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13761 APPLICANT TO FILL IN JNFOFLMATION WITHIN RED LINES - USE BALL. POINT PEN ONLY BUILDING PROJECT I DENT4 FICATION PERMIT NUMBER BUILDING LOt PLA APPLICATION & PERMIT 11542 Morning Spring Court BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 13 61 OWNER'S -PLAN CHECK VALIDATION NAME (415) DTV. ELECTRIC PERMIT FEE GREGORY GROUP, INC,„GNE - CONTRACTOR' - Win Dolphin ur. 90 OUTLETS-SWITCHES-RECEP 10,00/1.0030.00 NAME RWC, CA. 94065 ( SAME),n,No. B-430097 20 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S (415) PPLIANCES-RESIDENTIAL 4.00 ADDRESS Above PHONEPANELS 10.00 595-2100 I 10.00 DATE OF APPLICATION ARCHITECT ARAM BASSENIAN, AIA PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR O ENGINEER& ASSOCIATES LIC.No, SIGNS TRANS. 3.00 ARORFSC„.OS R ENG.3990 Westerly Place #170 SPECIALCIRCUIT 5.00 PERMIT VALIDATION AO Newport Bch. - CA, zap EMP.METER OR POLE INS. 20.00 Pap APPdcANra 220-C Twin Dolphin Dr. 7 MOTORS SEE FEESCH. 7.00 (� ] ADDWC CA 4065 SERVICE CHANGE 20.00 DE woo ` LICENSED CONTRACTORS DECLARATION //11��II�� {p u u I�' reby affirm that I am licensed under Provisions of Chapter 9 Wy QI ig TE < H (corn,///ening with Section 7000)of Division 3 of the Business and BLDG. I ELECT. PLG, MECH. Professions Code,end my license is in full fore Z i=a License Cla D Lie.Number . J D H m H ak Contractor ¢ a¢¢ OWNER-BUILD DELLA TION BUILDING PERMIT _ a w INFORMATION W O u- H I hereby affirm that I am exempt from the Contractor's License M ISL.- REFER TO ORD F uo,�, Y P VALUATION J Law for the following reason.(Sec. uires a,ermit ButtressandProfess ions pERMFT ISSUANCE 10.00TO= Code:Any city or county which structure permit to construct,alter, $109.000.00 Q ¢ ¢p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.N0, ELEC. O, requires the applicant for such permit to file a signed statement that TOTAL 149.00 ��p++ER MIT TO wm he is licensed pursuant to the provisions of the Contractor's License r z Q Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE W = thebasis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a ; by any applicant for a permit subjects the applicant to a civil penalty 00) 5. of not more than five hundred dollars($500).1: ALTER-DRAIN&VENT-WATER (EA. r� �N ✓'Ci ❑ 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 intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CONE. 5.00 --3 s x, Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 50,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not in tended or offered for sale,l l',however,thebuiIding GAS-EA.SYSTEM-1INC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE r builder will have the burden of proving that he did not build or ma- REB IND CON PB Other prove for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with IGIr��11 T ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply .S �r, � �� to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 3 _J1 contracts for such projects with a contractons)licensed pursuant to SEWER-SAN ITAfl V-STORM EA.200ft/10.00 the Contractor's License Law. TRACT No. PARCEL No. ❑ lam exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 7 (� reason Owner Date WATER SYSTEM 5.00 9 no ACC.GATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to sel Ginsure, or a certificate of Workers'Compensation Inslurance,or as Certified ZONING ENG.SITE NO. Copy thereof(See.3800,Lab.CJ. United Pacific Policy No. Company ' O ❑ Certified copy is hereby furnished. FIRE SPRINK, ENERGY T24 Certified' +y Is filed h I • Ity inspection division. MISC.- REFER TO ORD. Z p Applicant .