14832 POST THIS RD'NEAR FRONT,OF BUILDING -• PERniIrNUMBER
C1170F CUPERTINO 1 E3
INSPECTION-DIVISION
JOB INSPECTION RECORD
9S� PERMIT EXPIRATION .
,JOB ADDRESS 10123 North Wolfe' Road SP tlQI �Y ' _LOT#
PERMIT EXPIRES IF WORK'';
OWNER Vallco/Berman' S. CONTRACTOR IS 'NOT STARTED WITHIN &I
INSPECTION DATE INSPECTOR - INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION - ANCE OR -180 DAYS FROM
NOTE: - LASTCALLEDINSPECTION.
` UFER ALL GRADING 'AND DRAINAGE SHALL,BE INSTALLED . - 9
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND'CIT/'OF - ;PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED L/-;zz &7l =. ? �t � ✓`
- UNDERGROUND /SLAB
PLUMBING , —ye
ELECTRICAL -
ISSUANCE DATE
MECHANICAL BLDG, .I ELECT- ,PLG MECH.
pip . ® ,, a
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED : ; BUILDING PERMIT
WOOD FLOOR - - INFORMATION
l
PLUMBING VALUATION $/FT.
� � � _
MECHANICAL , - two '
PERMIT TO
-ELECTRICAL - - 7--: -
FRAMING. - -
INSULATION + - STORIES TYPE CONSTR
OCC.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
50 FT FLOOR AREA TOTAL ACREAGE
'ROOF. - NOTE:NO FINAL INSP.SHALL BE MADE:BEFORE-'
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING - RIES INDCON• PB GO-
` ,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP, ' ❑ ❑ 0 ❑ ED
_ ASSESSORS PARCEL ND
ROUGH - SAN.H -
PLUMBING ELECT.ENERGY g '
TRACT+NO PARCEL NO
TUBS&SHOWER PAN' - PLUMBING ENERGY
MECHANICAL MEOH.ENERGY, •+ :
ELECTRICAL - .. - - ACC.DATE . ACC FILE.NO
BUILDING ENERGY
FRAMINGELECT:FINAL TEST
2DOING ENG SITE NO.
INSULATION PLUMBING
GASTEST GAS
MECHANICAL FIRE SPRINK ENERGY T24
COVER NO WORK'UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N� I ❑ N�
FLOOD 2GNE A.LU C.
EXTERIOR SHEAR ELECTRICAL RELEASE
ANTERIOR,SHEAR- FIRE DEPT. Y❑ NEl Y ❑ N❑.
SHEETROCK - - GRADE .FEE SUMMARY
EXTERIOR LATH,- - - BUILDING
INTERIOR LATH. - - - TEMPORARY APPROVALS BUILDING .
- SCRATCH COAT 2 ELECTRIC PLAN CHECK
GAS'
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED joccuPANCY SEISMIC FEE
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. 4MICROFILM '
ARRANGE FOR INSPECTION BY.PHONING 252-4505, ELECTRIC
F ONE WORKING,DAY BEFORE REQUIRED INSPECTION. _ PLUMewG . t+ %=`tl
O PLEASE GIVE JOB ADDRESS WHEN PHONING.. L
z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! coNsr.rnx
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION,. P TOTAL
OFFICE COPY
APPLICANT TO FILL IN INF ATION WITHIN RED LINES — USE PILLL POINT PEN ONLY
�j
'
_ UBUILDINBPROJECTIDENTIFIC BI APPLICATION PE IT PERMIT NUMBER
14.832
UI LOING
ADDRESS
O,a N111�D1 �e �1� BUILDING —ELECTRICAL—PLUMBING—MECHANICAL
Wu q5 O+J PLAN CHEC K.VALIDATION
""ME QTV. ELECTRIC PERMIT FEE
L �1 HONE
corvrRAcroRs
NAME UTLETS-SWITCHES-RECEP 10.00/1:00
L.C.NO, I LIGHTING FIXTURES ,10.00/1.00
CONTRACTOR'S _ _ APPLIANCES-RESIDENTIAL 4.00
ADORE ss ,�I S
r� I ,PHONE �$'Q PANELS 10.00 DATE OF APPLI CATION
ARCHITECT ' PAN ELS IDV ER 200 AMP) - -''20.00 PLAN CHECK FEE P.C.NO.
OR
ENGINEER
LIC.No. SIGNS TRANS. 3.00
ARCH.OR ErvG. - SPECIALCIRCUIT 5.00 PERMIT VALIDATION
ADDRESS •
ZIP EMP.METER OR POLE INS. 20.00 '
ArS
ADDDRESSDRESS MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00 /3�rf�
woo LICENSED CONTRACT
a uU ORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 ISSUA CE DATE '
H Q m IcOmmepCiOg with Section 7000)of Division 3 of the Business m1J BLDG. ELECT. PLG. MECH.
