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13685 (2) _F .:. POST THIS CARD NEAR FRONT OF BUILDING CITY 'OF CUPERTINO PERMIT NDR,RE, INSPECTION DIVISION JOB INSPECTION RECORD (+ PERMIT EXPIRATION JOB ADDRESS �l S�� fe/c'LJ Sp'o_";v cJ'A1 . UNIT# LOT#{'3 PERMIT EXPIRES IF WORK OWNERCONTRACTOR ISNOT STARTED WITHIN INSPECTION DATE InSIGNED INSPECTION RECORD 180 DAYS OF PERMIT ISSU- - ANCE OR 180 DAYS FROM FOUNDATION LASTCALLED INSPECTION. LIFER � � �F( PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEE ,. - - UNDERGROUND /SLAB .aa PLUMBING ELECTRICAL - ,. ISSUANCE DATE MECHANICAL GV �� ♦ SLOGr ELECT. PLG. MECH- . �{I o o- DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 1 E BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION S/FT. PLUMBING , GI MECHANICAL - ELECTRICAL + PERMIT TO FRAMING w L STORIES TYPE CONSTR. INSULATION OCO.GROUP RES,UNITS PLACE NO SU BFLOOR UNTIL ABOVE HAS BEEN SIGNED (� ROOF SO 'Tr`LOCH AREA TOTALACREAGE - F DIAPHRAGM /! '' _�- BUILDING USE RES IND CON PB 00'x' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 9 ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH ^� z PLUMBING TRACT NO. PARCEL NO. GAS TEST - _) MECHANICAL � . ~��• �� . ELECTRICAL FINALS DATE INSP. ACCDATE ACO.FILE NO. FRAMING Ds-`/' - _ - C. SAN # ZONING ENG.SITE NO. INSULATION �^ 1,�Yj � PLUMBING � z ' GAS FIRE SPRINK ENE RGV T4A MECHANICAL - _� y ❑ N❑ Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH-INTERIOR -13-g8 ELECTRICAL FLOOD ZONE ArL.U.C. _j.,Z- LATH-EXTERIOR `._ - FIRE DEPT. Y,❑ N❑ Y 0 N❑ SHEETROCK f• GRADE FEE SUMMARY SHEAR INTERIOR BUILDING - SHEAR EXTERIOR �$a TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK 5- - GAS - AEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE �• OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. % MICROFILM ARRANGE FOR INSPECTION BY.PHONING 252-4505, ELECTRIC Lu - ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL -� IMPORTANT! CONST.TAX - f_ PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL ; �I OFFICE COPY . • CITY OF CUPERTINO OFFICE COPY GAS SERVICE NOTICE 7 - Z Z gyp — 19 �C O ' To You are hereby authorized to connect the GAS service for Owner or Tenant 1� � 11 0 At _ -P tfi& LA 1-I Q Ck" / New Service No. of Meters Reconnect No. of Add. Meters Move Service rM,ave Meter PLUMBING INSPECTOR VII : �� _ BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg.Dept, office Copy O Backflow Device Sanitary Permit No. /2 ZZ 7 Sewer Connection Plumbing Permit No. 0 Plumbing Final Lot No. Owner or Tenant - ('�,i Q (� �' 1/ (� (f At 1'/ C- &-/ SPy -e �� Tract Date Connected 3 _ 1 9,d p Date Final © • B' Jf PL MBING INSPECTOR -�5 r - - ELECTRIC SERVICE NOTICE loEFICE COPY BUILDING INSPECTOR'S NOTICE Y CITY OF CUPERTINO 19 To You ore hereby authorized to Connect electrical service for Owner or Tenant ` T �" P rJ l� V' I/ /Q.�It—/) U At Vi sI Pt A/ 5d No.of Wires Size of Wires, Size of Switch / A Motor Load Voltage Phase Heating Load K.W. Voltage No.of Meters Light-1 10New Service Remnnect—_ Heat IPO_Three Wve Mora Service_ No.of Add.Meters Power /Three ,Phasseen•, �s^'Move Meier ELECTRICAL INSPECTOR e'�L/ ✓�'/- U CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE �—o 7 Date ...........C.....:. ......�............. 19.-:;R�".. Building Permit Np. .................... The Building Located at ---- ...... Ownedby ..... .......... --------- -- m I Has' Been (�For Use As: ....\A1.. . ........... (Altered) ....... ................ ...........;................................................................... ................................................................. .... ............................................................................................................................................ .................................................................... .......... ................... ........................................... PD-7 7)�BUILDING INSPECTOR APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER T'.� APPLICATION & PERMIT 13685 . 9UDRE'NG Tot 34 � Plan zis 'w /,00R Ess LV BUILDING - ELECTRICAL-PLUMBING -MECHANICAL OWNEP'$ PLAN CHECK VALIDATION NAME Gregory Group, Inc. - OTY. ELECT RIC PERMIT FEE PHONE 9 CIS CONTRACTORS 10 OUTLETS-SWITCHES-RECEP 10.00/1.00 8f NAME Gregory Group, Inc. LIC.NO. LIGHTING FIXTURES 10.00/1.00 INTRAGTO S � PPLIANCES-RESIDENTIAL 4.00 - ADDRESS 220 Twin Dolphin Dr. , #C PHONE _ aO_ / PANELS 10.00 DATE OF APPLICATION ARCwTECT PLAN CHECK FEE C.NO. OR ARain Bassenian, A.I.A. PANELS (OVER 200 AMP) 20.00 ENGINEER uc.no. SIGNS TRANS. 3.00 aoo'Ess EN.t990 Westerly Pl. , SPECIAL CIRCUIT 5.00 PERMIT VALIDATION Newport Beach, CA nP 92660 EMP.METER OR POLE INS. 20.00 aooe Ess";220 TWin Dolphin Dr. , #C MOTORS SEE FEE SCH. (� Redwood City, CA 94065 SERVICE CHANGE 20.00 woo LICENSED CONf RACTORS DECLARATION q.• �N•+. <u �u 1 hereby affirm that I am licensed under provisions of Chapter 9 _ _ „--1 I ANe TE Z w (commencing with Section 7000)of Division 3 of the Business and � BLDG. H. wi Professions CodssBand my license is in full form aud6fkW. U r V O " L 'I Z O w _ Lianv: a 5 Lic.Number 3 V 7/ R.l E- R 9 Z F Date�j/ Contractor City pertlno u� a: >t ¢ ¢ 7 OWNER BUILDER DECLARATION 41L' �� �urV BUILDING PERMIT a a a O INFORMATION wr 1 hereby affrm that I am exempt from the Contractor's License MISC.— REFER TO ORD =/FT. FLL6o`� Law for the following reason.(Sec.7031.5,Buslnessand Profusions PERMIT ISSUANCE 10.00 /0^ VALUATION as Code:Any city or county which requiresa permit to construct,alter, aa,< improve,demolish,or repair any structure,prior Or to Its issuance,also ELEC.CONTR. LIC.NO. ELEC. q 0 LL requires the applicant for such permit to file a signed statement that TOTAL /0p PERMIT TO w $ he is licensed pursuant to the provisions of the Contractor's License / FZQ Law(Chapter 9(commencingwith Section 7000S�� )ofDivision 3 oftha L Bluiness and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE H 0 the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE''/CCONSTR. by any applicant for a permit subjects the applicant Ina civil penally ALTER-DRAIN& VENT-WATER (EA.) 5.00 na✓ �ry of not more than five hundred dollars($500).): ❑ 1,-as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and ProfessionsDRAINS-FLOOR,ROOF,AR EA,COND. .5.00 -3 Code'.The Contractor's License Law does not apply to an owner of properly who builds or Improves'themon,and who does such work FIXTURES-PER TRAP 5,00 SS SO.FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- meats are not intended or offered for"sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS-EASYSTEM-OVER 4 IEA) 200 BUILDING USE builder will have the burden of proving that he did not build or int- . . . RES IND CON PB Omer prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. 7044, Busine.vs LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL No. and-Professions Code:The Contractor's License Law does not apply to an owner of properly who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 �� 6 contracts for such projects with a contractors)licensed pursuant toSEWER-SANITARY-STORM EA,2DOft/1 00 the Contractor's Lire ase Law. / �. /6 TRACT N0. PARCEL NO. ❑ l am exempt under Sec. ,B.&P.C.for this / WATER HEATER W/VENT 6.00 f9e>r Re.sol Owner Date / WATER SYSTEM (�1-(, 9. `, 5.00 ACC.DATE ACE.FILE No. WORK ERS'COMPENSATION DECLARATION WATER TREATING EOU In. 5.1,70 I hereby affirm that I have a certificate of consent to self-insure, its) A uoR 1110 ZONING or a certificate of Workc,,Colnpensnlon firm, e,.or a certified ENG.SITE NO. copy thereof(Seo.3800,IaaC 1,- Policy No. Company—Slatted—Ea -i fS i r 0 �sj❑y� Certifcd Co y Is hereb fum had. FIRE SPRINK ENERGY T 24 Z p A*phcenit ire y „{lyq city inspection division. MISC.