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13335 POST THIS CARD NEAR FRONT OF BUILDING . CITY OF CUPERTINO ` ' " - PERMIT NUMBER INSPECTION DIVISION 3335 JOB INSPECTION RECORD / I�� e�rl Shre C-lam PERMIT EXPIRATION JOB ADDRES1yS,/'/) L - 1�,./]/ V UNIT# _LOT# OWNER 1'I �(,S\ 1-� ORK CONTRACTORj�F S NOPERMIT EXPIRES IF T STARTED WITHIN INSPECTION DATE NSIGNED INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM UFER .'t/P LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION y / i v POUVO CO RETE UNTIL ABOVE HAS BEEN UNDERGROUND /SLAB rI PLUMBING - 3f `.UGe(t\110 ELECTRICAL - �Ity ISSUANCE DATE MECHANICAL B�L-D�Gy. ELECT. PLG. MECH_ LB Q� (;9 5 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION SIFT. � � _ MECHANICAL -�! `JI ccco ELECTRICAL PERMITTO FRAMING (• ` -F-ow =DIAPHRAGMl STORIES TYPE CONSTR. i O��C,,IlC.GROUP RES.UNITS SU UNTIL ABOVE HAS BEEN SIGNED L` -11 • ROOF SO FT. (FLOOR AgEA TOTAL ACREAGE 113I .3 \1D N RES INDILDCON ING USEPB O hi,, NG UN IL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ROUGH �yyAlSJSESJJSORS PARCEL NO. PLUMBING 7- IO'1 -&&/ GAS TEST - _ T�R/AcJ NO. .PARCEL NO. MECHANICAL ,3^ .. p O /�-' ELECTRICALACC.OATE ACC,FI LE NO, FINALS DATE INSP. , 3,S dd FRAMING ;- .� SAN # INSULATION _I(, PLUMBING ZONING ENG.SITE NO. GAS MECHANICAL ' FIRE SPRINK ENERGY T-24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ IN Y ❑ N[:]LATH-INTERIOR EL`ECT8I CAL FLOOD ZONE A.L.U.C. LATH-EXTERIOR FIRE DEPT, Y❑ No Y ❑ NE] SHEETROCK ' GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR IZ-'tL1.gTEMPORA APPROVAL. BUILDING 0 `+ FIREWALLS ELECTRIC - -( PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE J L _- _tg OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM w ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC N ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL 4' -(� IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. l OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ,I BU I LDING PROJECT I DENTIFICATI ON PERMIT NUMBER F BUILOING APPLICATION & PERMIT 13335 ADORESs Berkshire Court LOT, I2 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME `111TUSt IV, IRC. PHo�iJ+15)969-7722 CITY. ELECTRIC PERMIT FEE CONTRACTOR'S NAME I/ OUTLETS-SWITCHES-RECEP 10.00/1.00 //(- Thrust IV, Inc. LID,NO. 319115 17 LIGHTING FIXTURES 10.00/1,00 57- CONTRACTOR'S ADDRESS TT11.. r�[r� O1 Z PPLIANCES-RESIDENTIAL 4.00 S-� -, 31anAin Dry PHONE 969-7722 �Z PANELS 10.06 24- DATE OF APPLICATION ARCHITECT Arch. PLAN CHECK FEE P.L.NO. DR Corp.W_Y 111Ur PANELS (OVER 200 AMP) 20.00 ENGINE�1 ' Van De �`(Q Y uc.No. SIGNSTRANS. 3.00 ARCH.OR ENg___ SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS JI�L"' Ted SOIL 'Erm, ZIP TEMP.METER OR POLE INS. 20.00 ^ y.Rtpa n T S ADDRESS - MOTORS ,,SEE?FEE SCH. c¢ z2D93 Tandings Dr. Mnt. View SERVICE CHANGE A J 20.00 'q,l I` �` foo LICENSED CONTRACTORS DECLARATION j Y l7 P/O a v u I hereby affirm that I am licensed under provisions of Chapter 9 m UANCE.I)ATSinn y a hu (commencing with Section 7000)of Division 3 of the Business and BLDG. rEOEOT. PLG. MECH. F o i Professions Cod a d my license is in full fur e( ct. { ,lnett+l+ Z i m a License I 1 Lic.Number + µ H W H aa Date Contractor YYVJJJ a sz s BUILDING PERMIT rc a OWNER-BUILDER DECLARATION Iu u INFORMATION w0 n _ I hereby affirm that I am exempt from the Contractor's License IMISC.