14476 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER _
CITY 'OF:CUPERTINO ' 14476
= INSPECTION DIVISION
JOB INSPECTION RECORD
+' +— PERMIT EXPIRATION
JOB ADDRESS 10120 IMPERIAL-AVE UNIT# nor#
PERMIT EXPIRES IF WORK l
OWNER. MEASUREX CORP CONTRACTOR .TECH ELECTRIC Is NOT STARTED WITHIN
INSPECTION DATE. INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU,
ANCE OR;180 DAYS FROM''
FOUNDATION - NOTE: -
LASTCALLEDINSPECT.ION. .
.` LIFER ALL GRADING AND DRAINAGE,SHALL BE INSTALLED '
PREGUNITE I - - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS'
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
? PLUMBING
+ ELECTRICAL dP - I ISSUANCE DATE -
MECHANICAL - •+ 1g LUG. ELECT, PLG. MEC,c,
EL El 13
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - BUILDING PERMIT
'WOOD FLOOR � INFORMATION
_ VAWATION $IFT.
PLUMBING � •
MECHANICAL
ELECTRICAL - # 1.PERMIr IU.
FRAMING
INSULATION '+� - .. .. STUDIES PE CONSTH
• OCC.GROUP REE UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
h ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn r r.ELDOR AReA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
• "
BUILDINGPSE
ROOFSHENES IND CON .. PH Otl,=,
APPLY NO ROOFING UNTIL ABOVEMAS BEEN SIGNED I FINALS ' DATE. INSP. ❑ ' 1:1 El ID ❑
ASSESSORS
' ROUGH SAN.a PARCEL NO.
-'
PLUMBING' ELECT.ENERGY,
PLUMBING ENERGY TRACT NO. PARCEL NO,
TUBS&SHOWER,PANS - -
• MECHANICALS MECH.ENERGY. -
' ACC,DATE ACC FILE NO. „
ELECTRICAL 1 BUILDING-ENERGY
FRAMINGELECT.FINAL TEST
INSULATION PLUMBING ZONING ENG.SITE NO.
�
GAS TEST- GAS
MECHANICAL - FIRE SPNINK ENERGY T-24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' Y ❑ ND '•:Y ❑ N❑
ELECTRICAL RELEASE -=� � - FLOOD TONE A"L.U.C.
, EXTERIOR SHEAR - -
INTERIORSHEAR FIREDEPT. ` Y❑ N❑ v ❑ N❑ '
SHEETROCK, .-4 GRADE - FEE SUMMARY
EXTERIOR LATH BUILDING - -
,INTERIOR LATH TEMPORARY APPROVALS BUILDING
SCRATCH COAT - - . ELECTRIC" PLAN CHECK I-
--S - - FEE ..
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNEDI OCCUPANCY SEISMIC FEE `
OCCUPANCY OF BUILDING ISNOTPERMITTED UNT,CBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM,' :
ELECTRIC - A
ARRANGE FOR INSPECTION BY PHONING,252-4505, 4
'Lu '0NE-WORKING DAY.BEFORE REQUIRED INSPECTION. PLUMBING
O PLEASE GIVE JOB ADDRESS,WHEN P.HONING:'
Z - . MECHANICAL
SEE PERMIT'FOR EXPIRATION DATE—
` IMPORTANT! ' corvsT.TAX .
PLEASE READ REVERSE SIDE BEFORE TOTAL. ,
CALLING FOR FINAL'INSPECTION. .
OFFICE COPY
. APPLICANT•TO FILL IN INFORMATION WITHIN REDLINES — USE BALLPOINT PEN ONLY
' IDENTIFICATION 'I BUILDING PROJECT PERMITNUMBER,.APPL'ICATION'& PERMIT
' 1447 hU V
. eulLolrvO
ADDRESS
wk y'A BUILDING—ELECTRICAL—PLUMBING—MECHANICAL
pp-
OWNER'a PLAN CHECK VALIDATION
A NAME - OTY. ELECTRIC PERMIT FEE '
PHONE a s"
CONTRACTORS '
A NnmE GG [OUTLETS-SWITCHES-RECEP 10.00/1.00
6�' •G/ uc.NO ILIGHTING FIXTURES 10.00/1.00 '
CONTRACTORS ,- PPLIANCES-RESIDENTIAL - 4.00
ADDRESS /1 SIC.
oy� �x
a7-'ll LAr%e J,f,-PHONE ro ' PANELS ' 10.00 DATE OF APPLICATION ' "
ARCHITECT, -- PLAN CHECK FEE P, .NO.
OR PANELS IOVER 200 AMP( '20:00 - _
. ENmNEEn, LIC.No, SIGNS.TRANS. - 3.00
AARC OR H
DaR ESS ENG SPECIAL CIRCUIT 5.00" v PERMIT VALIDATION
`zip TEMP.METER OR POLE INS. 20.00 -
f.,
APPLICANT MOTORS SEE FEE SCH. Al
APPLIEA
SERVICE CHANGE 20.00 L)
//�/p
_r o o•
LICENSED CONTRACTORS DECLARATION Sr/ 'r'f/ O4
u
¢u u 1 hereby affirm that I am licensed under provisions of Chapter 9 - 1 SUA CE DATE -
Nz O1 (commencing with Section 7000)of Division 3 of the Business and
a - + BLDG. ELECT. I PLG: MECH.-
Z Professions Co e,and my license is in full force and a fe I.
