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13327POST THIS CARD NEAR FRONT OF BUIL;DING. " CITY OF CUPERTINO INSPECTION DIVISION 2 ^�jJOB INSPECTION RECORD JOB ADDRESS ��' ``�"'-'�e_'' UNIT# LOT# OWNER � ��51 � CONTRACTOR {�(,C�' .i� PERMIT NUMBER 13327 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION - DATE INSP CTOR, ` - INSPECTION RECORD. FOUNDATION -j- ? -�-� p,�s— -4 Qd / oK if N �Q(fL(,F NRS UFER - -2 PREGUNITEPERMIT.VALDATION " 1 ISSUANCE DATE P R NO ONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL t 0 Ci Y - c, C. �Ly7 `ELECT/ c� PEO MEi �ry Its DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION VALUATION $/FT. WOOD FLOOR PLUMBING MECHANICAL -d• ELECTRICAynL� - PERMIT TO a�C1-�t�L _ FRAMING - @�. Q Y INSULATION. STORIES TYPE CONSTR. OCC. GRouup �^ RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO FT 33L�R/q�IIA 1 TOTALACREAGE DIAPHRAGM 1' eto C� 15 I ` b 8 BUILDINGUSE R NO CON P9 Orrrer ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS, BEEN SIGNED ROUGH ASSESSORS PARCEL NO. 3N2-'►-otG( 'f PLUMBING 4,j- - GAS TEST 3-/_ TRACT NO, PARCEL NO. MECHANICAL ELECTRICAL �� - FINALS '�' DATE INSP. ACC.UATE , ' ACCFILE NO. FRAMING - SAN # INSULATION - .�. ;AN ZONING ENG. SITE NO. GAS FIRE SPRINK Y ❑ N❑ ENERGY T34 Y ❑ N❑ MECHANICAL i i COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 3 LATH -INTERIOR ELECTRICAL FLOOD ZONE Y E. No, A. L.U.C. Y'❑. No LATH -EXTERIOR - 1 FIRE DEPT., SHEETROCK _;LQ- GRADE FEESUMMARY SHEAR INTERIOR BUILDING g BUILDING y (15 SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC - PLAN CHECK FEE -5c Ecd I. [- GAS NO TAPE OR PLASTER UNTIE ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM 'ARRANGE FOR INSPECTION BY PHONING 252-4505, Z ONE WORKING DAY BEFORE REQUIRED INSPECTION. o� PLEASE GIVE JOB ADDRESS -WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL IMPORTANT! READ REVERSE SIDE BEFORECALLING.FOR FINAL INSPECTION.AL FCO:NTAXPLEASE OFFICE COPY - V APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT_PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING -ELECTRICAL- PLUMBING -MECHANICAL PERMITNUMBER , BUILDING ADDRESS 22555 Salem Avenue tor413327 OWNER'. NAME TY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION Thrust IV Inc. PHONE(415 �4� DATE OF APPLICATION croRs NAME NAME Thrust, IV, Inc. LIC. NO.319115 OUTLETS -SWITCHES -RECEP 10.00/1.00 26 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS CO ADDRESS 2093 Landings DnHONE969-7722 2 PPLIANCES- RESIDENTIAL 4.00 �} ^1 PANELS 10.00 20 ARCHITECT Corp. Arch. OR O ENGINEE am Van De We Ih I®. PANELS(OVER 200 AMP) 20,00 PLAN CHECK FEE P,0. N0. SIGNS TRANS. 3.00 ARCH. OR ENDS ADDRESSame SPECIALCIRCUIT j, 00 PER ION EMP. METER OR POLE INS. 20.00 Ted Dedriksson En .:IP 41G 198-1, s 77T000'l//1 ADDRESS ADDRESS 6 MOTORS E SCH. 6 ^ SERVICE CHANGE 20.00 2093 Landings Dr. Mnt. Viet, pC�p�DD LICENSED CONTRACTORS DECLARATION r P 1013-7 1 hereby affirm that I am licensed under provisions of Chapter 9 'ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Professions C aaPpd my license is in full form gf1'ep. Licensse� CS�I s 1 Lic. Number 111 ..JJ I no BLDG. ELECT. JJ�jJf PLO MECH. �rLY4VI( lD�-C�/.�h Date1(% Conhacmr Ih,``]]77 BUILDING PERMIT OWNER -BUILDER DECLARATION I hereby collo that 1 am exempt from the Contractor's License Law for the following reason, chemuinsa,ermBusiness t tocand Professions Code: Any city or county which structure permit to construct,alter,, also improve, demolish, or repair any structure, prior n 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 Law (Chapter 9(commencing with Section 7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and INFORMATION MISC.