16512 (2) 11 P.OSTTHIS'CARD NEAR FRONT OF BUILDING
PERMIT NUMBER -
I - CITTOF CUPERTINO,
INSPECTION DIVISION,
hi JOBINSPECTION RECORD
f� � • '' PERMIT EXPIRATION �
,CrB ADDRESS � j —Y—UN,IT/# LOT# -I.t ,PERMIT EXPIRES IF:WORK
CANNER ,l?d''S"(rr L' CONTRACTOR V L • \ ^ . IS NOT STARTED-WITHIN
INSPECTION DATE INSPECTOR - INSPECTI RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ' - + ANCE OR 180 DAYS.FROM'
NOTE: LAST CALLED INSPECTION.
UFER• f" ALL GRADING AND DRAINAGE SHALL BE INSTALLED
' PREGUNITE' h "A - - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALiDANON
CUPERTINO STANDARDS.
GARAGE SLABS •,.1 - - i-
.! L"�'Ci'1'S• Ta
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
_UNDERGROUND./SLABPLUMBING
ELECTRICAL
=•+ - - '{��""' YK1.G'»,Q.(�,
ELECTRICAL. IESUANCCDATE 'f
MECHANICAL, t BLDG ELECT PLSGj WCH. -
_ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT
.�' WOOD FLOOR. INFORMATION
VALUATION $SET,
PLUMBING - - '
• MECHANICAL " + e �-... F
' ELECTRICAL - w. PERMIT1 tD + .
FRAMING PAI[) I--Cl.
INSULATION . . SII IRI S TYPE CONSTR
1988
- - -OCC,GHOWP - -HES,UNITS '—
A Ci'Vof Cupertino
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF 'r :NOTE NO`FINAL INSP:SHALL BE MADE BEFORE 5O'11 rLoor+AREA TOTAL ncREAce
V
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
ROOF SHEATHING - RfiS .INBUILOCON USE PB Dlrr '
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE - MSP.
ROUGH' SAN.k
ASSESSORS PARCEL NO.
_ •- ' ' '
PLUMBING . - - ELECT.ENERGY -
` TRACT NO, PARCECNO,
TUBS'&SHOWER PAN PLUMBING ENERGY
MECHANICAL . MECH.ENERGY •�
ELECTRICAL' - _ ACC.DATE ACC.FILL NO
.. l BUILDING ENERGY I
FRAMING - - ELECT.FINAL TEST "I
^].ONING ENG.SITE NO.
INSULATION , PLUMBING
. GAS TEST r _ GAS '
F
MECHANICAL - IRE SPRFNK; ENERGY za
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y 0 NE Y [. N�
' FLUOD LONf: AL.UC.'.
- . - EXTERIOR SHEAR - ELECTRICAL RELEASE Y ❑. N� v ❑ No
i.. INTERIOR SHEAR, FIRE DEPT. '
SHEETROCK. - " GRADE FEE SUMMARY
r EXTERIOR LATH _ BUILDING -.
.INTERIOR LATH" +o• TEMPORAR'Y`APPROVALS BUILDING
SCRATCH COAT + ELECTRIC - PLAN CHECK.,
G -
FEE
AS `
NO TAPE OR PLASTER-UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE '
0CC UPANCY.OF,BUILDING IS NOT PERMITTED,UNTIL BUILDING FINAL ISSIGNED'BY BUILDING INSPECT OR. MICROFILM
• "R' - -ELECTRIC
U { ., ;.. ARRANGE FO,R INSPECTION BY PHONING 2524505, E '
o�lONE WORKING DAY BEFORE REQIJIRED';INSPECT.ION PLUMBING
Z , PLEASE,'GIVEJOB•A.D:DRESSWHEN, PHONING: • .
