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13763 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PERpIrt NUMBER 13763 INSPECTION DIVISION JOB INSPECTION RECORD . PERMIT EXPIRATION JOB ADDRESS /S�e.Z M�/CI__G''MG' Si°Ri.1�r C��'T UNIT# LOT 7 PERMIT EXPIRES IF WORK OWNER C. i✓G CONTRACTOR - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION �(,� e� 5 ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PREGUNITE -I . PER TION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED �.a7- Ijy�X CL Qk kDEC 3 01981 UNDERGROUND /SLAB PLUMBING CIV cupedln0 ELECTRICAL ISSUANCE DATE MECHANICAL RLDG. ELECT. PLG. MECH. /•• 3. �/6 ❑ ❑ ❑ ❑ UO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL $1239000.00 PERMIT TO ELECTRICAL FRAMING sraRlEs TYPE CONSTR. INSLATION OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO,FT.FLOOR AREA TOTAL ACR EAGE �T DIAPHRAGM &04 BUILDING USE RES IND CON PB DlhxF APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ ROUGH ASSESSORS PARCEL NO L PLUMBING Ly.�,� ' TRACT NO. PARCEL No. GAS TEST �, MECHANICAL ELECTRICAL - — '� FINALS DATE INSP. ACC.DATE ACC FILE NO FRAMING C SAN n Z � -� PLUMBING 20NING ENC.SITE NO, INSULATION - �� GAS i — _1-aJ_'fig MECHANICAL FIRE SPRINK ENERGY F20 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y[3 No Y C] NE] LATH-INTERIOR - �• � ELECTRICAL _ FLaoD zorvE gL.u.c. LATH-EXTERIOR .S- FIRE DEPT. v❑ N❑ Y ❑ No SHEETROCK _s GRADE FEESUMMARY SHEAR INTERIO ` ( 'j'31� C BUILDING SHEAR EXTERIOR dog TEMPORARY APPROVALS BUILDING — 490 530 FIREWALLS ELECTRIC PLAN CHECK 310,83 GAS FEE / Ener NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN GNED OCCUPANCY SEISMIC FEE 13.19 OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTORLU . MICROFILM ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC 159.00 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. 97.00) — SEE PERMIT FOR EXPIRATION DATE - MECHANICAL 55.00 IMPORTANT! CONST.TAX 292,68 PLEASE READ REVERSE SIDE BEFORE TOTAL $1,571.16 CALLING FOR FINAL INSPECTION. OFFICE COPY A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJEOT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT ADDRESS LOT °37 PLAN 3AR BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 1 3763 115 2 Mornln S tin Court OWNER'S - - PLAN CHECK VALIDATION VEGORY GROUP, INC. 415-595-210 QTY• ELECTRIC PERMIT FEE PHONE crDRs NAME B-430097 99 OUTLETS-SWITCHES-RECEP 10.00/1.00 99,00 NAME Same LIC.No. LIGHTING FIXTURES 10-00/1-00 21.00 rONTRACTGR'a 220-C Twin D04TOn Dr. PPLIANCES-RESIDENTIAL 4-00 12.001 AMORE 55 RWC, CA. 94065 PHONE _ PANELS D.DD l0,D0 DATE OF APPLICATION ARCHITECT PLAN CHECK PEE P.C.NO. OR ARAM BASSENASSOCTATFSIAN, AIA PANELS (OVER 200 AMP) 20.00 ENGINEER LIC,NO. SIGNS TRANS. 3.00 ADDRESS ENO 3990 Westerly Place, #170 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zuP EMP.METER OR POLE INS. 20,00 PAID APPuca rs 220-C Twin Dolphin Dr. 7 MOTORS SEE FEE SCH. 7.00 !V ADDRESS RWC, CA, 94065 SERVICE CHANGE 20.00 OG Woo LICENSED CONTRACTORS DECLARATION L u U -3 hereby affirm that I am licensed under provisions of Chapter 9 PBI no E I" (commencing with Section 7000)of Division 3 of the Business and _EC-HB iProfessions Code,aD6 my license is in full force e a i o License Class 'Li J.'Number_ H m H ale Contractor. ><a a OWNER-BUILDER DECLAR ION BUILDING PERMIT o a MISC.- REFER TO ORD INFORMATION X 3 u H I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT, F IcOJ Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city orcounty which requires a permit to construct,alter, $123 OOO.00 2 ¢ Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. f o u requires the applicant for such permit to file a signed statement that TOTAL 159•OO PERMIT TO '' w$ he is licensed pursuant to the provisions of the Contractor's License ^�M H 2 i Law(Chapter 9(commencing with Section 7000)of Division3ofthe J GJ Q Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE $M = the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE,CONSTR. u ; - by any applicant fora permit subjects 5000lcant to the applicant acivil penaltyALTER-DRAIN&VENT-WATER IEA.) 5.00 � of not mora than five hundred dollars ❑ 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 {7 intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 K 3 Code:The Contactor's License Law does not apply to an owner of properly who builds or improves Thereon,and who does such work 12 FIXTURES•PER TRAP 5.00 50,FT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- trends are not intended