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15826POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER _ CITY .OF CUPERTINO � 15826 INSPECTION DIVISION JOB INSPECTION RECORD ' PERMIT EXPIRATION JOB ADDRESS l � 1 kW G UNIT# ' _LOT#ao - PERMIT EXPIRES wWORK 1 2 U OWNER ,� - CONTRACTOR IS NOT STARTED WITHIN I 180 DAYS OF PERMIT ISSU- , ANCE OR 180 DAYS FROM INSPECT ON DATE I INSPECTOR INSPECTIO RECORD •1 FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF LAST CALLED INSPECTION. � UFER PERMIT VALIDATION PR EGUNITE CUPERTINO STANDARDS. _I f - y j'` r' e GARAGE'SLABS-•' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB _ - ~� PLUMBING C" - ELECTRICAL - ISSUANCE DATE MECHANICAL BLDG ® ELECT 4 PLG , MECHwon-me Q Q: m� �✓ Jta. DO NOT POOR FLOOR UNTIL ABOVE HAS BEEN SIGNEDBUILDING PERMIT INFORMATION WOOD FLOOR ' VALUATION SIFT. PERMIT TO SFDll ." PLUMBING ; �V MECHANICAL ELECTRICAL Pat, Of C'u FRAMING -, STORIES TYPECONIEA INSULATION 066 GHDUP - RES UNHTS , PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $°' Er . FLOOR AREA Torg ACREAGE ` ROOF NOTE; NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID 2917 • DIAPHRAGM BUILDING USE ROOF SHEATHING HES IND CON PB DO, 2 E -]El El11 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS INSP. ASSESSORS PARCEL NO ROUGH SAN.#PLUMBING yy - ✓ ELECT. ENERGY TUBS&SHOWER AN •- Q PLUMBING ENERGYTRACT No., 8098 PARCEL No MECHANICAL. �� I tDATE MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC. DATE -ACC, PILE No FRAMING �� , ELECT. FINAL TEST. 'INSULATION __ t PLUMBING zoMNc ENC. SITE No. GAS TEST GAS, ' - MECHANICAL FIRE SPRI IN N ENERGY ra a ' N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR. .Z ELECTRIC AL RELEASE FLOOD ZONE v NEIv ALU.C. N❑ - INTERIOR SHEAR .*L FIRE DEPT.'- SHEETROCK I GRADE - FEE SUMMARY EXTERIOR LATH — — L BUILDING' BUILDING PLAN CHECK FEE TWO SEISMIC F RY 940 60 J,5 30. INTERIOR LATH L TEMPORARY APPROVALS, SCRATCH COAT 05ELECTRIC - - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED, BY.BUILDINGINSPECTOR.MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 7n 'Oar PLUMBING ' H ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 �, PLEASE GIVE JOB ADDRESS WHEN PHONING. Z, - — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL CONST. Tqx IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL T" CALLING FOR FINAL INSPECTION. OFFICE COPY /s3 9ie= O Z Z P:O LU _ CL Uo U_ U Q W 6 ♦- z U APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION - ' & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PER MITNUMBERAPPLICATION 1 15826, ADORE'S Lot # 206 Plan 3C 11648 Birch Spring COUrt rosma- .BNAME Gregory Group, Inc. & hmanson Dev. 4118R 595-2100 . CITY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION GATE OF APPLICATION NAAMERACTDRs Gregory Group, Incl,G;ND. B-430097 UTLETS- SWITCHES -RECEP 10.00/1.00 . LIGHTING FIXTURES 10.00/1.00 CONTRACTOR ADTRACGRs 220-C Twin Dolph In Dr. ODRESS RWC 94065 415PZ9,5-2100 PPLIANCES- RESIDENTIAL .4.00 PANELS 10,00 ORCHITECT ram assenlan, sso ENGINEER LIC. NQC-8395 . pgNELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS.' 3.00 ARC R.DRENS 2031. Orchard Dr. //100 ADDRESS Santa Ana lits. CA. 92,707 sPECIALCIRcuIT 5.00 PERMIT VALIDATION •- ISSUANCE DATE TEMP. METER OR POLE INS. 20.00 APPLICANT'S ADDREss 220-C Twin Dolphin Dr.RWC MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 ;_ LICENSED CON TRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, Mill m license is in full forty ff License Class�Y LiaNumber- µ_8__£__ UaR� Conlmcfor OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law forthe following reason. (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to constneq 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 file Contractor's License Law (Chapter 9 f commencing with