16696 I '
' POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
CITY OF CUPERTINO 1 gigs
INSPECTION DIVISION
• JOB INSPECTION RECORD .
^/ 1,, aDd9 PERMIT EXPIRATION
JOB ADDRESS /O/a3 wO�� UNIT# LOT#
PERMIT EXPIRES IF WORK
OWNER E,�.�Q.LE (fj 0 CONTRACTOR � . Ed/ IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION . - - ANCE OR 180 DAYS'FROM
NOTE: LAST CALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE - •• TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERM;r VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING ® �/ (�/3/4
ELECTRICAL ISSUANCE DATE
MECHANICAL e e"cT, PIG. �MecH
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED CII BUILDING PERMIT
WOOD FLOOR INFORMATION
VALUATION $IFT.
,PLUMBING
MECHANICAL ..50•
ELECTRICAL - `/ / PERMIT TO
el( �� T��� �
FRAMING dam« �a, e •Q Y/ ��'ORIEs TYPE corvsTR�
INSULATION
OCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 5°.rr FLOOR ARCA TOTALACHEAce
DIAPHRAGM. THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING RES IND CON PB O,Rw
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS 'DATE INSP, El El ❑ ❑'- ❑
ASSESSORS PARCEL NO,
ROUGH SANA
PLUMBING ELECT.ENERGY
TUBS&SHOWER PAN PLUMBING ENERGY - TRACT No. ; PARCEL No ,
MECHANICAL MECR ENERGY
ELECTRICAL ACC DATE ACC FILE NO.
BUILDING ENERGY -
FRAMING ELECT.FINALTEST
ZONING ENG.SITE NO.
INSULATION PLUMBING _
GAS TEST GAS
FIRE SPRINK ENERGY T-24MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [D N❑. v I] N�'
EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE A.L.0 C.
N
` INTERIOR SHEAR FIRE DEPT. V E] N.E] 1' 0 ❑
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH, BUILDING _
INTERIOR' LATH . TEMPORARY APPROVAL _ BUILDING
SCRATCH COAT - - ELECTRIC - FEE CHECK / •/
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUI LDING FINAL IS SIGNED B Y BUILDING INSPECTOR. MICROFILM '
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
a� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z - SEE PERMIT FOR'.EXPIRATION DATE MECHANICAL Q
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE {:' TOTAL r-'
CALLING FOR FINAL INSPECTION.
OFFICE COPY
I
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY
BU I LDING PROJECT I DENTIFICATI ON ^PERMIT NUMBER -
a ti.,NG APPLICATION & PERMIT 16,696
� C [�
4p1nRE55 }�. I .7
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL U6 '
OwrvEH'S PLAN CHECK VALIDATION
NA QTY. ELECTRIC PERMIT FEE
.• eaV (d / x E
CONTRACTORS'
OUTLETS-SWITCHES-RECEP 10.00/1.00NAME
.7"-r 4,?f
,J r}TA:O '
LIGHTING FIXTURES 10.00/1.00
rorvrRacroR'sADDRESS
APPLIANCES-RESIDENTIAL 4.00
�0
PHONL306J-0 7107 PANELS .10.00 DATE OF APPLICATION a
ARCHITECT PLAN CHECK FEE P.C.NO.
on PANELS (OVER 200 AMPI 20.00 ,
ENGINEER
' LIC.No. SIGNS TRANS. 3.00
ARCHESR END. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APPLICANT'S - MOTORS SEE FEE SCH.
aooREss �L
SERVICE CHANGE 20.00
O o o LICENSED CONTRACTORS DECLARATION p,M\N zI(
¢u I hereby affirm that I am licensed under p;OODUgRS.f C1mpD,9 toVYe lSS/UANCE DATE
vHi<w. (commencing with Section 7000)of Division 3 of the Business and "BLDG. ELECT. PLG. MECH.
r w z Professions Code yn 1 my license is in full fort¢ fgreqL O
i o T- License Gln s_O Lic.No n.her •���8a Q
O m r Dale JC�i / /e8- Contract.,
BUILDING PE MIT
¢ ¢ w OWNER-BUILDER DECLARATION INFORMATION
K o n N I hereby affirm that I um exempt from the Contractor's License MISC.- REFER TO ORD
3 u VALUATION- $/FT.
