16629 POST,THI RD"NEAR FRONTOF'BUILDING {
�' PERMIT NUMBER ,
CI , OFCUPERTINO 16629
INSP.ECTION ,DIVISION'
JOB INSPECTION RECORD
® " qq PERMIT EXPIRATION I
.. � ,, JOB ADDRESS�w�z1J Al.
WOLFC �`� �9
-K UNI # LOT PERMIT-EXPIRES IF WORK
OWNER! •..T
•;n (Y CONTRACTOR~-,Sj IS NOT STARTED WITHIN.I
INSPECTION DATE INSPECTOR- — INSPECTION REC RD ' 180 DAYS OF PERMIT ISSU-
FOUNDATION — - -- ANCEOR 180 DAYS FROM
NOTE:^ -
LAST CALLED INSPECTION.
LIFER •FALL GRADING AND DRAINAGE SHALL BE'INSTALLED
.. .. , .
PREGUNITE -TO COMPLY WITH THE APPROVED-PLANS AND CITY OF ?ERMITpVALIDATI ON
CUPERTINO . �
-STANDARDS .,,
GARAGE SLABS41
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING i .. .f V f;�,L={G, • . I
ELECTRICAL - _ i - - - v:' ISSUANCE'UATE
MECHANICAL` 'n ._ n_Dc FTELECT.- PLC, $, MECR,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT,
INFORMATION
WOOD,FLOOR VAUTAI U siFr.
PLUMBING- .. _
MECHANICAL _ ` •
ELECTRICAL' - - ,PERMIT o
FRAMING
INSULATIONSTORIES' ,TYPECONSTR,.—
,. , ' a - � ,
----- -- RESIUNITS.
'. •N-,-, PLACE NO SUBFLOOR UNTIL ABOVE,HAS BEEN SIGNED
SO FT.,FLOOH AREA TOTALACREACL •,
ROOF - NOTE:NO FINAL INSP.SHALL BE MADE'BEFORE"
DIAPHRAGMo. THE CONSTRUCTION TAXIS PAID ni
T ED_DING USE.
ROOF SHEATHING ,- - - RES IND CON
APPLY NO ROOFING-UNTIL,ABOVE HAS BEEN SIGNED FINALS' DATE INSP. ❑ E El ' ❑
ASSESSORS PARCEL NO.
- - ROUGH SAN.tta _ - -
e PLUMBING' - ELECT.ENERGY '
Q 1ACT NO. PARCEL NO.
T1 '&SHOWER PAN • E. ', PLUMBING ENERGY' v '
MECHANICAL MECH..,ENERGY - -
.a ., 'ELECTRICAL; r BUILDING ENERGY 000
narE, >ACC.Pae No, ,
•,':I FRAMING - ELECT.FINAL TEST-
INSULATION,: PLUMBING . " • '' -
. ' - ZONING'. FNG SITE NO.
-
GAS TEST _ � - � GAS-'
EN
FIRE SP ' , ERGY
MECHANICAL � .RINKLtd
• COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING • • Y,[] NE] Y 0' "�
c.
EXTERIOR SHEAR - E' ELECTRICAL RELEASE -
PLOOO A.Ly
zome
INTERIOR SHEAR ' - FIRE DEPT-: - ' ^ Y❑ "❑ + L '"�
• SHEETROCK - - - GRADE i FEE SUMMARY
_ - EXTERIOR LATH BUILDING' ? "
INTERIOR LATH - TEMPORARY APPROVALS BUILDI(�G.
SCRATCH COAT I: ELECTRIC PLAN.CHECK q
.„ GAS- FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDINGI$NOTPERMITTED UNTIL BUILDING FJNAL ISSIGNEDBY.BUILDING INSPECTOR. MICROFILM
' ARRANGE FOR INSPECTION BY PHONING 252-4505, :1 fib' ELECTRIC
ONE.WORKING DAY BEFORE REQUIRED INSPECTION., nnelvG.
