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12486 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO ` .. ' PFRM1TTNU4 86 INSPECTION DIVISION � yJOB INSPECTION RECORD JOB ADDRESS 10121 WESTMINSTER CT "UNIT# LOT# PERMIT EXPIRATION 16 s _ PERMIT EXPIRES IF WORK OWNER THRUST IV INC CONTRACTOR THRUST IV, INC I IS NOT'STARTED.WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. LIFER - —.147 PREGUNITE - PA"loanory 1 ''2. 'fs �Jltl 7 !(� POUR NO CONCRETE UNTIL ABOVE HAS BEE SIGNEO • 1*. UNDERGROUND /SLAB PLUMBING of tj�0 ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ELECT. PLG. MEC El 0 13 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING - 204000 MECHANICAL ' ./�� / PERMIT TO ELECTRICAL _ FRAMING i/ 8YDW' STORIES TYPE CONSTR. INS CATION Z a � i OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED I I R-3 1 r ROOF J SO,FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM 3236 CuperIRO RES INDUILOCNONUSE PS ONrr APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ® El 1:1 ❑ ' El ROUGH ASSESSORS PARCEL NO. PLUMBING ^4- v_30 4c, GAS TEST a,.29, Ac PARCEL No. MECHANICAL -9014 �, - J ELECTRICAL G.- p_' FINALS DATE INSP. A 'DATE ACC.FILE NO. FRAMING SAN #:' ZONING ENG.SITE NO. INSULATION PLUMBING GAS 9 MECHANICAL I- _ FIRE SPRINK ENERGY T 2 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [:] N Y D N[] +'-- — FLOOD ZONE A.L.U.C. LATH-INTERIOR _ -C ELECTRICAL LATH-EXTERIOR �_,�j_ 7 FIREDEPT. �r/ YEl NO Y ❑ NEI SHEETROCK I GRADE FEE SUMMARY SHEAR INTERIOR BUILDING �j;rrl SHEAR EXTERIOR �1.g'S7 TEMPO RAR`f;APP ROV' L' BUILDING 693.00 FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC t o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING -- �i PLEASE GIVE JOB ADDRESS WHEN PHONING. •��,' Z - SEE PERMIT FOR EXPIRATION DATE MECHANICAL IMPORTANT! CONST.TAX 280.00 PLEASE READ REVERSE SIDE BEFORE TOTAL ~~v CALLING FOR FINAL INSPECTION. ' OFFICE COPV CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE o T r 4 _ QGG ZV // Date ........L..............�........., 19..80 Building Permit No. .�........ ...go The-Building Located at J..U.. Zl......W.�...%MA-A. 4S...nr.....Cr..T ownerby ...... s.T....._T .... L. h ............L..... ................................. Has Been Comeletde) or Use As: .... ....!,J..1L✓..f^...................................... . .................................................................................................................................................. .................................................................................................................................................. ........_........................................................................................................................................ ...................... .... ........................................ PD-7 B G INSPECTOR E :. .A•QPLIC4NT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBERBUILDING APPLICATION 81 PERMIT ADtoE •,jt Ur21 WESTMINSTER CTI XJ BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 12486 OWNER'S - PLAN CHECK VALIDATION "AME OTY. ELECTRIC PERMIT FEE U .rl- NC PHONE CO"TRACTORS Q UTLETS-SWITCHES-RECEP 10.00/1.00 ZNG LIC.No.31 // LIGHTING FIXTURES 10.00/1,00 ADDREACroR's55 PPLIANCES-RESIDENTIAL 4.00 ADDRESS I� V 7Q ��,/ 65 A"VPHONE %y-7/22 a PANELS 10.00 � DATE OF APPLICATION OR P. ARCA. PANELS (OVER 200 AMP) 20.00RCNIT CT RPLAN ECK FEE - ) fnT Ervc1D1EBR,- VAN 1)6WE 8 LIC,NO. SIGNS TRANS. 3.00 ARCH ORESS ENG. SPECIAL CIRCUIT 5,00 '' PERMIT VALIDATION Sill 'Et ZIP EMP. METER OR POL INS. 20.00 u��1�0 APPLICANT'S - AODREss MOTORS - FEE 3 /AN . /aV.S - M Q +3 SERVICE CHANG 20.00 -7/j3/f7 w G G LICENSED CONTRACTORS DECLARATION S, U w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE GATE (commencing with Section 7000)of Division 3 of the Business and •x BLDG. ELECT. PLG. MECH. an Z Professions Col(1S,,an�1 m license is in full fo I d g f• U Z oJill =z License Class.11.-1 Y Lic.Number .4,I I, O w r 0 Dale_5_-Ia �Contractor + a m f BUILDING PERMIT I[ In REFER TO ORD OWNER-BUILDER DECLARATION INFORMATION w ;LL w I hereby affirm that I am exempt from The Contractor's License MISC.