16190 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
L:,.. CITY" OF CUPERTINO - 1
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS 1oS�l�, '�l/k ;/�'�7>�U ,& f .UNITII , LOT# - PERMIT EXPIRES IF WORK
OWNER .( U c!WGj CONTRACTOR '4/2. IS. NOT STARTED WITHIN
' INSPECTION ' D41E I INSPECTOR INSP CTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ' - ANCE OR 180 DAYS FROM
NOTE: .LAST CALLED INSPECTION. I
LIFER - ALL GRADING AND.DRAINAGE SHALL BE INSTALLED
PREGONITE 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 . - J'
' PLUMBING ti
ELECTRICAL ' ISSUANCE DATE
MECHANICALS - �- oc .ELECT PLG VECR.-
1 ❑ /'
NFOR
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED _ 0p IM PERMIT
WOOD FLOOR S C NFORMATION
VALUATION $/F T.
PLUMBING, UNI
MECHANICAL
. ELECTRICAL PERMIT TO
�, u
' FRAMING - v - `""&
INSULATION - s _Si ORI ES TYPE 7ONNTR.
- - OCC.CROUP RES.UNITS
PLACE NOSUBFLOOR UNTIL ABOVE HAS BEEN SIGNED..
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so'FT noon ow.A TOTAL AcnI;ACE
DIAPHRAGM - THE CONSTRUCTION TAXIS PAID
USE
ROOF SHEATHING � � � �• . RES IND
CON cory All 0'1,.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - FINALS DATE INSP. L 0 L L ' ❑
ASSESSORS PARCEL NO
ROUGH SAN.N -
� PLUMBING ELECT.ENERGY
TRACT NO. PARCEL NO.
TUBS&SHOWER PAN PLUMBING ENERGY -
MECHANICAL MECH.ENERGY
ELECTRICAL ': _ acc.Ogre Acc.INCE No
—J :. BUILDING ENERGY
- FRAMING • - ELECT, FINAL TEST zorriNG END SITE No.
INSULATION PLUMBING
GAS TEST GAS
FIRE SPRINK ENERGyL]n
MECHANICALp-
COVER NO NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING : - Y El �� ED NL
EXTERIOR SHEAR ELECTRICAL RELEASE PLOOD ZONE A.I C.
INTERIOR SHEAR- FIRE DEPT. v NE] Y L N❑
SHEETROCK GRADE 'FEE SUMMARY
EXTERIOR LATH BUILDING' . BUILDING
INTERIOR'CATH TEMPORARY-APPROVALS
SCRATCH COAT ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY _ SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM '
ARRANGE FOR INSPECT.ION'BY PHONING 252-4505,` ELECTRIC
ONE WORKING DAY BEFORE-REQUIRED INSPECTION. PLUMBING
0� PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
IMPORTANT!
CONST,rnx
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN UNLY
.PERMIT NUMBER
'BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT C (10
F
ryNG [JJ
/^ 7-0
1 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
LV PLAN CHECK VALIDATION
O
AMC OTY. ELECTRIC PERMIT FEE
S UTLETS-SWITCHES-RECEP 10.00/1.00
� J7-C, � sec.No.^ % LIGHTING FIXTURES 10.00/1.00
CONTRACTORS PPLIANCES-RESIDENTIAL 4.00
A
�POCk�pn frL E '�` PANELS 10.00 DAPLICATION
PLA........
E
ARcmTwr PANELS (OVER 200 AMP) '
.0 3.00 SIGNS TRANS. 3.00
PuC.MO. PERMIT VALIDATION
ARC.,OR E.G. SPECIAL CIRCUIT 5.00
ADDRESS
EMP. METER OR POLE INS. 20.00 I
APPLICANTS MOTORS SEE FEE SCH. ✓'� /
ADORE SS
SERVICE CHANGE 20.00
C O LICENSED CON'I'RACIORS IIECLARAI'ION
ISSUANCE DATE
a u w I hereby allirm that 1 am licensed under provisions of Chapter 9 BLDG. ELECT. PLG. _ MECH.
