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14069 I POST THIS CARD NEAR FRONT OF BUILDING PFRMIT NUMBER CITY OF CUPERTINO 14069 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 10266 MANN DRIVE UNIT# Lor# PERMIT EXPIRES IF WORK OWNED STEVE ZIVIVITCH CONTRACTOR MIKE LUEKI IS NOT STARTED WITHIN p INSPECTION DATE INSPECTOR INSPECTION RECORD C 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. LIFER PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB T PLUMBING .� ELECTRICAL f! (I�U ISSUANCE DATE ELECT. PLC. MECHANICAL El eLDE . me l DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR vnw AnoN 5/PT. PLUMBING MECHANICAL PERMIT To ELECTRICAL FRAMING STORIES TYPE CONSTR. INSULATION - __UGC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SQ FL FLOOR ARfiP TOTALACREAGE . ROOF DIAPHRAGM BUILOIUSE ' RES IND CON PB Olnm APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El ASSESSORS ASSESSOR&PANCEL NO, ROUGH PLUMBING TRACT NO. PARCEL NO. GAS TEST MECHANICAL PCC.UATE ACC FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING SAN # ZONING ENG.SITE No. INSULATION PLUMBING GAS FIRE SPRINK EN ERGY T YG MECHANICAL Y ❑ No Y ❑ No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A.L.0 C. LATH—INTERIOR ELECTRICAL q/� p_'�I'j LATH—EXTERIOR FIRE DEPT. Y❑ NEI yo NEI SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING 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 FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC n^': LU ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING • 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — CONST.TAX IMPORTANT! 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 BU I LDING PROJECT I DENTIFICATI ON PERMIT NUMBER Bgl N APPLICATION & PERMIT ADDHESS ftW✓/ 14069 ./ BUILDING -ELECTRICAL-PLUMBING -MECHANICAL OWNER'S V PLAN CHECK VALIDATION NAME,• WC_ Zi✓v✓` ��G' 7 QTY. ELECTRIC PERMIT FEE "PHONE T-r-r-T�Ii• cOITTRACTOR'Ss:� ( OUTLETS-SWITCHES-RECEP 10.00/1.00 NAME LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 ADDRES` Lpf E / PANELS 10.00 /0 - r0ATE0FN AR HI ECr PANELS (OVER 200 AMP) 20.00 .C.No. ORENGINEERLIc.No. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT 5.00 A0055 GE] IIP I O(/ EMP.METER OR POLE INS. 1 20.0AOORESSrB MOTORSSEE FEE SCH.APPLICASERVICE CHANGE 20.00 ., J w o o LICENSED CONTRACTORS DECLARATION ^ ^ G v U 1 hereby affirm that I am licensed under provisions of Chapter 9 r'n r' ISSUANCE DATE N< H (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. r-Ow Z Professions Cod license is in full fur o d`saf�c._!� ❑ ❑ ❑ iow- License Class j��f/t/�siis Numb e J Q m H o Date Contractor `a y E BUILDING PERMIT rc w OWNI- -BUILDF,R DECLARATION INFORMATION w LL w I herebyaffirm that I am exempt from the Contractor's License MISC.- REFER TO ORD p VALUATION $/FT. H LL o W Law for the following mason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 /6 - - Any city or county which requires a permit io construct,alleq ISo¢ 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. TE of Q ,. ell - O LL requires the applicant for such permit to file a signed statement that TOTAL OC(� PERMIT TO is $ he is licensed pursuant to the provisions of the Contractor's License rii Law(Chapter 9(commencing with Section 7000)of Division 3 of the Q Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE F S OSTORIES TYPE CONSTR. o the basis for the alleged exemption.Any violation of Section 7031.5 e- by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 of no[more than five hundred dollars(S500t): ❑ 1,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 tie work,and the structure is not intended Or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law docs not apply to an owner of • property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered ITT sale.If,however,the building GAS-EA.SYSTEM-1 INC.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 am- RES IND CON PB Omer prove for purpose of ale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business ILAWN 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 wIm builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITAR V-STORM EA.200ftI10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ Iamexemptunder Sec. ,B.&P.C.oRthis WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO. WORKERS'COMPENSA"PION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to sell-insu e, ZONING ENG.SITE NO. or a certificate of Workers'Compenszlim In umnc• r a cert ed copy lhereo��'($�y3�0 0,I.A.C.). Policy NoflJP.$b{>8fompany Q ❑ Certified copy is herFby furnished. - FIRE SPRINK ENERGY T 24 Z Z ❑ Ce Ie c pygg filed ith the cit ection div - MISC.- REFER TO ORD. Y❑ N❑ Y ❑ NC] Applicwi ,.Lfil- f' Oy PERMIT ISSUANCE 10.00 FLooDZONE A.L.U.C. � > CIiRTIFICA'rli OF 17XEMVTION FROM WORKERS' LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y❑ N� Y❑ N❑ 0. Cl (This section need not be completed if the Permit is for One TOTAL ::) 2 hundred dollars(SI00)or less.) U O_ 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H alit is issued,1 shall not employ any person in any manner so as to LL W become subject to the Workers'Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } h NOTICE 1'0 APPLICANT'. If,after making this Certificate of Ex- ? emption,you should become subject to to Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 1 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 H EATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 2 0 l Lenders Address - I certify that I have feud 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-COMP(3 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 BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned properly 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 may in any way accrue a• said City in consequence o the PERMIT ISSUANCE 10.00 In of thlSp mi. MECH.CONT. LIC.NO. MECH. TOTAL TOTAL Signatureo App ice C cion ale OFFICE COPY