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13733
POST THIS CARD NEAR FRONT OF BUILDINpr CITY �' r.0 F CUPERTINO +� rcRr NUMBER 13733 JD�PECTION DIVISION INSPECTION RECORD 116- JOB ADD PERMIT EXPIRATION UNIT# LOT# OWNER PERMIT EXPIRES IF WORK , INSPECTI ^ CONTRACTOR IS NOT STARTED WITHIN FOUNDATION DATE I INSPECTOR I INSPECTION RECORD 180 DAYS OF PERMI715SU • _ � ANCE OR 180 DAYS FROM UFER I �7 .,y, LAST CALLED INSPECTION. PREGUNITE -7 A -%o o 13 Q �1L'�S .,�•� PERMIT VAL IDATIO N _ POUR NO CONCRETE UNT UNDERGR L ABOVE HAS BEEN SIGNED - p� PLUMBING,' )LIND /SLAB /�� ELECTRICAL MECHANICAL Q7- ANCE DATEY ELECT. I PLG. MECR. DO,�OT POUR FL00POUR FL00 - O, El VI UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION PLUMBING COD FLOOR VALUATION SIFT, MECHANICAL ELECTRICAL E TO - FRAMING _ INSULATION STORIES TYPE CONSTR. .7PLA 47 Aw OCC,GROUP RES.UNITS— ,CE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED T A DI t ROOF SO,FT,FLOOR AREA TOTACREAGE PHRAGM �qr (y� BUU_DING USE I - (N RES IND CON PB Ome, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ 0 ❑ ' ASSESSORS PARCEL NO. ROUGH PLUMBING a •� _ GAS TEST 7 TRACT NO, PARCELNO,- MECHANICAL ' ELECTRICAL FINALS DATE INSP. A C.'DATE ACC.FILE NO, FRAMING _ SAN # . ZONING ENG.SITE NO. INSU L'ATION � PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY T 24 • - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y NE] Y "E) LATH-INTERIOR tj O ELECTRICAL - FLOOD ZONE A.L.U.C. LATH-EXTERIOR (� FIRE DEPT. Y❑ "❑ Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC , PLAN CHECK • - •' GAS FEE .. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNEDaccuPANcv SEISMIC FE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY.PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE — MECHANICAL ' CONST.TAX • uu IMPORTANT! • PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. 434.07 '� OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY OFBUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 13 3 AODREss Lot //61 Plan 1p! � BUILDING - ELECTRICAL-PLUMBING-MECHANICAL ° N PLAN CHECK VALIDATION is 5 DTV. ELECTRIC PERMIT FEE GREGORY GROUP> INC< , ' _ NAME ° ! 86 UTLETS-SWITCHES-RECEP 10.00/1.00 86.0( ob NAME Same „@-430097 LIGHTING FIXTURES 10.00/1.00 44- ADDRESS°°FEES 220-C Twin Dolphin Dr. APPLIANCES-RESIDENTIAL 4.00 12 PHORE _ PANELS 10.00 DATE OF APPLICATION OR RWq°T CA 9406r; PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEERARAM BASSENIP,N> AIA & ASSOCS 1 L.C.NO. SIGNS TRANS. 3.00 AARCHDDREGO SSS ENG. eS` r ace PERMIT VALIDATION y SPECIAL CIRCUIT 5.00 Newport Bch CA 92§P0 TEMP.METER QR POLE INS. 2000. APPLICANTS 6 MOTORS SEE FEE SCH. 6.00 ADDRESS 220-C Twin Diol phin Dr. educ� ` SERVICE CHANGE 20.00 P_GN[�+ coo o LICENSED CONTRACT RS DECLARATION ai w I hereby affirm that I am liccnved under provisions of Chapter 9 - ° NCE DATE �a (commencing with Section 7000) ted Division 3 of the Business and I-. L T. PLG. MECH. r. Professions CWe,aM my license is In full fu c• ct ❑ ❑ oz License Class IS Lipp.Number H Date C!bmmctor 01 J OWNER-BUILIYER DECLA ION DING PERMIT aw g �° - INFORMATION wr I hereby affirm that 1 am c tempt from the Contractor's License MISC.- REFER TO ORD u0 `� Law for the followingreason.ft5ee.703L5,Business and Professions VALUATION S/FT. PERMIT ISSUANCE 10.00 Code:Any city or county wh�eh requires a permit to construct,alter, QQno,use, or repair Any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. 'ELEC. 97 000.0 a. u. reQJ'on,the applicant for swill permit to file a signed statement that TOTAL PERMIT TO n he is licensed pursuant to tFTe provisions of the Contractor's License �z a Law(Chapter 9(commenryrrl6with Section 7000)of Division 3 ofthe pm 0 Business and Profesaiom//CCode)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE 4'H r§ the basis for the alk{ed Exemption.Any violation of Section 703 LS STORIES TYPI:CONSTR. � by any applicant for a.permit subjects the Applicant to a civil penalty ALTER-DRAIN IEA.) 5.00 '� of not more than fuse hundred dollars(S500),: N.y ❑ a a ownKf at the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole cis/-tfipensa[ian,will do the work,and the structure is not , intendcdgr offered for sale (Sec. 7044, Business and Profmions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 �J Ccde:'IPe Contractor's License law docs not apply to an owner of O proper" y who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 55.0 Stl FT.FLOOR AREA TOTAL ACREAGE himxl or through his own employees,provided that such improve- ment are not intended or offered for sale.If,however,the building GAS-EA.SVSTEM-I 6.00 or' provement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 