N a H R'ommrnnng x'ilh rrS��cclion 70001 of Uivisiun J of the Rmmas a l IL�JA/ U
D a Professions Cgdc,la license is in fulra• c- /�
O o Lccn lLl7_Ij/r{ Lic.Numbar _
O - w U-1c CmLme,y .�
r BUILDING PERMIT
Q y E
a wu OWNER-BUILDER DECL\RYrION ter INFORMATION
m I h by uflinn that I'nl se'l'l tr n d r Cut Li cmc
MISC.- REFER TO ORD VALUATION
u o a Llw tof the toll.. ,I g un,(Sc 7031.5.U,n, I Ile l -Ton' PERMIT ISSUANCE 10.00
t -
Code.R"city or dow, lhwhr91 1 mill In ', Imr.
a a o inlpinve, emolish,or rcpa0 any ,u,tuo,pnor In de issuance,also ELEC.CONTR. LIC.NO. ELFTA
Tc O T requires III pplic:nll for such Penni,to lile a HFm¢I slurcole 1 Iha, TOTAL PERMIT TO Hyl,s
. 9 he is Iiccnvr 'u"ou l to Ilm"o'i',ons of am Coinraewr''Licutu' I�YTIj• l'� tet/ PI L{I / 1+11
H z r Luw(Chupler Icummencing w ith Srcl ion 7000)of Uivi'iun 301111`' FEE / l C..�•f
a Bminess and Pr Sulu Cute)or Omt he 1, Ihrmfl..I-1111 TY. PLUMBING PERMIT 0 RIES TYPE CONSTR.
r the ba+is for lhu a 'god exemption.Any viulw ion ul'S1❑Ian 703 L$
by'any'applicant l. ' p<Imi,subject'Ihl applicant lualivilpcn'dly ALTER-DRAIN -WATER (EA.) 5.0 C�.
of not more than live undyed dollars(S5W).1:
❑ I,as owner of, property,ser Itry employers with`"use''°' BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS
,heir Rule cungmnvli.,, will do Ibe wolk,and 1111 stnmturr is Iml gREA,COND. 5.00
Inl<nded or ufI,T,J for le (Sec. 7044, Bu'int"uml 'rul<>siuns DRAINS-FLOOR,ROOF,
Code:The Comr,,t.i s Li -nu•Law dues nal nPldy to-11 owner ul 5,00 SD.FL FLOOR AREA TOTAL ACREAGE
,,.,,ty who builds.r imp ves then..,and who docs such wurl FIXTURES-PER TRAP
himself or through hi .
Ili,own , duyces.pruvwcd t101 such inA
1pro, GAS-EA.SYSTEM-1 INCOUTLETS 6.00
_ menu are not imrnddd or often I'ur rale II:however,the hwWing
m nrnl snW within o year o1 completion• (111 owner GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
in
Budder wdl tease the bu Nen set Pr 'ing tha,hr did out bind or tem RES WD CON PB 0 Nvr
prose for purpose sale.I. _ _ INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑
❑ 1,as owner of the pnqunly,and •s<hurvcly c.rnracong with
licensed wnvaewn 1. eon'trua the p Icct ISrc. 7044, Ifuu les. LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL r+o
and Professions Coder he Cunhunorl I\ -L+w docs 11,11 apply Q/D tl-" Il/'ll)
to un owner ul,...Pert, who build'orsolo.", hcrrun.and who LAWN SPRINKLERS OVER 5 IEA.) 1.00 S Tj lV I
,.of...1,to,Ruch projects.,fit i on,,,1.0�1,iI,nsed p11nuant to SEWER-SANITARY-STORM EA.20011/10.00 TRACT NO. PARCEL NO.
the Conte nut's Li"T',e Law. .SP.C.tin this
❑ lm11 t
esop,uncle.S<c. � I1
� WATER HEATER W/VENT 6.00
"axon - 5.00 ACC.DATE ACC.FILE NO.