Section 7000) of Division 3 of f he Business and Professions Code) or that he is exempt therefrom and the basis for lite 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 (S500).): ❑ I, as owner at the property, or my employees with wages their sole compensation, ofione will do Oto work, and the structure is not Set Intended or offered for sale (Sec. 7044, Business and Professions Code: Code: The Contractor's License Law does not apply to an ..net of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mentsarenotintendedor offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or inn- prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, BusinessLAWN and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereom and who contracts for such Pl-,LLtx with a contractors) licensed pursuant to lite Contractors License Law. ❑ Iain exempt under Sea ,B.&RC.to,fiis reason BLDG. ELECT. PLG. MECH. F II,1LJ BUILDING PERMIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE 10.00 a,E y,�gTION tLf o ONTO 1 > 65 $/FT. ELEC. CONTR. LIC. NO. - ELEC. TOTAL Cupertino, SF D W L_ OTY. PLUMBING PERMIT - FEE ALTER-DRAIN&VENT-WATER E ( A.) 5.00 STORIES 2 TYPE CONSTR. SNHR BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP • R-3 RES. UNITS 1 ROOF, AREA,COND. 5.00 FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-I1NC.40UTLETS 6.002917 GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 s0. FT. FLOOR AREA TOTAL ACREAGE ' BUILDING USE RES IND CON. PB Omer 1 INDUSTRIAL WASTE INTER.' '30.00 SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 (EA.) - 1.00 SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO, 8098 PARCEL NO. WATER HEATER -6.00 Owner Dale WATER SYSTEM 5.00 WORKE.RS'COMPE,NSATION DECLARATION I hereby affirm that I have a -certificate of consent to sell_insure, or a certificate of Workers' Compensation Insuinnce, of a L,Ut ted copy thereof (Sac. 3800, Lab.C,. United Pacific Policy No. Company ❑ Certified copy is hereby furnished. XI Certified copy is ped with the city Inspection division. Applicant ACC.DATE ACC. FILE NO, WATER TREATING EQUIP. 5.00 -ZONING ENG. SITE NO. - MISC. - REFER TO ORD. FIRE SPRINK Y N ❑ ENERGY T-24 Y ❑ NE] CERTIFICATF OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not he complete,] if the permit Is for one hundred dollarsf$100) or less I certify that in fire performance of the work for which this per- mit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant PERMIT ISSUANCE 10.00 FLOODZONE V N A.L. u.c. V N PLO. CONTR. LIC. NO. PLG. TOTAL OTY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 940.50 ALTER OR ADD TO MECH: 5.00 NOTICE TO APPLICANT: If, after making this Certificate of Ex- emption, you should become subject to the Workers' Compensation prom visions of )tie Labor Code, you list forthwith comply with such provisions or this permit shall be deemed revoked CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097,r's No ). �e uritf Pac' 'c Lender's No Lender'sAdmess - I certify that l havcreadthisappllcofionand state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives h i of this purposes. s city to enter upon the above-mentioned property for insp of (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of )tie ranting of this it APPLIANCE 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10=r-F.M.) 4.00 AIR HANDLING UNIT (OVER 10=C.RM.) 6.00 SEISMIC FEE 13.02 EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT 100,000 B.T.U.) 8.00 HEATING UNITIOVER100,000B.T.U.)9.50 MICROFILM - ELECTRIC 70.35 VENTILATION FAN (SINGLE) 4.00 BOILER - COUP (3 H.P. or 100,000ELT.U.) 6.00 PLUMBING 7D.35 BOILER-COMP (Own 100,000 BTU) SEE FEE SCR. MECHANICAL MISC. - ;REFER TO ORD. PERMIT ISSUANCE 10.00 . CONSTTAXO� MECH. CONT. LIC. NO. MECH. TOTAL TOTAL Signature want/Contractor . -Date OFFICE COPY