr Al
FRAMING �O_�
CO ELECT.FINAL TEST
INSULATION 40 PLUMBING ���•����'
GAS TEST GAS
r ant `a•rar.., rrn u.
MECHAfJ)CAL � ,❑ , r
COVER NO WORK UNTIL ASOV: HAS BEEN SIGNEO (HEATING
R �^p,- `-
EXTERIOR SHEA 'r"10''10^' "'
ELECTRICAL HELR:ASG
INTERIOR SHEAR FIRE DEPT. ' ❑ 'o
SHEETROCK GRADE FEE SOMMAI.
EXTERIOR LATH BUIL-DINGvv-2i
INTERIOR LATH Z(o MAPORA Y A PROVALS BUILDING E:
SCRATCH LCAT ELECTRIC PLAN CHECK
GA
F FEC:
NO TAPE OR PLASTER UNTILAOC_VE HAS BEEN SIGNED occurANcv SEISMIC FEE -
OCCUPANCYOF- BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 252-450.1, ELECTRIC y�.r,
• H Y ONE WORKING DAY BEFORE REQUIRED INSPECTION. " PLUMBING
O PLEASE GIVE JOB ADDRESS WHEN PHONING. ', MECHANICAL •� ::.
' J
- SEE PERMIT FOR EXPIRATION DATE -
I
IMPORTANT! � coNsr TAX
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. TOTAL / ,) L
APPLICANTS POST ING COPY
POST`THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER
CITY OF• CUPERTINO 15365
INSPECTION,DIVISION
JOB INSPECTION RECORD ��/✓
I'� • ' ` -; / PERMIT EXPIRATION
JOB ADDRESS '/03�o T✓ UNIT# LOT#j
I PERMIT EXPIRES IF, WORK
OWNER CONTRACTOR . '�1,Q IS NOT STARTED WITHIN
INSPECTIO DATE INSPECTOR INSPECTION RECORD ' 180 DAYS OF PERMIT ISSU- _
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
PREGUNITECUPERTINO STANDARDS. -
GARAGE SLABS, - (_ �B �,� L` '•
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING � .-
ELECTRICAL 4••sV� E 1'Z-9��i� ISSUANCE DATE
MECHANICAL 6^CS ELECT. PLG. MECH
2— (¢cl xz C4sr , ', E' 0 51
&CF- L
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDt-C� �JS�1 Z�/6'B CPe UILDINGPERMIT
R
NC N I INFORMATION
WOOD FLOOR - C` C A
' PLUMBING ,. LUAnoN 3/F T.
MECHANICAL -� -4_�y T[I _ V
ELECTRICAL `lc:T4(•Tod
FRAMING' - �- _ �.J �1�.
INSULATION sroRlBs Tuve CpNstR.
_/ � 0 S SIV/Y!✓L���
UC GROUP RES-UNITS
Z-3
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED °��'q
-� ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 5�( ! 7�nueA TnTAL AwEACE
DIAPHRAGM THE CONSTRUCTION TAXIS PAID
BUI IDI ON USE
ROOF SHEATHING .i(`' -p' RES IND• Pe om••�
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. Cl El
❑ ❑ ❑
' ASSESSORS ARCE
ROUGH SAN.a Ipo2 3S 7 —/ —
PLUMBING ELECT.ENERGY
TUBS 8 SHOWER PAN - PLUMBING ENERGY TRACT NO. PARCEL NO
MECHANICAL —1, _ J— .'MECH.ENERGY - Acc.DATE ACC.FILE No
ELECTRICAL - BUILDING ENERGY '
I
FRAMING ELECT.FINAL TEST -
ZONING ENG.SITE NO.
INSULATION PLUMBING
GAS TEST - GAS
FIRE SPRINK ENERGY r-2a
MECHANICAL v E] N❑ . [3 N❑.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOOZONE A.LU.C.
EXTERIOR SHEAR ELECTRICAL RELEASE �--I
y ❑ N❑ YL.J NEIINTERIOR SHEAR FIRE DEPT. -
SHEETROCK � .�_ :�(� GRADE FEE SUMMARY77
EXTERIOR LATH U i BUILDING BUILDING 33' �..
.INTERIOR LATH TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC PLAN CHECK
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE /W27
OCCUPANCY OF BUILDING ISNO TPIERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
„�3
ARRANGE FOR INSPECTION BELECTRIC
Y PHONING 252-4505;
LU ONE WORKING DAY BEFORE REQUIRED INSPECTION.
10PLUMBPLUMBING �e
O PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! coNST.rnx 63
PLEASE READ REVERSE SIDE BEFORE TOTAL f3
CALLING FOR FINAL INSPECTION. /
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUI LDI NG PROJECT I DENTI FICATION - PERMIT NUMBER
BUILDING c APPLICATION $L PERMIT 1 [36C
ADDREss10310 Tula Lane BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 15 �J
OWNER'S - PLAN CHECK VALID N
NAME James C. Hoffman OTY. ELECTRIC PERMIT FEE
PHONE 252--610 s'l�`f�
- MAMIi KOH . UTLETS-SWITCHES-RECEP 10.00/1.00
KOH Atlas- Corp. 204564- • LIGHTING FIXTURES 10.00/1.00 I
LIC.ND.
