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13802 POST THIS CARD NEAR FRONT OF BUILDING RMITNDM9EH CITY OF CUPERTINO P \,i INSPECTION DIVISION 13802 JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS /13wU'�T�' '�'"��' C UNIT# LOT# PERMIT EXPIRES IF WORK OWNER c/ /NG ,CONTRACTOR IS NOT STARTED WITHIN INSPECTION - ATE INSPECTOR INSPECTION RECORD 18BDAYS OFPERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION LASTCALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PAW UNDERGROUND /SLAB EC2 3 � PLUMBING j ELECTRICAL ATE PLG. MECH. MECHANICAL � � 00 NOT POUR FLOOR UNTIL ABOVE HAS PEEN SIGNED BUILDING PERMIT INFORMATION., WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL r PERMIT TO ELECTRICAL FRAMING INSULATION - sTGRIEs TYPETcorvs4R. OCC.GHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SQ FT,FLOOR AREA TOTAL ACREAGE ROOF DMPHRAGM ^Z BUILDING USE RLS IND CON PB O,nnr APPLY NO ROOFING UNTIUAB'OVE HAS BEEN SIGNED ASSESSORS PARCEL NO. ROUGH s: PLUMBING TRACT NO. PARCEL N0. GAS TEST MECHANICAL ELECTRICAL FINALS DATE INSP. ACC.DATE ACC.FILE NO, FRAMING -1.q-88 SAN # A.d- ^ ZONING ENG,SITE N0, INSULATION PLUMBING Ip-,. iS GAS OWk FIRE SPRINK ENERGY T-N MECHANICAL. YE] N[ Y ❑ N[] COVER NO WORK UNTIL ABOVE'HAS BEEN SIONEor , HEATING p (ago?LATH—INTERIOR ELECTRICAL FLOODZONE , A.L.u.c. LATH—EXTERIOR FIRE DEPT. v�' N� Y I] NQ SHEETROCK GRADE - FEE SUMMARY SHEAR INTERIOR -Z. — BUILDING - SHEAR EXTERIOR -Z - 9 TEMPORARY APPROVALS BUILDING , FIREWALLS ELECTRIC PLAN CHECK . r .iZ GAS FEE � NO TAPE OR PLASTER UNTIL ABOVE HAS BEM SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDINGFINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM I ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC i J LU ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — CONST.TAX �- IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL r. CALLING FOR FINAL INSPECTION. OFFICE COPY, _ _ - ! APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE PALL POINT PEN ONLY 'f y. BUILDING PROJECT IDENTI IS!CATION PERMIT NUMBER BUILDING h- APPLICATION & PERMIT 13802 ADDRESS. 11513 Country Spring Court l BUILDING=ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE ne ONEnn NAME coR's UTLETS-SWITCHES.RECEP 10.00/1.00 NAME uc.rvo. LIGHTING FIXTURES 10.00/1.00 ro ' oR's nDll PPLIANCES-RESIDENTIAL 4.00 ADDRESS 220 Twi n Dol phi n Dr. , Pradwirind City, CA PHON I PANELS loo0n DATE OF APPLICATION ARCHITECT OR Aram Bassenian, A.I .A. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.NO J� % SIGNS TRANS. 3.00 ARCH.OR ENG.-��D_Lles tarty Pl , 1f1/D SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS Ills�y y---)v'�r Yi al EMP.METER OR POLE INS. 20.00 AlA r nen MOTORS SEE FEE SCH. ADDRESS 220 Twin Dolphin Dr. , vN w wM / � Redwood • % SERVICE CHANGE 20.00 �01 woo 1 LICENSED CONTRACTORS DECLARATION 7 me W U I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE a w (commencing with Section 7000)of Division 3 of the Business and PLG. I MECH. F H z Professions Code and my license is in full for�p,�p��;f[�c{ Z0 0 s4 License Class_B Lic.Number�.SLL`JJ LZ7� LLY� Q se F w Date Contractor. a Y2 u BUILDING PERMIT Ii w u OWNER-BUILDER DECLARATION INFORMATION X ;a. I hereby affirm that I am exempt from the Co tractor's�A ansa MISC.- REFER TO ORD � .. 0 J Law for the following reason.(Sec.7031.5,Businefsand ProRssi°ns PERMIT ISSUANCE 10.00 vAl-unnoN S/Fi. Wva Cade:Any city orcounty whichrequiresa permit to construct,alter, / 7 t"ea <O Improve,demolish,or repair any structure,prior to its issuance,also ELEO.CONTR. LIC.NO. ELEC. DDo, requires the applicant for such permit to file a signed statement that TOTAL I PERMIT TO ab w9 m he is licensed pursuant to the provisions of the Contractors License c�� w/ Fi > Law(Chapter 9(commencing with Section 7000)o(Division 3 ofthe I C.J i o Business and Professions Code)or that he is exempt therefrom and OTY. 1. PLUMBING PERMIT FEE the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN III