18389 POST,THIS CARD NEAR FRONT OF.BUILDING
PFRNIIT NUMBER
- 'CITY ,OF CUPERTINO .. 18389
INSPECTION DIVISION
JOB INSPECTION, -
T II
00. 19 � HZf�CZ r�l , PE��MIR.EXP RAFIDN
JOB ADDRESS UNIT#- _LOT# III
r(� (,fcy ���� _ ),PERMIT, EXPIRES IF WORK
OWNER ',�z\ Eft- corvraACtOR l�l�SlJ'( �� .. IS NOT STARTED WITHIN
I INSPECTION DATE INSPECTOR I INSPECTION RECORD t80 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE. LAST CALLED INSPECTION.' -
I UFER I ALL GRADING AND DRAINAGE SHALL BE INSTALLED I •
PREGUN ITE I TO COMPLY WITH THE APPROVED PLANS AND CITY OF PEHMn VALIUAncN
CUPERTINO STANDARDS.
(GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS B :EN SIGNED rF ••�"
I UNDERGROUND /SLAB
t, (PLUMBING ./ _
(ELECTRICAL E- I l '
ISSUANC DATE
IMECHANICAL euu; I Fl.rcr I vL�c, I MO
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED I BUILDING PERMIT
I WOOD FLOOR I INFORMATION
VALUATION S/FT
(PLUMBING
MECHANICAL
' PERMIT TO
,• , 'ELECTRICAL � � ,
� J
(FRAMING -
INSULATION -� 5toaies TYPE CONSTR. I
OCC,GHOUP . RES UNITS
' I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED I
I� ROOF • + • I sa FT,FL *,"EA TOTAL ACREAGE
ROOF I '; +I yLNHE'CONSTRUCTION SXIIS AID MADE BEFORE RI/�Q1O ]ILOioNUSLPR
(DIAPHRAGM ION TA
I+ APPLY NO ROOFING UNTIL ABOVE+AS BEEN SIGNED 1',$FINALS( DATE , INSP. � ❑ - ❑ E
ASSESSDHS PARCEL NO
• I . ROUGH •°� . .SANk � I
PLUMBING + I ELECT.ENERGY
.I #
(TUBS 8 SHOWER PAN- I PLUMBING ENERGY ] I .I TRACT N. PARCEL NC. III
IMECHANICAL + I I MECH.,ENERGY
(ELECTRICAL , ACC.UATE ACC FILL NO II
I" .[BUILDING ENERGY ] I I
I FRAMING I I ELECT.FINAL TEST.' I • I
. I INSULATION � . (PLUMBING ' I{
ZONING - ENG SITE NO,'
;IGASTEST I"' .-; t ' IGAS
! ' I I' IMECHANICAL + FINE SPRINK ENERGY T 2
I COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED (HEATING - I I ° I] "1
EXTERIOR SHEAR l nI111DZON+ A L U,r-
' I (ELECTRICAL RELEASE( � I
(INTERIOR SHEAR . . IFIRE�DEPT.' I I ` � "� � 1 ' N�
,I SHEETROCK ` IGRADE I -
I + FEE SUMMARY
IEXTERIOR LATH
'I I (BUILDING -
-IINTERIOR- LATH TEMPO FBUILDING
l SCRATCH COAT' I I - ]ELECTRIC I PLAN CHECK.
I IGAS . I FEE
I NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED (OCCUPANCY " I I I SEISMIC FEE-
IS NOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR.( MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC_
o� ONE,WORKING DAY BEFORE REQUIRED INSPECTION. -rLUMeiNG
Z
PLEASE,GIVEJOB 'ADDRESSWHEN,PHONING.
SEE PERMIT FOR EXPIRATION-DATE — I„MECHANICAL
IMPORTANT! ' ,' I" CONST.TAX Ism
I;. PLEASE READ REVERSE.SIDE BEFORE .. TOTAL
CALLING FOR FINAL INSPECTION. V I /2) ,q�
OFFICE COPY .
I'.
^ APPLICANTTO FILL IN INFORMATION WI.THIN;RED LINES -r USE'BAL'L'•POINT.PEN ONLY '
". BTII LDI NO PROJECT,I DENTI FICATION
-
PERMIT NUMBER -
APPLICATION & PERMIT 1
ADp�E}; ' ,t�i gUILDING-ELECTRICAL-PLUMBING-MECHANICAL- •.1,-V3:8V
OWNER'S p I., „ .,. •* - -, cr PLAN CHECK VALIDATION '
NAM t '• t;'"- QTY.I 'ELECTRIC PERMIT FEE ' ' t
r''PHpNE 2/
;. CONTRACTOR Sr , n.
