14757 (2) ` POSTTHIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER f
CITY OF CUPERTINO 1
INSPECTION DIVISION " ����
JOB INSPECTION RECORD `
'•PERMITXPI RATION
JOB ADDRESS 19447 Pruneridge Avenue UNIT# _LOT#
PERMIT EXPIRES IF,WORK
OWNER Hewlett Packard Bldg. 467NTRACTOR - IS NOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- '
FOUNDATION - ANCE OR 180 DAYS FROM
NOTE:
UFER � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAS�`CALLED INSPECTION.'
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
'UPERTINO STANDARDS.
GARAGE SLABS '
M.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLABtvoTe, 2Y,d YT' Z 1 TO 6E. IA
I PLUMBING L�'�— \ l '-•`.+I / �L E
ELECTRICAL t ,.'1- v�d4'Y' ISSUANCE DATE.
MECHANICAL r />- i6v es�G �_ &Z l9.C, Blur,. ELEcr PLL. 'Meng
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
•G�CIS INFORMATION
WOOD FLOOR VALUATION
PLUMBING -
"✓
MECHANICAL '
ELECTRICAL ., PERMIT TO
I
FRAMING / .F''a'.,„o; 1�I'eu•G..
INSULATION STORIES TYPE.CONSTR.
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so FT FLOOR AREA rorAL ACRLACE
.' DIAPHRAGM THE CONSTRUCTION TAX IS PAID
EDI LDING USE
ROOF SHEATHING - RES IND 'ON PB 011—
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP" ❑ 0 0 D
ASSESSORS PARCEL NO
ROUGH SAN,#
PLUMBING - ELECT.ENERGY
TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO PARCELNr,p
MECHANICAL MECH.ENERGY
ELECTRICAL BUILDING ENERGY ACC DATE ACC.FILE NO
FRAMING ELECT.FINAL TEST
INSULATION PLUMBING
ZONING ENG.SITE NO.
- _
GAS TEST GAS
rJ- MECHANICAL FIRE SPRINK ENERGY T-24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' Y ❑ NY ❑ No
EXTERIOR SHEAR ELECTRICAL RELEASE ILnnu2ONe I .A,L U.c '
INTERIOR SHEAR FIRE DEPT. Y[] NEI Y ❑ NE]
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING Ei
INTERIOR LATH TEMPORARY APPROVALS BUILDING ry„p
SCRATCH COAT. ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCVOF BUILDING IS NOT PERMITTED UNTIL BUILDI NGFINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
. o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TAX .
PLEASE'READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
r AT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY :..
"- QUI LDI NG PROJECT I DENTI FICATION PERMIT NUMBER
�. noose:: BV APPLICATION & PERMIT 14757
][ .
kI)A47 1Mort.) ' ID p f4V� BUILDING -ELECTRICAL-PLUMBING-MECHANICAL P, r J
X' =ER�� T� �4
PLAN CHECK VALIDATION
PA GldA�.� 'q"4� - O S Z� DTV. ELECTRIC PERMIT FEE /�
ONE
9� T6
N mERacTORs UTLETS-SWITCHES-RECEP 10.00/1.00 /
a"SLIC-LI., _LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'$
ooa�ess /I//` 9 -APPLIANCES-RESIDENTIAL 4,00
p� U A3 PHONE J�� PANELS 10.00 DATE OF APPLICATION'
ORRCHrtECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO.
ENGINEER '
LIC.NO, SIGNS TRANS. 3.00
ADDRESS eNc. SPECIALCIRCUIT 5.0Q PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
ADDRESS rs - MOTORS SEE FEE SCH. /I "
aoREss
SERVICE CHANGE 20.00. yp 9 g (�
O o d
LICENSED CONTRACTORS DECLARATION - 1 /sJC.3/e6
< i w 1 hereby affirm that I am licensed under provisions of Chapter 9 Q OJ ) 'J ISSUANCE DATE
(commenting will,Section 7000)of Division 3 of the Business and
G ¢ n ^ ♦ 11Du ELECT. ,PLG. MECH.
1 r i Professions CodeP_ my license is in full foreppnarj.t. `l
ai m O License class P_ .Lie,Nmnbey/Sl9Y.i/ e] O�nst�- 0 11 E3
F w H J Uale�!�.'3��_Cmdractor A(!_a-L►E1iy�-- [[ V♦
se 2 a OWNER-BUILDER DECLARATION 1 BUILDING PERMIT
re a U INFORMATION
w ; u H I hereby nffinn that 1 am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION $/FT.