Owner Uat1 WATER SYSTEM
W'ORKI:RS'COJIPIiNSAI ON DECLARA'I ION WATER TREATING EQUIP. 5.00
1 herr by ulliml lb'+t I have a 111111111,0e,1I"Is"nt to x'Ibiluwe. ZONING ENG.SITE NO.
or u cert 11 bate I Wye rQkierl�j fb�`l}n Pe'U on
li/uuran',1 u/r a "WI M
copy the f Sc .}`C`1In L11 I-lcLL1�-'lS..�
copyt I FIRE SPRINK ENERGY TRI
O ❑ Certil ed copy'is ha•rehy lumi'haJ.
Z z ❑�Ccn is c0,Y IlNI1eJ h 1l/r fi/Iq-ing""wn dki.iun. MISC.- REFER TO ORD. r ❑ N❑ Y ❑ N'❑
APplicant �..�T7-1- w(�r,I
F 999 PERMIT ISSUANCE 10-.0017,1 U FLDODZONE A.L.uc.
cc - CERIWIC\IEOF E NEMPI'ION Iz9OAI N'URKERS' .� N Y❑ N❑
LU 1 CONIPENSA N I'IOINSURANCE PLG.CONTR. LIC.NO. PLG. V(� ❑ ❑
OTAL
CIL.
= Z ITh,' v�niosl need not he cum Plned ii 1111 penu'd i' tier ane
hu 1 drtry ths '1001 oroorin FEE FEE SUMMARY
U O I certify that • Imrnn,d.) an of the worst for which all.per CITY. MECHANICAL PERMIT
LL U mit i'a su je I Gull n ..play any pawn i1 tiny .untool i1 to
0 w Oule subject mlh<Ro n'CoinprnvUutl Luw's ui Cul,linnia. BUILDING
D-111 ICANTrn ALTER OR ADD TO MECH. 5.00
} tan NOT[Cl",TO API'LIG\NI': II,n .nuking this Certiflc-le of lis- 5.00 PLAN CHECK
Z anlpu0n,lo""l""lucmne xtbjcc am ordoA ll Cu N11111 4mn APPLIANCE FEE
pro.isiotr' ul the Labor Code. >vu m 1 l.nhwilh cuwpy' with AIR HANDLING UNIT ITO 10,000 D.F.M.) 4.00
(� su,h,rm isioro us this pencil Shull be Jaen ' .....ked.
CON'STRUCrION LENDING ACJSNCI• AIR HANDLING UNIT(OVER 10JID0C.F.M.) 6.00 SEISMIC FEE
I hereby 'Minn thin tro
here is - e0tructiun lending asellay for EXHAUST HOOD (WITH DUCT) 5.00
the parf.nnunee uI the work H r whish this Peewit isle d(Sec MICROFILM
3097,GC.1. r' _fes'I�1 m �T �� HEATING UNIT (TO 100,000 B.T.U.) 8.00
c
Lender's Name 1r111 111 If HEATING UNIT(OVER 100,000B.T.U.)9.50ELECTRIC
LenJu1 Add....
I cefidy trial I lra�c read tins aliplicaiion and n sI I It I the all VENTILATION FAN (SINGLE) 4190 PLUMBING
. nt mw,on a W t I asrva 1 ply 1lh II q' W euun BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
.rJinan end 't- > rcW-114 l b Winv
g on u tin and d
hereby UUIlh0rILC repruwinslikes us tl t ll) to enter Pon the BOILER-COMP IO_,IW 000 BTU)SEE FEE SCH. MECHANICAL
aha..•mentioned property for Impection purposes. REFER TO ORD.
(We) a"" Io von. ind"onil, and keep Ion nn les the Ci's oI MISC.-
CONST.TAX
uplrDno agaiubilaw ,judgments• emu ses and "Pen11111111111111101.00n li
sayin ' 'c.ru< ld City' ' an of the PERMIT ISSUANCE
N) A y ugaiml xaI mmq•'
�� MECH. M1
rann".1 lhi.' �t MECH.CONT. LIC.NO. TOTAL ` V_
J;��' TOTAL J �p
Signa rr ul TP,Iit.o I jCon true for U le
OFFICE COPY