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14624 POST THIS CARD NEAR FRONT OF BUILDING �1. PERMIT NUMBER .CITY OF 'CUPERTINO INSPECTION DIVISION . 14624 �1A JOB.INSPECTION RECORD w',I ve,Z PERMIT EXPIRATION `-y JOB ADDRESS �Q��3 /v �� b• UNIT# " _LOT#• - ;•PERMIT EXPIRES IF WORK , OWNER !/UcrcS7Frr✓Li) `119 lea /yq-C.Lc NrRgcroa - � `" IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU; FOUNDATION - - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED '�+ PREGUNITETO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION, GARAGE SLABS. t ' ' CUPERTINO STANDARDS: i � - • POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - - �(�, �• UNDERGROUND /SLAB PLUMBING, ELECTRICAL ISSUANCE DATE MECHANICAL ' , - BLDG ELECT, PLC,. MECR.; F '. r ti ❑ ❑ El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED �'N�� } BUILDING PERMIT WOOD FLOOR ` ...h1!1fl N FORMATION It -� rvr VALUATION -$/F T.' PLUMBING - .LILY �• 72 0000 MECHANICAL ELECTRICAL - PSDBSTiW it D n FRAMING - INSULATION sryRCS trvPE coNsrR. OCC:GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' -! - - SO,FT FLOON AR EA TOTAL ACREAGE ROOF• NOTE:NO FINAIliIV.SHALL BE MADE BEFORE DIAPHRAGM' - THE CONSTRUCTION TAX IS PAID - . t . BUILDING USE ROOF SHEATHING _ RES MD CON PB Om" ` APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ED . ❑ ❑ ASSESSORS PARCEL NO. ROUGH • SAN,# • PLUMBING ELECT.ENERGY ' TUBS BSHOWER PAN PLUMBING ENERGY -iRACT'NO. PARCEL NO,, MECHANICAL - MECH.ENERGY ' ' ACC DATE ACC,FILE NO. ELECTRICALBUILDINGENERGY FRAMING - - ELECT:FINALTEST zoNlNc ENc:SITE NO. . "INSUlAT10N PLUMBING GAS TEST GAS MECHANICAL FIRL.SPRINK ENERGY T„)A COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ N❑ ° ❑ : N❑ FLOOD ZONE A,L.0 C. EXTERIOR SHEAR ELECTRICAL RELEASE - INTERIOR SHEAR FIRE DEPT. Y❑ NO Y ❑ NO' SHEETROCK - GRADE FEE SUMMARY EXTERIOR 'LATH - BUILDING - BUILDING MAO*LATH - TEMPORARY APPROVALS SCRATCH COAT ELECTRIC.' PLAN CHECK 226.9$- 1 - GAS FEE ' - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY ` SEISMIC FEE- $.04 OCCUPANCY OF.BUILDING ISNOTPERNtITTED UNTILBUILDI NG FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC F- ' . ONE WORKING DAY BEFORE REQUIRED INSPECTION. O�:. PLEASE GIVE JOB ADDRESS WHEN PHONING. . * PLUMBING ' Z • ' f .' P MECHANICAL *f -.SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! 3 a CONST.TAX PLEASE READ REVERSE SIDE BEFORE *'"'' ' TOTAL ° $80.89. CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION .PERMIT NUMBER BUILDING APPLICATION & PERMIT /h� ADDRESS10123. N. Wolfe Rd. BUILDING -'ELECTRICAL-PLUMBING-MECHANICAL 14624 _,f, OWNER'S Q - !;� PLAN CHECK VALIDATIONQTY, ELECTRIC PERMIT FEE 1 y` � trlC�c��nL, 2yi3_lov°l PRONE $ CONTRACTORS 4 AME OUTLETS-SWITCHES•RECEP 10.00/1.00 LIC:NO. LIGHTING FIXTURES -10.00/1.00 CONTRACTOR - PPLIANCES-RESIDENTIAL 4.00 ' ADDRESS - PHONE PANELS • 10,00 r DATE OF APPLICATION' S ARCHITECT PLAN CHECK FEE -P.C.NO. OR ")"�Y-rx� PANELS (OVER 200 AMPb 20.00 - ENGINEER //��JJ -- ' LIC.NO.&&V&f -34 SIGNS TRANS. 3.00 ARCX.DRENG. 11111 MoN�C� Q,U , PERMIT VALIDATION ADD Ess SPECIALCIRCUIT 5.00 ,- L es A�g�as,c1 ZIP-JOVZq TEMP.METER OR POLE INS. 20.00 APPLICANTSMOTORS SEE FEE SCH. (�.L✓..R""� ADDRESS ADDfl • SERVICE CHANGE "• 20.00 00 LICENSED CONTRACTORS DECLARATION u w 1 hereby affirm that I am licensed under provisions of Chapter 9 - I ISSUANCE DATE w (Commencing with Section 7000)of Division 3 of the Business and 4 HBLDG. . ELECT. PLG. MECH. r D z Professions Code,and my license is in full force and effect. - ❑ ❑ ❑ , ❑ Z i w C License Class Lic.Number Dunt Contmclor 5 p ¢ ¢p ¢u 1 OWNER-BUILDER DECLARATION BUILDING PERMIT A w u. n I hereby affirm that I am exempt from the Contractor's License MISC.- _ ' REFER TO ORD INFORMATION • ra. LLo J Law for the following reason.