- REFER TO ORD vALUATIOg �x/�r'DD\ O`/ t/Js l//1 S/FT. PERMIT ISSUANCE 10.00 /Q ^� ELEC. CONTR. LIC. N0. /,I���� TOTAL TOTAL /"'7" PERMIT TO 45P Aj s/ OTY. PLUMBING PERMIT FEE STORIES TYPE CONST the basis for Ole alleged exemption. Any violation of Section 7031.5 by any applicantfor a permit subjects the applicant toa civil penalty of not more than five hundred dollars (55000.): ALTER -DRAIN -WATER IEA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not 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 does such work himself or through his own employees, provided that such improve. ments are not intended or offered for sale. If, however, the building BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP R�-- RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 / FIXTURES - PER TRAP 5,00 90" SQ FT. FLOOR AREA b TOTAL ACREAGE GAS-EA.SYSTEM-11NC.40UTLETS 6,00 4 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that h e did not build or im- prove for purpose of sale.). ❑ I, as owner of the property, an, exclusively contracting with licensed contractors to construct the project (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 GAS - EASYSTEM -OVER 4 (EA) 200 . .. BUILDING USE RE IND CON PB Omer ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 I LAWN SPRINKLERSCr V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. IAL4 11 ��ee contracts for such prajems will, u con raetorfs) licensed pursuant to the Contractor's License law. SEWER-SANITA YrSTORMEA?200tt110.00 /0- TRACT NO. PARCEL NO. ❑ lam exempt under Sec.-,B.&P.C. for this reason gv'� WATER HEATE `W/ E T 6.00 6- Owner Date WATER SYSTEM 5.00 p ftIDO 5' ACC. DATE ACC. FILE NO. WATER TREATI QUIP. 5.00 WORKERS'COMPIiNSATION DECLARATION I hereby affirm that I have a certificate ol'Cousenl to self -insure' or a certificate of Workers' Compe I su�r gr certif,,d copy themor(See. 3800, Lab.C.1. � 8� 27 �b� Policy No. Company ZONING ENG. SITE N0. _1 O FIRE SPRINK Y ❑ N ❑ ENERGY T-24 I Y ❑ N❑ ❑ Certified Copy is hereby furnished ❑ Certified copy is filed with the city inspection division. Applicant MISC.- REFER TO ORD. CERTIFICATE OF EXEMPT ON FROM WORKERS' PERMIT ISSUANCE 10.00 140 FLOOD ZONE A.L.U.C. PLG.CONTR. LIC, NO. PLG. /2�� TOTAL L COMI'ENSA'I'ION INSURANCE (This section need not be completed if (lie permit is for one Y N ❑ ❑ Y N ❑ ❑ CITY. , MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or less.) I certify that in the performance of the work for which this per. mil is issued, I shall not employ any person in any manner so as to become subject to the Workers' ComP ensation Laws of California. Date Applicant BUILDING �l 15 i ALTER OR ADD TO MECH. 5.00 NOT CE TO APPLICANT: If, after making this Certificate Ex- APPLIANCE 5.00 PLAN CHECK rs' sa emption, you should become subject to the Workers' Compensation you must drevoke comply with provisions io for Labor Cit shall such provisions or this permit shall be deemed revoked FEE AIR HANDLING I I• � � O,000OF.M.) 4.00 AIR HANDLING UNIT(OVEF.(110,OOb C.F.M.)6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for EXHAUST O'CjbJ(WITH bUGT) the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). F . I . B Lender's Name -5-1.08._ Lender's Address MICROFILM HEATING UNIT (TO 100,00 .U.1 8.00 Q /�. HEATING UNI 1(9V'ER• ,000B.T.U.19.50 ELECTRIC /vf 4. I certify that I 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 relating to building construction, and VENTILATION FAN (SINGLE) 4.00 /Q - PLUMBING BOILER- CUMP(3 H.P. or 100,000 B.T.U.) 6,00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL 1 �3• hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. MISC. - REFER TO ORD. CONST. TAX UX (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue -against suit) City in consequence of the PERMIT ISSUANCE 10.00 /O- granting of this Permit. 8/3/87 MECH. CONT, LIC. NO. MECH. TOTAL +ria`= TOTAL /zq, Signature of Appicant/Contractor Date OFFICE COPY . ,•e 1 ;� . Y „ '. t ,