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15815 POST THIS CARD NEAR FRONT OF BUILDING PERMIT MRER CITY OF .CUPERTINO 15815 INSPECTION DIVISION JOB INSPECTION RECORD• db _ PERMIT EXPIRATION JOB.ADDRESS � I�3 9 I RGNp C]�Q �N Cr'� GC— UNIT# _LOT# ��.Q`(•Z U1 ' . IaC PERMIT EXPIRES IF WORK owrvER O E✓, comrRAcfioR +' '� -pQ �" IS NOT STARTED-WITHIN INSPECTION DATE I INSPECTOR INSPECTI N RECOR 180 DAYS OF PERMIT ISSU FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. UFER 'ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE a: TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. ' -GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING .,3Q •!�✓ 4,...z' ,•5 r,""<'. ELECTRICAL. '•'ISSUANCE DATE MECHANICAL - .; BLDG. ELECT, PLG. MECH sass Q 4 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - (( v BuaDINc PERMIT WOOD FLOOR l - INFORMATION VALUATION $IFT. PLUMBING • C,�,DIj MECHANICAL - 178 281-, ELECTRICAL - P RMIT To FRAMING i L INSULATION sro I. TrPE,CONSTR. _ OCC.GROUP R S.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - R-3 . ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 5. IT.FLOOR AREA TOTAL ACREAGE all DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2726 'y - BUILDING USE ROOF SHEATHING _1 - RES IND CON PB O'l— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATEINSP. ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH sAN.n. I 6P �/�_ n _ PLUMBING C(, ELECT.ENERGY �-+�Y _ _I TRACT No. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY , MECHANICAL "2Lti, MECH.ENERGY .7_ 8098 - ELECTRICAL 'rj'7's BUILDING ENERGY ncc DATE Acc,FILE No ,FRAMING , 41D ELECT.FINAL TEST" INSULATION ,1aJL PLUMBING .. ZONING ENG.SITE NO. GAS TEST - GAS MECHANICAL EIRE SPRINK ENERGa'T-3a COVER NOVORK UNTIL ABOVE HAS BEEN SIGNED HEATING _ [-] "❑ ❑ "❑ EXTERIOR SHEAR ELECTRICAL RELEASE FL000 zorvE aL.u.c. INTERIOR SHEAR - FIRE DEPT.. ❑ rv❑ v ❑ N❑ SHEETROCK GRADE FEE SUMMARY +, EXTERIOR LATH BUILDING 7� g16��8 INTERIOR LATH " TEMPORARY APPROVAL BUILDING- - SCRATCH COAT ELECTRIC ' -' PLAN CHECK 16.50 GAS. FEEl0emy 6P DO NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPgNCY SEISMIC FEE 12.53 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 58.58 1� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. 68.58 — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! coNST. TAX 0-3 PLEASE READ REVERSE SIDE BEFORE TOTAL 1 CALLING FOR FINAL INSPECTION. OFFICE COPY - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY , ' •BUI LDI NG PROJECT I DENTI FICATION PERMIT NUMBER f ~ nooaess Lot--7f1 A 8 tan _ APPLICATION & PERMIT �I �� 11639 Birch Spring Court BUILDING -'ELECTRICAL-PLUMBING-MECHANICAL OWNERS Gregory Group, INC. & • NAME PLAN CHECK VALIDATION Ahmanson Dev. 415Rt595-2100 CITY. ELECTRIC PERMIT FEE CONTRACTORS NA UTLETS-SWITCHES-RECEP 10.00/1.00 AU"regory Group Inc LIC.r6.-430097 LIGHTINGFIXTURES 10.00/1.00 CONTRACTOR s 220-C Twin Dolphin Dr. APPLIANCES-RESIDENTIAL 4,00 RWC 94065 415r595-2100 PANELS 10.00 DATE OF APPLICATION ARCHITECT OR Aram Bassenian, AIA &Assoc -PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P:C.No. ENGINEER C-8395 - ARCH.OR ENG. 01 rC ar ruC.NOSIGNS TRANS. 3.00 . SPECIALCIRCUIT 5.00 PERMIT VALIDATION ansa Ana Hts. CA. 927 7 41Q EMP. METER OR POLE INS. '20.00 ADDR SST3 MOTORS SEE FEE SCH. n 220-C Twin DolphinDr.RWC SERVICE CHANGE 20.00 ' �(t E�tAt�Cy wo o LICENSED CONTRACTORS DECLARATION c u E, I hereby affirm that I am hearned under provisions o f Chrpter9 ISSUANCE DATE' st a (commencing with Section 7000)of Division 3 Of the Business and Psi k1r) F m i Professions CodeQ nd my license is in full force a c C c�di�, - BLDG. ELECT. PLG. MECH. i o,A License Class_Ij Lic.No her _ - ��0� (jI a m w Date CPntractor - ¢ ¢ wOWNER-BUILDER DECLARATION BUILDING PERMIT MISC.- INFORMATION w ;a. a I hereby affirm that I am exempt from the Contractor's License gEFER ¢ oj Law for the following 11.1.1.