15857 (2) POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO 15857
INSPECTION DIVISION
JOB INSPECTION RECORD
++� /J-� PERMIT EXPIRATION
JOB ADDRESS ``7 yl.--��`epA �1 UNIT# _LOT# PERMIT EXPIRES IF WORK
OWNER [ �QC'X-I CONTRACTOR (;�Q_0CjCXe_T IS NOT STARTED WITHIN
INSPECTION 6ATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU
FOUNDATION -$' NOTE: ANCE OR 180 DAYS FROM
.�-E�
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF 4� PERnvT VALUAnoN
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED '
UNDERGROUND /SLAB
PLUMBING I rr
ELECTRICALA
AQ ISSUANCE DATE
MECHANICAL - BLDG FLECr I PLG, MECH
DO NOT POUR FLOOR NTIL ABOVE HAS BEEN SIGNED - �f BUILDING PERMIT
00 NOT PeUR
WOOD FLOOR Cary INFORMATION
PLUMBING VALUATION $/FT.
MECHANICAL
ELECTRICAL PEHN1IT To
FRAMING .I
INSULATION STOW TYPE CONSTR
UCC GROUP PENT TS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED q.
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO I.00RAULA TOTALACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
ROOF SHEATHINGBUILDING USE
RES IND CON PB O'l-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 5d ❑ ❑ ❑ ❑
ASSESSORS PARCEL NO
' -
PLUMBING RCUGH SAN.N-�- ELECT.ENERGY
TUBS 8 SHOWER PAN - PLUMBING ENERGY TRACT NO PARCEL NO
MECHANICAL 3 MECH.ENERGY
ELECTRICAL <Z-,- � BUILDING ENERGY ACC DATE ACC FILE NO
FRAMING —'j_ ,,C ELECT.FINAL TEST
INSULATION _ PLUMBING 7vzomwc ENc.sire No,
GAS TEST (, IUD GAS U
MECHANICAL FIRESPRINK ENERGl T 7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v ❑ N❑ ° ❑ N❑
EXTERIOR SHEAR 1- Lt_-fa ELECTRICAL RELEASE FLOODZONE A UC.
INTERIOR SHEAR FIRE DEPT. `"❑ N❑ ❑ NO
SHEETROCK ' GRADE FEE SUMMARY
EXTERIOR LATH BUILDING — Z
INTERIOR LATH TEMPORARY APPROVALS BUILDING
SCRATCH COATfn
ELECTRIC PLAN CHECK
GASFE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC�FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDMG FINALISSIGNED BY BUILDING INSPECTOR.
0.73
MICROFILM ,
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
ONE WORKING DAY.BEFORE REQUIRED INSPECTION. PLUMBING
H�
ZO PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE + '
CALLING FOR FINAL INSPECTION. TOTAL
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER.
BUILmocAPPLICATION & PERMIT 15857
ADDRESS
3111J�� 51 Sierra Spring Court BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
NAMe a Gregory Group, Inc. & PLAN CHECK VALIDATION
. Ahmanson Development PHONE 415/595-21 OTY ELECTRIC PERMIT FEE
CONTRACTORS
NGreME UTLETS-SWITCHES-RECEP 10.00/1.00
gory Group, Inc. uC.NO. B 43009] LIGHTING FIXTURES 10.00/1.00
CONTRACTORS 220-C Twin Dolphin Dr. APPLIANCES-RESIDENTIAL 4.00
4OWSSfT1AKIINC 5
rU�Y•M1LPHONE 415/595-21 PANELS 10.00 DATE OF APPLICATION -
ARRCHITECTArarn bassenian, AIA & PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER Associates DO NO, C-8395 SIGNS TRANS. 3.00
ARCH.OR
(�(�
ADDRESS ENG. .t 1W SPECIALCIRCUIT 5,00 PERMIT VALIDATION
Santa Ala Hts• Ca zip 92707 TEMP.METER OR POLE INS. 20.00
APPLICANT MOTORS SEE FEE SCH.
A
� R Twin Dolphin Dr. RK 94065 SERVICE CHANGE 20.00
0 0 o LICENSED CONTRACTORS OECLARAT ION -
a i w 1 hereby affirm that 1 am licensed under prwieions of Chapter 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
H w i Professions Code. my my license is in full force afl�hr 7 KX
Iso w- License Cl: q Lie.Number YJIAL'7/ 1y1 fJl
r t-D Dna�4+-'-l-.1�-- Contractor Ifs- WI
Q y E Ja 1
a OWNER-BUILDER DECLARATION BUILDING PERMIT
a D w o MISC.- REFER T ORD INFORMATION
X g -y I hereby affirm that I um exempt from tire Contractor's Liccmc
H u. oj Law for the followingreason.(Sec.7031.5,Business and Professions pERM1T ISSUANCE p VALUATION $/FT.
