The URL can be used to link to this page

13673 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT ADDRESS / BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 13673 OWNER'S allee) PLAN CHECK VALIDATION NAME P09L.II5 - QTY. ELECTRIC PERMIT FEE CONTRACTORS Co a 0 r (313 UTLETS-SWITCHES-RECEP 10.0011.00 NAME ,4LIGHTING FIXTURES 10.0011.00 go CA TRSSTOfls SA.NJ Je3E1 '(I�. APPLIANCES-RESIDENTIAL 4.00 C 'T PHONE W / PANELS 10.00 DATE OF APPLICATION ARCHITECT I PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEE ' FJ� 'I o. SIGNS TRANS. 3.00 ARCH.OR ENG SPECIAL CIRCUIT 5.00 PERMIT VALIDATION AOO ss`S. p MA ZIW EMP.METER OR POLE INS. 20.00 PAID ^ APPLICANTSMer MOTORS SEE FEE SCH. �•r f�r� AD LO:W f#f 118 O J SF1N J��. 4lq , SERVICE CHANGE 20.00 f '02 LICENSED CONTRACTORS DECLARATION ,�pppp a U w 1 hereby afNrm that I am licensed under provisions of Chapter 9 5 tlAYE (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELE PLG. MECH. Z i Professions Co�dy�g an I license is in full for�yaydp act1__ zO= LicensgClas�S�_ Lic.Number Glef 13 ❑ ❑ ❑ Z, O Dale'l Conlraclor � .T- a y f BUILDING PERMIT ¢ ¢w a OWNER-BUILDER DECLARATION INFORMATION woAUMISC.- REFER TO ORD 3 I hereby affirm that 1 am exempt from the Contractors License VALUATION SIFT. F u MO j Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10_.00 10 wCode:Any city or county which requiresa permit to construct,alter, 0c ¢¢0O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. Q i -C I requires the applicant for such permit to file a signed statement that TOTAL 192 PERMIT TO X$w he is licensed pursuant to the provisions of the Contractor's License Q I � i> Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ H $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. w. by any applicant for a permit subjects the applicant toa Civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP EES.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,AREA,COND. 5.00 Cade: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 S.00 S0.FT.FLOOR AREA TOTAL ACOEAGE himself or through his own employees,provided that such improve- mentsarenotintended or offered for sale.If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6,00 or an prevenient 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- prove for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 RES IND cory PB ower ❑ I,as owner of the property,um exclusively contracting with _ ❑ ❑ ❑ ❑ ❑ licensed contractors (a construes rhe project(Sec.7044,Business LAWN SPRINKLERS-1INC 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(EA.) 1.00 Con tracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCEL NO. the Contractor's License Law. ❑ lam 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. vv ct Is W RKERS'COMP17NSATI N')I:CLARATION WATER TREATING EQUIP. 5.00 I hereby fRrm that 1 have a certificate of consent to self-insure, - ZONING ENG.SITE NO. or a cerlifi to of Workers'Compensation Insurance,or a certified copy[heron ec.3800,Lub.- �l'TL1�"�Qr�J A-W- Policy No. - Co hereby - ' Q ❑ Cerl died copy is hereby famishedFIRE SPRIrvK ENERGY T RO CerliRed copy is filed with the. city inspection division. O Applicant VegT660Gq;1&f6_09To REFER TO ORD. y[D N❑ y ❑ N❑ it Lo CERTIFICATE,OF EXFMpTION FROM WORKERS, PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. LLI >_ COMPENSATION INSURANCE PLG.CONTR, LAC.NO. PLG. (I[,is-section need not be completed if the permit is for one TOTAL V❑ N[] V❑ N❑ 2 hundred dollars 1$100)or less.) U O I certify that in the performance oLrhe work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL f mit is issued,1 shall not employ any person in any manner so as t0 U become'subject ro the Workers'Compensation Laws o(Calil'ornia. ED Date Applicant ALTER OR ADD TO MECH. 5.00 - BUILDING } N NOTICE TO APPLICANT: If,after making this Certificate of Ex- F Z emplion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or-this permit sliall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4,00 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ.C.). Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC 2 (certify thatcorrect, readIgree application and all c that the above VENTILATION FAN (SINGLE) 4.00 information n correct. f agree to comply with all city and munry 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 properly for inspection purposes. _ (We) agree to save,.Indemnify and keep harmless the City of I MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way accrue,against said City in consequence of the PERMIT ISSUANCE 10.00 granting of this permit. MECH.CONT, LIC.NO. MECH. TOTAL TOTAL Signature of Applicant/Contactor Date OFFICE COPY , POSTTHISCARD NEAR FRONT OF BUILDING PERMIT NUMBER ' CITY OF CUPERTINO 13673 INSPECTION DIVISION JOB INSPECTION RECORD 1+ PERMIT EXPIRATION JOB ADDRESS 10300 BUBB ROAD' UNIT# LOT# 40 PERMIT EXPIRES IF WORK OWNER APPLE COMPUTER. ' CONTRACTOR BEST ELECTRIC IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSUF- FOUNDATION- ANCE OR 180 DAYS FROM LIFER LAST CALLED INSPECTION. PERMIT VALIDATION PREGUNITE pluo POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED FEB UNDERGROUND /SLAB G J PLUMBING City Of CU�/IIpp ��fp1pp ELECTRICAL iSSUP00A E MECHANICAL BLDG. ELEC . PLG. ME ❑ . d ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR vnwanaN s/FT. PLUMBING MECHANICAL ' PERMIT TO ELECTRICAL - FRAMING 'STORIES IC. PLCU INSULATION - srDRiEs TYPE CONSTR. OCC.GROUP HES.UNITS NP,LACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO,FT,FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE RES IND CON PB Oen« APPLY NO ROOFING UNTIL ABOVE HAS BEEN'SIGNED0` ❑ 0 ASSESSORS PARCEL NO. ROUGH PLUMBING - TRACT N0, PARCEL NO. GAS TEST MECHANICAL ACC.DATE ACG FILE NO. ELECTRICAL - FINALS DATE INSP. FRAMING - SAN # ZONING ENG.SITE NO, INSULATION PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY T-04 YEI YID COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING NEI "� LATH-INTERIOR ELECTRICAL FLOOD ZONE - A,L.LLC. LATH-EXTERIOR FIRE DEPT. Y❑ "I] Yo "[] SHEETROCK - GRADE FEESUMMARY SHEAR INTERIOR , -- BUILDING SHEAR EXTERIOR, TEMPORARY APPROVALS _ BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM — ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC I.-~ .F ONE WORKING DAY BEFORE REQUIRED INSPECTION.' PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! coNsr.TAX. ' PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. " OFFICE COPY '