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13831 POST THIS CARD NEAR FRONT OF BUILDING PF RM1,IT NUMBER .; • CITY .OF CUPERTINO � '4/ R INSPECTION DIVISION 40b 138 , 31 JOB INSPECTION RECORD - - PERMIT EXPIRATION JOB ADDRESS 104$1 N. DEANZA UNIT# LOT# 4TH F - PERMIT EXPIRES IF WORK OWNER APPLE COMPUTER CONTRACTOR HOLVICK IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. LIFER PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ELECT. PLG. MECR, DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL FRAMING sroRlEs TYPE CONSTR. INSULATION OCC.GROUP RFS.UNITS I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SD.FT,FLUOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE - RES IND CON PB DIM1PI APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ El I] E) ❑ ROUGH _ ASSESSORS PARCEL NO. ' .. PLUMBING GAS TEST TRACT NO. PARCEL NO, MECHANICAL ELECTRICAL ' FINALS DATE INSP. ACC.DATE ACC.FILE No. FRAMING SAN u ZONING ENG.SITE NO, INSULATION PLUMBING , GAS N T lr kf �J➢- tG1s MECHANICAL FIRE SPRINK ENERGY T 2 .9 id V ❑ N❑ V ❑ Nn COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LTTI FLOOD ZONE aL.u,c. LATH-INTERIOR ELECTRICAL LATH-EXTERIOR - FIRE DEPT. - L-(u,0'-1 1,.( Y N� Y0 N❑ SHEE_IROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING 1_� BUILDING SHEAR EXTERIOR .TEMPORARY APPROVALS FIREWALLS ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED'BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC FW- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL (6 CALLING FOR FINAL INSPECTION. - OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER ♦DING APPLICATION & PERMIT DREG jjE �/f1 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 1383 OWNER'S YY PLAN CHECK VALIDATION AME V� QTY. ELECTRIC PERMIT FEE CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 L lt.V i uc.NP/701-3-t LIGHTING FIXTURES 10.00/1.00 rory E Tons 3S A'VC -I0 PPLIANCES-RESIDENTIAL 4.00 ADORES G��L PHOIJL PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENOIPEOE LE v LIC.No. SIGNS TRANS. 3.00 ADDR.SS NG. CVI'Y '14 Zl SPECIALCIRCUIT rj.00 PERMIT VALIDATION ADDRESS •� 1 L`/ 9U1' d � ZIP/ • I EMP.METER OR POLE INS. 20.00 ADDRESS MOTORS SEE FEE SCH. Tr1�,� ADDfl E55 SA2nf, AS (j0 Al TAAC O 4 SERVICE CHANGE 20.00 �� /� 0 0 o LICENSED CONTRACTORS DECLARATION I �� s' G6 !/ ¢ I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE m ¢n (commencing with Section 7000)of Revision 3 of the Business and FLOG. 'ECE 1 IVPLG. MECH. H m Z Professions Code rid my license is in full fore t Jf .11 1 ❑ ❑ a: o m .License Class_._Lie.Number 9 w Data Contractor a x sa BUILDING PERMIT ¢ ¢w ¢ OWNER-BUILDER DECLARATION INFORMATION MISC.- REFER TO ORD X LL 1 hereby affirm that I am exempt from the Contractor's License VALUATION S/FT. F u_04 Law for the following mason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city orcounty which requires a permit to construct,alter, SC Q p Improve,demolish,or repair any structure,prior to Its Issuance,UISO ELEC.CONTE. LIC.NO. ELEC. / dOr y 0 w rcglllrCS the applicant for such permit f0(Ill-d signed Statement that TOTAL PERMIT TO w$ he is licensed pursuant to else provisions of the Contractor's License H a: i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthc Q 1"PPK0 V67- 4 Business and Professions Code)or that he isexempt therefrom and QTY. PLUMBING PERMIT FEE ¢1 O the basis for the alleged exemption.Any violation of5eclion 7031.5 STORIES TYPE CONSTR. i3� by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dothin($500),): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 their sole compensation,will do the work,and the structure Is not OCC.GROUP RES.UNITS intended 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 50.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- -� merits are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4(EA.) 2.00 auaolNc usE builder will have the burden of proving that he did not build or inr RES IND CON PB osnar prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the properly,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(See. 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 an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA,) 1.00 contracts for such projects with a contraetous)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACTNO. PARCEL NO. ❑ lain exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO, WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certi0cate of consent to self-insure, or a Certificate Of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lub.CJ. Q(Epv/� `_1f Policy Nmpany Q ❑ Cert CoCo Certified Copy is hereby famished. FIRE SPRINK ENERGY T24 Z 'Z ❑ Certi co is tiled wit the city nspection division. O Applicant MISC.- REFER TO ORD. y❑ N❑ Y ❑ N❑ ~ rn - PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.c. !r ; CERTIf ICATF,OF 117,ON FROM WORKERS' DJ COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG. CL 0 This sedum seed not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ D Z hundrml dollars(S 100)or less) U 0 1 certify that in the performance of On,work for which this per- QTY. MECHANICAL PERMIT R FEE SUMMARY LL P mit is issued,1 shall not employ any person in any manner so as to U become subject m the Workers'Compensation Laws OfCalifornia.Date Applicant ALTER OR ADD TO MECH. 5.00BUILDINGDo NOTICE TO APPLICANT: If,after amking this Certilicatu of Ex- emption,you should become subject to the Workers'Compensation APPLIANCE 5.00PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE suh provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00SEISMIC 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. MICROFILM 3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC . I certify that I have read this application and state 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 FEESCH. MECHANICAL a bove-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 inany ay Seer e,ag•'nst said City in onsequencc of the PERMIT ISSUANCE 10.00 s ting Of 11 permMECH.CONT. LIC.N0. MECH. rn ',0 8 TOTAL TOTAL q �y � gnature or Alnfica tractor Uate e OFFICE COPY