14993 r• -POST THIS CARD NwilO .
JILDING
CITY OF C '
14993 ,
V" INSPECTION.DIV.ISION
// JOB IINSPECTION.RECORD .
�•+ Q PERMIT EXPIRATION
JOB ADDRESS �I.I to8gr UNIT# _'LOT#I v,;���
- PERMIT EXPIRES IF WORK '
OWNER " CONTRACTOR IS NOT, STARTED WITHIN
DATE INSPECTOR OECRD180DAYSOFPERMITISSU:INSPECTION
r ,FOUNDATION ANCE OR 180 DAYS FROM
NOTE: - LAST ClILLEDINSPECTION.
- UFER O• 'ALL GRADING AND'DRAINAGE SHALL BE INSTALLED
PREGUNITE" • . - •TO CUPERTCOMPLY WITH THE APPROVED PLANS AND CITY OF. " ` PERMIT VALIDATION
INO STANDARDS. - -
GARAGE SLABS
ISE;•
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - - ''- ' �'• f ! - (AA, 1 -!
UNDERGROUND,/,SLAB r DEG 13,1988
PLUMBING - +- _ - -
ELECTRICAL _ Z 1 4+17 UI Cupertino
IssuANCE'DA r@
MECHANICAL I. - HI.uG. ELECT. P" nn EryCH(.,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT
_ INFORMATION -
- :WOOD FLOOR ' + VALUATION SIFT.
., PLUMBING: . . d
MECHANICAL' - r922. -
PERMIT TD
ELECTRICAL "' . • .: -
FRAMING "
SFOU
STORIES . TYPE CONSTR.
INSULATION
2 SM
OCG GROUP RES.UNITS
~ •• - • _ , FLOOR AREA i01PE ACREAGE -
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
$O.F
• - '. .ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE'
DIAP . -THE CONSTRUCTION TAX IS PAID
HRAGM'' 2400
uui EDlO N usE
ROOF SHEATHING � -� - � Hes IND, CON ve CO..,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED • ' FINALS DATE INSP. ® El ❑
ASSESSORS PARCEL NO.
ROUGH SAN.#
PLUMBING -F67 - .ELECT.ENERGY _ 'r :
- rRnc�i N,yo.:, PAHceE No.
TUBS 8 SHOWER PAN . •PLUMBING,ENERGY. - VV .`
MECHANICAL MECH.ENERGY E ACC.FILE NO.
ELECTRICAL. "BUILDING ENERGY
FRAMING. '�, ELECT.FINAL TEST.'. +'
ZONING ENG.SITE NO.
INSULATION ' ` PLUMBING
GAS TEST GAS
FIRE SPRINK ENERGY L2J
MECHANICAL
COVER.ND."WO RK UNTIL ABOVE HAS BEEN SIGNED HEATING 'Y O N❑ Y U. N�
EXTERIOR SHEAR ELECTRICAL RELEASE vuuro mrve n,Lu, c.
INTERIOR SHEAR Q FIRE DEPT. v� N� vL rv❑
,. SHEETROCK GRADE - - FEE SUMMARY
EXTERIOR CATH BUT LDING -
rELECTRIC
NG
INTERIOR LATH C�, - TEMPO RARY,APPROVALS 4IFIA
SCRATCH COAT — G'` . ELECTRIC HECK. 15.50'
., .. GAS .
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY r C FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR.
MICROFILM
.. c
ARRANGE FOR INSPECTION BY PHONING 252;4505, 60 99
LU ONE WORKING DAY BEFORE:REQUIRED ,INSPECTION. I PLUMBING
0� -PLEASE.GIVE JOB.ADDRESS WHEN PHONING. An on
Z 'MECHANICAL
SEE,PERMIT FOR EXPIRATION'DATE,=
CONST TAX rpt
.IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE. TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY'0
APPLICANT TO FILL IN INFORMATI dES -'USE E T'PEN.ONLY 1.
BUILDING PROJECT I DENTIFICATION PERnyTNUM tR ,
BUILDING �r�4•� PLICATION & PER n (�(�
ADDRESS 1 x669 Ol Ye "Y"'� UAAI L:. .r 4 J a7
Lot 259 1B'•, � - yy RUILDIN -ELECTRICAL-PLUMBING -MECHANICAL Le..
°"'"EHa Gregory Group, .Inc. IX PLAN CHECK VALIDATION
rvame OTY: ELECTRIC PERMIT. FEE
• Ahmanson Dev. ' 41.6,,1595-2100
CONTRACTORS OUTLETS-.SWITCHES-RECEP 10.00/1.00
PVegory Group, Inc.. LIGHTING FIXTURES 10.00/1.00 '
LIC.NO,
CONTRACTORS PPLIANCES-RESIDENTIAL - 4.00 '
ADDRESR ' 220-C Twin Dolphin Dr.'
RWC 94065 PHD4E15-595-210 PANELS 10.00 DATE OF APPLICATION
PLAN CHECK FEE - ?.C.NO.
ARCHITECT PANELS (OVER 200 AMP) - 20.00
ER Aram Bassenian; AA7A p{'
x1°3" C. uc"0.1.-8395 ISIGNS TRANS. 3.00 - r
ARCH.OR ENG. 2031 Orchard Dr.�1D0 SPECIAL CIRCUIT " 5.00 PEHMI T VALIDATION .,
ADDRESS
Santa Ana Hts. CA 2707 TEMP.METER OR POLE INS. 20.00
APPLICANrs
AODR2�
MOTORS SEE FEE SCH.
5 -
0 C Twin Dolphin Dr. RWC 940 SERVICE CHANGE 20.00
0 0 o LICENSED CONTRACTORS DECLARATION
I hereby affirm that I inn Iltenud under pruvisions of Chapter 9 - .ISSUANCE DATE
m a ads (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
F w Z Profess'lons Code.and}{� license is in full,once 1, r f - e- �I
Z,o m - License Class_D_Lic.Nihmber / ® , ®
Q H w Date - Contractor_'/ru.3yl -
a m s ( o- BUILDING PERMIT'
a,w OWNI?R-BUILDVK DIiCLARAfIONINFORMATION
w3 a- h I hereby affirm that I am exempt from the Contractor,License MISC.- r REFER TO ORD
.. 0v, Law fpr the following reason. 7031.5,Business and Professions pERMIT.ISSUANCE 10.00 VALUATION SfFT.
� - Code:Any city or county which requiresa permit toconstRlCt.alter, (l
a 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIF NO. ELEC. 15 ,922
O u requires lire applicant for such permit to file a signed statement that .TOTAL PERMIT TO
whe is licensed pursuit to the provisions of the Contractor's License '
Law(ChuPter7(commencing with Sectimh 7000)of Division 3 of the ( SFDU •- . -
a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT - FEE
r o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
p '; m by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.1500 2 5NHR•
of not more than five hundred dolUrs(S500).):
❑ I,as owner of the property,or my empluyces'wilh wages as BACK FLOW PROTECT. DEVICE 4.00 DCC,GROUP RES.UNITS
their sole Compensation,will do the work,and the structure is not
intended Or offered for sale (Sec. 7044,,Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 I
Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP - 5.00 SO.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-I INC.4 OUTLETS 6.00 2400 .
or improvencnl 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 build or an-
prove forpurpose ofsaler. i ' INDUSTRIAL WASTE INTER. ' 30.00 RES . IND CON PB " omen
O I,as owner of the properly.our exclusively contracting with tK ❑ ❑ - ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL No.
and Professions Code:The Contractor's License Law does not apply. - .S/
to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5 IEA:) 1.00 ID Y 3 •j 3.3
cahtractt for such projects with a conlmctous)licensed pursuant m SEWER-SANITARY-STORM EA.200tt/10.00
the Contractors License Law. •TRACT NO. TARCEL NO.
❑ l um exenhpt hinder Scc. .R.&BC,for this WATER HEATER W/V,ENT 6.00 . `
reason
Owner Dote WATER SYSTEM - 5.00
ACC.DATE. ACG FILE NO.
WORKERS'COMP6NSATTON DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm Ilhat I have a cerlifieale of consent 1.scl Ginsu R', ZONING- ENG.SITE NO.
a certificate of Workers'Compensation Insuranee.,or a certified ,
copy thereDf(see.3800,Lab.C.). United'Pacific.
Policy N.. Company
O , k Certified copy is hcrchy l a...hed. FIRE SPRINK ENERGY T 24
Z Z R Certified C, y is file with tiro city inspection division. -
O Apphrmt MISC.- REFER TO ORD. Y❑ rv❑ v ❑ N❑
cN CERTIFl 'A'f F.OPEXIiMPTION PROM WORKERS' PERMIT ISSUANCE • (10.00 FLOODZONEI H.L.U.C.
LU >_ COMPEN:A'1'ION INSURANCE: PLG(CONTR. LIC.NO. PLG. '
d 0 (This scct rr need not be completed.if the permit is for one _ TOTAL Y❑ N❑ Y ❑ IN CJ
Z It u Ed red dollars IS 100)or less.) -
U O I certify that in the performance of the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is ssihed.I shall not employ airy pawn in xny nhanncr en as to
U become subject to the Workers'Compensation Laws of California.
O w Date " Applicam - BUILDING 832.00
n ALTER'OR ADD TO MECH. 5.00
} ti NOTICE TO APPLICANT: If,alter making this Certificate of Ex. -
F. ? emption,you should become subject to the Workers Compensation APPLIANCE , ' - 5.00 PLAN CHECK- 15.50
provisions of the Labor Code, you nwsl I'urthwith conhply with
U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10MCF.M.) 4.00 FEE/energy 62.00
CONSTRUCTION LENDING AGENCY -. AIR HANDLING UNIT(OVER 100WC.F.M.) 6.00 SEISMIC FEE 10.85
I hcrchy altion that there iso construction leading agency for EXHAUST HOOD (WITH DUCT) 5.00
the prlormancc of the work Far which this femnit is issued(Scc.' MICROFILM
30p7,Civ.C.).. SeCUr>.t PACIFIC " HEATING UNIT(TO.100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 ELECTRIC
Lender's Addresses- �emlthlr_._ 60.90"
Icertily thin lYleve ri311`tlri. a � GDn and slate tial lDeabove - VENTILATION FAN (SINGLE) 4.00
information is correct I agree to comply with all city and county - PLUMBING 60.90
ordinances and state laws refuting to building construction, and BOILER-COMP(3 H.P.or 100,000B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEESCH. MECHANICAL
above-Inentioned Property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.-' REFER TO ORD.
upcifmo against-liabilities, 'ud•mse
m�ls, costs and expens which \ CONST.TAX
may in any way accrue against said City in Consequence of the r PERMIT ISSUANCE 110.00
....tingoflhis court L MECH:CONT. LIC.NO, MELH.
I � TOTAL TOTAL '292 00
Signature.,' ppfi mo/Contmetor )ate 0.
OFFICE COPY