(See 7031.5,Businessand Professions PERMIT ISSUANCEVALUATION ' $/FT. Lc > Code:Any city or county which mquiresa permit to construct,alter, - 10.00 178,281 ¢ ¢ ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. a u cense requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO n al m he is lid pursuant 10 the provisions of the Contractor's License H z ¢ Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe - 4 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE SFDUJL ¢ F S the basis for the alleged exemption.Any violation oCSectian 7031.$ STORIES TYPE CONSTR. a 3, by etomny applicant fore undue sObjects $500).he licant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(my em: 2 5NHR ❑ Las owner at the property,or or employees will wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation will do the work,and the s[mcRoe is not OCC.GROUP RES.UNITS intended or offered for sale(Sec. 7044, Rosiness and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 1 Code:Tim 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 50,FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. ments are not intended Or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 2726 Or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of proving that h - .e did not build or im- BUILDING USE pro 1,as owner.1 the.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Ocher ❑ L as owner of the property,he exclusively contracting with W 0 ❑ 0 licensed contractors to construct the project La does,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 W ASSESSORS PARCEL NO. 11 and Professions Code:The Contractor's License Law docs not apply LAWN am owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 �/_ contracts for such projects with u contractors) rsw licensed Pumt'to C[%60 the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/700 TRACT NO, PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C.for this - reason WATER HEATER W/VENT 6.00 8098 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKP-RS'COMPF-NSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, or a certificate Of Workers'Compensation Insurance,or a certified ZONING 'ENG.SITE NO. copythare.f(Sce.3800,Lah.C.).United Pacific Policy No, Company O ❑ Certified copy is hereby furnished. Z J(1 Certified copy is riled with the city inspection division. FIRESPRINK ENERGY T 24 F O Applicant MISC.- REFER TO ORD. Y [] Is Y ❑ No y CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > ' COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. 1 (This Section need not be completed if the permit is for one - TOTAL Y 0 N❑ Y E] NE] Z hundred dollars(S 100)or less) L) O I certify that in the performance of the work for which this'ran- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner sn as to O W become subject to the Workers'Compensation Laws oLColifornia. - Q. Date Applicant W ALTER OR ADD TO MECH. 5.00 _ BUILDING 916.00 } W NOTICE TO APPLICANT: If,after making this Certl(Icu[c oC Gz- F. Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 5.50 provisions of the Labor Code, you must forthwith comply with - C,J such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4,00 FEE /energy - CONSTRUCTION LENDING AGENCY - AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 12.53 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work Cor which this permit is issued(Sec. 3097,Civ.C.f HEATING UNIT(TO 100.000 B.T.U.) 8.00 MICROFILM Lender's Name Sec rip Pacific Lender's Address 1�1 , HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 68.58 I certify that)have re thispll c.tl n and spam that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING 68.58 ordinances and state laws relating to building construction, and BOILER-COMP(3H.P1or100,000B.T.U.) 6.00 hereby Bllth.rDe representatives of this city to enter upon the above-mentioned property for inspection purposes, BOILER-COMP (Own 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- _ REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONSTT may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 . O3 _ ranting of this perm' MECH.CONT. LIC.NO. MECH, TOTAL TOTAL Signature of Ap n1/ ntract.r Umeto 9M OFFICE COPY ��dB � . To" J 0 k n TF' O%j -rt Et-3 0V� F T�� a rt � F PRS-- OFF_ DR vT=-: