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13331 r<. POST THIS CARD NEAR FRONT OF BUILDING PFRMiT NDM11NEH CITY OF CUPERTINO 13331 � J? INSPECTION DIVISION JOB INSPECTION RECORD Xry _ ID�J-' ' `" UNIT# LOT# V PERMIT EXPIRATION BADDREI/S1S II( '�/ y ' '/ PERMIT EXPIRES IF WORK OWNER I y wJ, CONTRACTOR V I J-Y— IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSP CTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION A /- j LAST CALLED INSPEdTION. UFER 4# PR EGUNTEPERMIT VALIDATION- ,v ALIDATION- v 6 UR NIYCONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB y PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL city 0 �i � IR CT. PLG. MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING - _p' �' 1, t'„ MECHANICAL ' ELECTRICAL - PERMIT ro1 FRAMING - F OW L STO l S TYPE CONSTR. INSULATION _ iV OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 41 J 50,FT.PLO OR AREA TOTAL ACREAGE DIAPHRAGM (�� /� J �`� J Ir - r Z 5hCoWkw tl p C BUILDING USE NES IND CON PO Uiner APPLYAO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGEPLUMBING _/, ' ��— GAS TEST -/& TUACT'NO. PARCEL NO. 5C/J} MECHANICAL /02_/ f ELECTRICAL FINALS DATE INSP. ACC DATE ACC.FILE NO. FRAMING �„' SAN # INSULATION Z-+ 7 PLUMBING zoNlNc ENG.SITE NO. GAS MECHANICAL FIRE SPRINK- ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - 3 , O Y ❑ No Y ❑ N❑ - LATH-INTERIOR Z- - ELECTRICAL FLOODZONE A.L.U.C. LATH-EXTERIOR FIRE DEPT. ' '",`z Y❑ N❑ Y ❑ N❑ SHEETROCK - GRADE FEE SUMMARY SHEAR INTERIOR BUILDING _ SHEAR EXTERIOR 11 TEMPORARY APPROVALS BUILDING FIREWALLSELECTRIC i PLAN CHECK GAS FEE NO TAPE DR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE )� — OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR. MICROFILM a. Lu ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC /G' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING f�j7� ' z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMITFOR EXPIRATION DATE - MECHANICAL /j. •` J IMPORTANT! CONST.TAX a{�.�f- , PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. R OFFICE COPY APPLIC,'M FILL IN INFORMATION WITHIN RED LINES - USE BELL POINT PEN ONLY -BU LD1 NG PROJECT I DENTI FICATION PERMIT NUMBER }� BUILDING APPLICATION & PERMIT 13331 (' ADDRESS 1oi. kshise COUTt Lal' BUILDING-ELECTRICAL-PLUMBING-MECHANICAL "wrvER's` PLAN CHECK VALIDATION ME t IV Inc. PHDN 415 969-7722 OTV. ELECTRIC PERMIT FEE ERAcroRs OUTLETS-SWITCHES-RECEP 10,00/1.00 /1 Y Thrust IV, IDC, LIC,NO. 319115 LIGHTING FIXTURES 10.00/1.00 26 CONTRACTO ADDRESS T93 Landings Dr, '2 APPLIANCES-RESIDENTIAL 4.00 17 MU-Ust IV Inc. PHONE %9-7722 'L PANELS 10.00 QO DATE OF APPLICATION ARCHITECT PLAN C E K FEE P.C.NO. OR corp. k�i'Ch. PANEL$IOV ER 200 AMP) 20.00 �,,�.,.�p� ENGINEEa Van ,r l.dID v W Lt. No. SIGNS TRANS. 3.00 ARCHEN PE aooRESS ss G$B01E SPECIAL CIRCUIT • 5.00 RMIT TION VALID P, Ted 1�17ksscn ZIP EMP.METER OR POLE INS. 20.00 A UI noon SS - Io MOTORS LSEE,FEE SCH. G Clt��' 2093 iDI'. 1"(flt. VIEW SERVICE CHANGE !! 20.00 p / o a LICENSED CONTRACTORS DECLARATION IWI IU l) �I f' p/ {p/4 7 au u I hereby affirm that I am licensed under provisions of Chapter 9 ( (( E/ vHi a i (commencing with Section 7000)of Division 3 of the Business and { ISSUANCE DAT F o Z Professions Code,and my license is in full for lI j CL ity of Lno6r Ino BLDG. E T. PLG. MECH. ZO z_ o Licens l Lie.Number �1�11 L r j Date Lice-11P IS wst OWNER-BUILDER DECLARATION BUILDING PERMIT o ze " INFORMATION X ;a.y I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD Fu0¢ Law forthe followingreasom(Sec.7031.5,Business and Professions VALUATION $/ET. PERMIT ISSUANCE 10,00 /0.