The URL can be used to link to this page

13799 POST THIS CARD NEAR FRONT OF, B ,ILDING . .PERMIT NUMBER r Y CITY OF .CUPERTINb " 13799 INSPECTION DIVISION . JOB INSPECTION RECORD 1 -��p _ 'PERMIT EXPIRATION JOB'ADDRESS. `��Z `-"u� 4.��} ��"'I�� UNIT# LOT# _ PERMIT EXPIRES IF WORK OWNER 6.�102`� lS�LL y CONTRACTOR ' IS NOT STARTED WITHIN INSPECTION OATE 180 DAYS.OF PERMIT ISSU- INSPECTOR INSPECTION RECORD gNCE OR 180 DAYS FROM FOUNDATION 6- LASTCALLED INSPECTION'. LIFER a-(6 PERMIT'VALIOATA N, PREGUNITE _ tt POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED • \ Wim . UNDERGROUND /SLAB PAID PLUMBING �y ' ELECTRICAL - miw = NIECE. MECHANICAL - ❑1 00 NOT POURFLOOR UNTIL'ABOVE HAS BEEN SIGNED BUILDING PERM.IT - INFORMATION WOOD FLOOR - '• VALUATION $IRT. 'PLUMBING - - ' . P. MECHANICAL y PERMIT TO .ELECTRICAL FRAMING ' STORIES TYPE CONSTR. INSULATION ' (�•� - OCCGROUP RES.UNITS ' / ✓ PLACE NO SUBFL 0 UNTILA E"HAS BEEN SIGNED p,FT,FLOOR AREA "TOTAL ACREAGE ROOF DIAPHRAGM ' BUILOINc usE RES IND "CON PB Other APPLY NO ROOFING UNTIL ABOVE HAS BMN SIGNED ❑` ❑ ❑ Q ' ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING , i - , TRACT NO. PARCEL NO. ' GAS TEST yO y MECHANICAL 8.S-p - ELECTRICAL ^ FINALS 4DATEAINSP. FILE No. FRAMING SAN # �ZZZONING ENG.SITE ND. I SULATION� �/p- PLUMBINGKGAS MECHANICALFIRE SPRINK ENERGY T 2A COVER NO WORK UNTIL ABOVE HAS BEEWS10NED,, HEATING ❑ "❑ ° ❑ "❑FLOOD 201E A.L.0 CLATH-INTERIOR ELECTRICAL � N YE] NE] DEPT. . ATH-EXTERIOR L �' D SHEETROEK IV#40 IGRADE - FEE SUMMARY SHEAR INTERIORBUILDING Q - SHEAR EXTERIOR ff7-S�r TEMPORARY APPROVALS BUILDwc ,� FIREWALLS - ELECTRIC I I ' PLAN CHECK L G _ FEE AS �- NO.TAPE OF FEASTER UNTIL ABOVE HAS BEE19SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ELECTRIC /�, 'f .) ARRANGE FOR INSPECTION BY PHONING 252-4505; LU ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING o PLEASE GIVE JOB ADDRESS WHEN,PHONING. ' •. Z - MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - ' IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LI USE BALL POINT PEN ONLY }V . � PERMIT NUMBER `-BULCDI NG PROJECT I DENTI FICATI ON r BUILDI APPLIC�,`�� }& PERMIT 1 AODREN 11532 Country Spring Court 13799 (Lot 97 - BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME QTY. ELECT PERMIT FEE Gre or Grose Inc. PNONE 595-2100 CONTRACTORS NAME UTLETS-SWITCHES-RECEP 10.00/1.00 1 �. Gregory Group, Inc. LIC.N0.430097 LIGHTING FIXTURES 10.00/1.00 ,9 CONTRACTOR's 220 Twin Dolphin Dr-.IICD [APPLIANCES-RESIDENTIAL - 4.00 a„ ADDRESS Redwood City, CA PHONE 595-2100 IPANELS 10.00 DATE OF APPLICATION ARCHITECT Aram Bassenian, A.I .A. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE C,NO, OR ENGINEER 81 Associatessec.No. SIGNS TRANS. 3.00 ARCH.ORENG3990 Westerly Pl•. , #170 SPECIALCIRCUIT 5,00 PERMIT VALIDATION ADDRESS nP EMP.METER OR POLE INS. 20.00 APPUCAT•s 220 Twin Dolphin Dr. , nCR MOTORS SEE FEE SCH. A 'cR Redwood City, CA 94065 SERVICE.CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION aO ¢ u.0 1 hereby affirm that 1 am licensed under provisions of Chapter 9 ISS CE DATE 2 To (commencing with Section 7000)of Division 3 of the Business and BLppG PLG. MECH. 1- vii Professions Code,And my license is in full forpe,�pd,�[[ O 0 m G License Class-1$ Le.Number u t1111y� L,� Date Contractor 15 ¢ e W¢ OWNER.BUILDER DECLARATION FORMATION PERMIT MISC.- REFER TO ORD wg u w I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. r u O a Law for the following reason.