- SEE PERMIT FOR-EXPIRATION DATE- 'MECHANICAL '
IMPORTANT!, coNST.TAx
: .PLEASE READ REVERSE SIDE BEFORE TOTAL [
CALLING FOR FINAL INSPECTION:,
OFFICE COPY '
APPLICANT TO FILL IN INFORMATION WITHIN-RED LINES - USE BALL POINT'PEN ONLY
BU I LOINS PROJECT I DENTIFICATI ON, %.yPERMIT NUMBER
B ,
UILDING
APPLICATION &'PERMIT;
ADDRESS
TS BUILDING -ELECTRICAL-PLUMBING -MECHANICAL ,: 1�6�5I
�- LILq
OwNER's - PLAN CHECK VALIDATION
"Af° - " OTY.� ",.-.,- ELECTRIC PERMIT ` FEE
CONTRACTORS l9r�1C 4,lsGrve' . -
NAME CTOR'S
NAME UTLETS-SWITCHES-RECEP 10.0011.00
l l/ G (L 1. NO. 3e -LIGHTING FIXTURES 10.00/1.00
cosTOH . APPLIANCES-RESIDENTIAL 4.00oa �
3 �.J�x
IA (/L PHONE � Y PANELS � 10.00 DATEOF APPLICATION 1�
ARCHITECT . '" PLAN CHECK FEE P.0:NO.
OR - PANELS,IOVER 200 AMPI 20.00AC
ENGINEER - ' - - `
AtIiiuc.rvbJ ' ` SIGNS TRANS. _ .3.00
ARCH.OR ENO. - PERMIT VALIDATION
AOOREss - SPECIAL CIRCUIT' 5.00
1 MM'ei2Gtq•L f - zIP EMP.METER OR POLE INS. 20.00
• APPLICANTS - MOTORS ., SEE FEE SCH.
ADDRESS -
33 3 9GrPvZ Gf/r0 SERVICE CHANGE 20.00 4
O
0 z ,U CaC • (�
0 o LICENSED CON'TRACTORS DECLARATION1.S' 'I C /C
If v W I hereby affirm that 1 ant licensed under Provisions of Chapter 9 f ISSUANCE DATE ,F•
1 u neneing�with Section 7000)of U s slon3 of IIIc Business and -
�� BLDG.' ELECT. PLG. MECH.
r'0 H i I ole ions Code nd my license s in full titre ❑' ❑
0 o m 1¢cure Class Lmc Numhcr��-!
� m r w Dat D L 7- Y Commcmr tl. • ❑ �ELECT],
t ml; 1988, - BUILDING PERMIT;'
¢ ¢ w¢ - OWNER.NIIII,DER DECLARATION -
D A D - - - - INFORMATION -
` w ;u y I hereby affirm that'[unto ciempl from the Contractor's License MISC.- • TO ORD '
mo i. o,a Law for the following.,Sen.(See 7031.5,dusinessand PnRe'inns ( PERMIT ISSUANCE 10.00 v. yVALUATION $/FT. -
Code:Any city or county which requires a pennitto consmnat,aIle,
R ¢ ¢ EO. improve,demolish,or repair any srn¢Iurc.prior to its issuance,also ELEC.CONTR. LIG NO. ELEG
O requires 0m nPPllCant for such permit Io(ilea signed statement that T
u w m LL he Is Ilcensed.parstiadt lu tile OTAL PER MIT TOe provisions HI Contoictor's License _
HZLA Law(Chapter 9(commencing with Section 7000)oft)ivision 3 Rflhe
S 4 D Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE �1
¢ IT m the basis for the alleged exemption.Any violation of Seclior 7031.5 _ !?TORIES ,TYPE CONSTR.
in by any applicant for a permit subjects the applicant ton civil penalty -
•• :It nor more t hon live hundred dollars(S500f) ALTER-DRAIN&VENT-WATER (EA.) 5.00 `
O-1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE - 4.00 OCC.GROUP. RES.UNITS
_ heir sole compensation,will do the work,and the sfracture is not
intended or offered for sale (Sec.7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 '-
Code:The Contractor's License Law does not apply to an owner of
properly wIm builds nLlmpro,cs Ih ncoh,and who JOGS Sach workFIXTURES-PER TRAP 5,00 $D.FT.FLOOR AREA TOTAL ACREAGE
himsclfilm rhnmgh his owmemployees,provided that such improve-
mems are not intended moffered for sale if,however,Om building GAS-EA.SYSTEM-l1NC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00
bcabz.will hove the burden of proving that he did not huild or ire- BUILDING USE
prove for purpose of sale.). -1 INDUSTRIAL WASTE'INTER. 30.00 RES` IND CON PB Orem
ID 1,as owner of the properly,am exclusively-contracting will E] , ❑ [:] 0 , ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V:B. . 6.00 - ASSESSORS PARCEL NO.
