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15825 (2) POST THIS CARD NEAR,FRONT OF BUILDING " PERMIT 1NUMBER 5825 CITY OF CUPERTINO " INSPECTION DIVISION JOB INSPECTION RECORD 1l,., �p PERMIT EXPIRATION JOB ADDRESS `�/ `�"'�T`� UNIT# _LOT# ' `QCDU� PERMIT EXPIRES IF WORK OWNER CONTRACTOR 4gvm�-'� •IS NOT STARTED WITHIN ' INSPECTION DATE INSPECTOR INSPECTION RECORD leo DAYS DF PERMIT ISSU- ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. LIFER •,/, ALL GRADING AND DRAINAGE SHALL BE INSTALLED 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 Dare ' MECHANICAL BL D G ELF , PLG. NECH.' DO NOT PIOUS FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT W - INFORMATION . WOOD FLOOR OV VALUATION .SIFT. PLUMBING 14 ` MECHANICAL' -- •865 L PERMIT TO ELECTRICAL I134 _ FRAMING 1,1 SFDU H, - STORIES TYPE CONSTR. - INSULATION 2 OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - lU,lT.FLUORAHEA TOTAL ACREAGE ROOF - NOTE: NO FINAL INSP,SHALL BE TAX IS PAID ADE BEFORE 2917 DIAPHRAGM THE eulLnlrvc USE ROOF SHEATHING '2)41 • o Rki ES IND ❑N 11 ED NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS :. DATE INSP. Assessoas PARCEL No ROUGH SANAf PLUMBING -zQ-9wi ELECT.ENERGY' 3&w -1 I TRACT NO. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY - MECHANICAL MECH.ENERGY. 8098 ELECTRICAL - Q BUILDING ENERGY ACC.DATE ACC FILE NO FRAMING _ _ Ln ELECT,FINAL TEST ZONING ENG SITE N0. INSULATION PLUMBING GAS TEST. - -RR GAS FIRE SPRINK ENERGY T 24 MECHANICAL Y No Y 11 m0 COVER NO,WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR , ELECTRICAL RELEASE - FLOOD zorvE ALuc INTERIOR SHEAR �,3 FIRE DEPT. YC � NE Y ❑ N❑ SHEETROCK - C� GRADE FEE SUMMARY EXTERIOR LATH -�j- BUILDING >• INTERIOR.LATH - q TEMPORARY.APPROVALS BUILDING SCRATCH COAT - ELECTRIC - PLAN CHECK 15.50' GAS FEE 62.00 NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC F1302 EE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. ' MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ` UJ ONE WORKING DAY BEFORE REQUIRED INSPECTION, PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. 70.39 — SEE PERMIT FOR EXPIRATION DATE MECHANICAL IMPORTANT! coNST.TAx PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY /S39Ao- APPLICANT TO FILL IN INFORMATION WITHIN RED LINES = USE BALL POINT PEN.ONLY y_BUILDING PROJECT I DENTIFICATI ON PERMIT NUMBER r a9DIQLq°EI"�G o an APPLICATION & PERMIT 15825 1°IbLa7 Cedar Sprtng Court BUILDING -ELECTRICAL-PLUMBING=MECHANICAL r 0;MER'a----Gregory Group, Inc. & PLAN CHECK VALIDATION Ahmanson Dev. 41�ZA95-2100 OTY. ELECTRIC PERMIT FEE a CONTRACTORS NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 Gregory Group,InipIL,NP-430097 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S - win Dolphin Dr. APPLIANCES-RESIDENTIAL 4.00 ' ADDREShwc 94065 PHONE415-595-21 U PANELS 10.00 DATE OF APPLICATION on ARCHITECT Aram Bassenian,AIA&Assoc. PANELS (OVER 200 AMP,) 20.00 20.00 PLAN CHECK FEE ?.C.NO. ENGINEER LID.ND.0-8395 SIGNS TRANS. 3.00 AARCH.OR DDRESS ENG. 2031 Orchard Dr. 100 SPECIALCIRCUIT 5.00 PERMIT VALIDATION Santa Ana Hts. CA. 92707 EMP.METER OR POLE INS. 20.00 AP�PjMU1CpAjNr'$ - MOTORS SEE FEE SCH. ALGV=C Twin Dolphin Dr.RWC94065 SERVICE CHANGE 20.00 D o O LICENSED CONTRACTORS DECLARATION a v C I hereby affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE m< H (commencing with Section 7000)of Division 3 of the Business and BLDG.. ELECT. PLG. MECH. o Professions Code,a m license is in full force a Z, i N w License Class Lic.Number 4 UUy] F m H J Date Contractor a se a < BUILDING PERMIT ¢ OWNER-BUILDER DECLARATION �� a Q u,U INFORMATION ' w3 a I- I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD r =o J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VugT[ION