15824 i
POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
'CITY. OF CUPERTINO 15824
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
JOB ADDRESS II S .�I6 Ce 2101;5— S��cI�U C_f UNIT# _LOT# CZ/3'
/—mI Q U _ PERMIT EXPIRES IF WORK I
OWNER v f� I CONTRACTOR '.0 G O,U IS NOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSPECTIO RECORD I 'teo Dgvs of PERMIT lssu
ANCE OR 180 DAYS FROM
FOUNDATION ' ./•e NOTE: LASTCALLED INSPECTION.
UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNI TE TO COMPLY WITH THE APPROVED PLANS AND CITU OF Penn+n VALIDATION
CUPERTINO STANDARDS.
,GARAGESLABS. -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDPk
+
UNDERGROUND /SLAB Vr C=.Q- p'� V� S �•_ '-,. -(.,_„ "`''-"
PLUMBING
ELECTRICAL - ISSVJANCE DATE
MECHANICAL - SLOG ELERl CT. PLC. M�ECH
2 / 8b'
00 NOT PO FLOOR UNTIL,ABOVE HAS BEEN SIGNED BUILDING PERMIT
pR�D INFORMATION
WOOD FLOOR $ vALUaTION $,/FT.
PLUMBING
MECHANICAL O � IRS, 65
ELECTRICAL - PER
FRAMING ``�� Ot CUP ItIOD
STOR R.
INSULATION TYPE CONST
OC GROUP NITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS.BEEN SIGNED
• ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so F oB anca TOT _ acReaeE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2917
BUILDING USE
ROOF SHEATHING `qq - ries IND CON PB DO,—
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑
ROUGH SAN.N ASSESSORS PARCEL NO
PLUMBING Tolp out '7.-� ELECT.ENERGY RA 'f ' ,0�I N
TRACT NO. PARCEL NO
TUBS&SHOWER_ PAN PLUMBING ENERGY '
MECHANICAL 443 MECH.ENERGY 81198
ELECTRICAL BUILDING ENERGY ACC GATE ACC FILE No
,FRAMING - ELECT.FINAL TEST
ZONING ENG.SITE NO.
INSULATION ! PLUMBING - -
GAS TEST —Z — GAS
FIRE SPRINK ENERGY'T.24
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y E] NE]
EXTERIOR SHEAR _A5 - V ELECTRICAL RELEASE FLooO zorvE a.L U.c.
INTERIOR SHEAR "t„•U_Tn, FIRE DEPT. - 'Y❑ N❑. Y ❑ N❑!
� — '1 GRADE, FEE SUMMARY
SHEETROCK
EXTERIOR LATH _ BUILDING
INTERIOR LATH - TEMPORARY APPROVALS - 940.59
FSE
DING
SCRATCH COAiF —I'2, ELECTRIC - CHECK
13.02
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY MIC FE
OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. OFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, CTRIC
LLJ
F� ONE WORKING DAY-BEFORE REQUIRED INSPECTION. PLUMBING
0 PLEASE GIVE JOB ADDRESS WHEN PHONING. 70-35
ZMECHANICAL
� — SEE PERMIT FOR EXPIRATION DATE — . .
'.IMPORTANT! coNST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
BUILJDING INSPECTOR'S OFFICE `°os'r°°Cop "
CITY OF CUPERTINO
❑ Backflow Device Sonitary Permit
1.(..-' - ❑ Sewer Connection a Plumbing Permit No. ---- �J
\sf.Plumbing Final Lot No.
I
;a Owner or Tenant
At 1159 4,; F2
Tract
I
Date Connected 19—Dote Final _19
I
1
�
PL�sJJ{
f UMBING INSPECTOR J
� ' d9
I
PG BE
CITY OF CUPERTINO COPY
GAS SERVICE NOTICE
To . <
You are hereby authorized to connect the GAS
service for
r4 Owner or Tenant
A t I S S
I ' NewService
No. of Meters Reconnect
No. of Add. Meters Move Service
/ \Move Meter
PLUMBING INSPECTOR
ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE
CITY OF CUPERTINO
To
You are hereby authorized to Connect electri(c�n{service for
Owner or TenantAt
T
J
No.of Wires Size of Wires
Size of Switch
Motor Load Voltage Phase 3
Heating Load K.W. Voltage
SFDy
I I (
No.of Meters Light 110_New Service Reconnect
ll(1
Heot 120_Three Wire More Service
No.of Add.Meters Power Three Phase Move Meter
�� ELECTRICAL INSPECTOR r
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY.
BUILDING PROJECT IDENTIFICATION
PERMIT NUMBER
LDING ' APPLICATION'& PERMIT
AOOREss Lot �� 213 Plan 3A BUILDING-'ELECTRICAL-PLUMBING-MECHANICAL -
115824
1596 Cedar Spring Court
OWNER'S qq ❑ $ - PLAN CHECK VALIDATION'
NAAhmansofloCYvG 11 l'SI5�5-Z1o�• OTY,• (ELECTRIC PERMIT "FEE
4 PHONE.
CONTRACTOR
NAME 019TLET,S-SWITCHES-RECEP ,.10.00/1.00
Gregory Group, Inc. L,6 §,-43009T LIGHTING FIXTURES 10.00/1.00
roGrvQT�R{ACTOR'S 220 C, TWin 0 in r. PPLIANCES-RESIDENTIAL 4.00 -
AI�W 94065 ,JAP9572100 PANELS 10.00 ' DATE OF APPLICATION t�
ARCHITECT PLAN CHECK FEE C:NO.
