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12948 POST THIS CARD NEAR FRONT OF BUILDING " rFRNur rvuMREH CITY OF CUPERTINO 12948 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS10680 S.DeAnza Blvd. UNIT# LOT# PERMIT EXPIRES IF WORK. OWNER Byer Prop. CONTRACTOR Curt Myers Construction IS NOT'STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. UFER PREGUNITE - PERMIT VALIDATION a POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING f ELECTRICAL - - - ISSUANCE DATE . RLDG, ELECT- MECHANICAL PLG. MECH. ❑ ❑ 1 Oj ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION VALUATION $/FT. PLUMBING - .'�`• MECHANICAL PERMIT TO ELECTRICAL FRAMING " STORIES J TYPE CONSTR. INSULATION OCC'.GROUP - RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS.BEEN SIGNED SO.F1.FlOOR AREA TOTAL ACREAGE ROOF DIAPHRAGM 6U I LOI ON USE RES IND CON PR U+M1rr APPLY NO ROOFING UNTIL ABOVEHAS BEEN SIGNED ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING ' TRACT NO. PARCEL NO. GAS TEST . . MECHANICAL • ' ACC.DATE ACC.FILE NO. ELECTRICAL 'FINALS 1 DATE INSP.- --• FRAMING SAN # INSULATION PLUMBING ZONING ENO.SITE NO. - GAS MECHANICAL FIRE SPRINK ENERGY T]< "yF,-COVER NOWORK.UNTIL;ABOVEHASlEEN`SIGNED"MHEATING Y ❑ NO YO No LATH-INTERIOR - ELECTRICAL FLOODZONE A.L.u.c. YO LATH-EXTERIOR FIRE DEPT. ❑ N 'Y No I SHEETROCK GRADE FEE SUMMARY . SHEAR INTERIOR - BUILDING SHEAR EXTERIOR - - TEMPORARY APPROVALS 'BUILDING FIREWALLS ELECTRIC PLAN CHECK 1 GAS " FEE NO TAPE OR PLASTER UNTIL ABOVEIHAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTEDUNTI LBUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBINGf ' PLEASE GIVE JOB ADDRESS WHEN PHONING. i Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE•READ REVERSE SIDE BEFORE TOTAL CALLING FOR.FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU(LDINGPROJECT IDENTIFICATION ,A, PERMITNUMBER BUILDING APPLICATION & PERMIT ADDRESS •- ,�f/Pd s �C dyrz� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 12948 OVI pq'a G7 �7 PLAN CHECK VALIDAT ION •� NAME QTY. ELECTRIC PERMIT FEE L-F�/I D • PHONE co RA DR's / UTLETS-SWITCHES-RECEP 10.00/1.00 NAME (gip 3P$ LIGHTING FIXTURES 10.00/1.00 roNTRACTORs APPLIANCES-RESIDENTIAL 4.00 ADDRESS y J }� R �f, PHONE PANELS 10.00 - DATE OF APPLICATION Al.ITECT S' 9 Ads- PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE PX.NO. OR ENGINEER Llc.rva. SIGNS TRANS. 3.00 ADDRESS ENG' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 „ ) ADDRESS rs MOTORS - SEE FEE SCH. �Q /ul(/'II•'7t•�Ny ADDRESS J�. (J Sus (47%AC SERVICE CHANGE 20.00 D o o LICENSED CONTRACTORS DECLARATION O a is 1 hereby affirm that I um licensed under provisions of Chapter 9 ISSUANCE DATE y a a (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. I PLG. MECH. F N i Professions Code, d my license is in full force and eff I. ❑ z o w- License Class Lic.Number ❑ 9 H ac o Date S = �9 Contracto ¢ y BUILDING PERMIT m a, a ¢ OWNER-BUILDER DECLARATION INFORMATION od ° - MISC.- REFER TO ORD X ;LL N I hereby collo Thal I am exempt frons the Contractor's License vALUATIo�� r LL o J Law for the following reason.(Sec.703 t.5,Business and Professions PERMIT ISSUANCE 10.00 vs Code Any city Erectility which requires permit to construct,alma 2 2<2O improve,demolish,or repair any structure,prior to its Issuance,also ELEC.CONTR. LIC.NO, ELEC. w. D u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO whe is licensed pursuant to the provisions of the Contractor's License rzi Law(Chapter 9lcommencingwith Section 70001 o1Division 3 ollhe U� ¢ Business and Professions Code)or that he isexempt therefrom and OTY. . PLUMBING PERMIT FEE ¢=$ the basis for the alleged exemption.Any violation or Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(85000: O 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 Code:The Contractor's License Law does not apply to an owner of • properly who builds or improves thereon,and who does such work FIXTURES-PERT 5.00 SG.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are Rol intended or offered 1'or sale.If,however,the building GAS-EA.SYSTEM- INCA OU TS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM- V(ER•4 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL I ER. 30.00 ❑ I,as owner of the property,am exclusively contracting with E] [3 ❑ ❑ ❑ licensed contractors to construct the project(See.7044,Business LAWN SPRINKLEfl -1 6.00 ASSESSORS PARCEL NO, and Professions Code:The Contmetor's License Law does not apply to an owner of property who builds of improves thereon,and who LAWN SPRINKLE O ER 5 IEA.) 1.00 contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ tum exempt under Sec..,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner - Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. • WORK F,RS'COMPF-NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(See3800,Lall.C. J Policy No. Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z Certif=y isfilqil,with the city inspection division. p MISC.- REFER TO ORD. y 1 N❑ Y ❑ N❑ CCy CERTIFICATE OF EXE9ION FROM WORKERS' PERMIT ISSUANCE 10.00 d - FLOOD ZONE a.L.U.C. LU COMPENSATION INSURANCE PLG.CONTE. FIC.No. PLG. / CL Q (This section need not be completed if the permit is for one TOTAL fD Y❑ N❑ Y [] N❑ :) Z hundred dollars(S 100)or less.) U O 1 certify that in the performance of the work for which this per- QTY MECHANICA PERMIT FEE FEE SUMMARY LL P mit is issued,I shall not employ any person in any manner so as to O W bcmmEsub'e�c[I the Workers' tpcl cation Lawso Californ'a. BUILDING Date Applicant A D T 5,00 } N NOTI E TO A (CANT: If,after making this rtificale of six- ? emption,you should become subject to the Work s'Compensation q 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE L..1 such provisions or this permit shall be deemed revoked. AIR HApfdLfX UNIT( 0 1 F.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(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 9.00 - Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 /� Qy information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMPI3 H.P.or t00,0008.T.U.1 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over t00,ODOBTU)SEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep Iannless the City of MISC. REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in ny way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 f this permit. MECH.CONT.' LIC.NO. MECH. S S_P TOTAL TOTAL t azure of Applwan tractor Date OFFICE COPY i CITY OF CUPERTINO oVVE j GAS SERVICE NOTICE d_e 7Gti� f i s f You are hereby authorized to connect the GAS service for Owner or Tenant !=-'Y.�V At Neva Service iNo. of Meters Reconnect No. of Add. Meters Move Service ' Move Meter- PLUMBING eter PLUMBING INSPECTORZZ"ti /?