- m t improve, e,dem y demolish, countypair ichany reqstructres a ure, pio permit to construct,,alsoafter, ^A //�T7��/� C� S K Q p improve,demolish,or repair any sticture,prior to its issuance,also ELEC.CONTE. LIC.NO. /4 a 13 WV- C LL requires the applicant for such permit to file a signed statement that TOTAL m / PERMIT TO K $ he is licensed pursuant en the ng with provisions of the Contractor's License C H z a BussLaw(Chapterand Professions ode)or Section is 00)exempt the on 3 of the d F DW L E i c Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ H $ the basis for the alleged exemption.Any violation of Section 7031.5 STO S TYPE CONSTR. by any applicant fora hundred Subjects $500).licanttoacivil penalty ALTER (EA.) 5,00 � ��! of not more than five hundred dollars the applicant p.li .\ ❑ I,as owner at 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 y e structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 a�-3 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work /6 FIXTURES-PER TRAP 5.00 qe" SQ FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- I ments are not intended or offered for sale.If,however,the building I GAS-EA.SVSTEM-11NC.40UTLETS 6.00 (,- .[/. or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove 1,aso neeose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES I❑ ❑N ❑ p❑r ❑ d as owner of the property,he 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 ancontracts owner ofpropertywho builds tr improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 the Conte for such projects with a contractor(sj licensed pursuant to the Contractor's License Law. / SEWER-SA NITARY=ST,ORNIEA.200ft/10.00 /O- TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&BC.for this reason / WATER HEATER W/VENT__ 6.00 Owner Date WATER SVSITEM-] V L-1 5.00 S- ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to scl Ginsurc. or acertificate of Workers'Compe tion In ane or a certified 1 y 4 (1per Ind ZONING ENG.SITE NO. copy[here of lSec.3 Policy No, mpanyparry ❑ Certified Company copy isherebyFiled furnish the FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is Filed with the city inspection division. _ O Applicant MISC.- REFER TO ORD. Y[] N[] Y Q„ No CC CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 /Q- FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG,CONTE. LIC.NO. PLG. �o D. O (This section need not be completed if the permit is for one TOTAL I Y N Y N D Z hundred dollars(1100)or less) 0 O I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. C. Date Applicant BUILDING 'f'Y� 50 } N NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD Tl0 MECH. 5.00 (` F Z emption,you should become subject to the Workers'Compensation AppL1A NCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE (.1 such provisions or this permit shall be deemed revoked. AIR HANDLIN WUNIT(TO 10,000 C.F.M.1 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLINGUNIT OVER l0,000GEM.16.00 SEISMIC FEE I I hereby affirm that there'is a construction lending agency for EXHAUST HOO p,(W ITFILDUCTj1l0 5.00 �- the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C). +2 HEATING UNIT'(TO100,000 B.T.U.) 8.00 /y- Lender's Name �•I•B•-- - - -. 10 Lender's Address IqX 1 .. . HEATING UNIT(OVER 100,000B.T.U.)9.50 ELECTRIC I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 /Q- information is correct.1 agree to comply with all city and county PLUMBING -1 ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize ropertyfor ins of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL IV3� above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which ,�- CONST.TAX �0• may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 p granting of this permit MECH.CONT. LIC.NO. MECH. 8/3/87 TOTAL J e0 , Signature of Appicant/Contractor Date 43 TOTAL 1��/.t,_l I, OFFICE COPY