OR Aram Bassenian, A Assoc. PANELS (OVER 200 AMP) 20.00
ENGINEER ,C.NX-8395 SIGNS TRANS. 3.00
ARCH.OR ENG. 2031 - ,PERMIT VALIDATION
ADD ss rC ar, r. SPECIALCIRCUIT a. 5.00
Nanta. Ana Hts,: CA. 92707
ZIP EMP.METER OR POLE INS. 20.00
aFFucarvrs - - MOTORS SEE FEE SCH. '
A°pREaa220-C Twin. Dolphin hin DR.RWC9406 - -
- � p SERVICE CHANGE 20.00
-,o2 LICENSED.CONTRACTORS DECLARATION -
< D 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
L., (commencing with Section 7000)of Division 3 of the Business and
G ¢n BLDG. ELECT, I PLG. MECH.
H 7 z Professions Code,and H license is in full force a e fd�`}r
i w D Licensa Class N Lic:Number / -
F ,A r E Date - Contractor
a m E , ' BUILDING PERMIT
¢,o6 a, OWNER-BUILDER DECLARATION INFORMATION
X 3:u m 1 hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD
u O¢ Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT.
H - - PERMIT ISSUANCE ' 10.00 '
Code:Any city or county which requiresa permit to construct,alter,
2 wELEC.CONTR. LIC.NO. 1$x,865
¢ a Q improve,demolish,or repair any structure;prior to its issuance,also ELEC. f$1.0. -
i D, requires the applicant for such permit to file a signed statement that _ 1O_ PERMIT TO
,
x$w he is licensed pursuant to the provisions of the Contractor's License
Wiz¢ Law(Chapter9(commencing with Section 7000)of Division 3 of the p}rr Qrt)R�`FD�I-
E E D Business and ProfessionsCode)or that he is exempt therefrom and OTY. . , PLUMBING PERMIT til ®1 UP
= r C, the basis for the alleged exemption.Any violation bfSection 7031.5 STORIES TYPE CONSTR.-
La ;m by any applicant for a permit subjects the applicant to civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00
of not more than five hundred dollars($500).): 2 5NHR '
❑ I,as owner of the property,or my employees with wages as BACKFLOW PROTECT. DEVICE - ' 4.00 DCC.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 DRAINS-FLOOR,'ROOF,AREA,COND. '5.00
Code:The Contractor's License Law does not apply to an owner of R-3 +
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5,00 Sa FT.FLOOR AREA TOTAL ACREAGE'
himself or through his own employees,provided that such improve-
ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11 INC.4 OUTLETS. 6,00 2917
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4.IEA.) -; 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 - 3000 p(-y
❑•I,as owner of the property,am exclusively contractng . .
ng with (�' ❑ ' ❑ , ❑ ❑
licensed contractors to construct the project(Sec. 7044,BusinessLAWN 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 property who builds or improves thereon,and who LAWN SPRINKLERS r OVER 5(EA.) 1.00 �D
contracts for such projects with a contracoms)licensed pursuant to - -
theContractor'sLicenseLaw. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT.NO: PARCEL NO.
❑ I am exempt under Sec. ,B.&P.C.for`this , WATER HEATER W/VENT 6.00 BQ96
reason
Owner - Date -_ WATER SYSTEM 5.00
ACC.DATE . ACG FILE NO.
WORKE-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 ,
1 hereby affirm that'I have acertificare ofconsent toself-insure, ZONING ENG.SITENO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(See.3900,Lab.0 United PacifiC,
Policy No. Company - - -
Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z 2 @ Certified copy is fled with the"city inspection division. MISC.- REFER TO ORD.
O' AQAlicunt Y ❑ , N❑ i YO, N❑
~ + PERMIT ISSUANCE 10,00 CERTIFICATE EXEMPTION FROM WORKERS' FLDOD ZONE a.L.U.C.
Lu
W > COMPENSATION INSURANCE PLG.CONTR. LIC.N0. - PLG. '
CL Q (This section need not be completed if the permit is for one TOTAL- Y❑ NO 'Y El IN
hundred dollars($100)or ux,.)
U O I certify that imthe perfair ance of the work for which this pen CITY. MECHANICAL PERMIT FEE FEE SUMMARY
U. F mit is issued,I shall not employ any person in any manner so as to
O W become subject to the Workers'Compensation Laws of California.
Date Applicant BUILDING 940.50-
a ALTER OR ADD TO MECH. ' 5.00
} N NOTICE TO APPLICANT: If,after making this Workers'
Certificate Compensation
Ex-
? emotion,you sheLbecame sobject to the Workers Compensation gppLIANCE 5.00 PLAN CHECK
provisions io the Labor Code, you must forthwith comply with FEE
U such provisions Or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000GF.M.) .4.00 /energy
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.)-6.00 SEISMIC FEE' 13.02
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(W ITH;DUCT) - 5.00
the performance of the work for which this permit is issued(Sec. - MICROFILM
3097,Civ.C.). QreCUr ity P F HEATING UNIT IT0100,000 B.T.U.) 8.00 -
Lender's Name + � C
Lender's Addre � eI Tr - -1'T • H,EATING.UNIT(OVER 100,000B.T.U.)9.50 ELECTRIC 70.35
I certify that 1 have read t is application and store that the above -VENTILATION FAN (SINGLE) 4.00
information is correct.1 agree to comply with all city and county - PLUMBING 70.35
ordinances and state laws relating to building construction, and BOILER-CDMp(3 H.P.Or 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP tosser 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes. 70.35
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. -
upertino against liabilities,judgments, costs and expenses which - - 10,00CON T.TAX 3
may in any way accrue against said City in consequence of the PERMIT ISSUANCE- . . O
ranting of this pe it MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL
Signature o (cant/Contractor Dale
OFFICE COPY. � 9✓