• z PLEASE GIVE JOB ADDRESSMHEN PHONING:• Pw
,".
= SEE PERM IT'.FOR•EXPIRATION DATE
,. MECHANICAL .
IMPORTANT! r4 CONST.TAX
:
d PLEASE,READ REVERSESIDE.BEFORE;_ TOTAL.
CALLING FOR FINALANSPECTION... ,:
OFFICE COPY
APPLICANT TO FILL IN INFMATION WITHIN REDLINES -USE' �L.POINT PEN ONLY ' -
�' -Iy BUILDING PROJECT IDENTIFI - , PERMIT NUMBER
/ 9UILDING
APPLICATION,& P IT
OR WUILDING—ELECTRICAL—PLMBING—MEMECHANICAL 16629
1A -
r.
OWNER'5 PLAN CHECK VALIDATION
QTY. ','ELECTRIC PERMIT FEE
N iGI G ONE L u,
• C NTRAC R.5 n
!N A5 R UTLETS-SWITCHES-RECEP' 10.00/1.00
f a
J�GY✓G No l/ jJ LIGHTING FIXTURES 10.00/1.00
9(J
CONTRACTOR'S: ` , PPLIANC ES-RESIDENTIAL 4.00
'
ADDRESS "
,JAIIONE t PANELS , 10.00 DATE OF APPLICATION 11'
- ' ARCHITECT - P.0NO.
.
OR - PANELS (OVER, N CHECK FEE PLA
200 AMP( 20.00 ,
' ENGINEER , -
' LIC.No. SIGNS TRANS. 3.00 z" -
v ARCH.OR ENO. 5OO PERMIT VALIDATION'.
ADDRESS - SPECIAL CIRCUIT,
EMP.METER,OR POLE INS. 20.00
APPLICANT'S �^
AODREss:
MOTORS SEE FEE SCH.
.I -
" SERVICE CHANGE' 20.00 -
-o - ..
¢'i.
' (l
woo LICENSED CONTRACTORS 0 Q _
r /
w 1= "$
¢ o w I hereby gaffirmit that I n licensed under provisions of Chapter 9 O`e ISSUANCE DATE C
1O (commencing with Section]000)of,Divlsion 3 of site Busine5}and BLDG: ELECT. 'PLG. MECH.'
Professions Cod .rq rry license is in lull foryy �f L f/'" + - O ❑
Z z=Zo ;cense Class{DY 'Lie Number
r
DateContractor
BUILDING PERMIT
¢ is w �; OWNER-BUILDER DECLARATION - - INFORMATION
w 3 A 1-• 1 limebyafflrm'that I-am exempt from the Contracto'r's Lie cost, MISC.- - �', ' ,REFER TO ORD
u ow VALUATION. $/FT.
¢ Law for the following reason.(See.7031.5,BusinessanciProfessions PERMIT ISSUANCE 10.00
Code;Any city or,county which requi res a permit to co nslrue I,alter, -
2 la ¢�O' improve;demolish,or repair any structure,prior to Its Issuance,also ELEC.CONTR. - LIC.NO. - $LEC. `
a o¢ requires the applicant for such permit to file a signed statement that - TOTAL PERMIT
Ax$y,:, he is licensed pursuant to the provisions of the Contractor's License _ ,-i
r _ i>•
Law(Chapter 9(commencing whhSection 7000)ofDivlsion3ohhe - ° `� x. ML t
¢ Business and Professions Code)or that he isexempt therefrom and QTY. PLUMBING PERMIT FEE -at the basis for the alleged exemption.Any violation of$eclion 7031.5 'STORIES TYPE CONSTR-
w. 5, by any applicant for a permit subjects the applicant fua civil penalty ' ALTER-DRAIN&VENT-WATER (EA.) 5.00
'
of not more than five hundred dollars($500).7: '
❑ '1,as owner of the property,or my employees with wages as BACK F LOW PROTECT: DEVICE 4.00 OCC:GROUP RES.UNITS {
their able compensation,will do the work,and the structure is not - -
intended or offered for sale (Sec. 7044,-Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 -
Code:The Contractor's License Law does not apply to an owner of i
property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 50.FT,FLOOR AREA TOTAL ACREAGE
himself or'through his own employees,provided that such improve• GAS-EA.SVSTEM-1 6.00 ments are not intended or offered for sale.If,however,the building " t -
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM.OVER 4(EA.) -2.00 Buao NO USE holder will have the burden of proving that he did not build or int- RES IND ICON PB Otte
r '
prove for purpose of sale.).. - INDUSTRIAL WASTE INTER.'.. 30.00
❑ -1,as owner of the property,am exclusively contracting with ^❑ • ❑ /❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPR INKLER$- 1 INC 5 V.B. . 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractmis 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 suchrojecls with a contractors)licensed pursuant to
p ' , SEWER-SANITARY.-STORMEA.200ft/10.00 TRACT NO. PARCEL NO.
