14536 POST THIS CARD NEAR FRONT OF. BUILDING PERWTNUMBER
CIT:Y.:0 CUPERTINO
14538-
INSPECTION DIVISION'
JOB INSPECTION RECORD ,
PERMIT,EXPIRATION : •i'
JOB ADDRESS 1535, JAMESTOWN DR. - 'UNIT#
'r PERMIT!EXPIRES IFS WORK
OWNER SAL ALGERI '- CONTRACTOR CHAPMAN CONST. 'i'' - IS NOT'STAR7ED WITHIN
- INSPECTION - DATE INSPECTOR INSPECTION RECORD 1BU DAYS OF PERMIT ISSU
FOUNDATION - ANCE OR 180 DAYS FROM,
NOTE: - - ,I LAST CALLEDINSPECTION.
UFER ALC GRADING-AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE - • - TO COMPLY,-WITHTHE APPROVED PLANS AND CITY OF. PERnuLI TVAUATIDN
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL I ISSUANCE DATE
MECHANICAL - BLDG ELECT I PLG. MECH
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED _ �Buaowc PERMIT
INFORMATION
WOOD FLOOR VALUATION . SIFT.
PLUMBING J
MECHANICAL
ELECTRICAL _ PERMIT TO
FRAMING.
STORIES TYPE CONSTR.
INSULATION
OCC.GHOUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN-SIGNED _ " '"T•
SO.FT FLOOR AREA TOTAL ACREAGE
ROOF NOTE:NO FINAL INSP.SHALL'BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
40 BUILDING USE
ROOF SHEATHING.' •'HES IND CON Pe on,., ..
APPLY NO'ROOFING'UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP, ❑ [:1 ❑ 11 ❑
ROUGH SAN.N ASSESSORS PARCEL NO
PLUMBING''- ELECT.ENERGY
^ TRACT NO.. PARCEL NO
TUBS 8 SHOWER PAN - PLUMBING ENERGY - •,p
' . MECHANICAL - - - MECH.ENERGY -
ELECTRICAL - �"'- ' BUILDING ENERGY ,,I, - E ACC DATE ACC.FILE NO
FRAMING ' - - ELECT.FINAL TEST '
INSULATION PLUMBING ZONING END SITE.NO.
- -
GAS TESTGAS' '
MECHANICAL .^k., _ FIRE SPRINK ENERGY T 2
-COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED- HEATING `❑ N❑ Y ❑ N❑
EXTERIOR SHEAR`.,, ELECTR ICAL RELEASE ,S. Boon zoNe A.L.0 C.
INTERIOR SHEAR FIRE DEPT. Y❑ -,-ED Y LI N❑
SHEETROCK GRADE • FEE SUMMARY
EXTERIOR LATH - BUILDING
.INTERIOR LATH
TEMPORARY APPROVALS. .:.I : euILDINc ,
SCRATCH COAT ' ELECTRIC - PLAN CHECK ,
GAS FEE -!
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY , .• - -' SEISMIC FEE ,
" OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED By BUILDING INSPECTOR. MICROFILM'
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC "
H- ONE WORKING DAY BEFORE.REQUIRED INSPECTION. 'PLUMBING , I �
z PLEASE GIVE JOB ADDRESS WHEN PHONING.' , '
SEE PERMIT FOR EXPIRATION DATE— MECHANICAL
I I
IMPORTANT! 'r CONST. TAX
_ PLEASE READ.REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION. TOTAL .
-
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY -
'
BUILDING PROJECT IDENTIFICATION PERMIT NUMBEROULDING APPLICATION & PERMIT '
ADDRESS - BUILDING -ELECTRICAL-PLUMBING-MECHANICAL ' 14536
I OWNER'S
PLAN CHECK VALIDATION
NAME �y
SGI /1!t/4
/ / DTV. ELECTRIC PERMIT FEE
I ' ! ri i PHONE
CONTRACTORS, OUTLETS-SWITCHES-RECEP 10.00/1.00 � -
G�G 4z V �! LIGHTING FIXTURES 10,00/1.00
esTOR'S APPLIANCES-RESIDENTIAL' 4.00 Zjnoas
g/ PANELS 10.00P
DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO:
OR
ENGINEER ., A/' //�
1. ev �T1. ' UP.NO, SIGNS TRANS. .3,00
ARCH.OR ENG. - PERMIT VALIDATION
ADDREss SPECIALCIRCUIT" 5.00 '
EMP.METER'ORPOLE INS. -20.00
ADDRESS r$
t - ' MOTORS "' SEE FEE SCH.
ADHE55
SERVICE CHANGE - 20.00
.100 LICENSED CONTRACTORS DF.CLARATiON
a 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE GATE
z c (con ttienclng with Section 7000)of Division 3 ol'ti a Business and
Ie a - BLDG. ELECT. PLG. MECH.
r N i Professions Code nd y license is in full fore'an eL'V. �. - �0_ ❑ ❑ .❑
Z O m - License C las Lic.Number <A If I/ (I
4 N 1- w Uate y 2 _Contractor Q y
¢ Y ¢ a I, -OWNER-BUILDER DECLARATION C BUILDINGRM PERMIT
¢ w u -. INFORMATION
X i e N 1 hereby affirm that I am exempt from file Conliactor's License I MISC.- •' REFER TO ORD
u0a Law for the following reason.(Sec:7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Q` VALUATION S/FT.
