13769 (2) POST THIS CARD.NEAR FRONT OF Bo ILI5[NG
A PERMIT NLiM 8 E11 .
- - CITY OF CUPERTINO .
- INSPECTION DIVISION ^ ' 13769
JOB INSPECTION RECORD
t
- PERMIT EXP;RATIO
' JOB ADDRESS '` �'L1• "-" �� y, UNIT# LOT# N
'
^- - ' ' a __ _ - - PERMIT EXPIRES IF WORK
OWNER �'VCL.�EL..F- C1'11•LQ liLJC• CONTRACTOR IS NOT STARTED WITHIN -
INSPECTION DATE JINSPECTOR INSPECTION RECORD ' 180�DAYS OF PERMIT ISSU- -
FOUNDATION - C
ANCE OR 180 DAYS FROM
UFER - •i I^qJ. ;LAST CALL DINSPECTION.
PREGUNITE' PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
' ' UNDERGROUND /SLAB
PLUMBING
ELECTRICALCJ�MISSUANCE DATE
' MECHANICAL +Loc. E Ecr, PP�L--Gyy. M�-ECyH.
Ely L'1
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION `
WOOD FLOOR yuATsyy„yg. $/FT.
` PLUMBING O VpFU1JUJ�-
1 MECHANICAL
ELECTRICAL, i,
FRAMING
srDRgs TYPE CONSTR.
INSULATION
OCC.ARQRES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED OO
ROOF SO FT.FLOOR AREA TOTAL ACREAGE
• 2263
DIAPHRAGM .
q BUILDING USE 1..
LZ C HESV IND CON, ' PB Ouuv
APPLYO. R FING UNTIL ABOVE HAS BEEN SIGNED CX El' 1:1 ❑' E
ASSESSORS PARCEL NO.
. ROUGH ,:.'' '�.j
PLUMBING.` '
GAS TEST - TRACT NO. PARCEL NO.
7995
MECHANICAL' 40-A
ELECTRICAL ^ FINALS DATE IN p ;ACC,.DATE ACC.FILE NoFRAMING ` SAN # wzoNc q ENG.SITE No.INSULATION , PLUMBING i
of - GAS �.
: MECHANICAL FIRE SPRINK ENERGYTQ4
YO Y 11
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING �f. OO�� I NEINEI
FLOOD ZONE A.L.U.C.. .
LATH-INTERIOR ELECTRICAL -� - r� N� vl] NO
LATH-EXTERIOR FIRE DEPT:
, SHEETROCK _ • GRADE _ FEE SUMMARY '
SHEAR INTERIOR BUILDING BUILDING
SHEAR EXTERIOR.. . 2Z, TEMPOR Y APP OVALS -
FIREWALLS ELECTRIC PLAN CHECK
AS, r
FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY i • SEISMIC FEE ' �•-' t,
OCCUPANCY,OF BUILDING IS'.NOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR; MICROFILM -
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
� j ONE WORKING DAY BEFORE REQUIRED INSPECTION. - PLUMBING
Z PLEASE'GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — ''' MECHANICA_4� 6'1CONST.TAIMPORTANT;PLEASE READ REVERSE SIDE BEFORE F `'+ TOTA
CALLING FOR FINAL INSPECTION.,'
L
OFFICECOPY.
_ r
. reel 2;
W
LL
46
ui
5
j SAPPLICANT TO FILL IN INFORMATION WITHIN RED LINES = USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTI FICATION - .
PERMIT NUMBER
A.DRE, 1�_ unri'se Spring Court APPLICATION & PERMIT
(Lot 65 2 Plan 2B1 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 13769
OWNER'S PLAN CHECK VALIDATION
. NAME QTY. ELECTRIC PERMIT FEE
Gregory Group, Inc. PHONE 595-2100
CONTRACTOR
NAME 115OUTLETS-SWITCHES-RECEP 10.00/1.00
Gre or Grou In�vo' 430097 LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S CA,
O p In Dr. APPLIANCES-RESIDENTIAL 4.00'
ADDRESS
City, CA. PHONE 595-2100 1 PANELS 10.06 in DATE OF APPLICATION
ARCHITECT; PLAN CHECK FEE P.C.NO.
OR nl Aram BLssenian, A. I.A. & PANELS (OVER 200 AMP) 20,00
ENGINEER Associates „L11.NG. " SIGNS TRANS. - 3.00
ADDRESS ENG. 7 Wastorly P l . ,' #1 70 � � SPECIAL CIRCUIT 5,00 PERMIT VALIDATION.
'•
Newport Beach CA nP92660 TEMP.METER OR POLE INS. 20.00
ADDRESS 220 Twin Dolphin Dr. , ;,",C" MOTORS SEE FEE SCH.
