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12640 POST THIS CARD NEAR FRONT OF BUILDING PFRMIT NUMBER CITY OF CUPERTINO ` 12640 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION!��. JOB ADDRESS TANDEM COMPUTER UNIT# LOT# PERMIT EXPIRES IF WORK OWNER 10501 N TANTAU CONTRACTOR CUPERTINO ELECT ISNOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - - & A /t3 ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. UFER P,AY•f/i DoT L: -S aM PREGUNITE PE�IT VAUD-ATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -¢u- _ hr ,^l , 7A UNDERGROUND /SLABAL PLUMBING (T1�Y1 198811 ELECTRICAL uMJCEUATE MECHANICAL - JBE LEcr. Pw. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDBUILDING PERMIT WOOD FLOOR INFORMATION r VALUATION S/FT. PLUMBING MECHANICAL ' PERMIT TO ELECTRICAL FRAMING STORIES TYPE CONSTR. INSULATION OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.FT.FLOOR AHEA TOTAL ACREAGE • . - ROOF ' DIAPHRAGM BUILDING USE ' RES IND CON PB OIM1er APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED I] ❑ Cl El ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING - GAS TEST TRACT NO. PARCEL NO. MECHANICAL ' ACC.GATE ACC.FILE N0, ELECTRICAL FINALS DATE INSP. - FRAMING - SAN # ZONING ENG.SITE NO. INSULATION PLUMBING GAS FIRE SPRINK ENERGY T 24 MECHANICAL - YE-] NEJ YQ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH-INTERIOR ELECTRICAL FLOODZONE A.L.uc. LATH-EXTERIOR - FIRE DEPT. vE] N 0 N SHEETROCK - GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F_ ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING'. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICECOPY' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY -BVI LDI NG PROJECT I DENT[FICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT A.m..,i0501 N' T)q�n 1 .2640 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME .r�a�I� I� / �� DTV. ELECTRIC PERMIT FEE /-(A/D�fiAll PHONE � . CONTRACTOR'S - UTLETS-SWITCHES-RECEP 10.00/1.00 NA E L)J9 L 6.,NO. ZFILIGHTING FIXTURES 10.00/1.00 CONTRACTOR S PPLIANCES-RESIDENTIAL 4.00 ADDRESS ` �[ yAaAOnE �j� 00 PANELS 10.00 DATE OF APPLICATION A cwTET PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P77NO. OR ENGINEER ' sec.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION ADDRESS zm TEMP. METER OR POLE INS. 20.00 ADDRE NT5 ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 ro LICENSED CONRACFORS DECLARATION a v w 1 hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000).(Division 3 of the Business and BLDG. ELECT. PLG. MECH. ko Di Professions Cod and Icense is in full(urge f o i o2 o License Cje • p J Lin.Number_( DEC � V �JO ❑ ❑ ❑ a H w Dalc /�' Contractor ,/ I- - - G'cGG U BUILDING PERMIT 2 a or ¢ OWNER-BUILDER DECLARATION INFORMATION MISC.- F E w I hereby affirm that 1 am exempt from the Contractor s License VALUATION uoa Law for the following reasen.(Sm.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Q � r_ No Code:Anycity orcounty which requiresa permit construct,alter, Qw Q 2O Improve,demolish,Or repair any structure,NCture,prior W Its issuance,also ELEC.CONTR. LIC.NO. (� ELEC. ec - D ¢ requires the applicant for such permit to file a signed statement that pf 4r o ! 7/637 TOTAL PERMIT TO E 9 he is licensed pursuant In the provisions of the Contractor's License lJ .mss Law(Chapter 9(commencing with Section 7000)of Division 3 oftbe G�Cv 3 i o Business and Protassimis Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE to H g the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE COrvSTR. s ; � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 offer morn than five hundred dollars(SSOO).): ❑ I,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 n nut - intended or offered for s.lc (Sec. 7144, &Isiness and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code The Contractor's License Law does not apply to an owner of . properly who builds or improves thereon,and who docs such work FIXTURES,PER TRAP 5.00 Sa FT.PLOORAREA TOTALACREAGE himself or through his own employees,provided that such Improve- incou are not intended or offered for sale.If.however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 IEA.) 2.00 BUILDING USE . builder will have the burden of proving that he did not build or int- RES IND CON PB Our., prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 A ESSORS PARCEL N0. and Professions Code:The Contractor's License Low dues not apply to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts forsuch projects with a contrac(ons)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCEL NO. ❑ I am exempt under Scc. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason - Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COAIPENSATION DECLARATION WATER TREATING EOUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure. ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy there. (s 3 Lah.C.).f_£A)&1e _rwarl ), Policy No��mpany U ❑ Certified copy is hereby famished FIRE SPRINK ENERGY T 24 z Z ptrT�; Cent if d RprY is filed witqq [h�e ty inspection division. O APpdcamfO��t/�. MISC.- REFER TO ORD. y N❑ y N❑ 2y CERTI FICAT E OF EX E MPIION F ROM WO R K E RS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Lu > COMPENSATION INSURANCE PLG.CONTR. LIC-.NO. - PLG. Q. 0 '(This section need not he completed if the permit is for one TOTAL Y❑ N❑ Y ❑ N❑ Z) Z hundred doll...($100)or less.) U O 1 certify that in the Nffommnce of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any person in any manner so as to O become subject to the Workers'Compensation Laws of Califomin. U i Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT: If,aftermaking this Certificate of Ex- F_ Z emption,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply will) FEE U such provisions or this pennit shot]be deemed revoked. AIR HANDLING UNIT(TO 10MCF.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 for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sen. MICROFILM 3097,Civ.C.): HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's AddHEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC �9 ress 1 certify that I have road this of,fA cation and side that the above VENT LATI ON FAN (SINGLE) 4.00 - infonnation u correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-OOIJP(3 H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP JO ,11Y o00 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agreeto save, indemnify and keep harmless the City of MISC.- REFER TO ORD. C tin. against liabilities,JuJgment., cost 'cad ex nus which PERMIT ISSUANCE 10,00 CONST.TAX ay m any way accrue against slid City sense en � the Banti &ofthM'perrad. _ ECH. T LIC.NO. NOTAL TOTAL . 6,, 3� j Si lure of Applicant/Contras;or qate OFFICE COPY