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14027 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14027 INSPECTION DIVISION ^� JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS, 0 'E'd" ��Q' UNIT# LOT# S PERMIT EXPIRES IF WORK OWNER G��'q-'e•� `�E✓. CONTRACTOR GZZ '6LR G7 IS NOT STARTED WITHIN INSPECTION 1DATE7,1111SPECTOR' INSPECTION RECORD 1BODAYSOFPERMIT ISSU FOUNDATION ANCE OR 180 DAYS FROM LIFER 6C LASTCALLED INSPECTION. PREGUNITE , PERMIT VALIDATION 5 / POUR NO CONCRETE UNTIL ABO E H VBEE"IGNED; P►iD �` 1- / UNDERGROUND /SLAB PLUMBING Y �' ELECTRICAL - EDATE MECHANICAL CI R t PLG. MECH. 0 0 o . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $/FT. PLUMBING - MECHANICAL _ n� PERMIT TO ELECTRICAL FRAMING STORIES TYPE_CONSTR. INSULATION .OCC.GROUP RESPNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED r SO.FT.FLOOR AREA TOTAL ACREAGE ROOF ,V 17 , F DIAPHRAGM BUILDING USE HES IND CON PB Olney APPLYAO ROOFING UNTIL ABOVE HAS BEE SIGNED El ❑ 1:1 E-) Q ROUW 1 ASSESSORS PARCEL NO. —�_ — _ - TRACT NO, PARCEL NO. GAS TEST - p- or O.H' MECHANICAL epV'CO ACO OATS ACC.wLE No. ELECTRICAL FINALS DATE " .;'INSP. FRAMING tWCj SAN 0 j��,G�s INSULATION S ZONING ENG.SITE NO. PLUMBING GAS FIRE SPRINK ENERGY T 24 MECHANICAL YE] N[] Y ❑ N[] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE ALU.L. ,. LATH-INTERIOR0-y/ ELECTRICAL " Y[] N� Y0 N❑ LATH-EXTERIOR - FIRE DEPT, � SHEETROCK GRADE FEESUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING FIREWALLSELECTRIC .PLAN CHECK GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE.,HAVBEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL'ISSIGNED BY BUILDING INSPECTOR. MICROFILM w ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC o~� ONE WORKING DAY BEFORE REQUIRED INSPECTION. P.LUMBING . PLEASE GIVE JOB ADDRESS WHENPHONING. z " f - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX tirti' 7 PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL 1. OFFICE COPY - -; - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY •r I BUILDING PROJECT IDENTIFICATION PERMIT NUMBER aDILDING APPLICATION & PERMIT . 140 7 ADDRESS OMILLARD LANE, LOT 5 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL NAME GERARD DEVELOPMENT " �� "� PLAN CHECK VALIDATION CORP. ( 415 ) 941-4141QT.Y: 'd,; ELECTRIC PERMIT FEE - PNONE CONTRACTOR'S NAMEUTLETS-SWITCHES-RECEP 10.00/1.00 uC.No.$ LIGHTING FIXTURES 10.00/1.00 c. CONTRACTORS ADIgDRESS Z APPLIANCES-RESIDENTIAL 4.00 PHON PANELS - 10.00 Q- DATE OF APPLICATION ARCHITECT f'j . j z PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER ARCHITECT C13629 LIC.No. SIGNS TRANS. 3.00 ARCH.ORI) PERMIT VALIDATION ADDRESS LOS" GATOS, CA. 9503 SPECIAL CIRCUIT 5.00 �D 'z,P EMP.METER OR POLE INS. 20.00 APPLICANT s MOTORS SEE FEE SCH. ADDRESS DDREss 141 FIRST ST.; - .,,��f�1q SERVICE CHANGE 20.00 9 \��` /O a '02 LICENSED CONTRACTORS DECLARATION ` U a O U I hereby affirm that I am licensed under provisions of Chapter 941 . V ANCE DATE G w (commencing with Section 7000)of Division 3 of the Business and L ELECT. PLG. MECH. F n i Professions Code,and my license is in full fo n e e 1Iyyll o 0`�c Licen Class- Lic.Number y F w Dal¢ ��- Course a x f.Ji a - BUILDING PERMIT R m tt a OWNER-BUILDER DECLARATION Qo u INFORMATION a'xr 3 w I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u o j Law for the following reason.(Sec.7031.5,Business and Professions pERMI?ISSUANCE 10.00 _ VALUATION $/FT. a Code:Any city Or county which requires a permit to construct,alter, r^e�� 5 Q o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. O LL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO whe is licensed pursuant to the provisions of the Contractor's License i n�� FiLaw. 9(commencinf D gwilh Section 7000)oivision 3 ofthe `1 a Business and Professions Code)or that he isexempt therefrom and OTY. PLUMBING PERMIT FEE $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE J-4///,<by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN&VENT-WATER (EA.) 5.00 l�'V/J't of not more than five hundred dollars(5500).): ❑ 1,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 . properly who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00Q- SO.FT,FLOOR AREA TOTAL ACREAGE himself or through his awn employees,provided that such improve- Itentsarenotintended or offered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 3071or 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 prove for purpose ofsale.). II INDUSTRIAL WASTE INTER. 