Redwood .Cit DA 94065 SERVICE CHANGE 20.00
Fa o LICENSED CONTRACTORS DECLARATION0'
a u,L, I hereby affirm that 1 am licensed under provisions of Chapter 9 DANCEDATE
Zw
,e (commencing with Section 7000)of Division 3 of the Business and ELECT. PLG. MECH.
a
H i Professions Cot anti my license is in full force and effect:
z 0 m o License CIa=:- Lic.Number.4.3DD97
o m F
Data ) Contractor
¢ w¢ OWNIi R-BUILDF,R DECLARATION BUILDING PERMIT
'.i a v INFORMATION
1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
r u o j Law for the following reason.(Sec.7031.5,Businessand Professions pERMFT ISSUANCE 10.00 10 x�}' p 5/FT.
so Code:Any city or county which requires a permit to construct,alter,
¢ ¢ ¢ improve,demolish,or repair any Structure,prior to its issuance,also FLEC.CONTR. LIC.NO. ELEC.
O W requires the applicant for such permit to file a signed statement that TOTAL " 1804 PERMIT TO
E
$a- he is licensed pursuant to Lha provisions o6tbe Contractor's License -
Hz > Law(Chapter 9(commencing with Section 7000)ofDivision3ofthe SFD411_
a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE
-a r$ the basis for the alleged exemption.An
g p y violation of Section 7031.5
malty STORIES TYPE CONSTR.
n3 � by any applicant fora handrail
dollars the($5000.)
toacivil penalty ' ALTER-DRAIN&VENT-WATER (EA.) 5.00 2
- of not more[hmI five hundred Dollars($500).)!' "
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE' -4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 R-3
Code:The Contractor's License Law does not apply man owner of
'property who builds or improves thereon,and who does suds work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA 'TOTAL ACREAGE
himself or through his own employees,provided that such improve.
.Cuts are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 r2263
or improvement is sold within one year,of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.1 2.00
hu der will have the burden of proving that he did not build ocino BUILDING USE
prove for purpose of sale.). .1. INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer
❑ 1,as owner of the property,am'exclo ively contracting with 0 ❑ O
licensedcontractorsm construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 / //ASSE9SSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not apply 3rP W -/-
to an owner of property who builds or improves thereon,and.who LAWN SPRINKLERS-OVER 5(EA.),' 1.00 .3/ 3-1 4
contracts for such projects with acontractods)licensed pursuant to SEWER-SANITAR V-STORM EA.200ft/10.00 / /
the Contractors License Law. TRACT NO. PARCEL NO.
❑ l am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.006 7995
reason
Owner - Uan' WATER SYSTEM 5.00 ACG.DATE ACC.FILE NO.
WORKERS'COMPENSAHON DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate of consent It,self-insure, ZONING ENG.SITE N0.
Or a certificate of Workers'Compensation Insurance,or a certified
copy mereof(Sec.3 800,
CORL"'c0nited Pacific/�1 -
Probe No. Company U
O ❑ Certified copy is hereby furnislictir FIRE SPRINK ENERGY T-24
Z Z X Certified )eJ'with Uon division. MISC.- REFER TO ORD.
O. Applicant---i _ Y p IN Y ❑ NC3
rn00
CIIRTII'I E OF EXEMPTION FROh1 WQRKIiRS' PERMIT ISSUANCE 10. FLOOD ZONE A.L.U.F.
LU - COMPENSATION INS URA NCI: PLG.CONTIT LIC.NO. P3 LG. 11
CIL 0Z (This section need not be con l leled if the permit is for one t TOTAL Y[:] IN V C3 IN E]
hundred dollvrs(S 100)or Ie.)
U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued,I shall not employ any person in any manner so as to
U
'U become subject to the Workers'Compensation Laws of California. BUILDING
0. Datc Applicum ALTER OR ADD TO MECH. 5.00 4
} to NOTICE TO APPLICANT: 11,after making this Certificate of lix-
h empioto.,you should become subject to the Workers'Compensation. - APPLIANCE 5.00 N CHECK
provisns of the Labor Code, you must forthwith comply with
U such provisions or this permit shallFEE
be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER I0)000GF.M.) 6.00 SEISMIC FEE l0 O/ '
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,Civ.CJ, HEATING UNIT(TO 100,000 B.T.U.) 8.00 8
Lender's Name CCU ltl PaClf 1C. HEATING UN IT 100,000 B.T.U.)9.50
Lender's Addre - , ELECTRIC
-® I Certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4,00
information is Correct. I agree to comply with all city and county -12 PLUMBING
ordinances and state laws relating to building construction, and BOILER•COMP(3 H.P.Of 100,000 B.T.U.)"6.00 6
hereby authorize representatives 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 10 CONST.TAX
may-in any ev 'cerin again t said City is consequence of the
granting of H' 'L' MECH.CONT. LIC.NO.
MECH.
/ 61 TOTAL
Signvture o plicae[/C munctor Uate
+ a
OFF,ICECOPY
I •.