buf der will have the burden of proving that he did not build or im. BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RE NO CON PB oma. 0 1,as owner of the property.Ant exclusively contracting with ❑ ❑ � ❑ licensed contractors to construct the project(Sec. 7044,Business; LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:1'he Contractur'a License Law does not apply p to an owner of properly who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 38 - / _�/ 3a contracts for such projects with a contmctorls)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200h/10.00 TRACT NO. PARCEL NO. 0 I am exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason J_ Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby AHlrm that 1 have a certificate of consent to sell-insure. or a certificate of Workers'COTepernatiun Insurance,or a certified ZONING ENG.SITE NO. copy thaeof(Scc.3800,1ab.C.). ++ Policy No. CnmpunyUniyed-Pacfi-c 1,2 O 0 CciUried copy is hereby furnished. FIRE SPRINK ENERGY T 44 Z Z yY] Certified yV fi;l d,yl the city inspection division. IFC Jp3licanl-/_�(L_- _ MISC.- REFER TO ORD. 10.00 v� N� v � rv� CC T CERTH 00AAJTE OF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 1 FLOOD ZONE A.LU. LU > COMPFN'SATION INSURANCE: PLG.CONTE. LIC.NO. Y[:3N� Y F] No to 'd O T his section ed not be completed if the permit is for one TOTAL Z hundred dollars(S 100)or less.) U O 1 certify that in the performance of the work for which this For- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not unlploy any person in any manner s°as to Ow. become subject to the Workeni Compensation Laws of CAlifomiu. a Dam Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } y NOTICE TO APPLICANT: If•after making this CcrtiOcate of E424-00 F Z emption,you should become subject to the Workeri Compensation 4 APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply with en 275.60 U such provisions or this permit shall be deemed revoked. 'AIR HANDLING UNIT(TO 1Q000C.F.M.) 4.00 FEE / Kg Irt) nn CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10)000QF.K) 6.00 SEISMIC FEE 6.79 I hereby affirm that there is a construction lending agency.for 1 EXHAUST HOOD(WITH DUCT) 5.00 5.00 the performance �h gg !g)Dch,N�s permit is Lssucd(Sec. MICROFILM 3097,Civ.0.). Ill�h Lf] OaL HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lcndcri Ndmc-3g9_Brtldford-St��1-01 - HEATING UNIT 100,000 B.T.U.)9.50 � Lcndcri Address I�1 f�� o�1/��q ELECTRIC 142.00 I certify that l lR wCadtMflppdAuld slate that the above 2 VENTI LATION FAN (SI NG LE) 4.00 B�Oh information is correct. I agree to comply with all city and county BAILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING (32 0D ordinances and state laws relating to building constriction, and hereby authorize representatives of this city to enter upon the BOILER-COMP (Oxer 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to so, , indemnify_and keep harmless the City of MISC.- REFER TO ORD. 5100 Cupertino against liabilities,judgments, cents and expenses which PERMIT ISSUANCE 1000 CONST.TAX may in any way accrue against said City in consequence of tbu 282.68 granting Oft Trait. MECH.CONT. LIC.NO. MECH. /�� - TOTAL I TOTAL $ ,434.07/ I Signature pplica Contmctur at 51 .00 OFFICE COPY CERTIFICATE OF COMPLETION • BUILDING INSPECTOR'S OFFICE CITY/OF CUPERTINO z E4 DATE BLDG.tPE�RMITNO. ' I J� THE BLDG. LOCATED AT CS S, a'f ] OWNED BY � e4COMeLEI�ED 1— \x V m € 4 HAS BEEN FOR USE AS °i IALTEREDI f � � 1 x� I' BUILDING INSPECTOR --/�pm C r t + i. BUILDING INSPECTOR'S OFFICE • .. CITY OF CUPERTINO Office Dept. Officecopy ❑ Backflow Device Sanitary Permit No. ) �� ❑ Sewer Connection Plumbing Permit No. - Plumbing Final Lot No. �. Owner or Tenant �...© I At Tract Date Connected 19—W Date Final A//)//,119 19 II @" LUMBI ECTOR � rjbM C ;-f-fl ELECTRIC SERVICE NOTICE OPY •e• BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO MOO. 1 v 8 To You ore hereby authorized to Connect electrical service for r Owner or Tenont �( �L=rS In(Zy G1l-uV jJ , At No.of Wires ` Size of Wires � $ize of Switch /00 Motor Load -�T Voltage Phase Hearing Load `•' K.W. Voltage No.04 Meters Q� Light 1 0_ New Service Reconnect Heat 170 three Wire More Service_ No.of Add.Meters Power iThree Phase Move Meter ELECTRICAL INSPECTOR `. \ rn MOFFICE 00 �"' �r CITY OF CUPERTINO COPY O GAS SERVICE NOTICE E ' .J , ` OO, lo IQ ebE LL TO You are hereby authorized to connect the GAS service for o Owner or Tenant At �.\ -� tAV cp © t New Service \I (-S L No. of Meters U��+ Reconnect — No. of Add. Meters "t"I' Move Service Move Meter PIUMBING,INSPECTOR \ ._