vo Code:Any city Or county which requiresa permit reconstruct,alter. 1001Qf ((��
QQ ¢Q improve,demolish,or repair any structure,prior lu its issuance,also ELEC.CONTE. LIQ NO. ELEC. ' 138)•ppM,
n w
- e¢ requires the applicant for such permit to file a signed statement that TOTAL es y he is licensed pursuant to the provisions of the Contractor's License PERMIT TO
z a Law.(Chapter 9(commencing with Section 7000)of Division 3 of the
4 o Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE
H$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
i 3 - by any applicant for u permit subjects the applicant too civil penalty
of not more than five hundred dollars($500).1: ALTER-DRAIN& VENT-WATER (EA.) 5.00 2 5W
O I,as owner of the property,or my employees with wages as BACKFLOW PROTECT. DEVICE 4.00 oCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sale (Sec 7044, Business and Professions m an owner of R-3 DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 O 1
Code:The Contractor's License Law does not apply
property Whe halll,Or immmel IhCROn,amd who dues nch werk F IXTUR ES-PER TRAP 5.00 SQ FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mentsare hot intended or offered for sale If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 2,161
or improvement is sold within one year of completion,the owner- GAS-.EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden of proving that he did not build or NO. BUILDING USE
prove 1,as owner
of sale.(. INDUSTRIAL WASTE INTER. 30.00 RES I❑ ❑N ❑ Other❑
❑ L as owner Of the property,he exclusively contractive with
licensed contractors to construct the project La dtoes,Rosiness LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and nProfessions C,.Pe The solo,omructnr's oup,oc Law docs nut dpply /
to anctsfo ofhprojeyswiha contds nmpnwecensedomsamn and to LAWN SPRINKLERS-OVER5(EA,) 1.00
0.00 �b- O_J J_9
comitans for such projects with a contractor(s)licensed pursuant to [v �!! JJrP-ARL.
7�� �V
the Cmumen-'s License Law. SEWER-SANITAR V-STORM EA.200ft/10.00 TRACT NO. EL NO.
❑ I am exempt undo Sec. ,B.&P.C.for ells WATER HEATER W/VENT 6.00 ()9k'(0
on
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have u certificate of consent to self-insure,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lah.C.). Lhited Pacific
Policy No.-Company-
0
o. CompanyO ❑ Cemf• Opy is her by furnished. FIRE$PRINK ENERGY T.Z4
Z Z < Certi c ep j� I•J with the city inspcaian division.
F O nbplicum ✓�L. MISC.- REFER TO ORD. YE) N Y [D NE]
CERTIFICATE Olr EXEMPTION FROM WORKERSPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
Lu > COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG.
4' 0 (This section need not be completed if the permit is for one TOTAL Y[ NF] Y rye
=T Z hundred dollars(S 100)or less.)
U O 1 certily that in the performance of the work for which this per OTV MECHANICAL PERMIT FEE FEE SUMMARY
LL F mil is issued, I site]]not employ any person in any manner so as to
O w become subject to the Workers Compensation Laws of California.
} Dae Applicant BUILDINGtL NOTICE ALTER OR ADD TO MECH. 5.00 $776 DDw x
♦- Z vmption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of tiro Labor Code, you must lorlhwi0l comply will SCIrn
U such provisions or this permit shill be deemed revoked. AIR HANDLING UNIT(TO 10=1C.F.M.) 4.00 FEE Erle
CONSTRUCT ION L17NDING AG17NCY AIR HANDLING UNIT(OVER I4WOC.F.M.) 6.00 SEISMIC FEE
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the parfonnan, f the work for wpich this permit iv issued(Sec. MICROFILM
3097,Civ.C.l. fie_ urlty Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name -�, �y� �7�-z�� HEATING UNIT(0 V ER 100,000 B.T. .)9.50 �CC
Lender's Address��I-a1r--0ul_I- a*R1� ELECTRIC •P✓f 50
1 certify that I have read Dl is application and state that the above VENTILATION FAN ISINGLE) 4,00
information is correct. I agree to comply with all city and county PLUMBING $5
ordinances and state laws relating to building construction, and BOILER-COMPI3H.P.or100,000B.T.U.) 6.00 $65.50
hereby authoriec representatives of this city to enter upon the
above-mentioned property for inspection ur Ises. BOILER-COMP(Over 100,000 BTUI SEE FEE SCH. Qz❑.Cry
p I Y pe e P• MECHANICAL J�J .50
(We) agree to save, indemnify end keep harmless the City of MISC.- REFER TO ORD.
upertina against liabilities,judgments, costs and expenses which CONST.TAX �-y�
ay in any way accrue against said City in consequence of rite PERMIT ISSUANCE H. $297.03
anl� got this tell. MECH.CONT, LIC.NO. MECH.
TOTAL TOTAL
SIg {re of Applical t/Contac for ate-'-'�- $1326.76
OFFICE COPY