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14656 I POST THIS-CARD NEAR FRONT OF'BUILDING PERMIT NUMBER CITY OF CUPERTINO 14656 INSPECTION DIVISION JOB INSPECTION RECORD + PERMIT EXPIRATION JOB ADDRESS 10250 S.' DEANZA BLVD.. UNIT# _'LOT# . _ PERMIT EXPIRES IF WORK ' OWNER GREAT WESTERN BANK - CONTRACTOR GORDON ELECT IS NOT STARTED WITHIN . INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATIOM' ANCE OR 180 DAYS FROM NOTE: , - - LAST CALLED INSPECTION. - UF.ER • ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE ' TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. j GARAGESLABS- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -/6 3frdla y cT �� s t -� UNDERGROUND /SLAB t e h►� ��, PLUMBING - :pEer .. ELECTRICAL Q �� IQ (1;7 ISSUANCE DATE MECHANICAL ;eLOc. ELECT PLC. MECR. 2L2cT .� ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED -1$-88 15-<olMvvlw Past �:ZldaAO BUILDING PERMIT INFORMATION WOOD FLOOR WFLVALUATION SIFT. PLUMBING MECHANICAL 3-�3y='flS— /j L$cT lA — 1K t ELECTRICAL FRAMING - - •• L.r STORIES TYPE CONSTR. INSULATION , . . OCC GHODP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO FT FtOORAREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE • DIAPHRAGM- [ o g- - THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - RES IND CON PB 00- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ 1:1 ❑ ❑ ❑ ROUGH SAN.N ASSESSORS PARCEL NO PLUMBING - ELECT.ENERGY - TRACT NO. PARCEL NO ' TUBS 8 SHOWER PAN PLUMBING ENERGY PAL MECHANICAL MECH.ENERGY ELECTRICAL - - BUILDING ENERGY ACC DATE ACC,FILE NO FRAMING . ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING - GAS TEST- - GAS MECHANICAL FIRE SPRINK - ENERGY T-24' . v NQv N COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING , [:] ❑ 0 _ EXTERIOR SHEAR.- � ELECTRICAL RELEASE FLOOD ZONE A.L.0 C. - - • -INTERIOR SHEAR FIRE DEPT. YE Y0 N❑' SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING - INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT 3-26-9ELECTRIC PLAN CHECK GAS FEE NO TAPE+OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. .MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LU ONE WORKING DAY BEFORE REQUIRED.INSPECTION. PLUMBING z�. PLEASE.GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE = MECHANICAL IMPORTANT!' CONST.TAX 'PLEASE READ REVERSE SIDE.BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY _ „f BUILDING PROJECT IDENTIFICATION ,PERMIT NUMBER BUILDING APPLICATION & PERMIT 10C C aooREss 2SU S. DC-�41l�fr 13�V BUILDING-ELECTRICAL-PLUMBING-MECHANICAL of �. NAME s PLAN CHECK VALIDATION T� 6AvHCON�„ `{E QTY. ELECTRIC PERMIT FEE I4 CONTRACTORS ' NAME r 'ZD OUTLETS-SWITCHES-RECEP 10.00/1.00 m12.. dl-IG UG-C uc.No. qq ?0gJ JILIGHTING FIXTURES 10.00/1.00 V CONTFACIID - "'nDORESS rolls NT�Cl IFS APPLIANCES-RESIDENTIAL 4.00 C U't '2_46-s" L Ac�8982ro�// PHOrvE PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE - P,C:NO. on /A�, AL PANELS (OVER 200 AMP) 20.00 ENGINEER J&HA� /rJ LIc.No. SIGNS TRANS. 3.00 - _- ' ARCH,OR ADDRESS ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION :IP1gv?4 TEMP.METER OR POLE INS. 20.00 APVUCANTs MOTORS , SEE FEE SCH. ADDRESS S Do LA C rw !SERVICE CHANGE 20,00 �/ Q'/� , o o LIC17NSED CONTRACTORS DECLARATION ' l7/a O < Ri is v 1 hereby afllnn that I am licensed under provisions of Chapter 9 ISSUANCE DATE ' y<w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. r y i Professions Code,an my license is in full Cor'•' - ect ❑ .❑ Z O,n r Liecow" aass,__ �1.Lie.Number FL ❑ 2 Uale l��-Q Contractor Jr F N H J c `� \(� BUILDING PERMIT ¢ ¢ w¢ OWNER-BUILDER DECLARATION INFORMATION oA " MISC- REFER Tq A. ;A b I hereby aDlrm that I um exempt from the Contractor's License VALUATION $/FT. F A o j Law for the following reason.