13767 'POST THIS.CARD NEARFRONT OF'BUILDING
'•+I PC RMIT NUMBER
CITY .;OF CUPERTINO 13767
INSPECTION DIVISION
3' JOB INSPECTION RECORD
PERMIT EXPIRATION
IF
'JOB ADDRESS X&u v;e,f S`!F, SAR-��G C7 UNIT# - LOT# 6 t
/�� PERMIT EXPIRES IF WORK'
OWNER: Enee"b-o - gko U/ -: iv(y -.CONTRACTOR - ` IS NOT STARTED WITHIN
INSPECTION ATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSUe.'
NCE OR 180 DAYS FROM
A
l FOUNDATION. �'ASTCALLED INSPECTIOW,
UFER -
PREGUNITE - PERMIrNAODATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
' UNDERGROUND /SLAB . .
PLUMB NG J:
ELECTRICAL - CE DATE `
MECHANICAL
E PEc. MECR.
OO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ING PERMIT
t 'INFORMATION ..
WOOD FLOOR /VALUATIIl°u"-'C1 s/FT.
* PLUMBI NIS
"I .
MECHANICAL - -
y, ER MIT TO "
ELECTRICAL
FRAMING - - -
, = 'INSULATION - STORICS - rvae cONSTR.
- OCC.GROUP 'RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - - -
• ii'
ROOF . .a
.. SO.FT.FLO OR AREAf TOTAL ACREAGE
- I: ,L p .
DIAPHRAGM
eBUIL usE
CON
y Hf5' IND. .CON PB 011ix,
- APPLY,NO 0 I UNTIL ABOVE HAS BEEN SIGNED
ASSESSOR$PARCEL NO.
ROUGH :::�-j --J' . y3
PLUMBING j A"OL 1DTy,ft -
GAS TEST +�1� AwlTRACT NO. PARCEL NO.
MECHANICAL , ,S, ri
" ELECTRICAL ff_, LS•, DATE ' I SP. ATE ACC.FILE No.
FRAMING �'� tZONINGENG.SITE NO.
INSULATION — � AL, FIRE SPRINK, ENERGv,T.2e
7- 3 = ' NomCOVER NO WORK UNTIL ABOVE HAS BEE
LATH- INTERIOR I' ELECTRICAL' ' ELOOD ZONE A.L.u,c: -
��f'
` LATH-EXTERIOR.' ` - CO-17;> FIREDEPT. ?O PI] `v D. No
SHEETROCK; .,, 5-1 GRADE ' FEE SUMMARY
SHEAR INTERIOR BUILDING -
` SHEAR EXTERIOR 2 - ' -' TEMPO RARYAPPROVALS, BUILDING _.st,�"rJ
FIREWALLS - ELECTRIC PLAN CHECK ,¢ '
4lj GAS FEE_
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. SEISMIC FEE (-
OCCUPANCYOF BUIL DI NG IS NOT-PERMITTED UNTIL'BUILDING'F,INAL ISSIGNED BY BUILD ING INSPECTOR, ,MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252.4505, " 'ELECTRIC
H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING .
O� PLEASE GIVE JOB�ADDRESS WHEN PHONING. J51
ZMECHANICALSEE PERMIT FOR'EXPIRATION DATEIMPORTANTL $� CONST.TAXPLEASE READREVERSE SIDE BEFORE' r TOTAL '
CALLING FOR FINAL INSPECTION.,'-
,J ,
' . .• OFFICE COPY` .,•r.. T .. -
APPLICANT TO FILL IN INFORMATION.WITHIN RED LINES -.USE BALL POINT PEN ONLY.
BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
aIIILDING Sunrise Spring Court APPLICATION & PERMIT
ADOREaa ' (Lot 67 - Plan 3B
BUILDING -ELECTRICAL-PLUMBING-MECHANICAL ' 1376T
OWNER'S PLAN CHECK VALIDATION
"AME - JAPPLIANCES
ELECTRIC PERMIT FEE
Gregory Group, Inc. PHONE 595-2100
NAME croR's UTLETS-SWITCHES-RECEP 10.00/1.00 112
NAME
Gregory Group, lnc., LIC No 4'3097 IGHTING FIXTURES 10.00/1.00 25
ArTo�o�FyEssr°�R's/�0 Twin (D�o�/l�phin Drive, Ste. C -RESIDENTIAL 4.00lilt CA 94065 PHONE 595-2100ANELS 1000 DATE OF APPLICATION
ARCHITECT ANELS (OVER 200 AMN 20.00PLANCHECK FEE P.C.NO.
DR Aram Bassenian, A.LA. & Assoc.ENGINEERLlc.Nor - IGNS TRANS. 3.00
ARO".°"ENG39% Westerly Place;,//170 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
AooREss
rt Beach CA Zap 92660 EMP.METER OR POLE INS. 20.00
ADDRESS 220 Twin Dolphin Drive; Ste.-C, MOTORS SEE FEE SCH. ] -
Redwood Cit CA 9405' SERVICE CHANGE- 20.00 DI
o o LICENSED CONTRACTORS DECLARATION q .ryq�D L// �7
¢U U ]'hereby affirm that I am licensed under provisions of Chapter 9 p •^ ISSUANCE DATE
,a< aa, (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. 'PLG. MECH.
