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13678POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS 20330 STEVENS; CREEK UNIT# LOT# OWNER APPLE COMPUTER CONTRACTOR AMERI F INSPECTION DATE INSPECTOR INSPECTION RECOR UFER POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING - ELECTRICAL MECHANICAL 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED WOOD FLOOR MECHANICAL ELECTRICAL FRAMING INSULATION PFHMIT NUMBER 13678 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN. 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. PERMIT VALIDATION :\4.�I SUANCE DATE I `BLD JELEECnCT, PLG. MECH. S BUILDING PERMIT C\h� INFORMATIONS VALUATION VFT PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF Q�fT. DIAPHRAGM RES APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED C C L ROUGH r❑ N� PLUMBING GAS TEST - - MECHANICAL ELECTRICAL FINALS ' DATE. INSP. FRAMING - SAN # INSULATION PLUMBING _ FEE SUMMARY GAS BUILDING. 7APPRO(/AR. ME HANI A ENG. C C L •v❑ N� r❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD20NE ❑ N ❑ A,L.U.C, ° ❑ N LATH -INTERIOR ELECTRICAL LATH—EXTERIOR - .FIRE DEPT. SHEETROCK - - .GRADE Ej, 0 Do a _ FEE SUMMARY SHEAR INTERIOR BUILDING. 7APPRO(/AR. . BUILDING SHEAR'EXTERIOR .' TEMPORARY FIREWALLS ELECTRIC PLAN CHECK FEE - GAS' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, oo ONE WORKING DAY BEFORE REQUIRED INSPECTION: Z - PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. Tnx' IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL • . • OFFICE COPY - 10 O Z_ z N cc - LLI > CL Z) z U0 LL U Ow z Al APPL16ANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY - BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING -ELECTRICAL- PLUMBING -'MECHANICAL PERMIT NUMBER 13678 BUILDING ADDRESS 20 O rTFiZ/ENS CA.C� / J OWNER'S 3 NAME f�-f�' PPLE /le V' 74 ?,t OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION .r //ewe( n. PHorvE CONTRACTORS NAME OUTLETS -SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 4,,f -,"Cox. A.,)p, LIC. NO, TROACTOR(j APPLIANCES -RESIDENTIAL 4.00 PCON ADDRESS i � DATE OF APPLICATION PANELS 10.00PHONE ARCHITECT OR ENGINEER LIC. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 A ones ENC' SPECIAL CIRCUIT - 5.00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP AD CANTS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 / \ oi/ ISSUANCE DATE LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and PoR essions CMI 1111 m icome Is In full fI a ( L`ife ./ License IS LIC. Number BLDG.ELECT. �fIIJ��I! 'l❑ PLG. MECH. ❑ DTIC Contra el0r ^111., friN A - - Cj t �J OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law forthe followingreuson.(Sec. 7031.5, Businessand Professions 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 Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and , PERRMATION (y110BUIL[611G MIT MISC. - REFER TO ORD PERMIT ISSUANCE 10.00 ( w ALUATION $/FT. ELEC. CONTR. LIC. N0. ELEC. TOTAL PERMIT O . OTYPLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of5ection 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (8500)): ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wagesas 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, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: Tho 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. Montsarenotintendedorofferedforsale. If, however, the building FIXTURES - PER TRAP 5,00 SO. FT. FLOOR AREA - TOTALACREAGE GAS - EA. SYSTEM -11 NC.4 OUTLETS 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.).INDUSTRIAL C3 1, as owner of the properly, am exclusively contracting with GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Omar ❑ ❑ ❑ ❑ ❑ WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, business and Professions Cade: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO, contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ Iran exempt under Sec.-, B.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. GATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORK E RS'COMPENSATION DECLARATION I hereby affirm that I have a Certificate ofconscnt to self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG, SITE NO. copy thereof (($cc. 3800, Lab .C.I Policy No.� Company E /3 ❑ Certified copy is hereby furnished. �y c ) ❑ Certified ;W1 Is Bled w11't�h the cV IfGPL9iY1 division. ApplicanI A B4 fart/ ryfON FIRE SPRINK Y ❑ N ❑ ENERGY T-24 Y ❑ N❑ MISC- REFER TO ORD. CERTIFICATEOP EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. PLG. CONTR. LIC. NO. TOTAL COMPENSATION INSURANCE (This section need not be completed if the permit is for one Y ❑ N ❑ Y [:] N ❑ hundred dollars IS 100) or less.) I certify that in the performance of the work I'or which this per mit is issued, 1 shall not employ any person in any manner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensation Laws of California. Date ApplicantALTER NOTICES TO APPLICANT: If, after making fids Certificate of Ex- . . OR ADD TO MECH. 500 APPLIANCE 5.00 PLAN CHECK FEE emption, you should become subject to the Workers' Compensation such provisions ons or thof the isperor n permit shall be deemed rou Must evoked hwith comply with AIR HANDLING UNIT (TO 10MC.F.M.) 4.00 AIR HANDLING UNIT (OVER 10=11C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency ]or EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued (Sec. 3097, Civ.C.L MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 H EATI NG UNIT (OVER ER 100,000 B.T.U.) 9.50 ELECTRIC Lender's Name Lender's Address - 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 ordinances and state laws relating to building construction, and PLUMBING BOILER-COMP(3 H.P. oF100,000 B.T.U.) 6.00 BOILER -COMP (Over t00,000BTU) SEE FEE SCH. MECHANICAL hereby aufhorin representatives of this city to enter upon the above-mentioned property for inspection purposes. Misc.- - REFER TO ORD. (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 said City in consequence of the CONST. TAX PERMIT ISSUANCE 10.00 gran tin fill permit r e MECH. CONT. LIC. NO. MECH. TOTAL - TOTAL S 5[/a Ignam of Applican[/Contractor a e OFFICE COPY