' and Professions Code:The Contractor's License Law•does not apply
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 contractor(s)licensed pursuant to SEWER-SAN EA.2001t/10.00
the Contractors License Law. TRACT NO., PARCEL NO.
❑ I ore exempt under Scc. ,B.&P.C.for this
Cason WATER HEATER W/VENT 6.00 "
reason
_ Uare WATER SYSTEM -5.00
ACC.DATE ACC,FILE NO.
'WORK 17 RS'COMPI NSA'I ION DECLARATION - WATER TREATING EQUIP. " 5.00
Imrehy'uffinn that'I have a cerlificule of Consent to sail-insure, '
nr a certificate of Workers'Compensation Insurance,or a certified r ZONING ENG.SITE NO.
copyrheregJ(S• 38 1 h.C.): -
PolicyNoSL a�ZE�uny-__F1QUC.
❑ Certified copy islmereby furnished. FIRESPRINK ENERGYT-24Z,Z �,;1 ,rtificd (Bpy js filyd/ it}y_ly 1pc •try ir�mcl ion division. - -
Fp A'pplicunt=E(/ C(tz- �rlG�tb MISC.- REFER TO ORD. yO N❑' ' Y0 N[]
W CF.RTIPICATEOF I?XIiMPTION PROM WORKI:RS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 e.
-W > CWIPENSATION INSURANCEPLG.CONTR. LIC.NO. PLG
CL O (Pots Section need'oot he completed if the permit is for one TOT.AL -Y D NO V ❑ N❑
D hllndred dollars(81001st lcxx,) - -
U O I certify that in the performmnce of We work for which this per- CITY. - MECHANICAL PERMIT FEE 'FEE SUMMARY '-
LL f mil is issued,1 shall not employ any person to any nuinnerso as to
O w become subject to rhe Workers'Compensation laws of California.
0. [):lie Applicant ALTER OR ADD TO MECH. 500 BIIIUILDING
} N NOTICE'f0 APPLICANT: If,after making this Certificale of E.' . '
Z emplimr;you sh....Id become subject to the Wcrkc,,Compnsallon APPLIANCE -' _ 5.00 -P„LAN CHECK. -
provisions,of the Labor Cade, you must forthwith comply with FEE
U such provisions or thispermit shall be denned revoked. AIR HANDLING UNIT(TO 10=C.F.M.1 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10;MC.F.M.16.00 SEISM IC FEE .'
I hereby uffinn tint here is a construction Iendtng agency fur ' EXHAUST HOOD(WITH DUCT) - 5.00
the Perfon.im,c of the work for whic,filis permit is issued(Sec. MICROFILM
3097,Civ.C.)." - HEATING UNIT(TO 100,000 B.T.U.) 8.00
_ Lender's Nome HEATI NG UN IT 100,000 B.T.U.)8.50
-' Lender's Address ELECTRIC e r
If ccllif, that I have read this appTURiorand state 0fit the above VENTI LATION'FAN (SINGLE) 1. '4 00 _
Int m mo
ron,is correct I agree IO comply with all City and countyPLUMBING
Nmances'and Stare laws relating to building construction and BOILER-CUMP(3 H.P.or 100,000 B.T.U.) "600
hereby toreprcu tIv ,t n purposes
tors city to enter upon the
above menentioneded pro y f e of-oBOILER-COMP (Over 100,000 BTU)SEE FEESCH. MECHANICAL
(We) agree In I
ve AVInnify and lice, harmless the City of MISC.- REFER TO ORD. _
-rgnartino-agaim liab' :,judgirents, costs and-ex Iamses which - CONST.TAX
Top trimly ay ticillidr, against said City in consequence of the PERMIT ISSUANCE 10.00
•• 1 runes of ms MECH.CONT. LIC.NO. MECH. - -
_ TOTAL
TOTAL /7
S gnat a of APP cant/Contraclm - Date •q 1 - I
OFFICE COPY