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15366 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT'PEN.ONLY BU I LDING PROJECT IDENTIFITION - PERMITNUMBER - BUILDING APPLICATION & PERMIT 6 ADDREBB 10300 Tula Lane, Cup. BUILDING - ELECTRICAL-PLUMBING-MECHANICAL J 536 v OWNER'S PLAN CHECK VALIDATION "AME_ James C. Hoffman QTY. ELECTRIC PERMIT FEE PHONE 252 -6107 CONTRACTORS NAMEKOH Atlas Corp. 204564 OUTLETS-SWITCHES-RECEP 10.00/1.00 sec.NO. LIGHTING FIXTURES 10.00/1.00 CO.TRACY4� n� PPLIANCES-RESIDENTIAL 4.00 ADOREa Cu ertino PRO NE4155 PANELS 10.00 DATE OF APPLICATION RcnrtECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.GiNO. OR O ENGINEER - sec.No. SIGNS TRANS. 3.00 neo ESS ENO SPECIALCIRCUIT _ 5.0Q PERMIT nVALIDATION ZIP .EMP. METER OR POLE INS. 20.00 ADDDRE APPLICANT SS Nrs MOTORS SEE FEE SCH. 10260 Tula Lane, Cup. SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION a U u I hereby'affirm that 1 am licensed under provisions of Chapter 9 G. fT ISSUANCE PATE y< h (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. r z Professions Cod• and my license is in full fore�pr0��II rJ(C%y ��� i O',f, - Liam-,C1 se c.Nu mlxr_LS1 yb-•J.f)4 Oz r D Fiat c_Jf_l.7/_fl0 Contractor - `¢ „ ` . BUILDING PERMIT OWNER INFORMATION DECLARATION MISC.- RE TO INFORMATION Lhemby of ern that Iain exempt from the Contractor's License IIA LUATION S/FT. ; Huo� law for the following reason(Sec.703L5,Business and Professions PERMIT ISSUANCE 10.00 mN Code:Any city orcounty which iequirusa permit to construct.alter, V✓ V QU,Q improve,demolish,or repair any structure.prior to its issuance,also ELEC. LIC.NO, ELEC. D Q Irritates Ibe applicant for such permit to Ille a signed statement that TOTAL PERMIT TO w$ he is licensed pursuant to the provisions of the Contractor's Licenw ai Law(Chapter 9(conrmencing with Section 7000)of Division 3ofthc A a Business and Professions Code)or that he is exempt therefrom and QTY, PLUMBING PERMIT FEE re the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit objects the applicanno.civil penalty gLTER-DRAIN& VENT-WATE (EA.) 5.00 of not mom than Ove hundred dollars(S500)J: - ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. 4.00 their Tole compensation,will do The work,and the stmctere is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AMWCOby0.00 �_J�. ^ Code:The Contractor License Law docs not apply 1.an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TR 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- +� stents am'not intended or offered lin sale.If,however.the building GAS-EA.SV$TEM- .40UT S 6,00 .3S40 or improvement is sold within one year of completion,the owner- GAS-EA.SVSTE R 4 JtA)' 2.00 BUILDING USE builder will have the burden of proving that he did not build or no RES IND CON PB Omer Prov.for Purpose ofsak.). INDUSTRIA W EIN E 30.00 ❑ ❑ ❑ ❑ ❑ I,as owner of the property,am"elusively contracting with - licensed contractors to eNostmet the project(Sec.7044,Business LAWN SPR IV RS- 1 IN V.B. 00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's Livens.Law does not apply to an owner of properly who holds or impmves thcr.or.and who LAWN SPR LERS-O 5(EA.) 1 6.AO J S7-/3-/H contracts fur such projects wiser a amooeto0,)licensed punoant to SEWER-SA I ARV-ST RM EA.200ft/10.00 the Contractor;License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec. .B.&P.C. or this WATER HE TER W/ NT 6.00 ,a7 7 reason Owner Date WATER SYSTEM 5.00 ACC.DATF ACC.FILE NO, WORKIiRS'CO.