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13118 POST THISCARDNEAR FRONT OFBUILDING .' PERMIT NUMBER CITY OF CUPERTINO 13118 INSPECTION DIVISION JOB INSPECTION RECORD ~9y� 20650 VALLEY GREEN DRIVE _ PERMIT EXPIRATION JOB ADDRESS UNIT# LOT# PERMIT EXPIRES IF WORK OWNER APPLE COMP,, INC CONTRACTOR HARTJE CONSTRUCTION IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD ' 1B9 DAYS OF PERMIr ISSU- ANCE OR 180 DAYS FROM FOUNDATION �"(�' /�!f LIFER. LAST CALLED INSPECTION. 1 W PREGUNITE I F� rm lw PERMIT VALIDATION. . viekA POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED `rV`�, UNDERGROUND /S AB - PLUMBING i�Cl1'/"'7 C C L TRI A ELE C1�Y ,SEDATE MECHANICAL Lo Ar. PLG. IJEC DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILo1nGP(,�E,(�_RIMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING - .7 MECHANICAL PERMIT TO ELECTRICAL • FRAMING STORIES rtlC 7� • _ STORIES TYPE CONSTR. INSULATION ' t OCC.GHOUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ''''�� ROOF' SO,FT,FLOOR AREA TOTAL ACREAGE . r� DIAPHRAGM +� BUILDING USE HES IND CON PB O,ner APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ 1:1 ❑ 11 ASSESSORS PARCEL NO, ROUGH' PLUMBING TRACT NO. PARCEL NO. GAS TEST MECHANICAL ' " ACC.DATE ACC.FILE NO • ELECTRICAL FINALS DATE INSP. FRAMING SAN #. SITE NO.. INSULATION � PLUMBING � � ZONING ENGS' GAS FIRE SPRINK ENERGY T 24. ' MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING _ Y ❑ N❑ Y E] 'N❑ ' LATH-INTERIOR ELECTRICAL FLOOD ZONE ALU.C. . LATH-EXTERIOR - ' FIRE DEPT. Y ❑ NF] l Yo .N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING / 2 +` SHEAR EXTERIOR - - TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK GAS FEE . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTEDUNTIL BUILDING FINAL•ISSIGNED BY BUILDING INSPECTORI MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING 0. PLEASE GIVE JOB ADDRESS WHEN PHONING. {J — SEE PERMIT FOR EXPIRATION DATE — ' MECHANICAL Ty U .. CONST.TAX IMPORTANT! ' PLEASE READ REVERSE SIDE BEFOREo-•S CALLING FOR FINAL INSPECTION. TOTAL �, OFFICECOPY, ' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENTI FICATI ON PERMIT NUMBER ' a BUILDING APPLICATION & PERMIT - ' `� 13118 - BUILDING-ELECTRICAL-PLUMBING-MECHANICAL PLAN CHECK VALIDATION h � " ME QTY. ELECTRIC PERMIT FEE � c HONE y NAMERAcroR's UTLETS-SWITCHES-RECEP 10.00/1.00 0 v_1 LIC.NO. LIGHTING FIXTURES 10.00/1.00 r- NTRACTORS - PPLIANCES-RESIDENTIAL 4.00 F O E8O HONE PANELS 10.00 DATE OF APPLICATION CR0IT59ECTPANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR ENGINEER . 4�11`- SIGNS TRANS. 3.00 ` C.NO. ARCH.ORENG. SPECIAL CIRCUIT • 5.00 PERMIT VALIDATION AGGRESS ZIP TEMP.METER OR POLE INS. "20.00 PAID AMOTORS SEE FEE SCH. AGDGRESSDRESS SERVICE CHANGE Al 20.00 !1 Doo LICENSED CONI'RACfORS DECLARATION L ^�� u w I hereby uffinn that I am licensed under provisions of Chapter 9 J,�;•• JC ISSUAND ATE.a• n a n (commencing with Section]000)of Division of the Busm",and BLDG. ELECT, PLO:-' ECH. F N i Professions Co end y license is in full f f H. FL Chi— upertino �. o Z H 7Y U Lic.Contractormb a.y s'J� - - BUILDING PERMIT a ¢ OWNER-BUILDER DECLARATION INFORMATION a os ° w ;u N I hertby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD u_o ¢ Law for the following reason.(See.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION SIFT. Code:Any city orcounty which requires a permit to construct.alter, 2 ¢ < FO improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. j O I[ require the applicant for such permit to file a signed statement that TOTAL -3 PERMIT TO r� whe is licensed pursuant to the provisions of the Contractor' License Law(Chapter 9(comurnmemg with Section 7000)o f Division 3of the ¢ Business and Professions Cale)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ =$ the basis for the alleged exemption.Any violation of8eclion 703 1.5 STORIES TYPE CONSTR. by any applicant for apmut subjects the applicant to a civil PenaltyALTER-DRAIN&VENT-WATER (EA.) 5.00 -�' of not more than Eve hundred dollars(S500).): ' ❑ 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 (J Code The Contractor's License Law does not apply Io an owner of property who builds or improves thereon;and who does such work FIXTURES-PER.TRAP 500/dSOFT.PLOORAREA TOTALACREAGE himself or through his own employees,provided that such improve- , mems are not intended or otiered for It,If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or -EA.SYSTEM-OVER 4(EA.) ' 2.00 improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or iGAS nr BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB omar ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to corutrvct 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 docs not 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 contraetons)licensed pursuant to the Contractor's License Law. W S ORM EA.200ft/10.00 TRACT NO. PARCEL NO. O I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/V NTE-� 6.00 reason Owner Date WATER SYSTEM .� 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSA'I'ION DECLARATION WATER TREATING EQUIP. 4 -T 5.00 1 hereby affirm that I have a certificate ofconsent to self-inmre, x; ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,1ab.C. /y4�z` Policy No. C.;u,nm �,�{X Y+ ` - - Q x ❑ Certified copy is hereby urnlshed. or VUf1GIL II FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is�G?led wit h city inspection division. MISC.- REFER TO ORD. F O� APPlicant -DC}/e-�j -� Y ❑ No , Y ❑ N❑ T CERTIFICATE.OF F:xEMrfION FROM WORKERS' PERMIT ISSUANCE 10.00 - FLOOD ZONE A.L.U.C. W a COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. Y N Y N d 0 (This section coed not be completed if the permit is.for one TOTAL ❑ ❑ ❑ ❑ Z hundred dollars(5 100)or less.) U O 1 certify that in the perfomtanee 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 g.•�y._.- become subject to the W'orketi Compensation laws of California. U w Date A licant BUILDING �7Q if a pf ALTER OR ADD TO MECH. 5.00 ,(/� } to NOTICE TO APPLICANT: If,after making this Certificate of lis- F 2 emption,you should become subject to the Workers'Compensation APPLIANCE I!_ _ u f r 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 UNITdOVER 10J]OOGEM.16.00 SEISMIC FEE 75�' 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 Remail is issued(Sec. - MICROFILM 3097,Civ C.). t HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC U ' 1•,t I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 0 0%1S mronnatwn is correct:I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 1 D0,D00 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the verO o0 BOILER-COMP lo1W,000 BTU)SEE FEE SCH. MECHANICAL about-memiotted property for inspection purposes � (Wc) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgtnenis, colas and expenses which PERMIT ISSUANCE 10,00 16 - CONST.TAX may any way accrue against said City in consequence of the thisIL MECH.CONT. LIC.NO. MECH. w=4 6`q�e2TOTAL .26TOTAL �,•Js u alure of Appllcan ontrector Datc -` OFFICE COPY