- REFER TO ORD. Y [:J N Y ❑ N[] ~ • PERMIT ISSUANCE 10.00 CL n CER IFICATIi OF EXEMPTION FROM WORKERS' IV FLOOD ZONE A.L.U.G. W > COMPF.NSAI'ION INSURANCE PLG.CONTR. LIC.NO. PLG. y� NEI v � N� Q. O (This section need not be, completed if the permit is for one TOTAL L Z) Z hundred dollars(S100)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,1 shall not employ any person in any manner so as to Ow become subject to the W'orkmi Compensation laws of California. BUILDING Q. Date—Applicant ALTER OR ADD TO MECH. 5.00 } W NOTICE. TO APPLICANT: If,after making this Certificate of Ex- p - H ? eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK /P ^ provisions of the labor Code, you meet forthwith comply with FEE U such provisions or this permit shall be deemed revoked, AIR HANDLING UNIT(TO 10=CFAL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT IOVEA 10 c.E 6,00 SEISMIC FEE ` I hereby affirm that there is a construction lending agency for / EXHAUST HOOD (WITH DUCT) ••5,00 ,r•' the parfrmu ce of the work for which this permit is issued(Sea. MICROFILM 3097,Civ.C.). t I HEATING UNIT(TO 100,000 B.T.U.)�,8,00 -, Lender's Name HEATING UNIT(OVER 1OQ000B'T-,U:)0.50 Lender's Addmss t ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.0 _ L.-„ information is correct.I agree to comply with a0 city and county I F,,....... PLUMBING ordinances and state laws relating to building construction, and BOILER-COfvP13 H.P.or100,000B.T:U.1 •6.00 9z" hereby autlimme representatives of this city m enter upon the BOILER-COMP (Over 101i 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. q Cupertino against liabilities,judgments, costs and expcows which PERMIT ISSUANCE10,00 CONST.TAX may in any way accrue against slid City in consequence of the gran0ng of a emit. MECH.CONT. LIQ NO. MECH. OTAL 1TOTAL � 6 Slgnmu fAppbcant/Comora.r Date OFFICE COPY CITY OF CUPERTINO INSPECTION DIVISION UbUJ JOB INSPECTION RECORD PERMIT EXPIRATION r •��'� B ADDRESS /S�� JE VGhI Soe� -C-4 -/]t UNIT# LOT# ��•�� i PERMIT EXPIRES IF WORK 7FOUNDATION NER o ^'•/� CONTRACTOR IS NOT STARTED WITHIN INSPECTION ATE INSPECTOR INSPECTION RECORD 180DAYS OFPERMIT ISSU- ANCE OR 180 DAYS FROM ITI LASTCALLED INSPECTION. ER PERMIT VALIDATION PREGUNITE i POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG, ELECT. PLG. MECH. Iif g ❑ ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED eu1L PERMIT INFOBUILDING RMRM ATION WOOD FLOOR vALUAT,oN SIFT. PLUMBING PERMIT TO MECHANICALI .. ELECTRICAL FRAMING STORIES TYPE CONSTR. IN ULATION i3 lw OCG GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 1 ROOF SO FT FLDDR AREA TOTAL ACREAGE PHRAGM BUILDING USE RES IND CON PB Olnn APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 0 0 ❑ CI El ASSESSORS PARCEL NO. I ROUGH PLUMBING GAS TEST TRACT NO. PARCEL NO. j MECHANICAL 2-L/_ ACC.DATE ACC.FILE NO. ELECTRICAL FINALS DATE INSP. FRAMINGPe"' COVVCCtInpS - SAN ZONING ENG.SITE NO. INSULATION PLUMBING - GAS f FIRE SPRINK ENERGY T-24 MECHANICAL Y E) N[—] Y C:) N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1HEATING f " / * F LOOD ZONE A.L.0 C. LATH-INTERIOR(1\ ,. ELECTRICAL � z LATH-EXTERIOR - FIRE DEPT. Y I] NO Y ❑ NO SHEETROCK - _ _ GRADE f 'FEE SUMMARY . SHEAR INTERIOR - BUILDING SHEAR EXTERIOR �/-1 TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK FEE cv -31 ;_ .v_k r- GAS j NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 1 i OCCUPANCYOF BUILDING IS NOT PERMIT TED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 112 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING I PLEASE GIVE JOB ADDRESS WHEN PHONING. I MECHANICAL -SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX t PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. a - -.PPLI"NTS POSTING COPY _ I