(Sec.7031.5,Businessand PrpfessionsPERMIT ISSUANCE 10.00 vAwnnON- f w� E Code:Any city or county which requiresa permit to construct,alter, 72 000 . ¢ ¢Q D improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. [;.0 r n w m LL requires the applicant for such permit to file a signed statement that , TOTAL PERMIT TO he is licensed Pursuant to the provisions of the Contractor's License H z i Law(Chapter 9(commencing with Section 7000)of Division 3 of the rPE�ESTRIAN' TUNNEL i 4 o Business and Professions Code)or that he is exempt therefrom and QTY. - 'PLUMBING PERMIT ``CCFE "' N Ce H$ the basis for the alleged exemption.Any violation of Section 7031.5 11` �' STORIES TYPE CONSTR. i 3 by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER IEA.) 5.00 ,y Q of not more than five hundred dollars(S50D1.): ❑ Las owner of the property,or my employees with wages as - BACK FLOW PROTECT.DEVICE 4.00 LAI x - OCG.GROUP RES.urv1T5 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,AR EA,COND. '5.00 Ill1 Code:The Contractor's License Law does not apply m an owner of property who builds on improves thereon,and who docs such work FIXTURES-PER.TRAP.' 5.00 SQ FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- merits are not intended orOffered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 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 im- BUILDING USE PTforpurpose of sale.). - RES IND CON PB Other s I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 E] Q Q O Q IiCE contractors to construct the project(Sec.7044,Business LAWN 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 who builds or improves thereon.and who - LAWN SPRINKLERS-OVER 5 IEA.)- 1,00 - contracts for Such projects with a cmvract_or(s)licensed Pursuant t° SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO, PARCEL NO. ❑ 1 am exempt under Sec. ,ELAP.C.fur this WATER HEATER W/VENT 6.00 rcuson Owner Date WATER SYSTEM' 5.00 ..ACC.DATE ACC FILE N0. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5,00 1 hereby affirm that I have a certificate ofconsent to self-insure, - ZONING ENG.SITE NO. I or a certificate of Workers'Compensation Insurance,or a tertified ' copy thereof(Sec.3600,Lab.C.). 5 Policy No. Company - - 0 ❑ Certified copy is hereby furnished. FIRESPRINK ENERGY T-Z4 Z Z ❑ Certified copy is Filed with the city inspection division. MISC.-, REFER TO ORD. 0 Applicant - V ❑ IN CD Y C - INC] � y CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT'ISSUANCE 10.00 FLOOD ZONE A.L.II.C. UJ 2: COMP17NSA1'ION INSURANCE PLG.CONTR. - LIC.NO. PLC. CL 0 (This section need not be completed if the permit is for one - _ TOTAL Y-C] N[] Y INC] Z) Z hundred dollars(8100)or less,) U'0 1 certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY - 'LL 1- mit is issued, I shall not employ any person in any manner so as to Wbecome subject to the Workers Compensation Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5.00 .BUILDING 349.00 to NOTICE: TO APPLICANT: If,after making this Certificate of Ex- - ? eruption,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK Provisions of the Labor Code, you must forthwith comply with FEE 226.95 C..1 such provisions Or this permit shall be deemed revoked, 'AIR HANDLING UNIT(TO.10MC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 5.04 1 hereby affirm that floue 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.). - HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) - 4.00 information is correct.1 agree to complywithall city and county' - PLUMBING - ordinances and slate laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 h i f this ti t i th hereby authorize representatives of cty to enter upon the BOILER-COMP(Own 100,000'BTUI SEE FEE SCH. MECHANICAL �. above-mentioned property 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 ,.PERMIT ISSUANCE' _ 10.00 CONST.TAX may.,in any way accrue against said City in consequence of the rani of this Permi. MECH.CONT. LIC.NO. MECH. TDTAL TOTAL 580.89 Signature of Applicant/Contractor Dam i OFFICE COPY