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13988 (2) _ POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PERMIT NUMBER INSPECTION DIVISION 13988 JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS X0030 �cf�a-L^4 i+ `�� UNI'T1# LOT# 'S PERMIT EXPIRES IF WORK OWNER c C_OR (20CONTRACTOR Cd P_ 2 IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTIONR ORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION LASTCALLED INSPECTION. UFER PREGUNITE PERMIT VALIDATION _GPa_ S L z POUR NO CONCRETE UNTIL ABOVE HAS BE SIGNED ,/ UNDERGROUND /SLAB PLUMBING ELECTRICAL I ISSUANCE DATE MECHANICAL �p ' \ ;EL T' PLO. I"a DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED „ Ot``UBU UDING PERMIT I . WOOD FLOOR - CItY INFORMATION VALUATION S/FT. PLUMBING MECHANICAL a� ELECTRICAL PERMIT TO FRAMING STORIES TYPE CONSTR. INSULATION - SOCC GROUP HES UNITS � r PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF • SO.Fi.FLOOR ARCATOTAL ACREAGE BUILDING USE HES IND CON PB 0"" APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ , ❑ ROUGH A SSESSORS PARCEL NO. — PLUMBING GAS TEST .TRACT NO. PARCEL No. MECHANICAL _1i FOCI 540 ELECTRICAL FINALS DATE INSP. ACC.DATE Acc.FILE No. FRAMING —ZQ SAN # 29 zorvlNc ENG.SITE No. INSULATION PLUMBING �77 (I6 GAS ' MECHANICAL FIRE SPR)NK ENERGY T-24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ❑ "❑ Y ❑ NE] LATH-INTERIOR ELECTRICALFLOOD ZONE A,L.U.c. ' Y LATH-EXTERIOR FIRE DEPT. El NO Y IN SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS' BUILDING FIREWALLS ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE �•' OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDINGFINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM 1 �- ARRANGE FOR INSPECTION BY PHONING 252-4505ELECTRIC , ' F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING fr! 0� 'PLEASE GIVE JOB ADDRESS.WHEN PHONING. Z MECHANICAL J - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX ; PLEASE READ REVERSE SIDE BEFORE TOTAL f♦ CALLING FOR FINAL INSPECTION. OFFICE COPY i t FINAL GRADE ' SUPE-SLIP- - File No. . . � Dat'.— Location Subject _ Notes , Approver j Date Inspector y �f - r q • -.I. 7, 1 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ERA LD1 NG PROJECT I DENTI FICATION PERMIT NUMBER BUILDING ^l APPLICATION & PERMIT ADDRESS L0 13988 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION CE �.�/�' y�I 1 nn QTY. ELECTRIC PERMIT FEE C/ I/1/ (-/{ PHONE 1110-I�t t3 3�`�s� \/ CONTRACTORS •/fL�/X_ E f,y�l�y\�� UTLETS-SWITCHES-RECEP 10.00/1.00 .l LIC.NO.VJa f I& LIGHTI NG FIXTURES 10.00/1.00 O �- r, TRAcroRs PPLIANCES-RESIDENTIAL 4,00 /DDREss p N LIK,(o �� PANELS 10.00/0 - DATE OF APPLICATION ORRC ITECT PANELS (OVER 200 AMP) 20.06 PLAN CHECK FEE P.0.NO. NGINEER LIC.N 'S) (J' SIGNS TRANS. 3.00 ARCH.OR EN SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS EMP.METER OR POLE INS. 20.00 APPUCAMOTORS SEE FEE SCH. ADDRESSS 1✓ /` (Oa ,lJ JL SERVICE CHANGE 20.00 Y pG woo LICENSED CONTRACTORS DECIARAT N <u w I hereby affirm Into I am licensed under provisions of Chapter 9 ISSUANCE GATE N (commencing w Section 7000)of Division 3 of the Business and ¢ BLDG. P� MECH. r ¢ Professions Cod nd my license is in full fo�e1fi}[ (U z O$3 - License C a Lic.Numbs 1 OI p p� r Date I Contractor 1�C'.O / a m f - BUILDING PERMIT aa ¢ OWNER-BUILDER DECLARATION A o a u INFORMATION wH 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u0� Lew for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 1600 (� VALUATION S/FT. Code:Any city orcoun.y which requiresa permit toconstroct,alteq QQ¢ Improve,demolish,or npalr any structure,prior to Its sumanee,also ELEC.CONTE. LIC.NO. ELEC. C u requires the applicant for such permit to file a signed statement that TOTAL IG e.w he u licensed pursuant to the provisions of the Contractor's License PERMIT TO F i Q Law.