oroffered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder 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 RES IND CON PB Other ❑ I,as owner of the property,am exclusively contracting with 1& ❑ ❑ ❑ ❑ 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 to an owner of property who builds or improves thereon,anti who LAWN SPRINKLERS-OV ER 5 IEA.) 1.00 J / / 1 3' ,Z 32 contracts for such projects with a contractor(s)licensed pursuant to J 4 Io t the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 ❑ 1 um exempt under Sec. .BAP.C.for this 'TpRACT NO. PARCEL NO. reason I WATER HEATER W/VENT 6.00 / GS� Owner Dale I WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent[o self-insure. ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(See.3800,Lab.C.). United Pacific •t /2.214 Policy No. Company 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Q g$ Certified y Bled he city inspection division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ AfOrlicunl �'� V N V N ~ m PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU CIiRTIPIC TE COMPENSATION INS PROM WORKERS' I W � COMPENSATION INSURANCE PLG.CONTR. LIC.N0. PLG. CIL 0 (This section need not be completed if the permit is for one TOTAL 97.00 Y❑ N❑ Y❑ N D Z hundred dollars($IGO)or less.) U O 1 certify that in the performance of the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,1 shall not employ any person in any manner so as to OW become subject to the Workers'Compensation Laws of California. LU G. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 490.50 >_ m NOTICI7 TO APPLICANT: If,after making this Certificate of Ex- L.. ? emplion,you should become subject to the Workers'Compensation 4 APPLIANCE 5.00 PLAN CIL+IECK 318.83 provisions of the Labor Cade, you must forthwith comply with FEE f-net U such Provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10);1100C.F.M.) 4.00 9Y CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 1000DC.F.M.) 6.00 SEISMIC FEE 8.19 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.). Sacramento S&L I HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)8.50 Lender's Addre t ELECTRIC 159.00 1 certify that I have read t Rapp Walton and state that the above 3 VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all Lily and county PLUMBING 97.00 ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the MECHANICAL 700 BOILER-COMP(Over ,000 BTUI SEE FEE SCH. CCAL 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 exwhich PERMIT ISSUANCE 10.00 CONST.TAX 292,6B may in any way accrue against said City in conseqpensesuence of[he granting of MECH thi rmi MECH.CONT. LIC.NO. . '�/ � TOTAL 55.00 TOTAL $1 ,571 .16 Signature of caul/C olructor ue OFFICE COPY CITY OF CUPERTINO OFFICE GAS SERVICE NOTICE To You are hereby authorized to connect the GAS service for Owner or Tenant q/1 J, g ._ J At New Service No. of Meters Reconnect i No. of Add. Meters Move Service j Move Meter I PLUMBI INSPECTOR hv'� @- i Q CITY OF CUPERTINO L CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE 1 U Date ............ ... �.�r...........1 19.`.'.�?.... \' Building Permit No. .Q.. .��..:3 The Building Located at ....d. .b...Z...(.1. .r1A.�. ...s�. .l.�,t.l.l....�,r Owned by ....G-v.... ,0..r y....... .........l..l(til.(d.................................. Has Been «) For Use As: .... b.-W---/.......................................... ............................ ................................................................... ........................................... ............................................................................................................................................. ................ ......................................... ..... .... PD-7 BUILDING INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE JJ CITY OF CUPERTINO '�j )pT—V� jC / / 9 I To 1 You are hereby authorized to Connect electrical service for � 1J- e Owner or Tenant 4 r At t 2_ 1l/1 0 r Y No.of Wires Size of Wires Size of Switch y Motor Load Voltage Phase 1 Heating Load K.W. Voltage !1 Light I10—New Servicey Reconnect No.of Meters 1 Heot •'j 120eThree Wire More Service— Na.Of Ad Meters 1 Power f Three Phase Move MI/et'er ©w ELECTRICAL INSPECTOR �� �Qn_.rGtt/1 —` �— BUILDING INSPECTOR'S.O.FEJ CE Bldg.Dept. CITY OF CUPERTINO Officecopy ❑ Backflow Device Sanitary Permit No. ❑ Sewer Connection Plumbing Permit No. 7h .l Lot No. .�--- Plumbing Final Owner or Tenant— At enant AA At ^� rl Tract / �✓ Date Connected 2 19_4Dete Final -t( 19 ILA© PLU BING INS E TOR