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13803 POST THIS CARD NEAR FRONT.OF BUILDING • PERMIT NUMBER CITY OF CUPERTINO • 13803 INSPECTION DIVISION 1 JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS ,I •� �'-� Cc-�u�T�Y �✓F'^� ` UNIT# LOT# �b I /�,./�, 1 .}�� PERMIT EXPIRES IF WORK OWNER Y t-{�a.� -VK C. CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR' INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION LASTCALLEO INSPECTION. UFER '34 PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL:ABOVE HAS BEEN SIGNED . UNDERGROUND /SLAPON p_ PLUMBING �,�fa' l���� ELECTRICAL s . I~ ss NCE DATE T. PLG. MECH. MECHANICAL ,u 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED G PERMIT INFORMATION WOOD FLOOR VALUATION s/FT. PLUMBING - fY ;• l"t MECHANICAL PERMIT TO ELECTRICAL FRAMING STORIES TYPE CONSTR. INS CATION n ' .3 OCC.GROUP RES.UNITS ::PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED o"f - SO,FT,FLOOR AREA TOTAL ACREAGE ROOF • Dh*PHRAGM -L BUILDING USE RES IND CON PB 0"... APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED D ASSESSORS PARCEL NO. ROUGH , PLUMBING TRACT NO. PARCEL NO. GAS TEST 1 MECHANICAL ^�-]- ACC.DATE ACC.FILE NO. ELECTRICAL -/ ��fILLpp,, FINALS DATE INSP. FRAMING !, �T/v G SAN #t`ZZ ZONING ENG.SITE NO. INSULATION, PLUMBING 0 O GAS FIRE MECHANICAL Y ❑ NE Y ❑ ISPRINK ENERGY N COVER NO WORK UNTIL ABOVE HAS BEEN,SIONEO HEATING � aooD ZONE aL U.C. LATH-INTERIOR ELECTRICAL LATH-EXTERIOR ' FIRE DEPT. Y NO Y I] "� SHEETROCK 971 GRADE FEESUMMARY -. SHEAR INTERIOR - BUILDING, - " SHEAR EXTERIOR. - G TEMPORARY APPROVALS BUILDING - FIREWALLS ELECTRIC PLAN CHECK FEE r ILA GAS NO TAPE OR PLASTER UNTIL BOVE HAS BEEN SIGNED OCCUPANCY I -SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. _ MICROFILM ARRANGE,FOR INSPECTION BY PHONING 252-4505, ELECTRIC LU ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING oPLEASE GIVE JOB ADDRESS WHEN PHONING. Z - MECHANICAL ( _ - SEE PERMIT FOR EXPIRATION DATE - 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 7� BUILDING PROJECT IDENTIFICATION PERMIT NUMBER °DISG 11523 Country Spring Court APPLICATION & PERMIT ADDRESS 13803 Lot 101 - BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OINNERS NAME .L PLAN CHECK VALIDATION QTY. ELECTRIC PERMIT FEE Gre or Group, InCProNE 595-2100 CONTRACTOR'S NAME LLTOUTLETS-SWITCHES-RECEP 10.00/1.00 � Gregory Group InC1,IC.N0.430097 LIGHTING FIXTURES 10.00/1.00C,ONTRAC3 ADDRESS 220 220 Twin Dolphin Dr. , IICII 3 PPLIANCES-RESIDENTIAL 4.00 Redwood City, CA PHON695-21 0 PANELS 10.00 DATE OF APPLICATION ARCHITECT Aram Bassenian, A.IA. PLAN CHECK FEE P.C.NO.. OR . PANELS (OVER 200 AMP) 20.00 ENGINEER ' 81 Associates LIC.No. SIGNS TRANS. 3.00 ARL..°RENG.3990� Westerly Pl . , #170 SPECIAL CIRCUIT 5,00 PERMITVgLIDATION ADDREss N zl EMP.METER OR POLE INS. 20,00 nooliiss Ts 220 Twin Dolphin Dr. , IICII MOTORS SEE FEE SCH. ,gyp Redwond City CA 94n6S SERVICE CHANGE 20.00 r02 o a LICENSED CONTRACTORS DECLARATION ,y <u t I hereby affirm that I am licensed under potvisions PhChapter 9 U ,Ha Q n (commencing with Section 7000)of Ulvisiort:3 of th<ODMness and ATE r w i Professions CcAc,and my license is in full for' pI�I f el.zo i w o License Class-),$ Lia bomber-4. ELECT. MECH. �p�l L H j Dafe Contractor YJ ¢ ¢ El w o OWNF.R.BUILDER DECLARATION - BUILDING PERMIT MISC.- REFER TO OR _ INFORMATION X ;u w I hereby affirm that I am exempt from the Contra, License VALUATION $/FT. � uoj Law for the following reason.(Sec.7031.5,Businessand Professions pERMlT ISSUANCE ' 7 w> Code:Any city or county which reyuirdsa permit to construct,alter, 10.00 ¢ ¢ ¢ Improve,denl°hah,nr ttpalf any slNCtpre,prl°r Io ilS ISSnanCC,aIs. ELEQ CONTR. LID.NO. ELEC01 // ✓ s/ w d mu requires the applicant for such permit to file n signed statement t / PERMIT TO e w he is licensed pursuant to the provisions of the Contractor's hat TOTAL License HiQ Law(Chapter9(commencing with Section 7000)of Division3of the (+ � w/,. r D Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE V 'v ¢f m [he basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a;.. by any applicant fora permit subjects the applicanuoucivil penalty ALTER-DRAIN 5.00 of not more than five hundred dollars(5500).): ❑ 1,as owner of the property,or my employees with wages as ot BACK FLOW PROTECT,DEVICE 4.00 Iheir sole compensatioq will do the work,and [ structure is n intended or offered for sale(Sec. 7044, Businessss - ,COND. 5.00 OCC.GROUP RES.UNITS and Professions DRAINSFLOOR,ROOF,AREA Cade:The Contractor's License Law docs not apply to an owner of ' property who builds or improves thereon,and who does such work Ja FIXTURES-PER TRAP 5.00 SO FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. meats are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for 1.as ownerose of the.). INDUSTRIAL WASTE INTER. 