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15808 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMITNUMBER CITY .OF CUPERTINO 580 INSPECTION DIVISION JOB•INSPECTION RECORD /� n Jj''�' • PERMIT EXPIRATION I oP-" JOB ADDRESS I D) l g[P—c 1 cr UNIT#' _LOT# . - - PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN' INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM I NOTE: UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE .TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE LATE MECHANICAL BLDG. ELECT PLc. VEER. .�, Z ® RLE 00 NOT POAR FLOOR UN IL ABOVE HAS BEEN SIGNED euaowG PERMIT WOOD FLOOR - - - INFORMATION PLUMBING _ VALUATION SIFT. � - � � 1 MECHANICAL 1.940922 ELECTRICAL - PCRMII U FRAMING - SFDtUL- II INSULATION - - STORIES TYPE CONSTE. 2 WHIR OCQ GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED A-3 . .� • . _ ROOF � � NOTE:NO FINAL INSP,SHALL BE MADE BEFORE SOFT.FLOON AREA TOTAL ACREAGE THE CONSTRUCTION TAX IS PAID DIAPHRAGM BUILDING USE ROOF SHEATHING (,�+.kUC - RES IND . CON PB oloE, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ' ❑ ❑ ROUGH SAN.# assessoas PARceL No - PLUMBING - V ELECT.ENERGY �� TUBWE S&SHORPAN PLUMBING ENERGY - rNAcr No. PARCELrvO- MECHANICAL MECR ENERGY 8U 8 'ELECTRICAL rl BUILDING ENERGY - ACL.DATE 'ACC PILE NO. FRAMING � �� ELECT.FINALTEST ' -ZONING ENG.SITE NO. INSULATION, PLUMBING GAS TEST — GAS 'GOC, MECHANICAL FIRE SPRINK ENERGY raa_ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ "❑' ° ❑ "❑ EXTERIOR SHEAR L RELEASE FLOOD ZONE A.L.DO INTERIOR SHEAR XULI FIRE DEPT. ' Y ❑ N❑ Y N SHEETROCK r. GRADE FEE SUMMARY EXTERIOR LATH ' BUILDING IPGC BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK GAS .. FEE/eWrgy NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED 10CCUPANCY SEISMIC FEE In-As OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE'FOR INSPECTION BY PHONING 252-4505, ELECTRIC CIA ne ELI ONE WORKING DAY'BEFORE REQUIRED INSPECTION. PLUMBING y� zPLEASE GIVE JOB ADDRESS WHEN PHONING. 60.9c I =SEE PERMIT FOR EXPIRATION DATE- MECHANICAL CONST.TAX. IMPORTANT! PLEASE READ REVERSE SIDE•BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY � -Oo.D� APPLICANT TO FILL IN INFORMATION WITHIN'RED LINES - USE BALL POINT PEN ONLY • BUILDING PROJECT IDENTIFICATION PERMIT NUMBER -LaLDIN APPLICATION & PERMIT ADDRESS Q an- • 15808 11629 Birch Spring Court BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME bregory GrOUp, I5- nC Ahmanson Dev. 415 12100 PTY. ELECTRIC PERMIT FEE I� NAMeAcroas OUTLETS-SWITCHES-RECEP 10.00/1.00 Gregory Group, Inc. ,.NDB-430097 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS - WIn 0In r. PPLIANCES-RESIDENTIAL' 4.00 ADDrj4s$(� 94065 415-, 1 -2100 PANELS 10.00DATE OF APPLICATION ARRCHITECT Aram Bassenian, AIA & AssO . PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. O ENGINEER - C-B395: SIGNS TRANS. - - 3.00 uc.ND. ARCH OR ENG. rC ar r• PERMIT VALIDATION ADD Ana Hts. CA. 927C7im SPECIAL METIER OR POLE INS. 20.00 �- APPLICANTSMOTORS SEE FEE SCH. ki A°°RrissEaa220-C Twin Dolphin Dr.RWC94D p SERVICE CHANGE 20.00 1 0 0 0 LICENSED CONTRACTORS DECLARATION / < u u I hereby affirm that I am licensed under provisions of Chapter 9 E DATE vHi a y (commencing with Section 7000)of Division 3 of the Business and T- PLG. MECH. Professions Code,an license is in full force apde�fp�1. Z,i ev =o License Class Lic.Number 4.511'1y/ , m r w Date - Contractor P m N ' BUILDING PERMIT ¢ ¢ ¢ OWNER-BUILD17R DECLARATION a a u INFORMATION se ; y I hereby affirm that I am exempt from the Contractor's.Licens, MISC.- REFER TO ORD a__o a Law for the following reason.