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13214k* POST THIS CARD NEAR FRONT OF BUILDING . CITY OF CUPERTINO., INSPECTION DIVISION JOB INSPECTION RECORD ' SALEM AVENUE 2/3 JOB ADDR ESS - 'UNIT# LOT# OWNER THRUST IV, INC CONTRACTOR THRUST IV, INC - PFRMIT NUMBER 13214 I PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN '180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECO D FOUNDATION .. UFER PREGUNITE - PERMIT VALIDATION IssDANCE GATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 'ppkD UNDERGROUND/SLAB PLUMBING. ` JUI �,019�� ' - - ELECTRICAL MECHANICAL ECT, PLG. MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION"E WOOD FLOOR VALUATION a SIFT, i PLUMBING MECHANICAL ELECTRICAL PERMIT TO A ' FRAMING INSULATION 7STORIES TYPE CONSTR. - OCC. GROUP" RES, UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO, FTI FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE NES IND CON PB OBie, ❑ ❑ ❑ ❑ 1:1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH ASSESSORS PARCEL NO. PLUMBING GAS TEST ' TRACT NO, PARCEL NO. MECHANICAL ELECTRICAL . ,FINALS DATE INSP. ACC. DATE ACC. FILE NO. FRAMING SAN # INSULATION PLUMBING ZONING ENG. SITE NO. GAS' FIRE SPRINK Y13 NE ENERGY T 2 .Y [] NC3 _ MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH -INTERIOR ELECTRICAL FLOOD ZONE No NE] 0.LU.L. . Y0 N� LATH -EXTERIOR .- FIRE DEPT, SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING BUILDING yt C 0 SHEAR EXTERIOR TEMPORARY APPROVALS- FIREWALLS ELECTRIC - PLAN CHECK FEE - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE _ J OCCUPANCY OF BUIILDING IS NOT PER MITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLEASE GIVE JOB ADDRESS WHEN PHONING. Z . — SEE PERMIT FOR EXPIRATION DATE — ELECTRIC PLUMBING MECHANICAL coNsr. Tax IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL -o / GSI OFFICE COPY ' APPdCANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY . BU I LDING PROJECT IDENTIFICATION APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 13 214 AG ADDRESooREas $ALCM pve COT 2 OwNEH'S rva/w�E ¢/S% Tr/ PHONE 2 QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION croR NAME 's NAME UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 uc.NO. DATE OF APPLICATION ADDRRAcroFs AGGRESS 209 L D/A( $ PHONE PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 GROW ECT OR /n�•a /Q "L No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. N0. SIGNS TRANS. 3.00 ADDRESS ENG SPECIAL CIRCUIT 5.09 PERMIT VALIDATION ZIP EMP. METER OR POLE INS. 20.00 PAID AS ADDREDDRESSS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 91 TAODATE (commencing with Section 7000) of Division 3 of the Business and Professions Co ,ay my license is in lull to�n}hef(ed. License Class �7 `/�� OG. E ECT. PLG. MECH. ❑ ❑ ❑ - Dote Contranof Contra for BUILDING PERMIT INFORMATION OWNER -BUILDER DECLARATION I hereby affirm that 1 so exempt from the Contractor's License Law forthefollowing ounty whiche.unruse itocnd Professions Code: e, dem y demolish, cvnmty whiny structure permit riot o construct, after, also improve, de m0 6h, Ur repair Eloy structure, a It Or t0 d5 Statement requires the applicant for such permit to fide i signed stmemem Ihat Ihna he is IicenscA pursuant m the provisions of ilii Conlrnctoi s License MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION 7n / f� $/FT. ELEG. CONTE. LIC. NO. ELEQ TOTAL PERMIT TO Law (Chapter 9(Commencingwith Section 7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE A-7,1.1/ LC the basis for the alleged exemption. Any violation of Section 7031.5 by anyapplicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): STORIES TYPE CONSTR. ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the sl ruchim is not BACK F LOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and ProfessionsDRAINS-FLOOR, Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- ments are not intended oroffered for sale. If, however, the building FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 SO. FT. FLOOR AREA TOTAL ACREAGE or improvement is sold within one year of completion, the owner. builder will have the burden of proving that lie did not build or im- prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contrucling with GAS • EA. SYSTEM - OVER 4 (EA.) 2.00 - BUILDING USE RES IND CON PB One, 13 ❑ ❑ 0 E] INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, unit who LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a contractors) licensed pursuant to the Contractors License Law. ❑ I am exempt tinder Sec.., B.&P.C. for this reason SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.96 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 W'ORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate .1 consent to sell' -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thereof (Sec. 3800, Lab.0SPATE Policy No. CompanyjM97 STA 7 _ FIRE SPRINK Y N ❑ ❑ ENERGY T 24 Y N ❑ ❑ ❑ Certified copy is hereby furnished. ❑ Certified copy is, fled with the city inspection division. Applicant Tt/Tr.4or�:r_Tr* MISC.- REFER TO ORD. CERTIFICATE OF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.LU.C. COhIPENSATION INSURANCE (This action need not be completed if the permit iS for one a PLG. CONTE.T uC. NO. PLG . OTAL Y ❑ N[ Y NC] hundred dollars (51001 or less.) I certify that in the performance or the work for which this per- mit is issued, I shall not employ any person in any mmnner so as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 0'0 become subject to the Workers' Compensation Laws of California. D to Applicant. NOTICE TO APPLICANT: If, after making this Certificate of fix- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE ' emption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked AIR HANDLING UNIT (TO 10MC.F.M.) 4.00 AIR HANDLING UNIT (OVER 10MC.F.M.)6.00 SEISMIC FEE �0 CONSTRUCTION LENDING AGENCY 1 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. 3097; Civ.C.). '' F- I - Fi` MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name. Lender's Address �t� HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC VENTILATION FAN (SINGLE) 4,00 I certify that I have read this application and stale that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER- COMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorizerepresentatives this city to error upon the above-mentioned propertyerty for inspection purposes. (We) agree to Save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against 'id City in consequence of the MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX g a t,g,or Ibis Pe I. • a 6.2�,bt MECH. CONT. LIC. NO. MECH. TOTAL TOTAL Signature of Applicant/Contractor Date OFFIGE copy