S/FT. Code:Any city or county which requires a permit to construct,alter, •'SI �k�OJ((J u,Q Improve,demofish,or repmr any structure,prat to its Issuance,also ELEC.CONTR. LIC.NO. TELE C. -U u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO he is licensed pursuant to the provisions or the Contractor's License ( Cupertino Hz> Law(Chapter 9(commencing with Section 7000)of Division 3 of the SFDUJL Q Business and Professions Code)or that lie is exempt therefrom and QTY. PLUMBING PERMIT FE r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. La by any applicant for o permit subjects the applicant too civil penalty ALTER-DRAIN III VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).) 2 5NHR CI 1.as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 CC.GRO OUP 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,AR EA,COND. 5.00 Cade:The Contractor's License Law does not apply to an owner of R-3 1 property who builds or improves thereon,and who does such work FIXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- �� menu.me not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 2917 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 build or im- RES- IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 T� Cl 1,as owner of the property,am exclusively contracting with 11 ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 - 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 - w/p contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 ��rr the Contractors License law. TRACT NO. PARCEL NO. ❑ .I am exempt under Sac,-,B.&P.C.for thisreason WATER HEATER W/VENT 6.00 '8098 Owner Dale WATER SYSTEM 5.00 ACC.DATE -ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate orconsent to self-insure, ZONING ENG:SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(See.3ROO,Lab.C.1'United Pacific Policy No. Company 10 ❑ Cetliliedcopyisberebyfurnished. FIRESPRINK ENERGY T24 Z Z X Certified copy is filed with the city inspection division. O Applicant - - MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑ Fy CC - CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Lu > I COMPENSATION INSURANCE PLG.CONTR, LIC.NO. PLG, d O ('chis section need not be completeo if the permit is for one TOTAL Y[:] IN C] Y ❑ ry❑ Z hundred dollars IS 100)or less.) U O 1 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 California. O y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 940.50 } w NOTICE'FO APPLICANT: If,after making this Certificate of Ex- F Z caption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 5.5D provisions of the Labor Code, you must forthwith comply with FEE /energy U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00 62.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 13.02 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,Cv C.). Security Pacif;c HEATING UNIT(TO 100,000 B.T.U.) 8.00 Landers Name 70.35 Lenders Addrer��1-"CQ�TTT -1 HEATING UNIT(0 100,000 B.T.U.19:50 ELECTRIC '. I 1 certify that I have read 5 appfdreW;d state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.1 agree to comply with all city and county PLUMBING ]0.35 ordinances and state laws relating to building construction, and BOILER-COMP13 H.P.Pr 100,000 B.T.U.) 6.00 hereby'authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 STU)SEE FEE SCH. MECHANICAL above-mentioned properly for inspection purposes. .(We70,15 ) to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperfino against liabilities,judgments, costs and expenses which CON T. AX0 j ayx,in any way accrue again t said City in consequence of the PERMIT ISSUANCE 10.00 - inn6ngofthispermit MECH.CONT. LIC.NO. MECH. TOTAL TOTAL ' Signature of Apphc onttactor Data OFFICE COPY � 9�-