NAME - OUTLETS-SWITCHES-RECEP 10.00/1.00 �pU
'�`%' a " •LIC NO LIGHTING FIXTURES' 10.00/1.00 V IVi
ADDRESS-, R's APPLIANCES-RESIDENTIAL, 4.00
ADDRESS-, + � , -
- p-i', •^! vRO '/G��Ipf y •,PANELS - ,' 10.00 •, DATE OF APP LICATION' -
ARCHITECT-' 0•
pR "� M { t.' PANELS (OVER,200 AMP); 20.00 PLAN CHECK FEE PC NO
._ ENGINEER "�&��
,/ .uc No +- SIGNS TRANS. 3.00
ARCH.OR ENG PERMIT VALIDATION-.
ADDRESS ''t s' SPECIALCIRCUIT ' n ' "'5.00 -
ZIP - rLEMP-METER OR POLE INS. . 20.00
•ADDRESsRS ,•,v vt'• - _ - IMOTORS SEE PEE SCH. s +
E SERVICE CHANGE - 20.00 -
Dow
7
_ I
.H O,D ; •-LICENSED CONTRACTORS DECLARATION 4 ��� � 9G
a U u I hereby"affmn that I am hcenaed uadecprovlswtis of Chapter 9 '• f r ISSUANCE DATE
N Q y •Icnmmemear,with Section 7000)of D,D,6n'3 of the Business and I --- - RLOG ELECT. PEG. MECH.
F N z Professions Cnde;and my Ilcense ism tell force and effect. ❑ ❑
z
:4 w0,n -- .License Class Con ra2l, �C�
r Dwa Date 'Contractor . L�y--
••,rc w ie r OWNER-BUILDER DECLARA'1'IUN. - :1"' c BUILDING PERMIT
a o a ° " ,INFORMATION
w ;a m• 1 hcicby'affirm that I'em exempt fromlhe Contractor's License, `' M16C.-- REFER TO ORD I t.
-^;F U,O,J, Law for the followmgreaum.(See 70315,Business and Professions PERMIT.ISSUANCE VALUATION
.Code-Any cnyorcounly,which reyeores a twocitto,costmet.alter, ,70.00 �Z�V �/(/�
¢ Q O improve,denmlish,'or repair anp structure,prmr-loits Issuance,also ELEC CONTR. LIC NO ELEC
-6�wG¢ requires the applicant for such pencil to file a signed st tcment that, TOTAL 2a. V PERMIT TO
9m"',:he a)located pursuunLlo the provisions of the Cpnlr:mtor's Lcense I y, "
• i o ' Bus nests�ddrProfesrs ins Cute tole Section
het he IOOOcmp�ther from and OTV.I, PLUMBING PERMIT ' TEE
wH"Om' the basis forthealleged exemption Any violation ofSection7031.5" STORIES TYPE CONSTR
a,, �, -by any applicant for a permit subjects the applicant toeclvd penalty"v gLTER-DRAIN -WATER IEA.) 5.00
_of not more than five hundred dollars($500)1
+� ❑ fl,as.owner of the property,or my employees with wages as I. . ggCK'F LOW PROTECT.DEVICE 4.00
`v,- •. 'Ihror sole compensation,will do file work,and the structure is nut I OCC.GROUP •c 'RES UNITS
imtended•or offered for Sale ISec',7044, and and Pocib,acros I .IDRAINS-FLOOR,ROOF,'AREA,COND.' 5.00 '
Code The Cohriclor's License Law does not apply to an owner of `
Property who builds or Improves thereon,and who does such work: FIXTURES-PER TRAP f 5.001 so:RT.FLOORPjREA TOTAL ACREAGE
himself or through his own employees,'provided that such improve- �yp,
meats are cut'mended or offered for sale If,however,the building ,(GAS-EA,SYSTEM-11NC.4 OUTLETS-6.001 b T I , .
or Improvement os sold within unciyear of,completion,the owner- ll
builder well have the burden ot'provmg that lie did not'ha or Ile-, f (GAS'-EA:SYSTEM-OVER 4 (EA.I' 2.001 + - BUILDING USE
_ prove foypurpa.acdslcl.-' i '. ." INDUSTRIAL WASTE INTER. 1I RES IND. CON PR one,
III/, es av,nC,:.t the property,am evclusively contracting with
.1 '! licensed contractors to cunlauct file p¢nect(Sec 7044LBusress LAWN SPRINKLERS:1 INC 5 V,B, 6.001 1111
El D El 0 El
and Professions Code The Ccmtructor's License Law does not apply ASSESSORS PARCEL NO
to an owner of property who bonds or improves thcremt,and who LAWN SPRINKLERS-OVER 5(EA.) 1 001 '
,• contracts for such projects with a contmetor(s)heensed punnuirt'b,
-the Contractor's Lea,,.La ,(SEWER=SANITAR V-STORM EA.200ft/10.001, TRACT NO..-. PARCEL NO. .