F
._04 Law for the following reason.(Sec.70J L5,Nosiness and Professions PERMIT ISSUANCE - 10.00
g N0 -L Code:Any city or county which requires a permit to construct,alter,
rc ¢ ¢O improve,demolish,or repair any strudure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. y
w
O u requires rite applicant for such permit to file a signed statement that TOTAL PERMIT
a w m he is licensed pursuant to the provisions of the Contractor's License
F z a
Law(Chapter 9(commencing with Section 7000)of Division 3 of the ��'4�rx�'CLQ
4 O Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE
¢ I- the basis for the alleged exemption.Any violation ofSectiona cion 7(131.5 STORIES TYPE CONSTR.
T 3 � by any applicant fora ervintdcojeds $5GO).he licam too civil penalty ALTER-DRAW&VENT-WATER (EA.) 5.00
of not more than five Imndred Aollars($500)J:
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE •4.00 OCC.GROUP RES.UNITS
• their sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND.• 5.00
Code:The Contractors License Law does not apply to an owner of
• properly who builds or improves thereon,and who does such well FIXTURES,PER TRAP 5.00 SOFT.FLOOR AREA TOTALACREAGE
himself or through his own employees,provided that such improve-
mentsarenotintended or offered for sale.If,however,lhebuilding GAS-EA.SYSTEM-1 INC.4 OUTLETS 6,00 -
or improvement is sold within one year of completion,the owner- GAS-EA. -OVER 4 (EA.) 2.00
builder will have the burden of proving that he did not build or im- BUILDING USE
prove for purpose of sale.). RES IND CON PB Other
❑ 1,as owner of the property,am exclusively contracting with L INDUSTRIAWASTE INTER. 30.00 1-1 ❑ 0 0
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 property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts tier such projects with a contractor(%)licensed pursuant U
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 'TRACT NO. PARCEL NO.
❑
reason tum exempt under Sea ,B.&I'.C.Iim this WATER HEATER W/VENT 6.00
_
\_
Own c ( Datyj WATER SYSTEM 5,00
ACC.GATE ACC.FILE NO.
WORK FRS'COMPENSATIO iCLARATION WATER TREATING EQUIP, 5.00
I hereby affirm that 1 have a certificate iif consent 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 JJ✓�1Fd)'litF�/rf/3A1r
0 ❑ Certified copy is hereby furnished FIRE SPRINK ENERGY T 24
Z Z ❑ Certi�'pd� Spy is (led witlI The ity iy�spectiom division.
2v/ licant�//1.4K-��fN_' "_�G-.-Q.a MISC:- REFER TO ORD. Y[3 N� Y E] N[D
~ PERMIT ISSUANCE - 10.00
III -
CERTIFICATE CMPE EXEMPTION FROM WORKERS' FLOOD ZONE AL.u.C.
O DON
n' (This SfCtion need coil belcempe ed RhPLG.CONTR. LIC.NO.
f the permit is for one TOTAL V N Y N
Z hundred dollars($100)or less.-)
U O I certify that in the performance of the work for which this per, DTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- 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.
y BUILDING
Dam Applicant
} W NOTICE TO APPLICANT': If,utter making this Certificate of fix- ALTER OR ADD TO MECH. 5.00
Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
Provisions of the Labor Code, you must forthwith comply withFEE
V such provisions or This permit shall be deemed revoked. AIR HANDLING UNIT(TO 1QWOC.F.M.) ' 4.00
CONSTRUCTION LENDING ACE NCY AIR HANDLING UNIT(OVER IOAODC.FM.) 6.00 SEISMIC FEE 3,§-02
I 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
Lender's Address HEATI NG ON IT(OVER 100,000 B.T.U.)9,50 ELECTRIC
I certify that l have lead This application aed Idb that the above VENTILATION FAN (SINGLE) 4,00
information n correct I agree to comply with all city ucti county BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 PLUMBING
ordinances and state laws relating to building ) nster upon
and
hereby authorize representatives ec 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. '
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any way accrue against said City in consequence of the
ran ' Ofthis permi MECH.CONT. LIC.NO. MECH.
TOTAL
/ S' TOTAL �6
x Signature of App want/Contract Uate
OFFICE COPY