\IPENSATION DECLARATION WATER TREATINd EQUIP. 5.00 I hereby affirm that I have o certificate of consent to sell-insure, ZONING ENG.SITE NO. or a ecToDcute of Workers Compensation Insurance,or a certilied copy thereol'(4, 3800,labC.)f. - 1'olicy,No. CnmPany-J.t.a.te-ACornp,.Inii O ❑ Cctlifmd copy is hereby fume hed. FIRE SPR INK ENERGY T-24 Z 2 ❑ Certified copy u Filed with the city inspection Division. MISC.- REFER TO ORD. O Applicant C .,,f�p Y � N� V � N� ~ i`0CC(A;'A-WA PERMIT ISSUANCE 10.00 LUN FSATIN INSUROS/WORKERSI FLOODZONE A.L.0 c. a_ COMPENSATION INSURANCE PLG.CONTE. sec.No. PLD. Y❑ N❑ Y [] N❑ d O hundred section $10 not he completed if the Permit is for one TOTAL _ Z hundred dollars 151001 or less.) L) O 1 certify that in the performance of(lie work for which this Iwi- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL h- mit is issued,1 slmll not employ any person in any imnner so as to Ow become subject to the Workers'Compensation Laws of California. BUILDING ll a Dat` Applicant ALTER OR ADD TO MECH. 5.00 } m NOTICE TO APPLICANT: IL after making this Certificate of Fx- ? emption,you should become subject to the Workers:Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Cade, you must forthwith comply with FEE U such provisions or this permit s11a11 be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=CF.M) 6.00 SEISMIC FEE /y-t7 I hereby ufNmt 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.). Cupertino Nat'.1.Bank HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ,QQJo� Lender's Address 20,27 n a ELECTRIC 'r tevens-Creel, I cer"'Hy that I have read this application and state IIIat the above' VENTILATION FAN (SINGLE) 4.00 `- in(orm5tion is correct, 1 agree o comply with all city and county PLUMBING �7`�"i^ BOILER- 13 H.P.or 100,000 B.T.U.) 6.00 ordinances and state laws relating to building construclion, and -"r hcreby)Buthuritu repmsentu[ives of this city 1. enter upon the BOILER-COMP IOver100,000BTU)SEE FEE SCH. MECHANICAL QQas� above-mentioned progeny far on oinesedipurpows. _ . (We) agree to save, indemnify and keep hannleas the City of MISC.- REFER TO ORD. Cupertino against liabilities.judgments, casts and expenses which CONST.TAX Only in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 granting of This permit. MECH.CONT. LIC,NO. MECH. TOTAL TOTAL 3 0 7(3 Signature of Applicant/Contractor Date OFFICE COPY .�7��92 /1/�4/Gi.i,y �� POST THIS CARD NEAJ.l, -H't d iLDING ' CITY OF INSPECTION N O �% JOB INSPECTION RECORD UNIT lilf PERMIT F.XPInA%' LO r it PElIK411 EXPIRE, OAN HT STARTEC CONTRACTOil t�, C., - i , - IS NO , INSPECTION UATF. INSPECTOR !NSPECTION RECORD 180 DAYS OF'PERh FOUNDATION NOTE: ANCE 08 180 DAY, UFFR ALL DANCING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPEC' FREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF —1,7111 CUPEVINOSTANDARDS. GARAGE SLABS POUR 140 CONCRETE UNTIL ABOVE 4AS BEEN SIGNED .1 V 1, %,tAy r�A Ur\JDERGP.OUND IISLAB I PLUMBING vi 0 tur- -Ri-w-v I--Ls-- ELECTRICAL np MECHANICAL E1j U11 190T POUR FLOOR UNTIL AUGVE HAS BEEN SIGNED BUILDING PEFIII)i WOOD FLOOR INFORMATION PLUMBING & 70 0 /7- C-1-1b'g fOrGHANICAL ELECIRICAL CE—,1 1"a�,,3 I,v PLACE NO SUBrLOGR U-NT'L ABOVE HAS BEEN SIGNED ROOr NOTE NO FINAL!NSP.SHALL BE MADE:BEFCIIE DIAPHRAGM 1 HE CONSTRUCI ON TAX IS PAID ROOF SH I E A If I I NG APPLY NO ROOFING UNTIL ABCOVE li;,S GF W SICNED FWALS DATE SANM PLUMBING ELEc r,ENERGY TUBS&SHCAVIUA'AN PLUMBINGT— FINERGY MECHANICAL k, 12 MECH.LNEHGY --- )/ - c; 11 — ".1- .,,I T. ELECTRICAL DUILDING ENERGY TRAMINGELECT,FNNAL REST INSULATION PLUMBING TAS TEST GA-I NIECHANIC/11- COWR NO WORK UNTIL ABOVE IIAS OC21i SIGNED HEATING EXTERios SHEAF— ELECTRICAL RELEASE— `� -, - INTERIOR SHEAR . 