17581All
POST THIS CARD NEAR FRONT OF BUILDING
PERMITNUMBER
- CITY OF •CUPERTINO
17581
INSPECTION DIVISION
.
JOB'INSPECTION RECORD
� Q GrG,hfdcC
�1�1
PERMIT EXPIRATION
,JOB ADDRESS' I� U NIT# _'LOT#'
` '• _
,
PERMIT EXPIRES IF WORK
owrvER ( ' CONTRACTOR 1
IS NOT STARTED WITHIN
teD DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM '
INSPEC ON DATE INSPECTOR
INSPECTION
RECORD
FOUNDATION
9-
NOTE: -
' ALL GRADING AND DRAINAGE' SHALL'BEINSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS.
LASTCALLED INSPECTION:
,L',
UFER
'PREGUNITE
• PERMIT VALIDATION y
I�I�i'f
-
IssuANce unre.
GARAGE SLABS � �
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLAB
PLUMBING
-
ELECTRICAL °
MECHANICAL
-
BLDG,
ELECT.
PLG. MecR.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
-
BUILDING PERMIT
INFORMATION
' WOOD FLOOR
VALUATION
S/FT.
PLUMBING
MECHANICAL
ELECTRICAL'I
q
APR + 0 198„
'PERMnTTO
���'
FRAMING
INSULATION
-
pity
V
I y of cptl1M!
sTUHIEs
-TYPE CONSTR.
-
OCC. GROUP`
-AREA
RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
NOTE: NO FINAL INSP. SHALL BE MADE BEFORE
THE CONSTRUCTION TAX IS PAID - •`
sa, s T, FLOOR
"
TOTAL ACREAGE
DIAPHRAGM.
ROOF SHEATHING
BUILDING USE
RLS IND CON PB tT,'h",�
❑ ❑ ❑ ❑ ❑'
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
FINALS DATE INSP.
• - 'ROUGH
sAN.n '
ASSE SSOHSPARCEL NO
PLUMBING -
ELECT. ENERGY
TuBsaSHOwER PAN
PLUMBING ENERGY
TRACT No.
-
PARCEL No,
MECHANICAL -
MECH. ENERGY,
ELECTRICAL � � �
BUILDING'ENERGY ' -
ACCDATE
'.
ACCFILE NO
.
FRAMING -
ELECT. FINAL TEST-* -
INSULATION -
PLUMBING r
ZONING
ENG, •ITE NO.
.�.'
GAS TEST-
GAS
F.MECHANICAL
�
F IRE SPRINK
'
❑ "❑
ENE4,11-TQ4
` ❑ "❑
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING -
EXTERIOR SHEAR �
ELECTRICAL RELEASE
FLOOD ZONE
Y ❑ NO
A, LU.C.
.
❑ NEI
INTERIOR SHEARFIRE
DEPT. -
SHEETROCK,.
GRADE
FEE SUMMARY
EXTERIOR LATH
BUILDING `
BUILDING
INTERIOR LATH -
.',TEMPORARY APPROVALS -•
SCRATCH COAT - -
ELECTRIC. —
PLAN CHECK
FEE' '
' ,GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN.SIGNED
OCCUPANCY !
SEISMIC FEE'
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR.
MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ELECTRIC
Z ;CIC
w.
H- ONE WORKING DAY BEFORE REQUIRED INSPECTION. '.
O� PLEASE GIVE JOB ADDRESS;WHEN PHONING.
Z
PLUMBING.:.