F y Professions Cork,and my license is'in full fore a�q,�jfr{t.
o i Ef n License Class 6 Lic.Number .71A7�L_ , WON
F w Date Contractor
Fh- _
- BUILDING PERMIT
Ir: a w a OWNER-BUILDER DECLARATION - INFORMATION
o e- " MISC-- REFER TO ORD
E
g LL F I hereby affirm that I am exempt from the Contractor's License ION
FUN J Law for the following reason.(Sec.7031.5;Business and Professions. PERMIT ISSUANCE 10.00 -10 j wo
Code:Any city or county which requires a permit to construct,alter,
ac w Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. 1TJ lAN
i ¢D¢ requires the applicant for such.permit to file a,signed statement that TOTAL 176 PERMIT TO
w$ he is licensed Pursuant to the provisions of the Coothetor's Lipase
Fza Law(Chapter 9(commencing wfill Section 7000)o'Division 3 of tie -
Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE SFM
¢ r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
by any applicant for a permit subjects the applicant to.civil penalty ) 5
of not more than five hundred dollars($500).): ALTER-DRAIN&VENT-WATER (EA. .00 2
❑ I,as owner of the property,or my employees with wages as BACK F LOW,PROTECT.-DEVICE •.4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and lhe'structure is not -
intended or offered for sale(Sec.7044, Business and Professions / DRAINS-FLOOR,ROOF,AREA,COND.,r 5.00 ,R-3 1
Code:The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 65 SD.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve- / GAS -11NC.40UTLET56.00 fj
meets are not intended or offered for sale.If,however,the building . 2310
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 buildbr ire. RES INDCON PB Other
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
13I,as owner of the properly,am exclusively emmucting wilb ® ❑ ❑ ' ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 6 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 contractors)licensed pursuant to
the Contnmtor's License law. SEWER-SANITARY-STORM EA.200ft/10.00 10 TRACT NO. PARCEL NO.
❑ Ixln exempLunder Sec. ,B.&P,C.Ibr this WATER.HEATER W/VENT 6 (j.00
reason 7995'
Owner 'Date WATER SYSTEM 5.00 5 ACC.DATE ACC.FILE NO.
WORKERS'COMPHNSATION D17CLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent to self-insure. ,
or a certificate orWorkers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
e°py thereof(See.3800,Lab.C.1hited Pac./Rel i ante '
Policy Nn. Cou pm y _ -
0 ❑ Cerlifiedcopyis hereby furnished. FIRE SPRINK ENERGY T 24
Z 2 N Certified o is f v' city inspection division. MISC.- REFER TO ORD.
O Applicant V ❑ N❑ V ❑ N❑
it~ m PERMIT ISSUANCE 10,00 FLOOD ZONE A.L.U.C.
CC CATH P EXEMPTION PROM WORKERS' / 1O.
LU 7 • COMPENSATION INSURANCE PLG.CONTR. LIC.NO. - PLG. 110 M
Z ('Phis scorn, need not be completed if the permit is fur one TOTAL J 00 Y❑ N❑ Y ❑ N❑
hundred dollars IS 100)or loss) ''
U O I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued.I shall not employ any person in any manner so as to
U become subject to the Workers'Compensation laws of Califomia.
Ul Date A hcant BUILDING .fes
11. Pp ALTER OR ADD TO MECH. 5.00 SSa
'} m NOTICE '1'O APPLICANT'. If,after making this Certificate of Ex-
F Z emption,you should become subject to the Wofkers'Compensation 4, APPLIANCE _ 5.00 PLAN CHECK d.^•a
provisions of the Label Code, you must forthwith comply with FEE �7•---
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNITIOVER iQOWOEM.) 6.00 'SEISMIC FEE /p a�
,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,CNC.T Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00 1
Lender's Name HEATING UNIT ER 100,000 B.T.U.)9.50 / 61-4
Lender's Address _rancucD,_ ELECTRIC /7N
1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information,is correct. 1 agree to comply with all city and county BOILER-COMP(3 H.P.Dr 100,000 B.T.U.) 6.00 PLUMBING j/
ordinances and state laws relating to building construction, and r_
hereby authorize representatives of this city to enter upon themBOILER-COMP lover 100,000 BTU)SEE FEE SCH. MECHANICAL dd ---
above-m �tioned property for inspection pnh
ugses.
(We) agree to save, indemnify and keep harndess the City of MISC.- REFER TO ORD. / G
Cupertino against,liabilities,judgments, costs and expenses which CONST.TAX
may in any way accrue,against said City in consequence of the PERMIT ISSUANCE 10.00
granting Of lm it. MECH.CONT. LIC.NO. MECH
OTA.
65 TOTAL jS35 3D
Signature ppli:ant/CmdGrrtof Dat
OFFICE COPY h- -