the Contractor's License Law. ,n
❑ tum exempt under Sec: BAP.C.1'or this WATER HEATER W/VENT ' 6.00 -
reason
Owner Dwe" WATER SYSTEM • ' ' 5.00
+♦' ACC,DATE ACC.FILE'NO.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 • .c .
I hereby affirm that I have acertificateofconsentqo self-insure, ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
.. >( copyth-"ry,•pflAe—C,1386➢OLab.C.7. •.
Policy+'+4/7� (CFSnpony
Q ❑ Cetlif¢d co " here f Tr - ^ FIRE SPRINK, ENERGY T-24
.Z• ' - Certil'icd I ' I i 'It in' ion division.
Applieat MISC.- ,REFER TO ORD, v❑ IN :e,Y ❑ N❑
N ' ERT]FICA i O' EXEMPTIO OM WORKERS' ` PERMIT ISSUANCE 1
�� FLOOD ZONE .'A.L.U.C.' "
LU COMPENSATIO SURANCE PLG,CONTR'. - LIC:NO: - -
CL O (This section need not be ornpleled if the permit is for one A CigS Y❑ N❑ Y ❑ N❑
Z) Z Inumbed dohars(S100)orleg ) I '- .( p
U O '1 certify that in the performance of the work for which this per. MECHANICAL PERM1�=TxG\ u FEE 0 FEE SUMMARY
LL F- mit is issued.I shall not employ any person in any manner so as to
Vfl6.00
become subject to tint Workers'Compensation Lows ofCalili rnia. VC. Date Applicant ALTER OR ADD_TO MECH. BUILDINGto NOTICE TO APPLICANT: If,.11,making this Certificate of Ex-
emption„you should become subject to the Workers'Compensation ' APPLIANCE PLANCHECKprovisions of the Labor Code; you must forthwith comply with FEEsuch provisionsor this permit shall be deemed revoked. AIR HANDLING UNIT'(TO 10=4 .F.M.)•CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000 C.F.M.) SEISMIC'FEEI hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITHDUCT)the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ,CJ. HEATING UNIT(TO 100,000 B:T.U.)Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)
Lender's Address ELECTRIC 9.
1 certify that 1 have read this application and state that the above 2 VENTILATION FAN (SINGLE) "4-.W
• information is correct. I agree to comply with all city and county - - PLUMBING
ordinances and slate laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of this.cily to enter upon the '7J
all , tinned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. ' MECHANICAL
e) agr a to save, indemnify and keep harmless the City'of MISC.- REFER TO ORD.
up.,'no airs judgments, . and eases which ,CONST.TAX'
ayin ccrue . 'n y in equence of the PERMIT ISSUANCE - -
ermit. CH.CONT. - LIC.NO. . MECH. -
u^
DSO- TOTAL ; TOTAL
gn tore of nl/ onlraclor Date
OFFICE COPY