- VALUATION I- u O J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 (f-� $/FT. i Code:Any city or county which requires a permit to construct,alter, 204,000 �,ZagO improve,demolish,or repair any structure,prior to its Issuance,also ELEC.CONTE. LIC.NO. ELEC, vvQQ W 0 Se requires the applicant for such permit to file a signed statement that TOTAL /a L3 -� PERMIT TO n w m he is licensed pursuant to the provisions of the Contractor's License 1- Low(Chapter 9(commencing with Section 700()of Division3ofthe SFDWL E 4 o Business and Professions Code)or that he is exempt therefrom and CITY, PLUMBING PERMIT FEE tl 1- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES.J TYPE CONSTR. . u; - by any applicant for a permit subjects the applicamto acivil penalty ALTER-DRAIN -WATER (EA.) 5.00 2 h of not more than five hundred dollars(S500.): ❑ I,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 the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 1 Code:The Contractors License Low does not apply to an owner of properly who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5= -- SO.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided That such im Prove GAS-EA.SVSTEM•11NC.40UTLETS 8,00 3236 / mentsare not intended or offered for sale.If,however,the h, )ding or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 IEA) 200 builder will have the burden of proving that h . . . e did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. ,30.00 7R[EES IND CON PB Omar ❑ I,as owner of The property,am exclusively contracting with I,J El ❑ 1:1 C1licensed contractors to construct the project(Sec. 7044,Business LAWN SPRI 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 properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 342-12-0 contracts for such projects with a contractors)licensed pursuant to SEWE $ I IAR YST9flM EA.200ft/10.00 the Contractor's License Law. ) ,[� � TRACT NO, PARCEL NO. ❑ I am exempt under Sec.-,B.&P.C.for this WATERHEATER W/VENT 6.00 reason �-- 8016 Owner Date WATE S ft5.00 S__ ACC.DATE ACC.FILE N0, WORKERS'COMPENSATION DECLARATION WATER TREATING EO IP. 5.00 1 hereby affirm That I have a certificate of consent to self-insure, ZONING y G.SITE N0. or a certificate of Workers'Compensation I r�pfer a certified ,F copy Thereof(Sec.3800,Lab.CJ. STATa {'LF/D F Policy d- No. Company- O Cl Certified copy is hereby forms ed FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is Filed with the city inspection division. MISC- REFER TO ORD. O Applicant Y❑ N01 y ❑ N❑ Lo CERTIF'ICATEOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 a FLOOD ZONE A.LU.C. W COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. 99 1 O ('fhls section need Rol be completed if the permit is for one TOTAL 1J I2 Y❑ N❑ Y❑ N❑ Z) Z hundred dollars($100)or les") ) 0 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued,I shall not employ any person in any manner so as It, become subject to the Workers'Compensation Laws of California. ii Date Applicant ALTER OR ADD TO MECH. 5.001 BUILDING 693.00 } W NOTICE TO APPLICANT: If,after making this Certificate of Ex- 1... Z emption,you should become subject to the Workers'Compensation ApPL1ANC 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE C..) such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION L17NDING AGENCY AIR HfjNDLING UNIT(bVER 10=C.F.M.) 6.00 SEISMIC FEE 14,28 1 hereby affirm that then 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,CieC.), pp HEATU4 QflNRPt1iV,00O B.T.U.) 8.00 (o Lender's Name �• O` i7 HEATING UNIT(OVER 100,000 B.T.U.)9.50 �D I li Lender's Addre Q - ELECTRIC vv I certify that I have rwd this application and state that the above VENTILATION FAN (SINGLE) 4,00 �- p 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 /3 e) ordimu ces and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property forinspectionBOILER-COMP (Over 100.000 BTU)SEE FEE SCH. MECHANICAL hipurposes. (We) agree to save, indemnify and keep harmless the City of Misc.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.0073-- CONST.TAX 280.00 may in any way accrue against said City in consequence of the granting of this permit. �1 MECH.CONT. LIC.NO. MECH. / sass&_ '1112 11�Patta TOTAL �3 �+ TOTAL / Signature of Applicant/Contractor Date 3'7� a� 5.4'67 OFFICECOPY