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13092 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 13092 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 19447 Pruneridge Ave. 4148 UNIT# LOT# _ PERMIT EXPIRES IF WORK OWNER Hewlett-Packard CONTRACTOR Farris Electric IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PREGUNITE PERMIT VALIDATION l POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL J1J ISSUANCE DATE MECHANICAL Gt We I,ggOG. ELECT. PILO_ MECH. City L' 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR AwnnoN SIFT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL , FRAMING STORIES TYPE CONSTR. INSULATION OCC GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED . ROOF SQ FL FLOOR AREA TOTAL ACREAGE I DIAPHRAGM ' • NUIL USE CON RLS IND CON PB Omer APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ 0 C1 EI ❑ ROUGH ASSESSORS PARCEL NO. ` PLUMBING - - TRACT NO. PARCEL NO GAS TEST MECHANICAL ACC.OATE ACC.FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING SAN # ZONING ENc.SITE No. INSULATION PLUMBING GAS FIRE SPRINK ENERGY T-ZE MECHANICAL Y C] N[:) Y C3 NF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A.L.U.C. LATH—INTERIOR ELECTRICAL LATH-EXTERIOR FIRE DEPT, N(_ SHEETROCK GRADE FEESUMMARY 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 OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM 4 ARRANGE FOR INSPECTION BY P=, 6N. ELECTRIC if ONE WORKING DAY BEFORE REQPLUMBING O� PLEASE GIVE JOB ADDRESS WHEZMECHANICAL — SEE PERMIT FOR EXPIRA IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICECOPV APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER yERADING APPLICATION & PERMIT _ 13092 ADDRE66 t3f [/ Clo% Ile- I%' le- BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME ♦�� Jj� ,/ (�/) OTY. ELECTRIC PERMIT FEE e,7r , NE J CONTRAC70R'6 NamEUTLETS-SWITCHES-RECEP 10.00/1.00 a- ��c4G u f` C:�� / c.NN. IGHTING FIXTURES 10.00/1.00 CONTRACTOR OIi's CONTRAS APPLIANCES-RESIDENTIAL 4.00 MU ,0 �� PHON CJ/� PANELS 10.00 �^ DATE OF APPLICATION OORRCHrt6cr PANELS (OVER 200 AMP) 20.00 Jq PLAN CHECK FEE P.C.NO. ENGINEER uc.No. SIGNS TRANS. 3.00 ADDRESSs ENG, PERMIT CIRCUIT 5.00 PEflMIT VALIDATION AZIP EMP.METER OR POLE INS. 20.00 ADDRESS MOTORS E SCH. ADDRESS SERVICE CHANGE %20.00 /CSG o o LICENSED CONTRACTORS DECLARATION 1,t !I„ / / �� < U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE w Q w (commencing with Section 7000)of Division 3 of The Business and BLDG. ELECT. PLG. MECH. r i Professions Codee)&license is in full for�e��yj,/ C ❑ ❑ z i w License lass IIJJ Lie.Numbcr..Al..fj.'fJ yL_t- ❑ O Z I-w Date ��'lass,. F - - J , Q y f J BUILDING PERMIT m x w OWNER-BUILDER DECLARATION INFORMATION E: 3 LL n I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION $/FT. Fw0J Law for the following reason. 7031.5,Business Professions PERMIT ISSUANCE 10.00 ,3 f 0 i Code:Any city or county which requiresa permit to construct,alter, w Q wQ Improve,demolish,Or repair any structure,prior to Its Issuance.also ELEC.CONTR. 71C.700. ELEC. al S: O 2 requires the applicant for such permit to file a signed st a l count that TOTAL 4? PERMIT TO whe is licensed pursuant to the provisions of the Contractor's License F z i Law(Chapter 9(commencing with Section 7000)of Division 3 fthe � % I a: o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE M H oN the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. y ?�� by any applicant for a permit subjects the applicant lila civil penally ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their ale 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 builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 6O.FT.FLOOR AREA TOTAL ACREAGE �• himself or through his own employees.provided that such improve- memsarenotintendedoroffered for sale.l f,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM.OVER 4 (EA.) 2.00 builder will have the burden of proving that Ile did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ I,as owner of the properly,am exclusively contracting with ❑ Cl ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:'file Contractor's License Law does riot apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a conlactoAs)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO, PARCEL NO. Cl I am exempt under Sec.-,It&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKE.RS'COMPE,NSATION DECLARATION WATER TREATING EQUIP. 5,00 I hereby affirm that I have a certificate ofconsent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.). Policy No. Company O ❑ Cerlilie l copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z ❑ Certi" copy fit with the ci�y�ffection division. MISC.- REFER TO ORD. O Applicant Y ❑ N❑ Y ❑ N❑ ~ rnCIiRTIf ICOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Lu W � COI COMPCNSAT'ION INSURANCE PLG.CONTR. LIC.NO, PLG. Z (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y❑ NEI hundred dollars(S 100)or Ic..) U O I certify that in the performance of the work for which this per OTY. MECHANICAL PERMIT FEE FEE SUMMARY W U mit is issued,I shall not employ any person in any manner so as tD become subject to the Workers'Compensation Laws of California. y Daae Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT: If,after making this Cerlificate of Ex- Z caption,you should become subject to the Workers'Compensation 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=C.F.M.) 4,00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C,F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency 1'or EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.0 HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATINGUNIT(OVER 100,000 B.T.U.) (� Leader's Address ELECTRIC 0930 1 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 laws relating to building construction, and BOILER•COMP 13 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the gOILER•COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL 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 PERMIT ISSUANCE 10.00 CONST.TAX may i any way accrue ag at said City in couseglpppneepf the Banti of this p n ..//)�� MECH.CONT. LIC.NO. MECH. TOTAL / j7 TOTAL Signature cul Ap�ant/Contractor OFFICE COPY