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13336 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PER �l" MIT NUMBER Im"LOHNG APPLICATION & PERMIT 10192 Berkshire Court ADDRESS MECHANICAL 13336 BUILDING OWNER'S PLAN CHECK VALIDATION NAME Thrust 'm/ T'�� CITY. ELECTRIC PERMIT FEE I Inc. PHO�(41 S)969-7799 CONTNAME ON OUTLETS-SWITCHES-RECEP 10.00/1,00 Thrust IV- Inc, LIC.NO. 319115 20 LIGHTING FIXTURES 10.00/1.00 20— DDSESCTORs ADDSS 2 PPLIANCES-RESIDENTIAL 4.00 CONFES PHONE 7722 ZPANELS 10.00 SO— DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR Corp. Arch, PANELS (OVER 200 AMP) 20,00 ENGINEE Van jk WeRhe uc.No SIGNS TRANS. 3.00 _ ARCH,OR ENCp_� SPECIALCIRCUIT 5,00 PERMIT VALIDATION ADDRESS Jtl1�C Ted Ded[]1CSSOR Em. ZIP TEMP.METER OR POLE IN$.� 20.00 APPLICANTS S MOTORS -o "SEE FEE SCH. ADDRESS SERVICE CHANGE '1,' ,_,20.00 w 0 O LICENSED CONTRACTORS DECLARATION �11D U a U w I hereby affirm that I am licensed under provisions of Chapter 9. ss•,np��\n ISSUANCE DATE HA c a (commencing with Section 7000)of Division 3 of the Businessand BLDG. ELECT. PLG. MECH. H D i Professions Co d my license is in full for�rc.Ty�k��q4rLU o i u� C Licens C con Numbract., ll'Ll.. VKJI Dale�J. / Contractor- xs BUILDING PERMIT cawOWNER-BUILDER DECLARATION INFORMATION w ;A w I herebyaffirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u o 4 Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 IQ� ..VALUATION $/FT. wp Code:Anycityorcountywhich requlresapermit toconstricl,alter, G (>z� OD0 iELEC.CONTR. LIC.NO. �O YYYWWW✓✓✓ IS x 4 O improve,demolish,or repair structure, ititissuance,also r any srucure,pror o s nce, ELEC. 0 u requires the applicant for such permit to file a signed statement that TOTAL /�2 PERMIT TO w8 he is licensed pursuant to the provisions ol'the Contractor's License H z Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe L 52 < D Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE IF -$ the basis for the alleged exemption.Any violation of Section 7031.5 STO S TYPE'CO/NST by any applicant fora permit subjethe cts toacivil penalty ALTER-DRAIN -WATER (EA.) 5,00 � P. of not mare than flue hundred dollars(E500)J: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not A— property or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's 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 9F6— 50.Fr.PLOO' himself or through his own employees,provided that such improve- RREA TOTALACREAGE � ments are not intended oroffered for sale.If,however,the budding t GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 Or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Omar l prove for purpose of sale). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the properly,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 who Contractor's License Law does not apply - ,S Lila) to tr owner of property who builds li improves thereon,and t to LAWN SPRINKLERS-OVER 5(EA.) 1.00 3/-//' Contracts for such License with a contraclor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITAR V-STORM EA.200th%10.00 /O TRATNp. PARCEL NO. ❑ I am exempt under Sec. ,BAP.C.I'or this WATER HEATER W/,VENT 8.001 (.a oU l/.r0- reason Owner Date WATER SYSTEM " (•� 5.00 .S ALC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING ECUIPp.'I-''r 5._00 \Ou I hereby affirm that I have a certificate ofconsent tO sal Giniare. k�/u ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C). State F1mds Policy No. Com &pany— [ �j O O Certified copy is hereby to ed. FIRE SPRINK ENERGY T24 Z Z O Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. O Applicant Y ❑ NO Y ❑ No ern CERTIFICATE OF EXEMPTION I7ROM WORKERS' PERMIT ISSUANCE 10.00 IO FLOOD ZONE A.L.U.C. L COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. /107L CL 0 (This section need not be completed if the permit is for one TOTAL /10�/ Y E] NE] Y E] NE] hundred dollars IS 100)or less) I U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL I. mit is issued,I shall not employ any person in any manner so as to OW become subject to the Workers'Compensa l ion Laws of California. Q. Date Applicant ALTER OR ADD TO MECk.