- REFER TO ORD o as o a Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION SIFT. fce> Code:Any city or county which requires a permit construct,alter, IL R a p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE, LIC.NO. ELEC. G u ERM requires the applicant for such permit to file a signed statement that TOTAL }P� 'IT•T'O is,$ he is licensed pursuant to the provisions of the Contractor's License r�VV A Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE F $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. d3 � by any applicant for a permit subjects the applicant toaCivil penalty ALTER-DRAIN IEA:) 5.00 of not mom than five hundred dollars($500).): ALTER- ❑ 1,as owner of the properly,or-my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCL.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00I Code:The Contractor's License Law does not apply to an owner of p - property who builds or improves thereon,and who does such work f/a FIXTURES-PER TRAP 5,00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. ments are not intended or offered for sale.Il',however,the building GAS-EA,SYSTEM-1 INC.40UTLETS 6.00 ^N� or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Other the p prove for purpose of INDUSTRIAL WASTE INTER. 30.00 0 ❑ 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License s th does not apply ��` to tr owner of property who builds tr improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 (�((f contracts actor's h projects with a contractoKs)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM�EA.200ft110.00 jP0+ TRA TND. PARCEL NO. reason l am exempt under Sec: ,B.&P.C.for this WATER HEATER W/V NT n " 6.00 -' O /I Owner Date III WATER SYSTEM �t.. OA 5.00 5' ACC.GATE tv - ACG FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATIN :EQUIP. Dk�jI;'(\8.00 I hereby affirm.that I have a certificate of consent to self-insure, - 1 f or a certificate of Workers'Coto,sa is l�a$,ora certified •r• �{1 ZONING ENG.SITE NO. copy thereof(Sec.3900,Lab.CJ.G�e[n/� [[�� [a/ Vs' Policy No. ComPany_111EJ 7=1 _ 0 ❑ Certified copy is hereby furnished. FIRE SPR INK ENERGY T-24 Z Z ❑ Certified copy is filed with the City inspection division. O Applicant MISC.- REFER TO ORD. I y � NQ v ❑ N� CC y CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 /O- FLOOD ZONE A.L.U.C. LU > COMPI'.NSATION INSURANCE PLG.CONTE. LIC.NO. PLG. IL o (This section need not be completed if the permit is for one TOTAL /27-1 Y N Y NF] D Z hundred dollars($100)or less.)' U O I certify that in lire performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to 0 W become subject to the Workers'Compensation Laws of California. 5b y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING r m NOTICE TO APPLICANT: If,after making this Certificate of Ex- F ? emption,you should become subject to the Workers'Compensation APPLIANCE FEE"In PLAN CHECK provisions of file Labor Code, you must forthwith comply with FEE U such provisions or this permit Shall be deemed revoked. _ AIR HANDLING UN4T,(T090,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNITIOVER IOJ- C.'M,) 6.00 SEISMIC FEE 5,05 I hereby affirm that there is a construction lending agency for , EXHAUST HOOD (WITH DUCTI,,r11`s 5.00 s• the performance of the work for which this permit is issued(Sec. MICROFILM HEATING UNIT( O�OO,000 :t-.U.) 8.00 30.d.r's am FIB � 60 Lender's Name HEATING UNIT(OVER'100;000 B.T.U.)9.50 Lender's Address-�.� 19, r •.- ELECTRIC ga' I•certify that I have read this application and state that the above VENTILATION FAN (S NGLE) 4.00 /(p information is correct I agree to comply with allcity and county PLUMBING / �U ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL - above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. ^ �7 Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 /O CONST.TAX U C% may in any way accrue against said City in consequence of the granting Of this permit. MECH.CONT. LIC.NO. MECH. 8/3/87 TOTAL 47 eo TOTAL x381. s • Signature of Applicant/Contractor Date OFFICE COPY