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13683 CITY OF CUPERTINO 13S83 ' INSPECTION DIVISION s JOB INSPECTION RECORD [�- [� PERMIT EXPIRATION JOB ADDR ESS I�.na� alt ✓E^I y:/,e ,!'-d UNIT# LOT# [[//�� PERMIT EXPIRES IF WORK OWNER .�CCrO lT/LOC/'o CONTRACTOR IS NOT STARTED WITHIN INSPECTIO ATE INSPECTORINSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - = - �nm4�%rar 'ONCE OR 180 DAYS FROM LIFER 114 AK AST CALLED INSPECTI ON. PREGUNITE /.� V�wc OK —mil VALIDATIONM u0 i POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ! PLUMBING ELECTRICAL ISSUANCE GATE MECHANICAL ��//�� BLDG. ELECT. PLG. MEC-. �� pv ❑ ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING vnwAnory s/FT. MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION STORIES TYPE CONSTR. OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF 50.FT.E LOOR AREA TOTAL ACREAGE IAPHRAGM BUILDING USE I RES ND CON PIT Orae, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED E:] ❑ ❑ ❑ ❑ ROUGH ASSESSORS PARCEL NO PLUMBING GAS TEST _a. ✓ TRACT NO, PARCEL NO MECHANICAL ELECTRICAL _ L4,11 I --- ._FINALS DATE •INSP. ACC.DATE ACC.FILE NO • I FRAMING - SAN 1t �aa INSULATION - PLUMBING ZONING ENG.SITE NO. GAS MECHANICAL FIRE SPRINK ENERGY T.]1 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING �� Y ❑ NO ` ❑ "❑ LATH-INTERIOR ELECTRICAL E FLOOOZONE A.L.D.C. LATH-EXTERIOR FIRE DEPT. Y❑ N❑ Yo N❑ SHEETROCK _ =� GRADE or, _ ' FEE SUMMARY SHEAR INTERIOR - BUILDING 7� f SHEAR EXTER16R _ BUILDING y TEMPORARY'APPROVALS FIREWALLS - ELECTRIC PLAN CHECK GAS FEE NOTAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX �. PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. APPUCANTS POSTING COPY __ i POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PERMIT NUMBER INSPECTION DIVISION 13683 JOB INSPECTION RECORD (+ PERMIT EXPIRATION JOB ADDRESS /16_4�/ s SK• o7Nr� 14 . UNIT# LOT# `�"L�1 - ' PERMIT EXPIRES IF WORK OWNER 62A-C U CONTRACTOR IS NOT STARTED WITHIN INSPECTION ATE I INSPECTOR INSPECTION RECORD 1 180 DAYS OF PERMIT ISSU- FOUNDATION / T �� ANCE OR 180 DAYS FROM LIFER 'Y LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION ' r POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDD- UNDERGROUND /SLAB PLUMBING ELECTRICAL, ISS,UANCE DATE MECHANICAL {B I. U T. PLG NECK 27 El� DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION PLUMBING WOOD FLOOR VALUATION s/FT. ' MECHANICAL ELECTRICAL ' - _ - PERMITTO FRAMING INSULATION sioRlEs TYPE CONSTR. f 9-3�P OCG GROUP RES,UNITS ACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO.FL FLOOR AREA TOTAL ACREAGE DIAPHRAGM J BUILDING USE RES IND ' CON PB Otnr, APPLY.NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - 0, ❑ 0 ❑ E) ROUGH _ - ASSESSORS PARCEL NO, PLUMBING GAS TEST + TRACTNO. PARCEL NO. � � - MECHANICAL i S— ,.f ACC.DATE ACC FILE NO, ELECTRICAL FINALS WDATEINSP.FRAMING '-� SAN * ZONING ENG.SITE NO. INSULATION. PLUMBING GAS MECHANICAL - In FIRESPRINK ENERGY!2<COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Aw Y ❑ NE] -Y ❑ No LATH-INTERIOR ` -I - ELECTRICALFLOODZQNE A.L.U,C. LATH-EXTERIOR 6 - FIRE DEPT. Y❑ N[ Y❑ No SHEETROCK - -98 Zr GRADE FEE SUMMARY s. SHEAR INTERIOR BUILDING SHEAR EXTERIOR L„ � - TEMPORARY APPROVALS BUILDING ', - FIREWALLS ELECTRIC PLAN CHECK ' GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCYSEISMIC FEE., _.. OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC LL, ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING /'7- Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE- MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMAMN WITHIN RED LINES - USE BALL POINT PEN ONLY ` BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BDILDIf-G APPLICATION & PERMIT _ 13683 noonEss Lot 32 - Plan 36 BUILDING-ELECTRICAL-PLUMBINQ-MECHANICAL OWNERS Seven springs Drive ' PLAN CHECK VALIDATION NAME Gregory Group, Ino. OTY. ELECTRIC PERMIT FEE PHON - CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 qY NAME Gregory Group, Inc. UC.No. 430097 / LIGHTING FIXTURES 10.00/1.00 21 cDNTRACTo PPLIANCES-RESIDENTIAL 4.00 (z ADDRESS ��20 Twin Dolphin Dr. , #C Reciwood City. A PRONE 595-2100 PANELS 10.00 B^ DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 2D,DQ PLAN CHECK FEE .C.N OR Aram Bassenian, A.I.A. ENGINEER iates UC,No. SIGNS TRANS. 3.00 I. ARC ". H.ORE PERMIT VALIOATION ADDRESS 990 westerly Place, #170 SPECIAL CIRCUIT 5.00 V p>Ll ch CA zIP TEMP.METER OR POLE INS. 20.00 ADDAIPL.E95 T522O TWln Dolphin Dr. , #C MOTORS SEE FEE SCH. 7 ,�.•_ - -, Redwood City CA 94065 SERVICE CHANGE 120'00 1 woo LICENSED CONTRACTORS DECLARATION It�Cy�plsflno M o u 1 hereby affirm that 1 am Bcensed under provisions of Chapter 9 n'_(' r ' ISSUA CE DATE <i (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. H w i Professions Code,yd my license is Nin full forr�� -L 3 z O w- License Cla Lic.Number_ el lino 9 w r w Date Conlractor Cd of C p a y f J BUILDING PERMIT ¢ ¢ i OWNER-BUILDER DECLARATION INFORMATION K N I hereby offirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD Use for the following reason.