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13440 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO NUM1,BI41 INSPECTION DIVISION 3440 JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS 11000 N. WOLFE ROAD (COMPU #ROOM) _LOT# PERMIT EXPIRES IF WORK OWNERHEWLETT PACKARD - 42L1 CONTRACTOR HEWLETT PACKARD IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECO D 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 160 DAYS FROM LAST CAL LED I NSPECTI ON. UFER PERMIT VALIDATION PREGUNITE ?vuLv POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB rf_D PLUMBING ,,� p ELECTRICAL Ram �i Pn IIlSstIArv;E DATE �. 'BLDG. ELECT. PLG. MECH, MECHANICAL 0 0 O DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL 1*7&F, FRAMINGr"�Y TYPE STORIES TYPE CONSTR. INSULATION OCC GROUP UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ Sp.fT,FLOOR FRE4 TOTAL FCREAGE ROOF DIAPHRAGM auuDlrvc USE RES IND CON PB 0"', El 0 El 0 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED SP ASSESSORS PARCEL NO. ROUGH PLUMBING TRACT NO. PARCEL NO. GAS TEST ACC.DATE ACF FILE NO. MECHANICAL ELECTRICALFINALS DDATEINSP. FRAMING 7SAN # ZONING ENG.SITE NO. INSULATION PLUMBING GASFIRE SPRINK ENERGY L}4 MECHANICAL Aw ' D N0 Y ❑ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A.L.U.C. LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEPT. v N� v �] N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING . SHEAR EXTERIOR TEMPORARY APPROVALS •! FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE A, OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM t ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC "U ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. _ Z MECHANICAL ol - SEE PERMIT FOR EXPIRATION DATE - CONST.TAX' IMPORTANT! _ PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION- OFFICE COPY TI APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY �9UI LD1 NG PROJECT I DENT]FICATION PERMIT NUMBED �./ BUILDING Ak' APPLICATION & PERMIT gDRESS tV00 EI WOl C C""e: k1BUILDING-ELECTRICAL-PLUMBING -MECHANICAL 13 440 OeINER'S PLAN CHECK VALIDATION 417 DTV. ELECTRIC PERMIT AkItFir tLA, PHONE 7Qro9 ^� CONTRACTOR �syy� OUTLETS-SWITCHES-RECEP' 10.00/1.00 �� .3G �°�- jf' OpfI P4KAEt).LIC.No. LIGHTING FIXTURES 10.00/1.00 CONTRACTORS APPLIANCES-RESIDENTIAL 4.00 ADDRESS PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECTPANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. 5.00 PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT cap TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. ADDRESS SERVICE CHANGE 20.00 Foo LICENSED CONTRACTORS DECLARATION ¢u I hereby affirm that I am licensed older provisions of Chapter 9 - ISSUANCE DATE N a y' (commencing with Section 7000)of Division 3 of the Business and BLD0, ELEWTo PLG. MECH. H N z Professions Code,and my license is in full force and effect. .J )G'O ❑ ❑ z o m - License Class Lic.Number g H w Date Contractor BUILDING PERMIT ¢ ¢w 4 OWNER-BUILDER DECLARATION INFORMATION o MISC.- REFER TO ORD K a w I hereby affirm that 1 am exempt from the Contractor's License VALUATION $/FT. wLLoQ Law forthe foltsvingreas.n.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to construct,alter, ac a, a 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. o u P requires the applicant for such permit to file a signed statement that TOTAL PERMIT &w$ he is licensed pursuant to the provisions of the Contractor's License ,I FiQ Law(Chapter 9(Commencingwith Section 70000ofDivision 3 oflhe C�p [� s D Business and Professions Code)or that hLUMBING PERMIT FEE e is exempt therefrom and CITY ¢ I_ o the basis for the alleged exemption.Any violation ofSection 7031.5 STORIES TYPE CONSTR. a ;m by any applicant for a permit subjects the applicant to a civil penalty gLTER-DRAIN&VENT-WATER (EA.) 5.00 of not more titan five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as ggCK 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 ProfessionsDRAINS-FLOOR,ROOF,AR EA,CON D. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 $o.PT FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- -11N GAS-EA.SVSTEMC.4 OUTLETS 6.00 meats 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 DON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with 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 contractofs)licensed pursuant to SEWER-SANITARY-STORM EA.2001t110.00 TRACT NO. PARCEL NO. the Contractor's License Law. X I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Ume WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate.1 consent to self-insure, ZONING ENG,SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.). Policy No.-Company - 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 ,. Z Z O Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. Y[:] N[ YC] N Applicant FyE 10.00 fLOOD ZONE CC - CERTIFICATE 01'EXEMPTION FROM WORKERS' PERMIT ISSUANCa.L.u.c. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. v N� v F] N❑ n- CI (This section need not be completed if the permit is for one TOTAL Z) Z hundred dollars IS 100)or less) U O I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY mil is issued,I shall not employ any person in any manner so as to w become subject to the Workers'Compensation Laws of CalifBUILDING ornia. q Date Applicant ALTER OR ADD TO MECH. 5.00 O .) } to NOTICE TO APPLICANT': If,after making this Certificate of Ex- F Z emption,you should become subject to(lie Workers'Compensation JAPPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE C.1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 I1 CONSTRUCr1ON LENDING AGENCY AIR HANDLING UNIT(OVER 10)"C.EM.) 6.00 SEISMIC FEE G� 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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ.C.L Lenders Name HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that I have reud this application and stale that e above VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all cilie and county PLUMBING ordinances and state laws relating m building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize Deprescnmtivcs 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 may in any way accrue against said City in consequence of the ra ting of this Permit. MECH.CONT. LIC.NO. MECH. 3t 07 TOTAL TOTAL ignatureof Applicant/Contractor Datee OFFICE COPY