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12684• 0 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO ~. INSPECTION DIVISION JOB INSPECTION RECORD _ - • •- JOB ADDRESS 10725 N. DeAnza - UNIT# LOT# OWNER DeAn d Office Center CONTRACTOR PERMI T NUMBER ; 12684�`� PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION UFER PREGUNITE PERMIT VALIDATION ear 11 RPR 2 2 1907 BLDG. Ch ❑ ❑ �� C , POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND / SLAB PLUMBING ELECTRICAL MECHANICAL DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR • vnwnnoN- sIFT.- PLUMBING. MECHANICAL ELECTRICAL• PERMIr TD y FRAMING INSULATION STORIES TYPE CONtSTR.• 1 OCC. GROUP-. RES, UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SQ FT. FLOOR GREA TOTAL ACREAGE .DIAPHRAGM' BUILDING USE RES IND CON PB Omer ❑ Cl ❑ -❑ 11ASSESSORS ' - APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED PARCEL NO. �f ROUGH PLUMBING ' TRACT NO. , PARCEL NO. GAS TEST MECHANICAL ACC. DATE ACC. FILE NO. ELECTRICAL' FINALS DATE INSP. FRAMING. SAN # ZONING- ENG. SITE NO. INSULATION PLUMBING .�•• GAS FIRE SPRMK Y ❑ N❑ - ENERGY T 24 v ❑ N❑ MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOOZONE Y ❑ N❑ A.L.U.C. Y ❑ N❑ LATH—INTERIOR' ELECTRICAL _ LATH—EXTERIOR FIRE DEPT. SHEETROCK GRADE FEESUMMARY SHEAR INTERIOR BUILDING BUILDING , SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC _ PLAN CHECK FEE GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING ISNOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. I ,MICROFILM ARRANGE FOR INSPECTION BY PHON=252-4505JELECTRIC w ONE WORKING DAY BEFORE REQUIRo� PLEASE GIVE JOB ADDRESS WHEN PHPLumBwG Z SEE PERMIT FOR EXPIRATIOCONST. MECHANICAL TAX IMPORTANT!PLEASE READ REVERSE SIDE BEFORETOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY lLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LDI NG PROJECT I DENTI FICATION APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 12684 y� aUILDING AD�R� / f- OWNER'S E OTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION NA N c Rs UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 I.C. NO. DATE OF APPLICATION CONTRACTOR'S S ADDRESS N sP� !4 cyp APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 ARCRITECT OR ENGIN CC''/� G N" Qlc. rvo7 7 PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. IDA Z`P S TRANS. 3.00 ARCH. OR ENG. ADDRESS Zip SPECIAL CIRCUIT 5,00 PE TION APR 2 2 19V� EMP._METER OR POLE INS. 20.00 - A ADDRESS ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 - Mi; off 1KAI,,( _ LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE O commencing with Section 7000) of Division 3 of the Business and Professions Code.. my license is in full forll�n�Cf y. icense Class _f _ Lie. Number -G.4_ ro-3 BLDG. El ELECT. El PLG. MECH. ❑ ate -/_per Contractor BUILDING P RMIT OWN/ER-BU LDF.R DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Businessand Professions INFORMATION IMISC.- REFER TO ORD VALUATION $/FT. PERMIT ISSUANCE 10.00 Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License ELEC. CONTE. LIQ NO. ELEC. TOTAL PERMIT TO CITU. PLUMBING PERMIT FEE Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 STORIES TYPE CO STR. by any applicant for a permit subjects the applicant toa civil penalty of not more than five hundred dollars ($500).): ALTER -DRAIN -WATER IEA.) 5.00 ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AR EA, CON D. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's 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. mems are not intended or offered for sale. If, however, the building GAS-EA.SYSTEM-I1NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im- prove for purpose of sale.). ❑ 1, as owner of the property,' am exclusively contracting with licensed contractors to construct lire project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves floncon, and who GAS - EA. SYSTEM -OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PB Ooau ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS -,1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with it contractors) licensed pursuant to the Contractor's License Law, RACT NO. PARCEL NO. SEWER -SANITARY -STORM EA. 200ft/10.00 ❑ I am exempt under Sec.-, BAP.C. for this WATER HEATER W/VENT 6.00 reason Owner Dale WATER SYSTEM 5.00 ACC.OATE ACC. FILE NO, WORKERS'COMPENSATION DECLA TI WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate Olen sent 1 self -insure, or a certificate of Workers' Compensation Insu nee, o a certified ZONING ENG. SITE NO. copy thereof ISec. 900, Lab.C.). Policy No. mpany ' ❑ ed shere furnished. FIRE SPO INK ENERGY T 24 Certi e h 0 by sp io plicant _ _ _ Y ❑ N❑ Y ❑ N❑ MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. ICA'I'E OF EXEMPTION FROM WORKERS' PLG.CONTR. LIC. NO. PLG. ��'' IOTA COMPENSATION INSURANCE 's section need not be completed if lire permit is for one Y❑ N❑ .Y❑ N❑ OTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars (S I00) or less.) I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant BUILDING ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: If, after making this Certificate of Ex- emption, you should become subject to the Workers' Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed revoked AIR HANDLING UNIT (TO 10=CF.M.) 4.00 FEE AIRHANDLING UNIT(OVER I0,000C.RM.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ.C.). HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATI NG UN IT (OV ER 100,000 B.T.U.) 9.50 ELECTRIC Lender's Name Lender's Address VENTILATION FAN (SINGLE) 4.00 ' PLUMBING I certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws rellkmNo building construction, and BOILER - COMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 STU) SEE FEE SCH. MECHANICAL hereby authorize representaf es of is city to enter upon the above-mentioned properly to inspecii purposes. (We) agree to save, inde ify and 'cep harmless the City of Cupertino against liabilities, ju ents, costs and expe scs which ma any ay accrue ainst I conseq see of the n of permit. MISC. - REFER TO ORD. CONST. TAX , PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL tJ nature of Applicant/Conrado .Date VrMa Wry