H LL o¢ Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 49,00.
Code:Any city or county whichrequiresu permit to construct,alter, 3rd•+-I-n
x ¢¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC.
al D W requires the applicant for such permit to file a signed statemOnt that TOTAL PERMIT TO -
A w $ he is licensed pursuant to the provisions of the Contractor's License
H z a Law(Chapter 9(commencing with Section 7000)of Division 3 ol'the w�c7Q/(J�e
i O Business and Professions Code)or that he isceempt therefrom and QTV. PLUMBING PERMIT FEE
¢ H m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
c ; - by any applicant for a permit subjects the applicant tau civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.
of not mare than five hundred dollars($500).):
00-
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sale,(See. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00
Code:The Contractors License Law does not apply to an owner of -
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.F.T.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mentsare not intended oroffered for sale.l f,however,the building GAS-EA.SYSTEM-.1INC.4 OUTLETS 6.00
or improvement is sold within one year a(mmplction,0.c owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or int- RES IND CON PS Our.,
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ I,as owner of the property,am exclusively contracting with
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 IEA.) 1.00
contracts forsuch projects with a contractons)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑ 1 am exempt under Sec.-,B&P.C.for this WATER HEATER W/VENT 6.00
reason
Owner - Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO,
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent to sell'-insure. ` ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec 3800,Lab.C.).
POI Icy No. Company V /
C) ❑ Catilied cg is her by furnishe FIRE SPRINK ENERGY T-24
Z Z e_certi d' y is le vit the inspection division. -
O A"tic. MISC.- REFER TO ORD. y� N� YE ,NE]
rnPERMIT ISSUANCE '99-69 - FLOOD ZONE A.L.U.C.
LU CIiR FICATEOP9A% TIN PROM WORKERS'W COMPENSATION INSURANCE PLG.coNiR. LIC.No. - PLO.
1 0 (This Section need not be completed if.the permit is for one TOTAL Y❑ Y❑ N�
:) Z hundred dollars IS 100)or less.)
U O I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL Q mit is issued, t to tile
not rkero'y any person in a w manner Ser as to
V become subject to the Workers'CompeCsution Laws of California.
Do Date Applicant 2 ALTER OR ADD TO MECH. BUILDING 3/ 7
} 0 NOTIC17 TO APPLICANT: If,after making this Certificate of Ex-
F ? emplum,you shotdd become sullied to theWorkers'Compensation APPLIANCE 5.00 PLAN CHECK'
provisions of the Labor Code, you must forthwith Comply with FEE
C..1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=11F.M.) 4.00 t^
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=CF.M.) 6.00 SEISMIC FEE s"Zv
I hereby affirm that,there is a construction lending agency rot EXHAUST HOOD(WITH DUCT) 5.00
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name d /lw < /' HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
Lender's Adress
I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
' information is correct.I agree to comply with all city and county PLUMBING
ordinances and slate laws relating h. building construction, and BOILER-CUN1P(3H.P.or100,000B.T.U.) 6.00 rgry
hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. ;MECHANICAL 300-0-
above-mentioned property for inspection purposes.
(We) agree to slut, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against liabilities,judgments, costs and expenses which' , a CONST.TAX
may in way accrue .gat id City in consequence of the PERMIT ISSUANCE -+9:09'
r ng this rmiL MECH.CONT. LIC.NO. MECH.
TOTAL
e- do / s� 3 0 TOTAL a-) .9a
i a[ureo Applicant/Con actor Jute -
OFFICE COPY