O 1-am • tin ec` ' "l . for this
,..=_ reason J t _ WATER'HEATER W/VENT 6.001
Uute - ;.
r1 ,.', ' WATER SYSTEM - 5.001 ACC DATE-,. ACC FILE NO
,•• o kKBRS',C iPCl sn71ON DECLnRATION;- WATER TREATING EQUIP,� 5.001
11 Phi�ss by afUmi'Ih,d I have a camfwIl t ul'consent to self.moan, I.
nr'feertificate of Workers'Cumpensation Insurance;ora'ierllt ual'i M - ZONING ENG.SITE N0.
a:a,•copy thereof(See 3800,Lah.C.), '. , ,(-+x""
..Pulley No l Crun,ey _
❑ Certified copy lsherebyfurnished. I FIRE SPRINK ENERGYT-
O Cerf10ed o os Iiled,with the it' ms a Iron division 24
z Z - wt PY' P'c
0• Apphcanr - ` a +: MISC.= REFER TO ORD. YE] .,N E . - r N0
N CIIRTIFICAI E OF EXENIFPION FRONT WORKERS' PERMIT ISSUANCE 10.001 FLOOD ZONE A.L U C.
LU COMPENSATION INSURANCE PLO CONTR' LIC No PmG
�'0 1'Ihu'section need"col he completeH d the'pennn is for one < - (TOTAL ,• V ]'.
U O hunderlify that
lS1001 or lcscl '; -
Lcertify alai In the perk.... nce',of tie v,nrk D"whmh this per- OTV. MECHANICAL PERMIT FEE 'FEE SUMMARY •. "I'
not is issued, I shall not employ any person In any manner so as to
U hemme subject m the Workers'Compensation Laws of Caldornia ++
i , DffiC - Mppllcani ' "`" ,I ALTER OR ADD TO MECH. g.60 .,� BUILDING 99'�^�a 1
}.to N01lCL TO APPLICANT V,,aftee making-this Cerhfunate of fix- 111
-F 2 enophon,you should become subject I.the Workers'Compensation APPLIANCE . . 5.001 'I PLAN CHECK.
-provisions of the Laboq Code, you'niust forthwith conoply wit.
'U such provisions or(his permit shall he deemed revoked! AIR HANDLING UNIT(TO 10,000al 4,001 FEE
CONSTRUCTION LENDING AGENCY L;. AIR HANDLING UNIT(OVER 10MOC.RM.) 6.001 SEISMIC
A hereby affirm that there is.a construction leeding ngen,y tar If EXHAUST HOOD (WITH DUCT) 5.001
the permonctoeu of the�work for which this peim04n issued(Sec I MICROFILM`
3097,Qv C) ' - HEATING UNIT(TO 100,000 B.T.U.) 8.001 I
Lender's Nano^ + -
Lender'sAdil - HEATING UNIT(OVER 100,000 B.T.U.)9.50, ELECTRIC "
D'
I certify 1 ' _D
' Illy that I hove read this applitahon and state that the above I VENTILATION FAN (SINGLE) 4.001 � - '
Information Is correct I agree to .omply will] all city and count PLUMBING I .
�i ordman,es and,state laws,relating rebuilding construction,'and
, ,BOILER-COMP(3 H.P.Or 100,0008.T.U.)"6.001 .i, •� ��` , —
hereby entamed j reprrtyfor ms evt,o is coy e"en ter upon the BOI LER-COMP Over 100,000 BTU)SEE FEE SCH.
above-mentioned property fonnspechon purposes � '. � MECHANICAL. I. 'i,
., (We) agree to save, mdem enn keep'haUrc,, the City of MISC.-'_ REFER TO ORD:I I
` Cupertino a•a us lmbohto judg cents, costs and expenses which " � CONST.TAX
may,in a^ac agymst Nod,01y m consequence of.the, PERMIT ISSUANCE 10.001
gran oft PC iJ/ _
�•:• "- + " MECH.CONT : LIC NO. i MECH.
r/ ///•D TOTAL
1.'.' ry. 'sir of Apphta if o Dam ;... / TOTAL �j 1
" OFFICE COPY