30.00 I❑ ❑N ❑ Other❑ ❑ d as owner of the properly,he exclusively contracting with licensed contractors to construct the project(Sec. 7044,Business I LAWN SPRINKLERS- I 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 / 6-17- ,? 31�,,,�? contracts for such projects with a contractods)licensed pursuant m Y �r the Contractor's License Law. I SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ [am exempt under Sec..BAP.C.for this reason - I WATER HEATERW/VENT6.00 Owner Data WATER SYSTEM 5,00 5� ACC.DATE ACC FILE NO. WORKERS'COMPENSATION 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. copy thereof(Sec.3800,Lab. ) Policy No. CompanyUn]_ted_Paci-f_i-c/Re-1 O ❑ Certified copy is hereb furnished. Z Z CX Certified copy the city inspection division. FIRE BPRINK ENERGY LYa F p Applicant MISC.- REFER TO ORD. Y E] NEI v N� cc CERTIFI ,OF AEMPTIONF B1I WORKERS' PERMIT ISSUANCE 10.00 in FLOOD ZONE A.L.U.C. Lu MPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. tl O (This section need not be completed if the permit is for one TOTAL ��� Y❑ N� Y ❑ N� Z hundred dollar,0100)or IessJ U Q I certify that in the performance of the work for which this per- QT,. MECHANICAL PERMIT FEE FEE SUMMARY F mit LL is issued,I shall not employ any person in any manner so as to U become subject to the Workers'C°mpensation Laws of California.' 0°1. Date Applicant ALTER BUILDING 5C } N NOTICE TO APPLICANT: If,after making this Certificate of Ex OR ADD TO MECH. 5.00 s F. ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 r-' p provisions of the Labor Code, you must forthwith comply with U / V3 V such provisions or this permit shall.be deemed revoked AIR HANDLING UNIT(TO 10MOC.F.M.) 4.00 FEE PLAN CHECK CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MOQEM.) 6.00 SEISMIC FEE O d/ I hereby affirm that there is a construction lending agency for I EXHAUST.HOOD(WITH DUCT) 5.00 s the performance of the work for which this permit is issued(Sec. 3097,Civ.C.), I HEATING UNIT(TO 100,0MICROFILM 00 B.T.U.) 8.00 Lender's Name Security Pacific Lender's Address HEATING UN ITgFAN (SINGLE) 0,000 B.T.U.)9.50 ELECTRIC I certify that l It sae is app Ica ton and�IS t al the he above VENTILATION 4.00.D.-nation n correct.1 agree to comply with all city and county BOILER-COMP(3 ,000 B.T.U.) 6.00 PLUMBINGordinances and orate laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOI LER-COMP BTU)SEE FEE SCH. MECHANICAL (p/ above-mentioned property for inspection o (h purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way acerae,against said City in consequence of the PERMIT ISSUANCE 10.00 granting of[his MECH.CONT. LIC.NO. MECH. In J 1' TOTAL 00 TOTAL S�xd Signatu� nt/C (tractor Dal OFFICE COPY BUILDING:INSPECTORI OFFICE CITY OF CUPERTINO Bldg.Dept. Offi,e Copy ❑ Backflow Device iSanitary Permit No. O Sewer Connection Plumbing Permit No. ❑ Plumbing Final Lot No. l Owner or Tenant i — G- �OiQ-4 �i-QOII� Ar III ri—23 Co�uT �V SPf2 i Aga R Tract Date Connected OGT, (U 19�� DatenFina�loe-- t eO ,— , _19 ' PLUMBING INSPECTOR ,f I I CERTIFICATE OF COMPLETION ° ^ BUIItDING INSPECTOR'S OFFICE CITQY OF CUPERTINO DATE 9 V BLDG. PERMIT NO..( THE BLDG. LOCATED AT S23 CaU(J-Ry OWNED BY— PC E CS(Z\/ G-Ezp� HAS BEEN (COMPLETED) FOR USE AS (ALTERED) i ti I BUILDING INSPECTOR t FFIE CITY OF CUPERTINO COPY GAS SERVICE NOTICE ' 9 4 I To 0 You are hereby authorized to connect the GAS service for Owner or Tenant 6-PI✓ c9.00�Y -1Q"OJP At ( ( �i? r'ncIZV 5m Lo'(- / J New Service X }}}; No. of Meters I Reconnect No. of Add. Meters Move Service 1I Move Meter PLUMBIC 'NSPECTOR T� ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO 19 _ ToF1`. }You are hereby authorized to Connect electrical service for i kfi 'Owner or Tenant � 6"�l) .tM— � 1� , c�i�a�l r (fir—iyT nT- 10! - No.of Wires Size of Wires Size of Switch 'j Motor Load Voltage Phase fHeating Load K.W, Voltage Noof Meters Light 110New ServiceR�on 1111 . I Hear 120 Three Wrte More Service No.of Add. Meters Power Three Rho se Move Meter �M ELECTRICAL INSPECTOR 4'%J