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13143 • POST THIS CARD NEAR FRONT OF BUILDING PERMI r NUMBER CITY OF CUPERTINO 13143 INSPECTION DIVISION 'i JOB INSPECTION RECORD 1�3 PERMIT EXPIRATION JOB ADDRESS 11000 N. WO1Pe Rd at TAntaub 1ktead Lor# PERMIT EXPIRES IF WORK OWNER _ CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION _ _fj� ANCE OR 180 DAYS FROM LIFER 7 LASTCALLED INSPECTION. PERMIT VALIDATION - PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - 11. UNDERGROUND /SLAB PLUMBING ��'�"� ELECTRICALISSUANCE DAT SLOG. ELECT. PLG. MECH. MECHANICAL © 13 0 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION siFr. PLUMBING MECHANICAL y PERMIT To ELECTRICAL0E'F A FRAMING STORIES TVpECONSTR. INSULATION OCL.GROUP RES UNITS III`- r h PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SI FT FLOOR AREA TOTAL ACREAGE ROOF DIAPHRAGM BUILDING USE Wk HES IND LON PB Otla APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El ❑ ❑ ❑ ❑SSESSORS PARCEL NO. A ROUGH PLUMBING TRACT NO. PARCEL NO. GAS TEST MECHANICAL ACC.DATE ACC,FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING SAN # ZONING ENG.SITENO. INSULATION PLUMBING GAS FIRE SPRINK ENERGY T24 MECHANICAL Y ❑ N❑ v ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Loop ZONE A,L. C. LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEPT, v E] NE:] lN ❑ SHEETROCK GRADE FEEE S SUMMARYY SHEAR INTERIOR BUILDING BUILDING I « _`•,� SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ELECTRIC / .. w ARRANGE FOR INSPECTION BY P=DATE - CONST. ONE WORKING DAY BEFORE REPLUMBING 0 PLEASE GIVE JOB ADDRESS WHE Z MECHANICAL - SEE PERMIT FOR EXPIRTAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL r�/ CALLING FOR FINAL INSPECTION. OFFICE COPY `/� PLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI IJG PROJECT I DE I FICATI ON PERMIT NUMBER UDI iE5 A " NG1/000 0 IxT an � APPLICATION & PERMIT A Y b r &AW BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 131 OWNER' PLAN CHECK VALIDATION rNAME ([ QTY. ELECTRIC PERMIT FEE Qzld HONE r 7 CONTRAO 's UTLETS-SWITCHES-RECEP 10.00/1.00,/0 � J' NAME LIC.NO. Y LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S PPLIANCES-RESIDENTIAL 4.00 AODH Ess _ PHONE PANELS 16.00 Q DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,06 PLAN CHECK FEE P.C.NO. OR ENGINEER LOC.NO, SIGNS TRANS. 3.00 ARCH.On ENC' SPECIAL CIRCUIT 5.66 PERMIT VALIDATION ANRESE ZIP EMP.METER OR POLE INS. 20.00 APPLICANT'S MOTORS SEE FEE SCH. ADDRESS SERV ICE CHANG 20.00 • tp 0 0 o LICENSED CONTRACTORS DECLARATION 1< ��t.,? a v 1 hereby a(I irm That I am licensed snider provisions of Chapter 9 „s 9 � I 11)r ISSUANCE OA (commencing with Section 7000)of Division 3 of the Business and r. L y BLDG.-1 ELECT. PLG. MECH. Fm i Professions Code,and my license is in full force and effect. J �( �no ❑ z 0 ut License Class Lia mer NubC)?� o z. o H Date Contractor bx� Q1 Co, "si, s _ Cir7 BUILDING PERMIT a w 4 OWNER-BUILDER DECLARATION REFER TO ORD INFORMATION is3 LL H 1 hereby affirm that I am exempt from the Contractor's License MISC.- VALUATION $JET. u o Q Law 1'or the following reason.(Sec 7031.5,Business and Professions PERMIT ISSUANCE 10.00 .6 � N Code:Anycity orcounty which requires a permit to construct,alter, Qp s- O Improve,demolish,or repair any structure,prior tO its issuance'.also ELEC.CONTR. LIC.NO. ELEC. ¢ requires the applicant for such permit to file a signed statement that TOTAL 1 PERMIT TO X m w he is licensed pursuant to the provisions or the Contractor's License F Z r Lot.(Chapter 9(Commencingwith Section 7000)of Division 3 ofthe "rMPz QT'FlCE �(C(�j• Z 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE e H o the basis for the alleged exemption.Any violation of Section 7031.$ STORIES TYPE CONSTR. a_ by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) $.00 of not more than five hundred dollars 05000.): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's 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 TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for Sala If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year Of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Omar prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 El El E] 11 E) licensed 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 Codc The Contractors License Law does not apply to an owner oIproperty who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects will,a contractorls)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ I am exempt under Sec. B.&P.C.tar this WATER HEATER W/V ENT 6.00 reason,/� - /}��.,, owncl .w.�/J/__!1�{ Dale /!�' .4_ WATER SYSTEM 5.66 ACC.DATE ACC.FILE NO. U�'W�ORRKFRRS'CCO'MMPENSAT10N DECLARATION WATER TREATING EQUIP. 5.00 1 hereby al❑rm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.CJ. Policy No. Company Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is fled with ire City inspection division. MISC.- REFER TO ORD. O Applicant Y❑ N❑ V E] No CCN CERTIFICATE OF EXEMPT ION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL Q (This section need not be completed if the permit is for one TOTAL Y❑ N❑ I Y❑ N❑ 0 Z hundred dollars IS 100)or less I L) O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F 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. Date Applicant BUILDING - } h NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 - F Z eruption,you Should beconm subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE V such 000 provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10, C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE (p 3 1 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.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 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 PLUMBING 1 ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)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. Cupert against hall ties,jl gI ,'its, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX ma any way ac _ag' n t d Cily in conscyuence of the g g of this per MECH.CONT. LIC.NO. MECH. G �S TOTAL TOTAL Ignature of Ap icant/Contrac Or Date OFFICE COPY