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1583314 �r POST THIS CARD NEAR FRONT OF BUILOJNG PERMIT NUMBER CITY OF CUPERTINO 15833 INSPECTION DIVISION JOB INSPECTION RECORD ' JOB ADDRESS ,�� Q $11LW RD 0I nl cr G7U//N++IT,�,#�� _ LL++OT# PERMIT EXPIRATION, 1 PERMIT EXPIRES IF WORK 'G , OWNER SO- CONTRACTOR LS lccisv%Z LT/tO U' IS NOT STARTED WITHIN -' 180 DAYS OF PERMIT ISSU. . ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTI N RECOR FOUNDATION _NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED UFER �� PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. ' r 1 ISSUANCE DATE ' GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING - ELECTRICAL MECHANICAL RIOc ELECT PLG. MEER - 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED O 1nO I V 1 BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION 110 194 540 $IFT. PLUMBING% - - MECHANICAL. 1t OlDAPef ELECTRICAL PERfr1IT TO SFDU - ' FRAMING- INSULATION STORIES 2 TYPE CONSTR 5HNR OCC GROUP RES. UNITS R-3 1 , PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID s°. FT FLOORAREA roraL ACREAGE DIAPHRAGM - euIL CON use Res IrvO Pe bm— cory 0 D ❑' ❑ ❑ ROOF SHEATHING - APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.N ASSE55ORSPARCELNO - PLUMBING — EC ELECT. ENERGY TUBS 8 SHOWER PAN _ j_ Q PLUMBING ENERGY TRACT NO, PARCEL NO MECHANICAL MECH.ENERGY ELECTRICALBUILDING ENERGY. A Are ACC, FILE NO ' FRAMING. �( ELECT. FI NAL TEST INSULATION PLUMBING 'i—)� ZONING ENG. SITE NO GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T as Y ❑ N "Y ❑ N❑, COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE Y E] N ❑ A,L UC. ' Y L7 IND INTERIOR SHEAR FIRE DEPT. SHEETED GRADE - FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC FEEN CHECK GAS' SEI I NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OGGUPANCY OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR.MICROFIL PAS ' M ARRANGE FOR. INSPECTION BY PHONING 252-4505, ELECTRIC: "� ONE WORKING DAY BEFORE REQUIRED.INSPECTION. O� PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING -SEE PERMIT -FOR EXPIRATION DATE =. MECHANICAL CONS T.TAx r IMPORTANT! PLEASE'READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY T. ,. 0, O Z Z M.LO Ui > CL D z 00 LL U Ow F Z A IWJ APPLICANT TO FILL IN INFORMATION WITHIN RED LINE,- USE BALL POINT. PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION &'PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER„ i 15833 6DILDINGPlan 4A An11E608 Birch Spring Court yy OWNER'S Gregory Group Inc tl NAME Ahmanson Dev. . 4�,§rE595-2100 PTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION NAMQRACTORs Gregory Group, Inc LIC. NO. B-430097 UTLETS-SWITCHES -RECEP 10.00/1.00 ILIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S 220-C Twin Dol hln Dr. ADO&ESISC 94065 415;,510-2100 jH PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 ARC IITEECT OR Aram Bassenian, A A Asso ENGINEER -g95 ' uc, No, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH. OR 5N02031 Orchard Dr. 100 ADDSanta Ana Hts. CA. 92107 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION - TEMP. METER OR POLE INS. 20.00 APPLICANT'S ADDRESS 220-C Twin Dolphin Dr. RWC9 MOTORS SEE FEE SCH. WraE SERVICE CHANGE 20.00 AID�� LICENSED CONTRACTORS DECLARATION I hereby affirm ;bat I an licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of II1C Buslaeas and Professions Code, and ��[[IIy license is In full furca h let t. License Clays T[y_ Lie. Nam an 616. Dam 'Contractor ISSUANCE DATE t L G. ELECT. I PLG. MECH. City of Cupe OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the following reason.(Sec. 7031.5, Business and Professions Code: Any city or comity which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of Ilia e Contractor's License Law (Chapter 91 commencing with Section 7000) of Divkkm 3 of the Business and Professions Code) or that he is exempt therefrom and BUILDING PERMIT INFORMATION MISC.- REFER TO ORD VALUATION 194,540 S/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO ' SFD - OTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR, the basis for the alleged exemption. Any violation of -Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S5001.): 2 5NHR ALR N&VENT TER-DAI-WATER (EA.) 5.00 ❑ I, as owner of the property, car my employees with wages as their sole compensation, will do the work, and the structure is nor intended or offered for sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 OCG. GROUP R-3 RES. UNITS 1 DRAINS -FLOOR, ROOF, AR EA, COND. 5.00 bde: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mentsare not intended oroffBred for sale. If, however, the building FIXTURES - PER TRAP 5.00 So FT. FLOOR AREA 3047 TOTAL ACREAGE GAS- EA. SYSTEM• 11NC. 4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner builder will have the burden of proving that he did not build or im. prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE Res IND CON PB Om.r 9 ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business 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- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. C - contracts for such projects with a comractnr(s) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200tt/10.00 TRACT NO, PARCEL NO. ❑ lam exempt under Sec.-, B.&P.C. for this reason 8098 WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORKI:RS'COMPFNSAT10N DECLARATION WATER TREATING EQUIP. 5.00 I herebyaffirm that I have a certificate of consent to self -insure. or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy themof(See, 3800, Lab.C.). United Pacif1 C_ PolUy( No. Company ❑i Certified copy is hereby furnished. J, Certified copy is fled with One city inspection division. Applicant FIRESPRINK Y ❑ N ❑ ENERGY T-24 Y ❑ No MISC. - REFER TO ORD. CFR1'I FICATE 017 EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. PLG.CONTR. SSC. NO. PLG. TOTAL COMPISNSATION INSURANCE ('This section recd mol be completed if Ilia permit is for one Y ❑ N ❑ Y ❑ N ❑ hundred dollars IS 100) or less.) I certify that in One performance of the work for which this per, mit is issued, I shall not employ any person in any manner so as to OTY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 972.0 become subject to the Workers'Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. .5.00 NOTICE TO APPLICANT': it, after making this Certificate of Ex- emption, you should become subject to the Workers' Compensation provisions of the Labor Code, you most forthwith comply with such provisions or this permit shall he deemed revoked. APPLIANCE 5.00 PLAN CHECK FEE/energy 5.50 62-0 AIR HANDLING UNIT (TO 10=11F.M.) 4.00 AIR HANDLING UNIT (OVER 10=C.F.M.) 6.00 SEISMIC FEE 13.65 CONSTRUC'T'ION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of Ilia work for which this permit is issued (Sec. 3097, Civ.C.). Lender's Name Security Pacific Lender's AadrcTFm aYfl _radP,"O[_I-rT }QIjTj rte_ MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000B.T.U.)B.50 ELECTRIC ]3,1'3 I certify ictal l have read rI115 application JfItI ld(e l4a VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING 73.1 3 BOILER -COMP I3 H. P. Or 100,000 B.T.U.1 6.00 'BOILER -COMP (Over ,000 BTU) SEE FEE SCH. 100 MECHANICAL 73.13 hereby authorize representatives of this city In enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. (We) agree to save, indemnify and keep harmless the City of upertino against liabilities, judgments, costs and expenses which ay in any way accrue against mid City in consequence of the CONST. TAX p,. PERMIT ISSUANCE 10.00 mntjng of thi n MECH. CONT. LIC. NO. MECH. TOTAL TOTAL + Signature of plican t/Contractor Data OFFICE COPY