CONTRACTORS PPLIANCES-RESIDENTIAL 4.00
ADDRI-20480 Pacifica D "
Cup. veouE PANELS 10.00 DATE OF APPLICATION:
OR
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER
- LIC.No. SIGNS TRANS. 3.00 '
AEG R.OR ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
ADDNEScS
zip TEMP.METER OR POLE INS. 20.00
AOOR ESW T's MOTORS SEE FEE SCH.
ADDRE5510260 Tula Lane Cup.p- SERVICE CHANGE 20.00 /
o C 9LICENSED CONTRACTORS DECLARATION
o U I hereby affirm that I am licensed under provisions of Chapter 9 - I UANCE DATE
yaw (commencing with Section 7000)of Division 3 of the Business and DG. ELECT. PLG, MECH.
O Professions Code and my license is in full force and effect. FITI-
1�
i 0`� S License Cl/qss C Lie.Number.2.04.564 Zk
O H w Uatc�%-lT�. Contractor
a y s BUILDING PERMIT
re to w OWNER-BUILDER DECLARATION INFORMATION
E
LL n I hereby atfum that I am exempt from the Contractor's License MISC.- REFER TO ORD ] 0 VALUATION SIFT.
H .. 0 j Law for the following reason.(Sec.703 t.5,Business and Professions PERMIT ISSUANCE 1 of
Code:Any city or county which rcsluiress permit to construct.alter, /,1pa y 6
x ¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.' / 3 (� (ei A V
w qq
o u oxpdres file applicant for such permit to file u signed sutemm�l Hurl TOTAL (�f0 PERMIT TO -
u W m he is licensed Pursuant to the pon,kions of the Contractor',License 'nyyl
• an z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthc - Or-'gJ lq/4 �
- a Breinem and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE
H D the basis for the alleged cscmption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
a ;� by any mom than five
permit subjects Hheepplicrnuoacivil penalty ALTER-DRAIN -WATER IEA.)'5.00
of not more than or hundred subjects
the applicant
.1: -
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 tee.GROUP RES.UNITS
their sole compens,amn,will do the work,and the structure is not
intended or offend for sale (Sec. 7044, Busirass and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Q_
Code:The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 54 FT,FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve. -s
C ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC 6.00
.4 OUTLETS
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden of proving that he did not build or im
prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES' IND CON PB Cher
❑ 1,as owner of the properly,um exclusively contracting with ❑ESB ❑ E] E]licensed contractors to construct the project(Sec. 7044.Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 A.BBOHBPAHCEL NO.
and Professions Code'.The Conlmct.,'s License Law docs not apply - 9 p
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00. 3�'�_ 09
contracts for such projects with a colaractorls)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 .
the Contractors License Law. TRACT NO. PARCEL NO.
❑ I am exempt under Sec. -,B.&P.C.ler this - WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKFRS'CONIPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a ecrlilicate of consent to elf-iasum,
or a certificate of Workers'Cmnpenmtion Insurance,or a certified ZONING ENG.SITE N0.
copy themof(Sec.3800,WbC 1. .
Policy No._*_Comprny t L_-.e-Compen,I
O ❑ CeDitiedcopyish cru by tlnu,aw FIRE SPRINK ENERGY T.24
Z Z A❑ Certified copy is Idled Willi the city inspection division. MISC.- REFER TO ORD. -71--'--V Y N Y N
° p8f1 ❑ ❑ ❑ ❑
Cr y CI:RR�I 'ATb O1'Iia EMPTION PROM WORKERS' PERMIT ISSUANCE / FLooD ZorvE A.L.U.C.
LU > COMPENSATION INSURANCE - PLG.CONTR. LIC.NO. PLG. 6 j O y E) N❑ Y C:] N❑
� Z (This section need not he completed if the permit is for one TOTAL
hundred dollars(S 10(1 or kss.)
U O I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I shall not employ any Iverson in any Former so as to
U become subject m the Workers'Compensation Laws of California.
U a Dam Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 33
} to NOTICE TO APPLICANT: If,after making this Certificate of I>x-
F ? eruption,you should become subject to life W'orkeri Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you nowt forthwith comply with FEE
U such provisions or this permit shall be dcenmd mvokcd. AIR HANDLING UNIT(TO 10.000C.F,M) 4.00
CONSTRUCT ION LENDING AGENCY AIRHANDLING 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,Civ.C.). 3 HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's NameC Part.Zn.? tri HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
Lrndcr's AOdress G.-j]._(V��-�b'-tLe�ens-Cre -r
1 ocHily that 1 have read this appliciam"and nate that be above VENTILATION FAN (SINGLE) 4.00
•
int'onnxfirm is Correct.1 agree to comply with all city and county BOILER-CObP 13 H.P.or 100,000 B.T.U.1 6.00 PLUMBING O w
ordinances and nate laws relating to building construction, end
hereby authorize representatives of this city to enter upon the BOILER-COMP (OWIr 100,ODDBTU)SEE FEE SCH. MECHANICAL �ly 30
above-mentioned property for inspection purpous.
(We) agree to save, indemnify and keep humtless the City of MISC.-� REFER TO ORD-
upertino against liabilities,judgments, costs.and expenses which PERMIT ISSUANCE 1D.00 02 CONST.TAX V3
may in any way accrue against said City in consequence of the
•Hiring of ilia permit. MECH.CONT. LIG.NO. - MECH. .
TOTAL �6 30 TOTAL .20/.53
Signattept of Apple t/Contractor Date -
OFFICE COPY
L