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14032 (2) POST THIS CARD NEAR FRONT OF BUILDING RAIITNDM1,BER CITY OF CUPERTINO INSPECTION DIVISION 14032 JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS `��i��s ��/��CZ�� '�26EUNIT4i,, LOT# CD PERMIT EXPIRES IF WORK OWNER GSR a--2•� ��•� CONTRACTOR G ctR '. IS NOT STARTED-WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU FOUNDATION - ANCE OR 180 DAYS FROM CALLED INSPECTION. LIFER PREGUNITE PERMTvnuonnoN - :I PO 'NO CONCRETE UNTIL AGOVE HA BE SIGNED F +. UNDERGROUND /SLAB PLUMBING r ELECTRICAL ISSUANCE DATE BLDG. ELECT. PLG. MECH. MECHANICAL ET' ❑y 0' - r-1{ 00`NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT lJJ` 1 N FORMATI ON .. WOOD FLOOR VALUATIONs/PT. PLUMBING �r .d� - f J MECHANICAL r - wo ELECTRICAL PERMITTo " FRAMING STORIES TYPE CONST R. OCC,GROUP RES UNITS s LACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ _ SO,FT.FLOOR ARfA TOTAL ACREAGE ROOF 9 DIAPHRAGM ^ 7 BUILDINGUSE RES IND CON PB OWxr APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 122 ❑ ❑ 0 ❑ ASSESSORS PARCEL NO. ROUGH �3aZ6-`F`>L PLUMBING GAS TEST ' TRACT NO. PARCEL NO. ' C4�L'•� MECHANICAL ELECTRICAL - ACC.UATE ACC.FILE NO. -9'8Y FINALS a DATE, r z a INSP-s FRAMING g._- �$ SAN #/ a ZONING ENO.SITE NO. INSULATION •./ _moi PLUMBING 2S fid GAS FIRE SPRINK ENERGY RZ< ' MECHANICAL O,T. - Y ❑ N[] Yo N� COVER NO WORK UNTIL ABOVE HAS+BI _,S NED ,r"I HEATING FLOOD ZONE - A.L.U.C. LATH-INTERIOR I91-1?-Yr� ELECTRICAL � b_ -v LATH-EXTERIOR ,� 'Q FIRE DEPT. � N� Y � N❑ SHEETROCK GRADE '''"` FEESUMMARY.- SHEAR INTERIOR BUILDING - d-Z _ SHEAR EXTERIOR, TEMPORARY APPROVAL BUILDING " FIREWALLS ELECTRIC - PLAN CHECK GAS FEE - NO TAPE OR PLASTER UNTIL AB,OY,E i HAB'BEEN;SIGNEOj OCCUPANCY. SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINACIS SIGNED BY BUI LDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION,BY PHONING 252-4505,, ELECTRIC y • LU ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING - — Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - . MECHANICAL ; IMPORTANT! CONST.TAX r " PLEASE READ REVERSE SIDE BEFORETOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPL CANT'TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDINGPROJECT IDENTIFICATION PERMIT NUMBER" AO;;SLIDING APPLICATION & PERMIT Z14O3Z M!LLA'RD LANE LOT 10 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL - - OWNER'S v ' 't PLAN CHECK VALIDATION NAME GERARD DEVELOPMENT 'OTV7, e- ':," IIELECTRIC PERMIT(, FEE CORP. . ( 415 HONE 941-414 ,I I CONTRACTORS UTLETS-SWITCHES-RECEP 10,00/1.00 tle NAME 'Sd1W'^rs LIGHTING FIXTURES 10.00/1.00 L3(, uc.ND. CONTRACTORS I 'i' Z APPLIANCES-RESIDENTIAL 4.00 ADDRESS Aw J� f • 'LOS h-L- PHONE�N-QI4( PANELS 10.00 DATE OF APPLICATION ARCHITECTREG , PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR n•.� ENGINEER ARCHITECT LIC NO C13629 .SIGNS TRANS. 3.00 ` 5.00 PERMIT VALIDATION ARcH.DREN . N EREY .AVE. SPECIALCIRCUIT ' AOORE$5' LOS GATOS, CA. .IP 95030 TEMP.METER OR POLE INS. 20.00 APPLICANT r$ MOTORS SEE FEE SEH. 141 FIRST ST. SERVICE CHANGE 20.00 q 19`��2� /, oper Diao a -D c das R ( F i n- I hereby affirm that I am licensed under provisions of Chapter 9 UA CE DATE a (commencing with Section 7000)of Division 3 of the Business and •ELECT. PLG. MECH. H 3 i Professions Code,and my license is in full fQsf{�{pd oT License Class Lic.Numberlr_I- � _ 9 e,t-a Date1-_^_7./_._eb -Contractor a y 5 s NEZ7 BUILDING PERMIT ¢ ¢ W a OWNER-BUILDER DE ARATI_ON - INFORMATION o o'O MISC.