(Sec.7031.5,BusinesSand Professions PERMIT ISSUANCE - 10.00 VALUATION $)FT. r Code:Any cityorcounty which requiresa permit toconstruct,aller, 154 922 E m or to its issuance,also ELEC.CONTE. LIC.NO. f ¢ W ¢O improve,demolish,or repair any Structure,prior ELEC. DLL requires the Applicant for such permit to file a signed statement that TOTAL PERMIT TO ¢ w he is is licensed pursuant to the provisions of the Contractors License z a Law(Chapter 9(commencingwithSection 7000)ofDivision 3ofthe SFDUJL 4 D Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ $ the basis for the alleged exemption.Any violation affection 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant ton civilpenalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 2 SNHR of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure Is not /pS intended or offered for sale (Sec. 7044, BUcaress and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 1 '\-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 SD.Fr.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-l1NC.40UTLETS 6.00 2400 or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4 (EA) 200 BUILDING USE builder will have the burden of proving that h - . - . . ma-did not build or - RES IND CON PB Omar th prove for purpose of e.). INDUSTRIAL WASTE INTER. 30.00 0 El 1:1- ❑ I,as owner of the property,am exclusively contracting with 0. 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 docs not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 X/'n/n -9 contracts for such projects with a contractor(s)licensed pursuant to ale nary l-l� the Contractor's License Law. I SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec.-,B.&P.C.for this reason WATER HEATERW/VENT 6.00 8098 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE N0. WORKERTCOMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm.that I have a certificate of consent tO sel Dlnsare, ZONING or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO. copy thereof(See.3800,Lab.C.0 n i ted Pacific Policy No. Company O ❑ Certified ropy is hereby furnished. FIRESPRINK ENERGY T24- Z Z Certified copy is tiled with the city Inspection division. O Applicant MISC.- , REFER TO,ORD. Y ❑ N ' Y ❑ N❑ CL y CERTIFICATE OF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.c. EU > COMPENSATION INSURANCE PLG,CONTE:' LIC.NO.• PLG, D' O (this section need not he completed if the permit is for one TOTAL Y N Y❑ N Z. h undyed dollars IS 100)or less,) L) O I certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY ly F mitis issued,1 shall not employ any person in any manner so as to O W become subject to the Workcrs'Compensation Laws Of California. y Date Applicant ALTER OR ADDTO MECH. 5.00 BUILDING 832.0 >_ N NOTICE TO APPLICANT: If,after making this Certificate of Ex- I- Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 15.5 provisions of the Labor Code, you must forthwith comply with FEE energy 62.D U, spilt provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)MI)C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 10.8E 1 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,Ci,.C.). Securlt PacificHEATING UNIT(TO 100,000 B.T.U.) B.00 Lender's NameH EATI N G UN IT(OVER 100,000 B.T.U.)9.50 Lender's Address r-o-4th--1-r-- ELECTRIC 6n CIC I certify that 1 huv cad h s 1 cation and smte that the above VENTILATION FAN (SINGLE) 4.00 information is correct.Iagree to comply with all city and county PLUMBING ordinances and stale laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 6n 9 hereby authorize representatives!of this city to enter upon the BOILER-COMP Waar100,00011TU1SEEFEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperlino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 1600 CONST.TAX may in any way .cane against said City In consequence of ore ranting of this permit. - MECH.CONT. LIQ NO. MECH. TOTAL ////--Jfyy TOTAL ri 77 Signature of API onlractor Date OFFICE COPY.