(Sec.703 L5,Nosiness and Professions PERMIT ISSUANCE Code:Any City Or county which requires a permit to construct,alter, ELEC.CONTR. LIC.NO. s a a p improve,demolish,or repair any structure,prior to its issuance,also ELEC. O LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO A w $ he is licensed pursuant to the provisions of the Contractor's License HiQ Law(Chapter 9(commencingwith Section 70000of Division3ofthe EL..LsC.7 s 4 D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE 2 F$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. i3 - by any applicant for a permit subjects the applicant to a civil penalty, ALTER-DRAIN -WATER IEA.( 5.00 of not more than five hundred dollars(5500).): ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEVICE .4.00 NEC,GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for Sale(Sac. 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 SQ.FT.FLOOR AREA TOTAL ACREAGE . meets are not hrough ownemployees,c,AdeovidhJ ever,hat the improve- GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 rents are not intended or offered for sale.If,however.the building or improvement is sold within one year of completion,the owner GAS EASYSTEM-OVER 4(EA) 200 BUILDING USE builder will have the burden of proving that he dol not build or i - . . . on- RES IND CON PB Other prove for purpose'ofsale.). INDUSTRIAL WASTE INTER. 30.00 11El0 1:1 Cl❑ 1,as owner of the property,am exclusively contracting with licensed contractors to construct Bin project(Sea 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 A55ESSURS PARCEL NO. and Professions Code.The Contractors License Law does not apply wind owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 MA.1 1.00 commcts for such projects with it eontructons)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner - Date WATER SYSTEM 5,00 ACC.DATE ACC.FILE NO, WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE N0. . or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec 3800 LBMC.) Policy No.Pj�]�._Company (2,45• , O ❑ Certified copy is hereby furnis led. FIRE SPRINK ENERGY T-24 Z Z.. . O Certif d is f}I�d 'th the city inspection division. MISC.- REFER TO ORD. O pp Carl ' r� �„L�y. y.�••---- v❑ N❑ v ❑ N❑ � N. CERTIFICATE OF EXEMPT]ON WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.UC' Lu > COMPENSATION INSURANC17 PLG.CONTR. LIC.NO. PLG. ' _ CL 0 (This section need not be completed_ if the permit is for one TOTAL v❑ 'N❑ Y ❑ N❑ 0 Z hundred dollars IS 100)or Icss.) U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE'SUMMARY t LL mit is issued,I shall not employ any person in any manner So as to U become subject to the Workers Compensation Laws of Califoria. O w Date Applicant - BUILDING O_ ALTER OR ADD TO MECH. 5.00 ' } rn NOTICE ption,'f0 APPLICANT: If,alter making this rs'Coicme sa Ex ? em vision you should become subject to the Workers'Compensalion APPLIANCE - 5.00 PLAN CHECK provisions the Lobar Cyou most forthwith comply with FEE t.1 such Provisions or this permitit Shull shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.RM.) 6.00 SEISM IC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 r the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.L.. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that I have mad this application and state that the above VENTILATION FAN (SINGLE) 4.00 • informetion.is correct. I agree t0 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 FEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree t0 save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino 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 ring of this per it. /� MECH.CONT. LIC.NO. MECH. / i t 212-Sy TOTAL TOTAL ignalure of Applicant/I oonlrctor Date O-_ OFFICE COPY