- -1 5.00 BUILDING D } SO NOTICE TO APPLICANT': If,after making this Certificate of Ex- 2 emption,you should become subject to the Workers'Compensation APPLIANCE Y '�.'• 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10j100GF.M.).�54?00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.Ii SEISMIC FEE I hereby affirm that them is a construction lending agency for EXHAUST HOOD (WITH DUCT')- 5.00 S - the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100;000 B.T.U.) 8.00 Si MICROFILM 3097,Civ.C.). -- - Lender's Name T'' Lender's AddieX -J 9� HEATING UNIT(OVER 100.000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 '$ information is correct. I agree to comply with all city and county PLUMBING 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, indenmify and keep harmless the City of MISC.- REFER TO ORD. �7f� Cupertino against liabilities,judgments, costs and expenses which �x^ CONST.TAX b. •� may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 'v granting of this permit. n- MECH.CONT. LIC.NO. MECH. 44;g� 8/3/87 TOTAL yoo TOTAL Signature of Applicant/Contractor Date OFFICE COPY POST THIS CARD NEAR FRONT OF BUILDING , CITY OF CUPERTINO RMIT NUMBEa INSPECTION DIVISION 13336 JOB INSPECTION RECORD IDIa� Berl<sh� �� UNIT# LOT# I PERMIT EXPIRATION OW'NERJOB DDTR)E.SS �T PERMIT EXPIRES IF WORK owNER" I �I✓u5'� CONTRACTOR h�(LS� �J'� IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180*DAYS OF PERMIT ISSU- FOUNDATION _ �l ANCE OR 180 DAYS FROM UFER LASTCALLEDI NSPECTION. PRE UNITE - - PERMIT VALIDATION ' P. P R N ONCRETE UN IL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING , ELECTRICAL - - ISSUANCE DATE MECHANICAL BLDG, ELECT. PLG. ECH. Y� © cr- FVF, 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION Ilf, PLUMBING VALUATION $FT.•. Q_�,f: � � � - MECHANICAL MIN f 1}ig•VU 4 ELECTRICAL _ yyPPE-ERMIT TO}} _ FRAMING 1 'tj �,- IN ULATION STO 7 TYPE CONSTR. 9 OCC.G^ROOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO.FT.FLOORAREA TOTALACREAGE DIAPHRAGM •E- /ay RES BDCOON UILDUSE INPB C,ner APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 7 ❑ ❑ ❑ ❑ •ROUGH 1'(ASSESSORS PARCEL NO PLUMBING Q - l 'J� -' tl GAS-TEST - ��b: TRACT Ng PAHCEL,NO. MECHANICAL _ �V/`e ELECTRICAL Acc.OATS ACC.PILE No. L o- FINALS DATE INSP. .I FRAMING '] SAN.# INSULATION - _� _ PLUMBING ZONING ENG:SITE NO" GAS MECHANICAL ' FIRE BE RINK - ENERGY T 24 COVER O WORK UNTIL AB V.E-HAS BEEN�� D HEATING N ❑ "❑ Y ❑ "� p1 l - FLOOD zoNE A.L.u.o LATH-INTERIOR' t 3'23"�bg;5� ELECTRICAL _ LATH-EXTERIOR FIRE DEPT. v❑ "❑ v ❑ N❑ SHEETROCK I - = ".`-'F GRADE FEE SUMMARY SHEAR INTERIOR I -rj -8$ KIX, BUILDING- - - SHEAR EXTERIOR - 1-5-"dA TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC " �„Q��&- PLAN CHECK GAS —v- FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEENff SIGNED OCCUPANCY I ISEISMIC FEE t J, OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. 4-5:?,'=":�'"• MICROFILM 1' 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 j� L� + IMPORTANT! CONST.TAX a�t�ll, e:v PLEASE READ REVERSE SIDE BEFORE 1 CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPV