14811 POST.THI ARD NEAR FRONT OF BUILDING '. . - PERM ITNO'HER -
r. CIW OF CUPERTINO 14811
INSPECTION DIVISION
JOB INSPECTION RECORD ,
• - - - s, . . , PERM ILEXPI RATION
JOB ADDRESS 10323 North Wolfe Road uN1T# LLoT#
' P,ERMIT'EXPIRES IF WORK '
OWNERBerman' s CONTRACTOR IS NOT, STARTED'WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 186 DAYS OF PERMIT ISSU-
FOUNDATIONNOTE: , - ANCE OR 180 DAYS FROM
LIFER. -
ALL GRADING AND DRAINAGE SHALL BE INSTALLED
LAST CALLED,INSPECTION. `
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS-AND CITY OF PERMIT VALIDATION -'
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
. .UNDERGROUND /SLAB
PLUMBING •yr rl ;r �•
ELECTRICAL '
ISSUANCE DATE
MECHANICAL I ' -BLDG ELECT- PLG.. mecR
`. El O
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED • r BUILDING PERMIT -
'WOOD FLOOR - - INFORMATION .
• PLUMBING
VALUATION g'FT.
.MECHANICAL ,
ELECTRICAL - .PERMIT TO
FRAMING •s. C"+G.4 G.�
INSULATION STDRIEB TYPE CONSTR .
OCC.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
. ROOF - •sa.ET.FLOOR AREA TOTAL ACREAGE
NOTE,NO FINAL IIVSP.SHALL.BE MADE BEFORE`
• DIAPHRAGM THE CONSTRUCTION TAX IS PAID
- ROOF SHEATHING .. Hes BUILDING USEIND CON - PB OIL— ,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS - DATE INSP. ❑ ❑ ❑ ❑ ❑,
ROUGH SAN.p ASSESSORS PARCEL NO.
PLUMBING ELECT.ENERGY -
TUBS&SHOWER PAN, - PLUMBING ENERGY ' TRACT NO. PARCEL NO ,
MECHANICAL - MECH.,ENERGY -
ELECTRICALBUILDING ENERGYACC.DATE ACC FILE NO.
'
FRAMING ELECT.FINAL TEST -
INSULATION PLUMBING ZONING BNG.SITE No. •'
GAS TEST GAS
MECHANICAL ' ' FIRE SPRINK ENERGY T 2
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ "❑ ° ❑ N❑
EXTERIORSHEAR ELECTRICAL RELEASE ELOODeorvE ALuc.
INTERIOR SHEAR. FIRE DEPT. Y.❑ N❑ Y I❑ - No
SHEETROCK - GRADE. FEE SUMMARY
EXTERIOR'LATH BUILDING -
INTERIOR LATHTEMPORARY APPROVALS BUILDING
SCRATCH COAT JELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED juLFO,yrANCy SEISMIC FEE
OCCUPANCYOF BUILDINGIS NOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING,INSPECTOR. MICROFILM
w. ARRANGE FOR INSPECTION,BY.PHONING 252-4505, ELECTRIC it {4!
o� ONE WORKING DAY BEFORE. REQUIRED INSPECTION. PLUMBING
PLEASE GIVE JOB ADDRESS WHEN`PHONING'.-
- SEE PERMIT FJR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST:TAX
PLEASE READ REVERSE SIDE BEFORE' TOTAL' r
CALLING FOR FINAL INSPECTION. I "�
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY
BUILDINGPROJECT IDENTIFI N - - PERMIT NUMBER '^
ING APPLICATION & P IT
DRESS 14'811
' 16
N Q � BUILDING—ELECTRICAL—PLUMBING—MECHANICAL -
OWNER'S -
' NAME . ; PLAN CHECK VALIDATION
QTY. ELECTRIC PERMIT FEE -
ONE
CONTRACTORS `
N^f1E� �j M '33 3
UTLETS-SWITCHES-RECEP .10.00/1.00
(9 Q LIG NOS2,4001 LIGHTING FIXTURES 10.00/1.00 -
CONTRACTOR'S
AOOREss �� ,�� q APPLIANCES-RESIDENTIAL � - 4.00 -
V Q•�IN PHONES 2� PANELS - 10.00 Q DATE OF APPLICATION
ARCHITECT
OR PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER
ARCR.OREND UC.NO. SIGNS TRANS. 3.00 -
. - 1
- aooREss SPECIAL CIRCUIT _ 5.00 PERMIT VALIDATION
ZIP EMP.METER OR POLEJNS.' 20.00
APPLICANT'S
ADDRESS - MOTORS • SEE FEE SCH. -
SERVICE CHANGE - 20.00
o o LICENSED CONTRACTORS DECLARATION .. e�/
1 hereby affirm tiro[I am licensed under provisions of Chapter 9 ((( !! "
w 4 a (cammencing with Section 7000)of Division 3 of the Rosiness and ISSUANCE DATE --
H N 2 / PEore odyAa license is in full f0 f t1. BLDG. ELECT. PLG. MECH.