30.00 RES IND CON PBOmer ❑ 1,as owner of the property,am exclusively contracting with 0 ❑ ❑ ❑ ❑ licensed contractors to construct the project IS". 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(EA.) 1,00 LL-14 contracts for such projects with a contmctons)licenned pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. /0- TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C.For this WATER HEATER W/VENT 6.00 - 9.1 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP, 5.00 1 hereby affirm that 1 have,a Certificate of COnscut t0 self-IOsur¢, ZONING ENG.SITE NO. or u certificate of Workers'Compensation Insurance,or a certified copy thercof(Sec.3800,Lab.C.L Policy No.-Company- 0 o. Company0 O Certified Copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z Certified co d with the city inspection division. O Apphcam Misc.- REFER TO ORD. 2 A�lic.rY❑ N C]❑ Y N[]I- m O PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. � CERTI FICOM OF EXEMPTION FROM WORKERS' W � COMPENSATION INSURANCE PLG.CONTR. LIC.NO. � PLG. CL Z 1 /40'fhis section need not be completed if the permit is for one TOTAL � Y❑ N 1:1NE]Y❑ N hundred dollars IS 100)Or less.) U O 1 certify that in the performance of the work for which this per. QTY. MECHANICAL PERMIT , FEE FEE SUMMARY U. H mit is issued.I shall not employ any person in any manner so as to U become subject In the Workers'Compensation Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING �70 >_ N NOTICE TO APPLICANT: If,after making this Certificate of Ex- � Z emplion,you should become subject to the Workers'Com pensat ion APPLIANCE 5.00 PLAN CHECK - provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4,00 �--+ CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMICFEE /3 6q- 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 IS-- the performance of the work for which this permit is issued(Sec. MICROFILM 3097,CNC.). 1 HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Nam,,::�� LIATL B `g - HEATING UNIT(OVER 100,000 B.T.U.19.50 0 Lender's Address ELECTRIC I certify that 1 have read this application and state That the above VENTILATION FAN (SINGLE) 4.00 - information is correct. I agree l0 comply with all city and countyPLUMBING ordinances and state laws relating to building construction, and BOILER-COW(3H.P.or100,000B.T.U.) 6.00 6 hereby authorize representatives of this city IT enter upon the BOILER-COMP Over 100,000 BTU)SEE FEE SCH. MECHANICAL 3 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 CONST.TAX �+ I may in any way ue,against said City in consequence of the PERMIT ISSUANCE 10.00 O� ��- granting ofIK 11 MECH.CONT. LIC.NO. MECH. 1 V Z&-5Q TOTAL�3�D� TOTAL 30,a7a S' at re of Applie ractor Date CJ OFFICECOPY FINAL (RADE1119 ROUTE SLIP C' " i File No=' 0Z Date Locati *SuNec4tVt Approved Date Inspector OFFICE CITY OF CUPERTINO COPY ' GAS SERVICE NOTICE yrSI�J.� ,2 119 To - You are'hereby authorized to connect the GAS'service for Owner or Tenant ( TLS !� 11 At I New Service No. of Meters //M�-= Reconnect 1 ✓ No. of Add. Meters Move Service • Move Meter , PLUMBING INSPECTOR CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE Date .... Building Permit No-11M.7- .2......... 06 The Building Located at 4:21 /Af .VIA Ownedby .........Is— ........t�ZSA......................................................... Has Been � For Use As: ......... ................. (Altered) ...................................................................................................................... ........................... - ----------**-----*.............***......*...***- *....*......*........................*.. ............ ............................................................ ...................................................... E .............................. - N -77V-C--�krl ................... PD-7 BUILDING INSPECTOR