(Sec.703 1.5,Bminessand Professions PERMIT ISSUANCE 10.00 0^ VALOATION 5/FT. Cods:Any city or county which equiresa permit to conswct,alter, !/__Z_e.e_� ¢ ¢Q 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.LONTR. LIC.NO. ELEO, q _ T7 T jJPV DLL requires the applicant for such pemilt to file a signed statement that TOTAL /S9 IT TO X S he is licensed pursuant to the provisions of the Contractor's License E�� w� F z a Law(Chapter9(commencingwilh Section 7000)of Division3oflhe U , i D Business and,Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ H the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE C NST e ; _ by any applicant for permit subjects the appplicant loss penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 p of not more than five hundred dollars(S500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00eC.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 - 3 - Code:The Contractor's License Law does not apply to an owner of _ 1� property who builds or improves thereon,and who does such work 2. FIXTURES-PER TRAP 5a FT.FLODR AREA.00 60 STOTAL ACREAGE s himself or through his own employe ,provided that such improve- ments are nm intended or n Tcrcd for sale.If,however,the budding ( GAS-EA.SYSTEM-11NC.40UTLETS 6.00 % 3 J or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove for Purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 REs 'IND CON PB Omar ❑ I,as owner of the property,ant ex CIUSively contracting with ❑ ❑ ❑ ❑ he' nod contractors to consumer the project(Sec.7044,Business LAWN SPRINKLERS- IFI NC S V,,?B. 6.00 1 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 p contracts for such projects with a commclons)licensed pursuant to the Contractor's License Law. ( SEWER-SANITARYpSTORMEA.200ft/10.00 (Q^ TRACT NO, PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT6.00 reason - Date WATER SYSTEM nl ,LL.)ClLlssr5.00Ow"cr 6 ACC.DATE ACC.FILE NO, WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of c.aserl to elf-insure. ZONING or a certificate of Workers'Compensation Instanince,or a certifkA ENG.SITE NO. copy thereof(Sec.3800,Lab C.L_nited t Policy No. Company__2acl O ❑ CenIl-,ed Copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z 0 , 1ze,rtifwd h the city inspection divisio O n. MISC.- REFER TO ORD. Y [3N❑ y ❑ N❑ � N AM16� CERTIFICATEOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 0- FLOOD ZONE AL.U.C. 4 LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. o 0 (This section need not be completed if the permit is for one TOTAL /7^ Y❑ N❑ Y❑ N❑ hundred dollars(S 100)or IessJ U O 1 certify that in the Performance of the work for which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY LL - Init is issued,I shall not employ any person in any manner so as to Ow become subject to the Workers'Corn,roation Laws of California. BUILDING Q. DateApplicant ALTER OR ADD TO MECH. 5.00 } ran NOTICE TO APPLICANT: If,after making this Certificate of fx F 2 emption,you should become subject to the Workers''Conlpensat ion APPLIANCE 5.00 �^ PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE . (a/ U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNrr(OVER 10=C.F.Ki 6.00 SEISMIC FEE 8L9 1 hereby affirm that there is a construction lending agency for / EXHAUST HOOD (WITH,DUCT) 5.00 14c- the performance of the work for which this permit is issued f5ee HEATING UNIT (TO 100,000 B.T.U.) 6.00 MICROFILM 3097,Civ.C.). (� Lender's Name Lender's Address H EATING UN IT(O_VER100,000 B.T.U.)9.50 ELECTRIC � ^ 1i ly that l have read this application and stale that the above VENTILATION FAN-(SINGLE) 4.00 12_ information is correct. I agree to comply with all city and county gpILER-COfvP(3 H.P.or 100,000B:T.U:)I 6.00 PLUMBING 97 ordinances and state laws relating m huildid const roman, anJ hemby authorize representatives of this city lO enter upon the BOILER-COMP(OveiM 00,000 BT U1 SEE FEE SCH. MECHANICAL above-mentioned Property for inspection purposes. G70 (We) agree to save, indemnify and keep humnless the City of MISC.- REFER TO ORD. I ��� y. Cupertino against liabilities,judgments, an costs d cxpanus which CONT ST. AX (� may in any way accrue.against said City in consequence of the PERMIT ISSUANCE 10.00 /0^ granting Of this permlL MECH.CONT. LIC.NO. MECH. sp % �� roTAL z-- TOTAL 09„ '3/ Signa pP Kant/Co ractor Case � Sp � OFFICE COPY CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTGR'S OFFICE 4 o-t- z Date -.............-- ....--�.--�..�., 19.. Building Permit No // // �3- �•'� Inc Building Located at .....6.r-....--.. f Owned b rC� -�.P._ _O..If�O..-.. ..tQ.0 . Has Been (Completed) ,^ I ere �or Use As: --5-. _K�.--..Vv..-. ......................................... ................ ...:.......... .. . ..-._...-....-......... ...... ...--,.... . ......................... ................................................................. BU'IL�DI/NG INSPECTOR PD-7 y