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10951 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PrHMIi NU NTER,; INSPECTION DIVISION 099 51 V, JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS 11000 WOLFE ROAD UNIT# LOT# PERMIT EXPIRES IF WORK OWNER HEWLETT PACKARD CONTRACTOR EHRLICH ROMINGER IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE e_ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - t\, UNDERGROUND /SLAB Lt r Al-, _ PLUMBING �/1�(/,/F ELECTRICAL Piit18Ct1n0 ISSUANCEDAe L VI y BLDG, EL CT. PLG. MECH. MECHANICA ❑ Yn El ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUI DING PERMIT WINFORMATION WOOD FLOOR VALUATION S/FT. PLUMBING' MECHANICAL TO ELECTRICAL PER FRAMING STORIES TYPE CONSTR. INSULATION ' OCC.GROUP RES.UNITS I� ^•�� PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.FT.FLOOR AREA TOTAL ACREAGE ROOF DIAPHRAGM �1`Z7 BUILDING USE (/Z7 // RES IND CON PB 0II,P1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO. ROUGH PLUMBING TRACT NO. PARCEL NO. GAS TEST MECHANICAL ELECTRICAL FINALS DATE INSP. ACC.DATE ACC FILE NO. FRAMING SAN tt ZONING ENG.SITE NO. INSULATION PLUMBING GAS FIRE SPRINK ENERGY T-24 MECHANICAL Y [] N❑ Y ❑ NE COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A,L.U,C. LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEPT. v NE] Y I] NE] SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK F GAS EE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN.PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER `.ADDRESS . APPLICATION & PERMIT 10951 ADDRESS /tie BUILDING—ELECTRICAL—PLUMBING—MECHANICAL OWNER'S PLAN CHECK VALIDATION rvA E pn;;�� QTY. ELECTRIC PERMIT FEE E 1� v"OrvE aNTRAciDR NAME —/ OUTLETS-SWITCHES-RECEP 10.00/1.00 / LIc.No. e�a�lo.3 S LIGHTING FIXTURES 10.00/1.00 De(b r,ON ACT so - ' APPLIANCES-RESIDENTIAL 4.00 ADDfl E55 vNOrvE —� z PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ( uc.NO. SIGNS TRANS. 3.00 ADDRiSSS E"G' SPECIAL CIRCUIT S.DD PERMIT VALIDATION cap TEMP.METER OR POLE INS. 20.00 APvucn"rs 5`O a 1M ' MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE _UREFERTOORD woo LICENSEiD CONTRACTORS,DECLARATION /�/�I hereby affirm that I am licensed under provisions of Chapter 9ISSUANCE GATE (commencing with Section 7000)of Division 3 of the Business and fJBLDG. ELECT. PLG. MECH. yiProfessions Codn y license is in full for d I ...z0lass� se i Numberu�z wBUILDING PERMIT wOWNER-BUILDER DECLARATION MISC.— INFORMATION w ; ti I hereby affirm that I um exempt from the Contractors License VALUATION $/FT. jLaw forthe following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE Code:Any city or county which requires a permit to construct,alter, _ EcR¢o improve,demolish,or repair any structure,print to its issuance,also ELEC.CONTR. LIG NO. ELEC. //J��j� 0, requires the applicant for such permit to lite a signed statement that TOTAL ((JI PERMIT TO Kw he is licensed pursuant to the provisions of the Contractor's License rzi Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe 4 Qo Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢I_ the basis for the alleged exemption.Any violation of Sectior,7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant o a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(55000.): ❑ 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,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who huilds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. mems are not intended or offered 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-EASYSTEM-OVER 4 IEA) 200 BUILDING USE builder will have the burden of proving that he did not build or int- . . . RES IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ 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 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 aontractogs)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCEL NO. ❑ I an,exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKI?RS'COMPFNSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby all I'm her I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Com Pen ti n In u nce,o p certifcd copy theruof(Sec.3800 Lab C.).RrUOIIA a/O�W Policy No. Company L .0SUa� O ❑ Sertified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z Certified copy is fled with the city inspection division. O Applicant MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ CC y CERTIFICATKOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 C. LL �_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. (L o (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ D 2 hundred dollar,IS 100)or less.) U O I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I— mit is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. W Date—Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >— N NOTICE TO APPLICANT: If,atter making this Certificate of I7x- F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you quest forthwith comply with FEE U such provisions or this permit Shull be deemed revoked. AIR HANDLING UNIT(TO 10000C.F.M.) 4.00 CONSTRUCTION LF-NDING AGENCY AIR HANDLING UNIT(OVER 10A00C.F.M.16.00 SEISMIC FEE I herchy affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of ate work fuer which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50 x` Lendersnddmxs ELECTRIC I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 information is correct I agree to comply with all city and county PLUMBING ordinances and state lows relating to building construction, and BOILER-COMP(3 H.P.Or 100,0008.T.U) 6.00 hereby authorize representatives of this city to enter upon the r above-mentioned property for inspection purposes. BOILER-COMP(Over 100,000 BTW SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against ilities,judgments, costs and expenses which CONST.TAX may in any way cc a against said City in consequence of the PERMIT ISSUANCE 10.00 go hispe nit MECH.CONT. LIC.NO. MECH. 2 8� TOTAL TOTAL S re of Appli aN/Contractor Dare OFFICE COPY