MECHANICAL ,
—SEE PERMIT FOR EXPIRATION DATE — -
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE -SIDE BEFORE"
•
TOTAL
CALLING FOR FINAL INSPECTION. -
OFFICE COPY '
P,C, (/
fi
ELECTRIC SERVICE NOTICE a E. COPY
{
BUILDING INSPECTOR'S NOTICE
CITY OF CUPERTINO
r
I
19 /T /
+�
To
fiVoa
are hereby
oa horized to Connect electrical service for
V
i�
Owner or Tenant
At
No. of Wires
Size of Wires Size of Switch A94�7
i
Mobr Load
Voltage Phou
Henning Load
K. W. Voltage
No. of Meters
Gghi1110�_New Service y Reconnect
Hwr 110ih.ee Wne More Service
z
No. of Add. Meiers
l(I\
Power Three Ph.. Move Mere,
i -- •
O•
ELECTRICAL INSPECTOR
U v
O
Zz
H 0
UJ
ao
UO
U. V
Ow
}6
z
Al
I&I
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION
-
APPLICATION &PERMIT
BUILDING -ELECTRICAL -PLUMBING -MECHANICAL
PERMIT NUMBER,
'*�
, . 17581
BDIL INE
ADDRESS -
'
OWNER'
NAME
PHONE �
OTY. ELECTRIC PERMIT FEE
_
PLAN CHECK VALIDATION
..
Nome A TOR
OUTLETS - SWITCHES - RECEP 10.00/1.00
p. _ LIC. NO. ?-
DATEOF APPLICATION s
LIGHTING FIXTURES 10.00/1,00
n..a ssn off/s Ern '
Lt'S „)Ck%. 1 ONE C
PPLIANCES- RESIDENTIAL 4.00
PANELS - 10.00
ARCHITECT -
ENGINEER
G LIC. No.
PANELS (OVER 200 AMP) 20.00
PLAN CHECK EE .C. N0.
SIGNS TRANS.' - 3.00
ARCH. OR END.
ADDRESS
SPECIALCIRCUIT 5.00
PERMIT VALIDATION
EMP. METER OR -POLE INS. SU.00 10;00'
. - zIP
APPucalrrs
ADDRESS
MOTORS � SEE FEE SCR:
SERVICE CHANGE 20,00
-
LICENSED CONT RAC1'ORS DECLARATION
I
-
I hereby aIflml that I am licensed under provisions of Ch.ple, 9
(commencing with Section 7000) of Division 3 of the Busimv and
Professions Code, and my license is in full fora and effect
Licenw Class Lie, Number
Date' Contractor
ISSUANCE DATE
BLDG- ELECT. PLG. MECH.
❑ E]❑
UL 111'aill
BUILDING PERMIT
- INFORMATION
•
OWthaR-BUILDER DECLt tool RA'f10N
I hcmhy infirm that I am exempt from the Contractor's Lice
Law for the followingreason.(See. 7031.5. Businessand Pro(xsum,
Code: Any city or County which requires a permit to construct,alter,
- -
MISC. - REFER TO ORD
VALUATION ,
-$/FT.
PERMIT ISSUANCE 12 Q9:00 Z, 0o
ELEC. CONTR. LIC. NO.
ELEC. i
improve, demolish, or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that
he is licensed puu
rsant to the provisions offlue i s ba ContmctoLicunsc
TOTAL (�
�' PER TO
Low (Chapter 9 (commencing with Section 7000) of Division 3 of theO
Business and Professions Codcl or hat he is exempt therefrom and
OTY. PLUMBING PERMIT FEE
W
the basis for the alleged exemption. Any violation of Section 7031.5
by any applicant for a permit subjects the appbcant to civil penally
ofnol more than live buttered dollar(550(1.):
-
STORIES
TYPE CONSTR.
ALTER -DRAIN & VENT -WATER (EA.) 5.00
❑ 1, as owner of the property, or my employees with wages as
their sole compensation, will do the work, and the structure is not
BACK FLOW PROTECT. DEVICE 4.00
OCG GROUP
RES. UNITS
DRAINS -FLOOR, -ROOF, AREA, COND. 5.00
intended or offemd for sale (Sea 7044, Rosiness and Professions
Code The Contractor's License Law does not apply to an owner of
FIXTURES - PER TRAP 5.00
GAS - EA.SYSTEM - I INC.4 OUTLETS 6.00
SOL FT, FLOOR AREA
TOTAL ACREAGE
prol+erty w)o.bullds or improves hereon, and who does such work
himself or through his own employees, provided that such improve.
ments are not intended or offered far sale. if, however, the building
or improvement is sold within one year of completion, the owner -
builder will have the burden of proving that lie did not build (IF int.