(Chapter 9(Commenciagwilh Section 7000)of Division 3 ofthe J Business and Proressiom Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE ¢ = $ the basis for the alleged exemption.An g p he violation applicant action malty STORIES TYPE COWS/TR. a � by any applicant for ive hemi dollam($500plicant loacivil penalty ALTER-DRAIN VENT-WATER (EA.) 5.00 of not more than five hundred dollan(55 amp - ❑:%'I;'as'owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure¢not - C ROUP RES.UNITS intended or offered for sale(Sec. 7044, Businos and Professions DRAINS-FLOOR,ROOF,AREA,CONE). 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 .00 Sa FT,FLOOR AREA TOTAL ACREAGE meats are otintenugh de ownemployees,for salt.If,howevered that , the improve GAS-EA.SYSTEM-1 INC. OU 6.00 q mems see not intended or thin on fur sale.If,however,the building ) ♦ oC3S"' or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2!00 J builder will have the burden of proving that he did not build or ire- 12!00. 7 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER;(� 30.00 RES IND CON PB Doe, ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed Contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC15 V.B. 00 kD ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not apply "' to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 50EA.)3t -1:00 .369-3.) -0 �s contracts for such projects with a conaactorls)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 O / NO. the Contractor f License taw. TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.AP.C.for this I WATER HEATER W/VENT 6.00 POOCH Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILENO, WORKERS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of comem to sclf-insure, or.a cerlificaR of Worker:Compensation Imumnee,or a certifmd ZONING ENG.SITE NO. copy ((Sec:38Lab.C) Policy No.. Company YlJ1 1 Q ,❑,/Certified copy ishereby formatted. FIRE SPRINK ENERGY T-24 Z Z y Certified cop filed with the city inspection division. O Applicant �,(1 8� misc.- REFER TO ORD. Y❑ N❑ v❑ N❑ F- PERMIT ISSUANCE 1 .00/0 Lu CERTIFICATE EXEMPTION FROM WORKERS' FLOOD ZONE A.LUC. IL COMPENSATION INSURANCE PLG.CONTR. LIC.NO. fJ;L d Y❑ N❑ v ❑ N❑ D (This dollars SID net be Completed if the permit is for one Y TOTAL hundred dollen(SIDD)or less.) - s I U O 1 certify that in the perfum,unLc of the work for which this per- CITY MECHANICAL PERMIT,) % % \ FEE FEE SUMMARY LL I- mit u issued,I shall not employ any person in any manner so as to e��`` U become suhjecl to the Workers'Compensation Laws of C2kfornu. 0 d DateApplicantBUILDING } N NOTICE TO APPLICANT: If,after making this Certificate of lis- ALTER OR ADD TO MECH. 5x00 N F. ? rotation,you should become subject m the Workers'Compensation APPLIANCE �U 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with FEE U such provisions or this permit that be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000C.FM.) 6.00 SEISMIC FEE /O 3G I hereby affrad that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 xS the performances-oT� a work for w his perm.. a issued ISec. MICROFILM 3097, .o `J •ZL+`' I HEATING UNIT(TO 100,000 B.T.U.) 8.00 ' tender's Name HEATI NG UNIT 100,0(X7 B.T.U.)6.50 A� Lender:Ad 0.... 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 BOILER-CONP13 H.P.or 100,000 B.T.U.) 6.00 PLUMBING 9d s, ordinances and state laws relating to building construction, and hereby eatme t representatives forms of this city to enter upon the BOILER-COMP(0.100,000 BTU)SEE FEE SCH. MECHANICAL ✓Y above-mentioned property for inspection purposes. r (We) agree to save, indemnify and keep handless the City of MISC.- REFER TO ORD. Cu ino against liabilities judgments,cm.s and expenses which CONST.TAX S�7 CoQ dy any way eccfu agaipsl saiA Ci.y in onu luence of the PERMIT ISSUANCE 10.00 ^- C g an Of thIs p II. MECH. NMECH. .CONT. LICO. TOTAL a7 Oo p Slgnatureof Ap licoi TOTAL 113.L /3 93 Contractor ate OFFICE COPY