Z
i a License Cluss.�i n Lie.Number_ s2 _ � � ❑ ❑ -
F- _r j Date-4-1 oP Contracts p
oo
a m t G(� 1 BUILDING PERMIT
¢ ¢ a OWNER-BUILDER DECLARATION'
d eJ - MISC.— F RD INFORMATION
' w ; -1 hereby,afflrn that I am exempt from the Contractor's License
u O J Law for the followin,reason.(Sec.7031.5,Businessand Pntl'essions a _ VALUATION S/FT.
r._ b 'PERMIT ISSUANCE a 0. 0
Code:Any city or county which rcyuiresu purmutoconstruct,ulfor, - "
inmrove,de111011911,or repair any structure,prior tai ifs issuance,also EIEC.DONTR. -
w 1N
¢ 0'K' requires Nm applicant for such permit to lite u signed statement tial �
a,U.m °' he is liwnsed pursuant to the provisions of the Contractor's License _ PERMIT TO
• +F z a
Law(Chapter 9(commencing with Section 7000)of Division J of the - v E��7
4 O Business and Professions Code)or that he is exempt IhereGom and DTY. PLUMBING PERMIT FEE
¢ H the basis for the alleged exemption.Any violation of Section 703 t.5 I STORIES TYPE CONSTR.
u ; � _ by any applicant for a permit subjects the applicant o a civil penally ALTER
-DRAIN&VENT-WATER (EA.) 5.00 •'
of not more than five hundred dollars(1500)):
C] I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE .4.00 - OCC.GROUP RES..NITS
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
Code:The Contractors License Law does not apply to an owner of
property who builds or improves(hereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACR EADE
himselforthrough his own employees,provided that such improve- GAS-EA.SVSTEM•11NC.40UTLETS 6.00
meats are not intended or offered for sale.If,however,the building
or improvement is sold within one year of completion, the owner- BUILDING USE
EASYSTEM
OVER 4 (EA.) 2.00 _
I) - builder will liavc,the'burden ofproving that hGAS- :e did not build or im-
prove for purpose ofsalcJ. - INDUSTRIAL WASTE INTER. 3000 RES IND CON PB Other
❑ 1,as owne .
r of the properly,am exclusively contracting with 1:11-1 El El ❑
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 dues not apply
to an owner of properly who builds or improves(her«m,xnd who + LAWN SPRINKLERS-OVER 5(EA.) 1.00 '
comoses'for such projects with a contrac_tor(s)licensed pursuant(o SEWER-SANITARY-STORM EA.20011/10.00
the Contractors License Law. - TRACT NO. PARCEL NO.
rea❑son I ant exempt under Sec. ,li.&P.C.lot this WATER HEATER W/VENT . " 6.00
ar
' Owner Dale _ WATER SYSTEM - 5.00 ACC.DATE ACC.FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. - '5.00
.1 hereby affirm tha1-1 have a certificate of consent to sel4insure, - ZONING ENG.SITE NO.
or a cenifacale of Workers'Com ensanpo Insurance,or a certificvl
copy Ther��gqf lScc.J ;Lab.0 1 J- /�y
Policy NolanY
C ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGYT-24
z' ❑ Cerlifi� y is 0 d with a iny+enion Ji`, v MISC.- REFER TO ORD. . Y❑' N❑ Y E] N[_ -
- O App)icant R
PERMIT ISSUANCE 10.00
— CIiRTI FICATE OF.EXEMPTION IiROM WORKERS' FLOOD ZONE A.L.U.C.
L COMPENSATION INSURANCE PLG.CONTE, LIC.NO. PLG.
i"? Z ffhis section need not be completed if.the permit is for one TOTAL Y[3fe❑. Y F] N❑
hundred dollars(S)00)or less,)
U'O, 1'certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL+F• (nit is isawd, I shall not employ any person iu any manner so as to
t O W )Ccuind subject In the,Workers'Con+pensutlon-Laws of California. '
_ ry Date Applicant ALTER OR ADD TO MECH. 5.00 . BUILDING
5- N NO'1'IC r' 0 APPLICANT: II',after making this CUrlifieme of lix-
,a ? emption,you should become subject In The Workers'Comp iectmu APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, YOU most I'orthwilh Comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MCF.NL) 4.00
CONSTRUCTION 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,pert'ormance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). _ HEATING UNIT(TO 100,000 B.T.U.) - 8.00
Lender's Name _ HEATING UNIT IDV ER 100,000 B.T.U.)9:50 ELECTRIC Q B�
he do I.,Address
I certify llaal I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 -
information is correct. I agree to comply with all City and county PLUMBING
ordinances and stale laws relating lo.building Construction, and BOILER-CCBv Q H.P.Or,100,000 B.T.U.1 6.00
hereby authorize representatives of thiscityto enter upon.the
dove-mentioned properly for inspection purposes. BOILER-COMP (Over 100,000 BTUIIBEE FEE SCH. MECHANICAL
a
- (We) agree to save, indemnify and keep harmless The City of MISC.- REFER TO ORD.
Cupertino .,.just liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST„TAX
may in any v, accrue ntWinSt Said City in'Cens'equence of the - „
USChi ol'1 i3 nniL U MECH.CONT. LIC.NO: MECH.
+� . I �L'$�- TOTAL • TOTAL
Signatu of p icant/C ntraJoor Date
OFFICE COPY