13832 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
. -. . CITY. OF CUPERTINO 13832
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOBADDRESS 10431 N. DEANZA UNIT# LOT#
PERMIT EXPIRES IF WORK
OWNER APPLE COMPUTER CONTRACTOR CARL HOLVICK IS NOT STARTED WITHIN
INSPECTION DATE INSP CTORQ INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION L. 1,� �� g1-G C� ANCE OR 180 DAYS FROM
1
LIFER LASTCALLED INSPECTION.
PREGUNITE PERMIT VALIDATION.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED. &Y«'
UNDERGROUND /SLAB
PLUMBING C'c t' I ��
ELECTRICAL - nXlf&UA CE DATE-• I
MECHANICAL. 'BLnc" ELECT. PLG. MECH.
GIM Ll ❑ ❑ a ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR
VALUATION SIFT.
'PLUMBING -
MECHANICAL
ELECTRICAL --1061
LECTRICALp PERMIT To
FRAMING Ife�c5l Nln �
• INSULATION srORlEs TYPECONSTR.
OCC.GROUP A $.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
• Sl.FT,FLOORAREA TGTALPCRE.GE
ROOF.
DIAPHRAGM.
BUILDING USE
HES WD CON PB Omar
Cl
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 0 0 ❑
ASSESSORS PARCEL NO,
ROUGH
PLUMBING '
TRACT NO. PARCEL NO.
GAS TEST
MECHANICAL
ELECTRICAL FINALS DATE INSP. ACC.DATE Acc,FILE NO.
FRAMING SAN n
ZONING ENG.SITE NO.
INSULATION PLUMBING
L _ _ GAS •
MECHANICAL FIRE SPRINK ENERGYTza
`OO NE Y ❑ N[]COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD zarvE A.L.u,c.
LATH—INTERIOR ELECTRICAL 1 .
LATH—EXTERIOR - FIRE DEPT.
Y❑ N❑ Y ❑ N❑
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIORBUILDING 4,—
SHEAR EXTERIOR 'TEMPORARY APPROVALS BUILDING -
FIREWALLS ELECTRIC PLAN CHECK-
- FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
I
ARRANGE FOR INSPECTION BY P=PHONNING.
ELECTRIC
FW- ONE WORKING DAY BEFORE REQPLUMBING
2 PLEASE GIVE JOB ADDRESS WHE- SEE PERMIT FOR EXPIRMECHANICAL
IMPORTANT! coNsr.rax
PLEASE READ REVERSE SIDE BEFORE TOTAL i-
CALLING FOR FINAL INSPECTION.
OFFICE COPY -
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
�(
BUILDING APPLICATION & FERMI T 13832
"AM
oosE
NSR LJI BUILDING - ELECTRICAL-PLUMBING-MECHANICAL -
// WNER'S PLAN CHECK VALIDATION
QTY. ELECTRIC PERMIT FEE
Iq
PHONE
crOFs
NAME UTLETS-SWITCHES-RECEP 10.00/1.00
NAME •/ q
�Y ua No. Q` LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S SU vq� PPLIANCES-RESIDENTIAL 4.00 -
ADDRESS
("(01N LAW 912VPHONE -' 00 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO,
OR
ENGIN
c.No SIGNS TRANS. 3.00
ARCH,OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
�Q jo Z,P EMP.METER OR POLE INS. 20.00 nT'�
APPLICANT'S
ADDRESS ./n• MOTORS. SEE FEE SCH.
(Ij0 _(kA ON 5�1� SERVICE CHANGE 20.00 L,01//R.F.J
, 02 J Q
H O o LICENSED CONTRACTORS DECLARATION v g10la 7
st U� I herebyaffirm that I am licensed under provisions of Chapter 9 s!nP'
p P ... .i r11f11$$UANCE DATE
Q H (commencing with Section 7000)of Division 3 of the Busine and ys )BL'DG. 'ELECT. PLG. MECH.
r DProfessions Code nd my license is in full to
d'S
Oi=,o License Class Lic.Number V ❑ ❑ ❑ ❑
:r j Date �'1 Contractor
H
m M a OWNER--BUILDER DECLARATION BUILDING PERMIT
_ ¢a INFORMATION
w;o- y 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
F u. LLD J Law for the following reason. 7031.5,Businessand Professions pERMIT ISSUANCE 10.00 VALUATION SIFT.
m O Code:Any city or county which requires a permit to construct,alter,
a c s-G improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. TLE. /4
D M requires the applicant for such permit to File a Signed statement that TAL PERMIT TO
w$ he is licensed pursuant to the provisions of the Contractor's License p"
r z r
Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe RgLT/w IL J�OOaC..
4 c Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
t- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
u by any applicant for a permit subjects the applicant toa civil penally ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not mor.than live hundred 00112TS(8500).):
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 DCC.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,GOND. 5.00
Code:The Contractor's License law does not apply to an owner of
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-1 6.00
menta are not intended or offered for sale.If,however,the building
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or im- RES IND CON PB Ome,
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ Cl ❑
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 for such projects with a contractor(s)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft110.00 TRACT NO. PARCEL NO.
❑ I sm exempt under Sec. ,B.&P.C.I'or this WATER HEATER W/VENT 6.00 -
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO,
WORKf:RS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to self-insure,
or a certificate of Workers' .C.). tion In uragce,ort rtificJ copZONING ENG.SITE NO.
r a thereof( ec.of Work Is'Compensation
Policy No. Company-
O ❑ Certified copy Is hereby furnish.d. FIRE SPRINK ENERGY T-24
Z ❑ Certified copy is riled with the city inspection division. MISC.- REFER TO ORD.
O Applicant Y ❑ N❑ Y ❑ N❑
~ aa PERMIT ISSUANCE 10.00 FLooD zoNE A.L.u.c.
� - CERTIFICATE EI 9ATIOTIFROM WORKERS'
a Q COM Hot be Com INSURANCE ifthe PLG.CONTR. LIF NO. PLG
TOTAL Y❑ N❑ V❑ N❑
2 hundred
action need not be completed if the permit is for one
hundred dollars 1 n the pe lass.)
U O t certify that h the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
IL U mit is issued, I shall not employ any person in any manneror e m
V become subject to the Workers'Compensation Laws of California. V
y
Date-Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} m NOTICE TO APPLICANT: If,after making INS Certificate of Ex-
I- Z emption,you should become subject to the Workers'Compensation APPLIANCE 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
CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M:) 6.00 SEISMIC FEE
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. MICROFILM
3097,CN.C.). ` HEATING UNIT(TO 100,000 B.T.U.) B.00
Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00
information is correct.I agree to comply with all city and county PLUMBING
ordinances and state laws relating to building construction, and 130ILER-ODMP(3H.P.or100,000B.T.U.) 6.00
hereby authorize representatives of 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
m any w ' ac e a must said City in consequence of the
g f goft C MECH,CONT. LIC.NO. MECH.
O� TOTAL
amre Al ontmetor Date
OFFICE COPY