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15834POST THIS CARD,NEAR FRONT OF BUILDING ., ., CITY 01 CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD �� �•�^Q JOB ADDRESS V I 'UNIT # _LOT# �YJ awmac f OWNER mpoke��V• CONTRACTOR G C-fQljq PERMIT NUMBER 1 834 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 RECORD FOUNDATION - NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PR EGUNITE PERMIT VALIDATION ISSUANCE DATE. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL' MECHANICAL -. - ., BLDG. ELECT I PLG. MECHI DO NOT PDDR FLOOR UNTIL ABOVE HAS BEEN SIGNED " 1� BUILDING PERMIT INFORMATION WOOD FLOOR - PLUMBING - � � C\ty 0 ALUATION 194,540 $SFT. MECHANICAL,• ELECTRICAL PERMIT TO �{•�•- FRAMING' - INSULATION - STORIES TYPE CONSTR. - - OCC. GROUP R•S RES UNITS 1 - PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' HOOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE, ' THE CONSTRUCTION TAX IS PAID - SOFT. FLOOR AREA . a04aw TOTAL ACREAGE ` DIAPHRAGM ROOF SHEATHING, �•(,:a..Q LDING USE , RES IND CON PB Om,.,' © E "❑ ❑❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SI NEO FINALS DATE INSP. ROUGH SAN.# ASSESSORS PARCEL NO. �<L:C.. "" � •'^ PLUMBING �^ •\ ELECT. ENERGY _ � TUBS & SHOWER PAN PLUMBING ENERGY TRACT NO. ATE PARCEL NO. it Acc. FILE No MECHANICAL MECR ENERGY ELECTRICAL BUILDING ENERGY FRAMING Q ELECT. FINAL TEST' INSULATION �,�. PLUMBING ��- ZONING �, ENG, SITE NO. GASTEST GAS ' MECHANICAL EIRE SPRINK Y ❑ "❑ ENERGY. T:za Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR � ELECTRICAL RELEASE ' FLODD ZONE. Y❑ "❑ . . A UC Y❑ N❑ INTERIOR SHEAR FIRE DEPT. - SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN. CHECK FEE 15,60; GAS - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEIStT'gLg; OCCUPANCY OF BUILDING IS, NOT PERMITTED UNTIL BUILD ING FINAL ISSIGNED BY BUILDING INSPECTGR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, F_ ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. —SEE PERMIT•FOR EXPIRATION DATE''— ELECTRIC PLUMBING13.0 73 12, MECHANICAL coNsr. TAX 73, li 'IMPORTANT! „ PLEASE READ REVERSE SIDE BEFORE' CALLING FOR'FINAL INSPECTION. TOTAL T OFFICE COPY III'/ 5 is.: /s- -"\ o¢z Foo QUU y z t = i o 0 - 0 ayf ¢ ¢w V X3AB 0 ac E ¢ ¢ c 0 a a o u Kmm w �Z40 4 i O ¢F$ O Z H O Or W _ CL0 U O LL U Ow U APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY •• BUILDING PROJECT IDENTIFICATION APPLICATION&PERMIT . PERMIT NUMBER ' 15834 BUILDING dot 200 Plan 4B A�]TV19 Birch Spring Court BUILDING - ELECTRICAL- PLUMBING - MECHANICAL OIWNEoR'S Gregor roup, Inc. & NAR��lmanson Dev. 415-595-2100 CITY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE DATE OF APPLICATION !I CONTRACTOR5 NAE &egory Group, Inc. LIG. NO. B-430097 UTLETS-SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS - WC 94065 J15-595-2100 APPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 ARCHITECT ramassenian ssoc. OR r ENGINEER C-8395 LIC. No. PANELS (OVER 200 AMP) 20.00 - PLAN CHECK FEE P.C.,NO. _ " SIGNS TRANS. 3,00 I� ,1 ADD ADD ES fNG. •]031 Orchard Dr• IOD Ana Hts.CA. 92707,, SPECIAL CIRCUIT 5.00 ,D PERMIT VALIDATION _ 0 ISSUANCE DATE TEMP. METER OR POLE INS. 20.00 APPLICANT 20-C Twin Dolphin Dr. RWC 9406 MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions ul' Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and license it in full force .yl1�.fpry-f _4311V `i-[..