-- Y ❑ "❑ Y ❑ NE] CC rn CERTIF ATEOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Ui > COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG. CL o (This section need not be completed if the permit is for one TOTAL 92.00 Y❑ N❑ Y❑ N❑ ::) Z hundred dollars($100)or less.) U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL { mil is issued,I shall not employ any person in any manner So as to OW become subject to the Workers-Compensation Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 455.50 >_ to NOTICE TO APPLICANT: If,after making this Certificate of Ex- � Z emption,you should become subject to the Workers'ComPensation 4 APPLIANCE 5.00 20.00 PLAN CHECK 296.08 provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 / Ener irn on CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=11EM.) 6.00 SEISMIC FEE '76,3 1 hereby affirm that there is a construction lending agency I'or 7 EXHAUST HOOD(WITH DUCT) 5.00 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Cic.CJ HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name S a en S8L /lII.� HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address 149.00 1 certify that 1 have recd this app icanou and state that the above 3 VENTILATION FAN (SINGLE) 4.00 12.00 information is correct. 1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 10 6.00 92.130 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH, MECHANICAL above-mentioned property for inspection purposes. 55.00 < (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 CONST.TAX '2S'2.68 may in any way accrue against said City in consequence of the granting h. permi� MECH.CONT. LIC.NO. MEEOAL t �� 55.00 TOTAL ,497.89 Signal o�nt/Contra or Da OFFICE COPY CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE Date ......... _- j.. ................ 1 .. Building Permit No. �.3. .(... The Building Located at ....11T.-.'t Z...1..-.u.k ....S�rLllC.... Owned by ........\T...�S .Q..�.SD......�)-.V Q.J ..../. �.�t�............................. Has Been a d) For Use AAs: ... Q...�!l�f .................... ...................... .................................................................................................................................................. .................................................................................................................................................. .................................................................. ............ ...................... ............................... ...... .. ... .... �............. PD-7 BUILDING INSPECTOR POST THIS CARD NEAR FRONT OF ®UILDING CITY OF CUPERTINO PERMIT NUMBER INSPECTION DIVISION 13761 JOB INSPECTION RECORD l JOB ADDRESS -/�'QN,�'�`F'�� ' — " UNIT# LOT# PERMIT EXPIRATION PERMIT EXPIRES IF WORK OWNER 4s."c eR a 6R,0V' CONTRACTOR I ISNOT STARTED WITHIN INSPECTMN DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANC E OR 180 DAYS FROM FOUNDATIONV -`Lfe��B IN d C"tClpt l'1'6��cY' C LAST CALLED INSPECTION. LIFER PERMIT VALIDATION PREGUNITE r!^ ^o POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED DEC 3 0 UNDERGROUND /SLAB 687 PLUMBING ELEL^TRICAL CI'14sIIAr7E��wln MECHANICAL BLDG. ELECT, PLG. MECH. 0 0 ❑ -00 NOT POUR FLOOR IINTII ABOVE HAIS BEEN SIGNED BUILDING PERMIT WINFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING $109 r00 MECHANICAL PERMIT To ELECTRICAL FRAMING IN CATION STORIES TYPE CONSTR. . 3, ; . L.. OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO,FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE RES INCON PB Omm APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ROUGH ASSESSORS PARCEL NO. PLUMBING GAS TEST TRACT O. PARCEL NO. MECHANICALi 1 ELECTRICAL .y FINALS DATE INSP. ACC,DATE ACC.FILE NO. • FRAMING •� SAN » a PLUMBING ZONING ENG.SITE NO. ON INSULATI - �/ GAS MECHANICAL ./ EIRE SPRINK ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y [:] N[] Y ❑ N❑ LATH-INTERIOR ELECTRICAL FLOOD ZONE A,L.U,C. LATH-EXTERIOR FIRE DEPT. Y❑ N� Y0 N� SHEETROCK -a •- ° GRADE FEE SUMMARY SHEAR INTERIOR j- BUILDING SHEAR EXTERIOR 7' TEMPORARY APPFOVALSj BUILDING FIREWALLS ELECTRIC FEEN CHECK 296.08 _ GAS NOTAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE ' OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR: MICROFILM �! w ARRANGE FOR.INSPECTION BY PHONING 252-4505, ELECTRIC 149.00 H . ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. 92.09 — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! covsT.Tgx 8 PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL j r4�+7rBg OFFICE COPY