F w z Professions CoI]]1�L�k•,u J my license is in full for' of eel - ❑ ❑
z o m— License Class Lie.Number
2. m F Date
V W¢ 1 1,OOWNER-BUILDER DECLARATI N BUILDING PERMIT
D REFER TO ORD INFORMATION
X;u H 1-hereby affirm that I um,exempt from the Contractors License MISC.— _ VALUATION S/FT.
r u N to Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00
Code:Any.city or county which requires a permit to construct,alter,
f m EELEC.CONTR. LIC.NO.
< D prove,demolish,or repairany structure,prior to its issuance,also ELTA
i O u inquires the applicant for such permit to file a signed statement that TOTAL
im ;rr�� PERMIT TO /
X$ he is licensed pursuant to ole provisions of the Contractor's License ,[JL A &- V_ .LAe�C.!�J'1/
w i Q Law.(Chapter 9(commencingwilh Section 7000)of Division 3 ofthe / O z f
4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE'
6 H $ the basis for the alleged exemption.Any violation of Section 7031.$ STORIES
to TYPE CONSTR.
by any applicant for a permit Subjects the applicant Ica civil penalty ALTER-DRAIN&VENT-WATER IEA.) 5.00
of not more than five hundred dollars($5001.):
❑ 1,its owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4,00
OCC.GROUP RES.UNITS
their sole compensation,will the work,and the structure is not - _
intended or offered for sat (Se (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who docs such work ,2_ FIXTURES-PER TRAP 5.00 y�— SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve.
.cuts are not intended or offered forsale.If,however,the building GAS-EA.SVSTEM-11NC.40UTLET$ 6.00
or improvement is sold within one year of completion,the owner- SYSTEM-OVER 4(EA'.) 2.00 BUILDING USE
builder will have the burden of pGAS-'EA.
roving that he did not build or im" ' RES IND CON PB Omar
prove for purpose of sale.). INDUSTRIAL WASTE INTER, 30.00
❑ 1,as owner of the property,am exclusively contracting with
licensed contractors tD 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 -1.00
contracts for such projects with it contractors)licensed pursuant to SANITA
- RYSTORM EOOf
- t/1 '.�
the Contractor's License Law. SEWERTRACTNO. PARCELNO.
❑ I Mn exempt under Sec.—,W&P.C.for this WATER HEATER W/VENT0
reason
Owner 'Date WATER SYSTEM 5 ACC.OATE ACC.FILENO. .
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. ,
I hereby affirm that I have a certificate ofconsent m self-insure, ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(See.3800,Lab.C.). -
Policy No. Company '
O O CCDiliede M,.,IMMIlyfur,0 hed. FIRE SPRINK ENERGY T24
Z Z yf'Cerli' Ip Is file ith the city inspe n ivision' MISC.- REFER TO ORD.
yA1IJicaBl�jl� I V N E Y❑ N❑
— CERTIFICATEOF E)F-MITION FROM WORKEI PERMIT ISSUANCE 10.00 (� FLOOD ZONE aL.u.c.
W > COMPENSATION INSURANCE - PLG.CONTR. LIC.NO. vLG. /_Ozt- ❑ ' ❑ ❑
CL 0 TOTAL C/ V N V N
Z (This section need not be completed if ow permit is for one
hundred dollars(SI00)or less.)
U 0 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
Uy F mil is issued,I shall not employ any person in any manner so as to
O W become subject to the Workers'Compensation Laws of Cahlornin
Date Applicant ALTER OR ADD TO MECH. 5.00 _S= BUILDING
} Do NOTICE TO APPLICAN'P: If,after making of is Ccrlificu,of Ex-
F2 emplion,you should become subject to the Workers'Compensation APPLIANCE lopp, 5100 PLAN CHECK
provisions of the labor Code, you must forthwith comply with AIR HANDLING UNIT(TO 1 FEE
U such provisions or this permit shall be deemed revoked. C. M.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVE . .M.) 15M SEISMIC FEE
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WIT CT) 0
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.CJ. HEATING UNIT(TO 100,0 .) 8.00
Lender's Name HEATING UN IT(OVER 100,.00 B.T.U.)9.50 ELECTRIC
Lender's Address
I certify that l have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 (4/"
information is correct.I agree to comply with all city and county BOILER-COMP 13 H.P.or 100,000 B.T.U.) 6.00 'PLUMBING / f0
ordinances and stale laws relating to building construction, and
hereby authorize representatives of this city to enter'uponthe BOILER-COMP toiler e 100,000 BTUI SEE FEE SCH. MECHANICAL /��
above mentioned property for inspection purposes.
(We) agree to save, indemnify and ke harnoes_s the City of MISC.- REFER TO ORD.
uRerl o against liabilities,judgments, c IS and expenses which CONST.TAX
Sy
i any way accr a against id Ci i consequence of the PERMIT
•ISSUANCE 10.00
ranli of This pen i MECH.CONT. LIC.NO. MECH.
italftQ_I TOTAL 'r/b TOTAL
Ignat e o pplie nt/Contractor Date
OFFICE COPY