• yto Cotte:Any city or county which requiresapermit In construct,alter. ELEC. LIC.NO.
¢ a a p improve,demolish,or repair any structure,prior to its issuance,also ELEC.
'a w0 u requires the applicant for such permit to file a signed statement that TOTAL - PERMIT TO
re he is licensed pursuant to the provisions of the Contnmtor's License
Hzi
Law(Chapter 9(commencing with Section 70000of Division 3 oflhe E -Gt-
4 0 Business and Professions Code)or,Nmt he is exempt therefrom and GTV. PLUMBING PERMIT FEE
¢ 1-$� the basis for the alleged exemption.Any violation of Seclion 7031.5 ' STORIES - TYPE CONSTR.
o ; by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not More than five hundred dollars($500t): .. - - ,
❑ I,as owner of the property,or my employees with wages as BACKFLOW 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 (Sue. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CONO.. 5.00
- Code:The Contractor's License Law does not apply to an owner of -
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
`. himself or through his ownlemployces,provided that such improve=
meats are not intended or offered for sale.l l',however,the building GAS-EA.SVSTEM'-11NC.4OUTLETS 6:00 ' c
or improvement is Sold within one year of completion,the owner- GAS EASYSTEM' OVER 4 IEA.) 2.00
builder will have the burden of proving that h - . -
e did not build or im- _ BUILDING USE
Prove for purpose of sale). INDUSTRIALWASTE INTER. 30.00 REB IND CON 'PB oma,
❑ I,as owner of the property,am exclusively contracting with ❑ ❑. ❑ ❑ ❑
licensed ctmtommis In construct [lie prnivct(Sri. 7044,Business LAWN SPRINKLERS 1,INC 5 V.BS 1.6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law docs nor apply -
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contmcla forsuch projectswllh a contruatuds)licensed pursuunl to - SEWER-SAN EA.200ft/10.00
the Contractors License Law' - TRACT NO. PARCEL NO.
❑ tum exempt under Sec. ,B.&P.C.for this - WATER HEATER W/VENT _6.00 _
reaenn
Owner- •Date WATER SYSTEM 5.00 ACC.DATE - ACC.FILE NO.
WORKERS'COMPENSA7'ION DECLARATION - WATER TREATING EQUIP. . ' 5.00 t,
I hereby affirm that I have a certilicale of consent 10 self-insure, ZONING ENG.SITE N0.
or a certificate of Workers:Compensation Imurance,or a certified
O copy thereof(Sec.380
0,pab'.C.1. / / /N
Polic No. Cont an J 1 Z.!L/'
Certified copy is hereby lural sh tire -d / I FIRE SPRINK ENERGY T-24
Z
❑ Cert i(i• opy is 'led h the ily inspection division. -
Yifi s:�- yf MISC.- REFER TO ORD.
.. O Applicant-AMI V❑ N❑ Y ❑ N❑
tin / 00
LU - CERTIFICATE 01;EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10. FLOOD ZONE a.L_u.c.
W � � COMNiNSAI'ION INSURANCE PLG.CONTR. � LIC:NO.1 PLG, , '
Z (This-n+ction need not be completed it' the permit ie' for one "' TOTAL; Y[:] :IN❑ V,❑ N❑
hundred dollars IS 100)or less.)
U O. 1 certify that in the performance of the work for which this per; GTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued,I shall not employ any person in any'tanner so as to
become subject to the Workers'Compensation Laws of California
OLD Dnfc Applicant BUILDING
} 0.
N NOTICE:I'O APPLICANT: If,after making this Certificate of rix- ALTER OR ADD TOMECH. -5.00 '
I., emption,you should become subject To the Workers'Compensation APPLIANCE, _ 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply will FEE '
U such provisions of this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)000QF.rVt) 4.00
CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC.FEE -
I hereby affirm that Were is a construction lending agency for - EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work for which this permit is issued(Bea "MICROFILM -
3097,Civ.CJ.• HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name - IWn!{-
Lenfit'sAddress -' _ HEATING UNIT(OVER I00,000B.T.U.)9.50 . - ELECTRIC 3 �
I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
' information is correct, I agree to comply with all city unit 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 mthorre representatives of this City to enter upon the
above-mentioned property for Inspection purpoux. BOILER-COMP Inver 100,000 STUB SEE FEE SCH:, MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.'
upertino against liabilities,judgments, costs-and expenses which- PERMIT ISSUANCE 10.001CONST.TAX
may in any way carr:against sail City in consequence of the -
rant of this pj t �y MECH.CONT. LIC.NO.
MECH.
` dL.CG . ( ' flu- /z '/SP' TOT-l!i : TOTAL
\ Signature Applicant/Contractor� pate '�-
OFFICE COPY