� License Class Lin. Contractor Date '.Contractor BLDG. ELECT. PLG. MECH. - OWNER -BUILDER DECLARATION I hereby affirm that I;un exemptfrom the Contractor's License BUILDING PERMIT INFORMATION MISO-- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION 194 540 S/FT. P'i th Law for thefollowing reason. (See .uiresa•Bosinsss Bed Prufessions Code: Any county pairanh structurep riort oconsuance, her demolish, Gt repair any stridors, prior n its issuance, also requires, happlicant requires the applicant for such permit to file a signed statement thatTOTAL he is licensed pursuant to the provisions of the Contractor's License Section is7000) Law (Charter 9r(comeenC Code) Division3 and Business and Professions Code) or that he is tion ofSectiontherefrom and exempt the basis for the alleged exemption. Any violation of Section 7031.5 subjects $500n.ire licunt toe civil Penalty malty by any applicant love hundred ol'13 1. ascthanlivehundreddollars(myem: ❑ 1, as owner at the progeny, or my employees with wages as (heir sole compensation, will do the work, and the structure is not intended or offered for Sale (Sec. 7044, Business and Professions Code: 'flit 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 impowe- m emsarenot intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or ins Prove 1. as ownerose of the ❑ I• as owner of the property, nm exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business to Professions Codeproperty Contractor's License Lawstir docs, n apply to tr owner of property who builds It improves rased P, and who projectswith d contracmr/s) licensed pursuant to CommcR for such License the lamcoe License Law. ❑ lam exempt under Sec. ',B.&P.C. for this le.r n 1 ELEC. CONTR. LIC. NO. ELEC. PERMIT TO SFDU1L QTY. PLUMBING PERMIT FEE ALTER -DRAIN & VENT -WATER (EA.) 5.00 STORIES 2 TYPE CONSTR. SNHR BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP R-3 RES. UNITS 1 DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -11NC. 4 OUTLETS 6.00 SO. FT. FLOOR AREA 3047 TOTAL ACREAGE GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE me R $ I❑ ❑N PE,❑ ❑ ILL}�jsjll INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL No. M >^ LAWN SPRINKLERS -OVER 5 (EA.) 1.00 SEWER -SAN ITAR V -STORM EA. 200ft/10.00 TRACT No. 8098 PARCEL No. WATER HEATER W/VENT 6.00 0. Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self -insure, ZONING ENG, SITE NO. or it certificate of Workers Compensation Insurance, or u certified copy thereof(Sec. 38001 an C. 11.,I��I Policy No. Compan- nited-Pacific_ ❑ Certified copy is hereby furnished. x Cttlified copy is filed with the City inspection division. AIr$wCet MISC. - REFER TO ORD. FIRESPRINK Y ❑ N ❑ ENERGYT-24 Y F] NL] CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be COCl Pleted if lire permit is for on, PERMIT ISSUANCE 10.00 FLooO ZONE Y N A. L.U.C. V N Q PLG. CONTR. LIC. NO. PLG. TOTAL hundred dollars IS 100) or loss) I certify that in the performance of the work for which this per- mit is issued, I shall not Cnlploy any person in any manner so as to become subject to the Workers' Compensation Laws of California. QTY MECHANICAL PERMIT FEE FEE SUMMARY ALTER OR ADD TO MECH. 500 . Date Applicant NOTICE '10 APPLICANT: If, .Pitt making this Certificate of Ell- BUILDING 972.00 APPLIANCE 5.00 AIR HANDLING UNIT 10 C.F.M.) 4.00 PLAN CHECK FEE /energy 15.50 ealplion, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such pvisionsorthirpermit shall bedtemed revoked. m AIR HANDLING UNIT(OVER 10000C.FM.) 6.00 SEISMIC FEE 13.65 CONSTRUCTION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). . Lender's Name Securl _}•y-fy/ Lender's Address ��SDt Y MICROFILM HEATING UN IT (OV ER 100,000 B.T.U.) 9.50 ELECTRIC 73.13 I certify that l have read this application do statedo statet information is correct. I agree to comply with all city and county ordinances and state laws relating to building construclion, and VENTILATION FAN (SINGLE) 4.00 BOILER- COMP (3 H.P. or 100,000 B.T.U.1 6.00 PLUMBING 73. 13 abrebyove- authorize representatives for ins of this city to enter upon the above-mentioned property for inspection ofpurports. BOILER -COMP (Over 100000 BTU) SEE FEE SCH. MECHANICAL 73, 13 (We) agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertino against liabilities, judgments, costs and expenses which Tay in any way accIli, against olid City in consequence of the meting of Ibis per PERMIT ISSUANCE 10.00 CO ST. TA MECH. CONT. LIC. NO, MECH. TOTAL TOTAL �c Signature of Ap t/Contractor Uate OFFICE COPY