0 1` 7 .1 ; FIRE DEPT. SIIEF.*fFIOCKD-2- I GHADC FEE SUM.1AAA'I EXTERIOR—(.Afrl I(', I BUILDING INTERIOR LBUILDING / ' ATH k-,35 TEMPORARY NppnOVALS S('FIA1r,i I COAT ELECTRIC PLAN CHECK GAS FEE 7 N-0—TA-PE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIG74ED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F- ONE WORKING DAY BEFORE REQUIRED INSPECTION. l PLUMPING 0 PLEASE GIVE J06 ADDRESS WHEN PHONIING. MECHANICAL SFE PERMIT FOR E' P!,RATiON DATE — CONST. TAX I IMPORT AN � I -AD P -Ar F,—!PLEASE RE IEVERSE � EF, -! TOTAL CALLING FOR FINAL '1'41SIIECTION. Afl."LlICANTS,POSTING C011V ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTORS NOTICE CITY OF CUPERTINO To You are hereby authorized to Connect electriml service for Owner or Tenant •� �����_~{P I� At 103CC U L-A L N No.of Wires Size of Wires Size of Switch Motor Load voltage Phase Heating Load K.W. Voltage Light-110 New Service ReconnM Heal 170_ihree Wire No.of Meters More Service No.of Add.Meters Power Three Phase Move Meter Q" ELECTRICAL INSPECTOR t P.G S E CITY OF CUPERTINO COPY GAS SERV!CE NOTICE 19 To You are hereby authorized to connect the GAS service for Owner or Tenant S K �40 FF M A%'J At O CA rtULR L\Q • y New Service X No. of Meters Reconnect I Move Service No. of Add. Meters Move Meter PLUMBING INSPECTOR 1 BUILDING INSPECTOR'S OFFICE D,_ CITY OF CUPERTINO PI I x l ❑ Backflow Device Sonitory Permit No. ❑ Sewer Connection Plumbing Permit No. 53 C-6 ©- Plumbing Final Lot No. Owner or Tenont At 10?cb -I uuw r Tract Dare Connected 19_Dote Final �-� 19 r O• PLUMBING INSPECTOR CITY OF CUPERTINO CERTIFICATE OF GOMRLETION BUILDING INSPECTOR'S OFFICE Date .. .... .._ y................. 19............ Building Permit No. �........ ..... The Building Located at ..... ....... ......�-�.-j.......................................... Owned b FtGk ..:� IC)F F OJ Has Been . ((Atte ed))>For Use As: ..SF ��— - ......_............................................... I" ......._.................._.............................................---. ........................ ....................................... I .................... ............. .. ...... ..:.............................................................................. 0�0s PD-7 BUILDING INSPECTOR CITY OF CUPERTINO CERTIFICATE OF C,OWPLETION pBUILDING INSPECTOR'S OFFICE Date ..�_...Z g ..............., 19..-----"--- Building Permit No. �..-�.�.... 4.. The Building Located at ..... . .._.�.---_''' `c:�...... -N'-------......-----...._.....-.... Ownedby ...zth.....vipF.�C�N............................._....... .. ......................... Has Been Completed For Use As: .C F.Q W L (A fere ................................................._..........'--........_....................................................................... .................................................................................................................................................. ............................................................ til(_0 J ........ ............................................ PDQ BUILDING INSPECTOR