(Sec.703 1.5,Business and Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to Construct,alter, / Q ¢ Q 20 improve,demolish,or repair any Structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. v Te G¢ requires the applicant for such permit to file a signed statement that TOTAL / PERMIT TO whe is licensed pursuant to the provisions of the Contractor's License T wz/ H 2 < Law(Chapter9(commencing with Section 7000)of Division 3 ofthe <GJ Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE K H o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. c ; m by any applicant for a permitsubjects the applicant ton civil penalty of not more than five hundred dollars($500).1: �C_.. ❑ I,as owner of the property,or my employees with wages ALTER-DRAIN& VENT-WATER IEA.) 5.00 as BACK FLOW PROTECT,DEVICE 4.00 occ.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not vs / intended or offered for sale (Sec. 7044, Business and Professions17-DRAINS-FLOOR,ROOF,AREA,COND. 5.00 /y` -3 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work r/j FIXTURES-PER TRAP 5,00 BO.FT.FLODR AREA TOTAL ACREAGE himself or through his awn employees,provided that such improve- ments are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner 1 GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- proveforpurposeofsale.). INDUSTRIAL WASTE INTER. 30.00 IRry,Eyys WD CON PB ower ❑ I,as owner of the property,am exclusively contracting with L'J_ ❑ ' ❑ ❑ ❑ licensed contractors to construct the project(Sea 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 _ ASSESSORS PARCEL NO. anProfessions Code:The Contractor's License Law does not apply 3 7 to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 6 9- 3 ; d contracts for such projects with a contractogs)licensed pursuant to SEWER-SAN ITARV-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ 1amexempt under Sea ,B.&P.C.for this WATER HEATER'W/VENT 6.00 ,7'99 S" reason Owner Date WATER SYSTEM 5.00 ACC.oATE ACC FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified Copy thereof(Sec.3800,Lab.C. ,, 'p Policy N.._ Company PPPacifi.clRe.1 Q ❑ Certified copy' re i furni,he � FIRE SPRINK ENERGY T 24 Z Z O Certifiedc w' c' Iynsyf.Itltf diJfshim MISC.- REFER TO ORD. Y❑• N E] Y ❑ N[]O Applicant - yPERMIT ISSUANCE 10.00 / FLOOD ZONE A.L.U.C. LU - CERTIFI OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE PLG.CONTR. - LIC.NO. PLG CL . Y❑ N[3 Y ❑ N❑ CL O (This Section need not be completed if the permit is for one TOTAL D2 hundred dollars($100)or less) �p U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued;I shall not employ any person in any manner so as to O old become subject to the Workers'Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING NOTICE TO APPLICANT`. If,after making this Certificate of Ex- F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 0 PLAN CHECK �S provisions of the Labor Code, you must forthwith comply with FEE 7A U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=1 .F.M.) 4.00 cp CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10000CF.M.) 6.00 SEISMIC FEE 1 hereby affirm,that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM ' 3097,Cte.C.), HEATING UNIT(TO 100,000 B.T.U.) 6.00 ress�.S-C� pr/ Lender's Name Security Pr7C1'F1G Lender's AddHEATING UNIT(OVER 100,000B.T.U.)9.50 ELECTRIC -- I certify that'I have read this application anti state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 6.00 hereby Sultana representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEESCH. MEC4XFA above-mentioned property for inspection purpows. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONmay in any way accrue against said City in consequence of thegranting of this erm't. MECH.CONT. LIC.NO. MECH. // TOTAL' ..� L3 Signature icanl/Contractor D to Y OFFICE COPY - '