VENT-WATER (EA.) 5.00 2-- of not more than five hundred dollars($500).): - ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure Is not zz�� intended or offered for sale(Sec. 7044, Business and Professions I DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of Is who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 $Q FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improvm rents are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-l1NC.40UTLETS 6.00 U'D or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA. 2.00 auILDING USE builder will have the burden of proving that he did not build or am- pEa ,IN ON PB DO , prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 r/V�(I ❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business LAWN SPR INKLERS-1 INC 5 V.B. 6.00 00 /ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply 3�( b 9-3; 3 7-,.�3 to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.1 1.00 contracts for such projects with a contractor(s)licensed pursuant to I SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ I am exempt under Sec..,B&P.C.for this WATER HEATER W/VENT 6.00 reason i Owner Dale I WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm 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 lhereof(Sec.3800,Lab.C) Policy No. Company�ln-1_ted-P-W-RP-l1.a-n O ❑ Certifiedcop meby fu " d. FIRE SPRINK ENERGY T-24 Z Z )LIC Cert fad s 0 the cit 'nspection division. MISC- REFER TO ORD. CC y� N� y � NNC]APVlicant 10. CCH CIiRTIF E OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 00 1� FLOOD=ZONE L.U.C. Lu 7 COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLGTOTAL /13 00 Y N❑ V N� CL a (This section need not be completed if the permit is for one D Z hundred dollars(5100)or less.) L) O 1 certify that in the performance of the work for which this per QTY. MECHANICAL PERMIT FEE FEE SUMMARY LLmit is issued,I shall not employ any person in any manner so as to OW become subject to the Workeli Compensation Laws of California. BUILDING x�� Date Applicant ALTER OR ADD TO MECH. 5.00 >_ tan NOTICE TO APPLICANT: If,after making this Certificate of Ex- F.. ? emplion,you should become subject to the Workers'Compensation L4 APPLIANCE 5.00 a PLAN CHECK 3(- F3 provisions of the Labor Code, you must forthwith comply with FEE Q U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER I0,0MC-F.M.) 6.00 SEISMIC FEE 0C2 I hereby affirm that there is a construction lending agency for I EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00 A- Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC r7/ Lender's Address nC-1.$L 'r 1 certify that I have read this application and state that the above l VENTILATION FAN (SINGLE) 4.00 / information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.1 6.00 PLUMBING 3- ordinances and state laws relating to building construction, and x hereby authorize representatives of this City to enter upon the BOILER-COMP IOver 100000 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. Cupertino against liabilities,judgments, costs and expenses whichCONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 0 granting aft I MECH.CONT. LIC.NO. MECH.- TOTAL C L TOTAL 53-4--30 SBmatu ¢ 1/contractor v5tc OFFICE COPY -ice._. f--- ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE r CITY OF CUPERTINO v To �� ? 19 i3 0 ^ R You ore hereby authorized to Connect electrical service for TOw9er or tenant y •i. tAt7' "No. "No.of Wires Size or Wires Size of Switch Motor Load Voltage. Phase Hearing Load K W VoltageNo.of Meters L'9ht I10-New Service \7S� Reconnect He.,_,20 1 -Three wire More Service No.of Add.Meters Power Three Phase Move Merer �• ELECTRICAL INSPECTOR I CITY OF CUPERTINO OFFICE COPY GAS SERVICE NOTICE lS1f)t ty ; IIT i9I`�:R To You are hereby authorized to Connect the GAS service for Owner or Tenant rl`A! nA.0 - At ISI �I a � A10 , .0 � . 1 V New Service ✓i LSV I No. of Meters Reconnect No. of Add. Meters Move Service Move Meter PLUME INSPECTOR J "yT