,z0 m _G!Y License lass_S� Lic.Number - ,4 ,❑ F ❑ 11
2 _ H J Dale 1J�Conhuctor
M IcWa OWNER-BUILDER U[CLARATION BUILDING PERMIT
X 3 e' INFORMATION
LL H I hereby affirm that 1 am exempt from the Contractor's License MISC.— REFER TO ORD �'
LL O¢' Law for[he following reason(Sec.703 L5,Business and ProfessionsVALUATION $/FT.
Code:An y q I PERMIT ISSUANCE 10.00 /0 —'
ynolor wont on('Ce oiresarermittoconstruct,alteq-
S'2 4 improve,demolish,Or repair any structure,-Prior to its issuance,also ELEC.CONTE. LIC.NO. _
ELEC.
LL Rqua. the appheart fo[such Permit to file a signed statement that TOTAL PERMIT TO
e w m he Is 1 1,need pursuant to IF Provismus of the Contractor a License '
rzi Law(Chaptur9(comecomng with Section 7000)oCDivislon3
P o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE C `
¢r$ ' the basis for[he alleged exemption.Any violation of Section 703 L5 STORIES TYPE CONSTR.
a3 _ by any applicant for a permit subjects the applicanttoacivil penalty ALTER-DRAIN
of not more than five hundred dollars(S500)J: (EA.) 5,00 -
❑ I,as owner of the Property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 Oce.GROUP RES.UNITS
C
sole compenmtion,will do the work,and the structure is not
intended or offered for sale(Sec. 7044, Business and Professions b
Code:The Contractor's License Law does not apply to an owner of DRAINS-FLOOR,ROOF,AREA,COND. 5.00 -
. Property who builds or Improves thereon,and who does such Work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA -TOTAL ACREAGE ,
himself or through his own employees,provided that such improve-
mmtsarenotintended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion,tire owner-
- builder will have the burden of Proving that he did not build or im- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE
Prove for purpose ofsaleJ' INDUSTRIAL WASTE INTER: 30.00 RES„ IND CDN PB Other
❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ O
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1'INC 5 V.B. 6.00 ASSESSORS PARCEL NO.-
Code 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 eontractons)licensed pursuant to - -
theContractor'sLeceseLaw. SEWER-SANITARY-STORM EA.200ft/10.00 'TRACT NO. PARCEL NO.
❑ lam exempt under Sec. ,B.&P.C.for this
reason WATER HEATER W/VENT 6.00 .,
Owner Dme WATER SYSTEM 5.00 ACC.GATE ACC.FILENO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 ?
I hereby affirm that I have a certificate of consent to self-insure,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
C
opy thereof(Sec.3800,Lab'.CJ.q��„a� ,�-q-7
P�oli$${y'No. Company YCn'�� .4d✓l
'0 �' $+Certified copy is hereby furnished. �
Z Z FIRE SPRINK ENERGY T-24
- ��I]] Certified wpy is f71ed with [he city inspection division.
F: pT/. Applicant - - MISC.- REFER TO ORD. Y 0 N� Y [:] N�
X —1 CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOO ZONE -A.L.U.C.
LU — COMPENSATION INSURANCE PLG.CONTE. LIC.No. PLG.
tl O (This section need not be completed if the permit is for one TOTAL Y❑ N o Y ❑ -N❑
Z hundred dollars($100)or less.)
U O 1 certify that in the performance of.the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- mit is issued,1 shall not employ any person in any manner so as to _
O U • become subject to the Workers'Compensation Laws of California.
UJ
D. Date Applicant ALTER OR ADD TO MECH. 5.00l BUILDING
} N NOTICE. TO APPLICANT: If,after making this Certificate of -
F Z emptimm you dmuld'become subject to the Workem'Compensation APPLIANCE 500 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with . FEE”
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=1C.F.M.) 4.00 '
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=E FM.) 6.00 SEISMIC FEE
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 6.00
the performance of the work for which this Permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) .6.00 '
Lender's Name HEATING UNIT ER 100,000 B.T.U.)B.50 ELECTRIC / ��
Lender's Address -
IcertifythatI have readthis application and stale that the above VENTILATION FAN (SINGLE) 4.00
information is cor comply with all City*and county BOILER H.P.or 100,000 B.T.U.) 6.00 PLUMBING
orcb Aces and ate laws relatin o buildin onstruction, and
Fit authori'• tativev is el to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. ,MECHANICAL
above olio .Pert for' actio p Gives.
(We a o save Guy an cep harmless the City of MISC.- REFER TO ORD.
uperti ugam m 'It ,judg costs and expenses which CONST.TAX
may ' y wa a again d City in consequence of the PERMIT ISSUANCE 10.00
ra ng o his pe MECH.CONT. LIC.NO. MECH. -
�fTOTAL TOTAL laf"'"
ignat cant/C ractor
OFFICE COPY