- REFERTOORD Le ; u N I hereby affirm that I am exempt from the Contractor's License oa Law for the following reason, 7031.5,Business5nd Professions PERMIT ISSUANCE 10.00 vnLUAnoN S/FT. Fnw� Code:Any city or county which requires a permit reconstruct,alter, ¢ ¢Q 2O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CO NTH. LIC.N0. E LEC. C Lay LL requires the alicant for Such mit to file a si pppermit Statement that TOTAL PERMIT TO X n he is licensed pursuant to the provisions of the Contractor's License F z r Law(Chapter 9(commencing with Section 7000)of Division 3 Bribe J !J i c Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE It I-$ the basis for the alleged exemption.Any violation of Sect ion 7031.5 STORIES TYPE /CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 SNI` of not more than five hundred dollars(SSOOM: ❑ 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 BCC.CROUP RES.UNITS intended or offered for sale (Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 k-3 Code:The Contractor's License Law does not apply to an Bwner of property who builds or improves thereon,and who does such work 3 F IXTUR ES-PER TRAP 5.00 - SC.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments1 are not intended or offered for sale,If,however,the building azo/ or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVERA (EA.) 2,00 BUILDING USE builder will have the burden of proving that he did not build or im- prove for purpose of sale.). . INDUSTRIALWASTE INTER. 30.00 RES IND " CON PB Omer ❑ 1,as owner of the properly,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 properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under See. ,B.&P.C.I'orlhls yyATER HEATER W/VENT 6.00 (fQ6eL reason' Owner Date WATER SYSTEM 5.00 - - ACC.GATE ACC.PILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 Iereby affirm that I have a certificate of consent to self-insuov. or a certificate of Workers'Compensation Insurance,or a certified ZONING h -ENG.SITE NO. copy thereof(Sec.3800;Lab.C.). " Policy No. - Company -- 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z �Cerlified copy is f with • city inspection division. MISC.- REFER TO ORD. O APOlicant Y❑ N❑ V ❑ N❑ ~ rn _ PERMIT ISSUANCE 10.00 i' LU CERTIFICCOMPE COMPENSATION FROM WORKERS' � FLOOD ZONE A.L.u.c. CL > ' COMP,F.NSATION INSURANCE PLG.CONTR, uc,No. PLG. TOTAL CL O (This section need not be completed if the permit is for one T6�� Y❑ N❑ V [:] N❑ Z hundred dollars(S 100)or less.) V O I certify that in the performance of the work for which This per QTY. MECHANICAL PERMIT FEE FEE SUMMARY IL F mit is issued,1 shall not employ any person in any manner so as to ) . U become subject to the Workers'Compensation Laws of California. / eri LD Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING Ee 7. to NOTICE. TO APPLICANT: If,after making this Certificate of Ex. •� ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE C.1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10M011F.M.) 4.00 pp CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=1 .FM.) 6.00 SEISMIC FEE O � I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 I the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Cis C.). I1 Lender's Address HEATING UNIT(TO 100,000 B.T.U.) 8.00 T P Lender's Nam �_UIE' \1C7 ►J&TI �AN>✓ HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that l have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 - Q-p information is correct. I agree to comply with all city and county PLUMBING �� e ordinances and state laws relating to building construction, and BOILER•OOMP.(3H.P.or100,000B.T.U.) 6.00 hereby authorize representatives this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL 13s__/ (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 Q CONST.TAX 'r '7 may In any way accrue against said City in consequence of the granting oft ' rmn. MECH.CONT. LIC.NO. MECH. ✓� TOTAL3 TOTAL I Signature of Applicant/Contractor Uale - FFICECOPY