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13209 7.W POST THIS CARD NEAR FRONT OF BUILDING PERMITNUMReR CITY OF CUPERTINO �� INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 10431 NORTH DEANZA UNIT# LOT# PERMIT EXPIRES IF WORK OWNER APPLE corvTRAcroR AMERICAN NEON IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION. - ANCE OR 180 DAYS FROM UFER LAST CAL LED I NSPECTI ON. lµ PREGUNITE. ' 1- PERMIT VALIDATION' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCEAre' MECHANICAL ItLOG, ELECT. .PLG. MECR. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 1 ytTfuxdUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING _r MECHANICAL "PERMIT TO ELECTRICAL FRAMING ' - STORIES INSULATION YPE CONSTR. _ OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF _ SO.FT,FLOOR AREA TOTAL ACREAGE ' DIAPHRAGM , IIIIBUILDING USE RESP IND CON PB 00— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - ❑ cl ❑ 1:1 ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING TRACT NO. PARCEL NO. GAS TEST MECHANICAL ELECTRICAL FINALS DATE INSP. ACC,DATE ACC.FILE NO, FRAMING SAN # INSULATION PLUMBING ZONING ENG.SITE NO. ' GAS MECHANICAL FIRESPRINK ' ENERGY T.24 N COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y N❑ Y E] NEI LATH—'INTERIOR ELECTRICAL - FLOOD zorvE A.L.UC. LATH—EXTERIOR FIRE DEPT. vE] N❑ YI] NE] SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING `'`'>^ •_;, FIREWALLS ELECTRIC PLAN CHECK FEE GAS • . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM , ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC oONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING . yIP Z PLEASE GIVE JOB ADDRESS WHEN.PHONING— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.Tnx PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. / • , �` • OFFICE COPY' r.n. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT _ I ADD Ess r Ci/T 13209 - �A BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNERS PLAN CHECK VALIDATION Nwm PHONE CITY. ELECTRIC PERMIT FEE •,�. CONTRACTOR rvA E UTLETS-SWITCH ES-RECEP 10.00/1.00 IV LC.N0D.!�932/7 ILIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S /S APPLIANCES-RESIDENTIAL 4.00 wD RE55 �J / ✓ �( �I PHONE v 0 PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.No. ISIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 ' APPLICANTS ADDRESS MOTORS SEE FEE SCH. • SERVICE CHANGE 20.00 w 00 LICENSED CONTRACTORS DECLARATION �sssp�sp l a z W I hereby affirm that 1 ant licensed under provisions of Chapter 9 n )'MANCE DATE (commencing with Section 7000)of Division 3 of the Business and p L ELECT. PLG. MECH. Ni Professions Cod ane -d m,. cense is in full force a f U1 y ❑ ❑ ❑ ❑ O i w License Class yz�- Lic.Number H m F.j Datc Contracto ¢ ae s F:�._ ` BUILDING PERMIT ¢ ¢w ¢ WNER- UILDF,R DECLARATIO INFORMATION oA " MISC.- REFER TO ORD X 3 U.w I hereby affirm that I am exempt from the Contractor's License VALUATION 8/FT. wwo ¢ Law for the following reason. 7031.5,Business and Professions PERMIT ISSUANCE 10.00 r - Code:Any city or county which requiresa permit to construct,alter, 2 rt ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC,CONTH. LIC.NO. ELEC. G ¢ requires the applicant for such permit to file a signed statement that - TOTAL PERMIT TO E: m u, he is licensed pursuant to the provisions of the Contractor's License H z a Law(Chapter 9(Commencing with Section 7000)of Division 3 ofthe 4 D Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE ¢ H$ the basis for the alleged exemption.Any violation of Sect ion 7031.5 1 STORIES TYPE CONSTR. a ; •. by any applicant for a permit subjects the applicant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than live hundred dollms(5500).): ❑ 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 intended or offered for sale (Sec.'7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. •5.00 Cade:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5,00 SQ.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- inents are not intended or offered for sale.if,however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 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 int- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,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 Law duos not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts I'or such projects with a contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL N0. ❑ 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. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate.[Workers'Compensation Insurance,or a certified copy thereof(Seel 3800,Lab.C.). Policy No. Company O ❑ Certified copy is her ifurnished. FIRE SPA INK ENERGY T-24 f -oPy le Z Z Certiwith heI inspection ivision. Opicact MISC.- REFER TO ORD. 10.00 v❑ N❑ v ❑ IN[]~ CC �va PERMIT ISSUANCE CE TIFICATE OF EXEMPTION FROM WORKERS' FLOOD ZONE A.L.U,C. LU _ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG, CL O frhis section need not be completed if the permit is for one TOTAL Y❑ N❑ Y❑ N❑ Z) Z hundred dollars IS 100)or less.) U O I certify that in the performance of the work I'or 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 U become subject to the Workers'Compensation Laws of California. BUILDING V54-C y Date Applicant ALTER OR ADD TO MECH. 5.00 } W NOTICE TO APPLICANT: If,after making this Certificate of EX )- Z emption,you should become subject to the Workeri Compensatioi, APPLIANCE 5.00 FEE CHECK Ka� provisions of the.Labor Code, you must forthwith comply with 7 9P-2U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE LSA I hereby affirm that there is a construction tending agency for EXHAUST HOOD(WITH DUCT) 5.00 the 3097,Civ.0 MICROFILM performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name 0 elA k, HEATING UNIT(OVER 100,000 B.T.U.19.50 Lender's Add res' �-'v-- ELECTRIC I certify that I li a r6 ead this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county BOILER-COMP13 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. BAILER-CAMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino agsvk�� ties,judgments, costs and expenses wich CONST.TAXma anye against • iJ City in consequence of the PERMIT ISSUANCE 10.00 gr gf I MECH.CONT. LIC.NO. MECH. TOTAL 3 9 TOTAL Signature of Ap lican/Contractor Dare OFFICE COPY ,