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13597 POST THIS RD NEAR FRONT OF BUILDING PFRMR NUMBER CI1�'OF CUPERTINO INSPECTION DIVISION 13597 JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS 20363 STEVENS CREEK uNlTtt - Lor# ' PERMIT EXPIRES IF WORK OWNER LA BOULAN CONTRACTOR DEANZA PROPERTIES IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - - ANCE OR •180 DAYS FROM LIFER LAS TCALLEDINSPECTION. • PREGUNITE , PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ^ " UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE 'MECHANICAL O�'T BLDG. ELECT. PLC. MECH. { .D ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED Cjty Of GUD 4'11'0 BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION $/FT: PLUMBING MECHANICAL ELECTRICAL PERMIT ro FRAMING STORIES TYPE CONSTR. INSULATION - OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF "SO.Ei.FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE - IT IND CON PB Olhe, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ El 11 ASSESSORS PARCEL NO. ROUGH 11 1 PLUMBING -3-87 Cgk V GAS,LEST TRACT NO. PARCEL NO, MECHANICAL i — - Acc.DATE . Acc.FILE NO, ELECTRICAL - �, 6, FINALS DATE INSP. FRAMING PeAA. (y 0"I SAN # I / ZONING ENG.SITE NO. INSULATION PLUMBING GAS — /ji I MECHANICAL' _ 8•"if� FIRE SPRINK ENERGY T2G YEl COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "El ° N[] LATH—INTERIOR ELECTRICALIt,f FLOOD ZONE A.L.U.C. LATH—EXTERIOR FIRE DEPT. w L gi in Y❑ NE] Y N� SHEETROCK j0 GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIORTEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK r - FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE % OCCUPANCYOF BUILDING IS NOT PERMITTED UNTI L BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING.252-4505, ELECTRIC oONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INF(&MATION WITHIN RED LINES -.USE ALL POINT PEN ONLY ' ?�15 ✓ BU ING PROJECT IDENTIFI N APPLICATION & P IT PERMIT NUMBE X ""`D' ` 13597 %DDRESS Bw BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWry ER's PLAN CHECK VALIDATION • X. NAME �} BBU Ff�',' t ///� 5�(}] DTV. ELECTRIC PERMIT FEE r(J PHONE / V' corvrsncT s f "t UTLEITS-SWITCHES,-RECEP 10.00/1.00 AME LIC No. 7/LIGHTI NG F IXTURES 10.00/1.00 F EESESS TOR's � )APPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMPI 20.00 5n k eJ11C.No. SIGNS TRANS. 3.00 AARCH OR DDRESS ENG. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP TEMP. METER OR POLE INS. 20.00 ADDRESS S f` j' MOTORS SEE FEE SCH. C !� 'I ')SERVICE CHANGE 20.00 �/` -'u �'/E w O O LICENSED CONTRACTORS DECLARATION _ f�- ; r� D/� / a / a u u I hereby affirm that I am licensed under provisions of Chapter 9 L •' JISSUANCE[[[DATE n "' (commencing with Section 7000)of Division 3 of the Business and a H BLDG. ELECT, C. MECH. ❑ Professions Code,and my license Is In full force and effect. s o z H o License Class Lic.Number `+rVI - P-,UDt41� r w H w Date Contractor 'ams a BUILDING PERMIT rt a OWNER-BUILDER DECLARATION K o a UINFORMATION W g a. G I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD FU04 Law forthe following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. y0 Code:Any city orcounty which requires a Permit to construct,alter, '/ a �Yv to� 40 improve,demolish,or repair any structure,prior to its issuance,also ELEC.LONTR. LIC.NO. ELEC. 7 22 a w0 u requires the applicant for such permit to file a signed statement that TOTAL . PERMIT TO m m he is licensed pursuant to the provisions of the Contractor's License r > Law.(Chapter 9(commencingwith Section 7000)of Division 3 of the ic Business and Professions Code)or that be is exempt therefrom and OTY. PLUMBING PERMIT FEE /All �HP.t O✓@'j Ie I- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant lora permit subjects the applicant toa Clvllpenalty of not mom than Ove hundred dollars(5500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00^� ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUPRES.UNITS their sole compensation,will do Be work,and the strucnue 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 thereon,and who does such work (, FIXTURES-PER TRAP - 5.00 so.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that suchimprove- memn s are ,of intended or offered for sale.11',however,the building o-_:{ GAS-EA.SVSTEM-1 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of proving that he did not build or an. BUILDING USE prove for purpose of saleJ' INDUSTRIAL WASTE INTER3000 RES NO CON PS Omer ❑ I,as owner of the properly,am exclusively contracting wait . . ❑ ❑ ❑ ❑ ❑ 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 Contractors License Law does not apply to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OV ER 5(EA.) 1.00 contracts for such projects with a contractors)licensed Pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO, PARCEL NO. Cl lam exempt oder Sec.-,B.&P.C.Iia this WATER HEATER W/VENT 6.00 on Owner Date a4 WATER SYSTEM 5.00 ACO.DATE ACC.FILE N0. WORK.RS'COMP° SA"PION DIiCLARATlO U WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-nslne, or a certificate of Workers'Compensation Insurance,or it certified ZONING ENG.SITE NO. copy thereof'(Sri.3800,Lab.CJ. ' Policy No. Company O ❑ Certified copy is hereby furnished FIRE SPRINK ENERGY T-24 Z Z D Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. O Applicant Y❑ N❑ Y ❑ N❑ ~ w UJ - CERTIFICATE OP EXEMPTION PT ION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 c. W MP �_ COIiNSATION INSURANCE. PLG.CONTR. LIC.NO. - PLG. CL 0 (fin, section need not be completed if the permit is for one TOTAL V❑ N❑ Y ❑ N❑ Z) Z hundred IS 100)or less.) U O 1 cerlity that in the performance of IIIc work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL - mit is issued,1 shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. ry/ d Date Applicant ALTER OR ADD TO MECH. 500 BUILDING J!p Sa > to NOTICE: 'TO APPLICANT': If,after making this Certiliwle of F:x- . ?I- emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions ILabor Code, must forthwith comply wills FEE (.1 ' such provisions or ns or this permit shall b be decried revoked. AIR HANDLING UNIT(TO 10,000GF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE 7 I 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.C.L tC HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9,50 Lender's Address ELECTRIC • 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 PLUMBING ordinances and.state laws relating to building construction, and T_" BOILER-COMP(3 H.P.or t00,0008.T.U.1' 6.00 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. CONST.TAX iEAtEractor abi flies,judgments, costs and expenses which le against said City in consequence of the PERMIT ISSUANCE 10.00 MECH.CONT. LIC.NO, MECH.TOTAL TOTAL / 3 v9 nt onlractor Date OFFICECOPY