- . - . .00
GAS EASYSTEM OVER 4 IEA) 2
BUILDING USE
prove for purpose ofude.).
❑ I, as owner of the properly, am us,hrivcly Contracting with
RES IND CON P8 Odur
11 El El 1:1 ❑
INDUSTRIAL WASTE INTER. 30.00
licensed contractors m construct the project (Sec. 7044, Business
and Profcsuons Code: The Comruclor's License, Lew does not apply
to an owner of property who builds or improves thereon, and who
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00
ASSESSORS PARCEL N0:
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
contracts for such projects with it contraclons) licensed pursuant to
the Contractors License Law.
O tum exempt under Sec.., B.&P.C. lin this
on
gEWERSANITAR V -STORM EA, 200ft/10.00
i TRACTNO.
PARCEL NO.
WATER HEATER W/VENT 6.00
Ower Date
WATER SYSTEM 5.00
ACC. DATE
ACC. FILE NO.
WORKERS'CO.MPENSA'I'[ON DECLARATION
WATER TREATING EQUIP. 5.00
I hereby affirm that I have u le'lificute of convent to self -inulin,
ZONING
ENG. SITE N0.
or a certificate n� jlev Co. ). <I_ surylCe, a lifted
copy here 1I& ld uh.C.l. /l/ L,
Policy No. Company
-
FIRE SPRINK
-
v ❑ NE
ENERGYT ]a
Y ❑ N❑
❑ Ccrtilicd copy) hemby l urniehud'
ryCert it ted edy(�[l yC{�,he c' y inspection division.
Applicam
r
MISC. - REFER TO ORD.
CIiRTIP lei 'NPT 10 PROMWOR
PERMIT ISSUANCE 10.00
FLOOD ZONE
A. L. U.C:
ATI
YI'liis section Fared e lot be complON eted lit, he pennit is for one
Y ❑ N ❑
Y ❑ N ❑
PLG. CONTR. LIC. NO.
TOTAL
hundred dollars IS 100) or to.,)
I Cerlity that in the perlomm rce of the work for which this PenQom.
mit is issued, I shall not employ any perum in any mann,, so as to
MECHANICAL PERMIT FEE
FEE SUMMARY
-
become subject to the Workers' Compensation Laws of Calilornia.
ALTER OR ADD TO MECH. 500
5.DO
Dare Applicant
NOTICE 'f0 APPLICANT: IC after making this Certificate of Ex-
BUILDING
APPLIANCE 5.00
AIR HANDLING UNIT (TO 10MC.F.M.) 4.00
PLAN CHECK
FEE
'
you should become subject to the Workers'Compenmlion
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked. -
AIR HANDLING UNITIGVER 10,000GEN1) 6.00
SEISMIC FEE
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for
EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work fat which this permit is issued (Sec
3097; Cile.Cf.
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Name.
Lender's Address
HEATING UNIT (OVER 100,000 B.T.U.)9.50
ELECTRIC
'Z `�
CVC
VENTILATION FAN (SINGLE) 4.00
I c,rtily that l hovcread thisapPlication and slate that the above
information is correct. 1 agree to comply with all city and county
ordinances and stale laws relating to building construction, and
PLUMBING
_
BOILER-ODMPI3H.P.or100,000B.T.U.) 6.00
hereby amhrriz, rep clan itwe-s of this city to enter upon -the
atwvomannlioned property formspection purpoxs.
-BOILER-COMP IOse. 100,000 BTU) SEE FEE SCM.
MECHANICAL
o
o ave, indemnify and keep hapol,, the City of
MISC. - REFER TO ORD.
lubililies, jud is, costs and expenses which
we acugu' ist� >.id Ci y in consequence of the
erini
L.f
CONST. TAX
PERMIT ISSUANCE 10.00
MECH. CONT. LIC. NO. - MECH.
TOTAL
TOTAL
2`Z:(�
pI n /Contra tor' Uutc
OFFICE COPY .