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13764 !' POST THIS CARD NEAR,FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 13764 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS��.7Z r4 AJ/ilf�r _14-ogmar «r UNIT# LOT# 36 PERMIT EXPIRES IF WORK OWNER �404VAY (7/(OU/° /^IC/ CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM, LASTCALLED INSPECTION. UFER PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PAID UNDERGROUND /SLAB PLUMBING DEC .� O 198/ Cpl ELECTRICAL k -59" ISSUANCE GATE MECHANICAL ' o MECH. Q BUILDING PERMIT 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED INFORMATION WOOD FLOOR vn INFONSIFT. PLUMBING MECHANICAL - $109 000.0 ERMIT TO ELECTRICAL FRAMING ( !` STORIES TYPE CONSTR. IN CATION OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BftSIGNEID ROOF OFT.-FLOOR ARE TOTAL ACREAGE DIAPHRAGM 6btA 151 BUILDING USE RES IND CON PB Ober APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 0 ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING ' TRACT NO. PARCEL NO GAS TEST "7cf, MECHANICAL I I l ELECTRICAL -9-s-SI6 4or FINALS DATE INSP. ACC.DATE ncc.FILE NO. FRAMING - SAN # ZZ ZONING ENG.SITE N0. INSULATION 1,30-0 PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY T 24 - � COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v E] NEI v E:] N LATH-INTERIOR i ELECTRICAL aooD zoNE - AL.U.C. i LATH-EXTERIOR y FIRE DEPT. v "❑ v ❑ N[j SHEETROCK - S GRADE FEESUMMARY SHEAR INTERIORP}CepF bl ..8$ BUILDING SHEAR EXTERIOR 9: �, TEMPORARY APPROVALS BUILDING 455.50 FIREWALLS ELECTRIC PLAN CHECK 296.08 7-I GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECT ORMICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC 149.0 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 92. 04 z� PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL 55.0( IMPORTANT! CONST.TAX 282m6f PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. $"Tim, OFFICE COPV APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER 14 BUILDING LOT /136 PLAN 2AR APPLICATION & PERMIT 13764 ADDRESS BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME (415) OTY. ELECTRIC PERMIT FEE E NAME CTORi UTLETS-SWITCHES-RECEP 10.00/1.00 90 no NAME LIA6,,430097 LIGHTING FIXTURES 10.00/1.00 20 (10 roNTRA PPLIANCES-RESIDENTIAL 4.00 ADDRESS 220-C Twin Dolphin Dr. CA 94065 (415) PHONEEQE PANELS 10.00 GATE Of APPLICATION A T PANELS (OVER 200 AMP) 20.06 PLAN CHECK FEE P.C.NO. OR ARAM BASSENIAN, AIA 2. A(z(znrTA:rES LIC.No, SIGNS TRANS. 3.00 ARCH.OREN SPECIAL CIRCUIT 5,60 PERMIT VALIDATION al ADDRESS 3990 Westerly Place170 EMP.METER OR POLE INS. 20.00 PAID ADDR S p - ANT AdDRES MOTORS SEE FEE SCH. Dtb n k �WC CA 9406 SERVICE CHANGE 20.00 etfQ' _v Doo LICENSED CONTRACTORS DECLARATION ^;`� <u u I hereby affirm that 1 am licensed under provisions of Chapter 9 W[r Quawke N<i (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PL . MECH. i Professions Code,an my license is in full forcg gp� ff r,( o 0 W License Class Lic.Number_ are Contractor a y BUILDING PERMIT ¢ ¢ ¢ < OW CR-BUILDER DECLA ION wu MISC.- REFER TO ORD INFORMATION F ;A I hereby affirm that I am exempt from the Contractor's License u. o Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION g/FT. fw>S Code:Any city or county which requires a permit to construct,a Iter, $109 OOO.00 ¢ ¢¢ O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. , 0, requires'the applicant for such permit to file a signed statement that TOTAL 149 Uti PERMIT TO W :1 se " he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe 4 �l Business and Professions Code)or that Ise is exempt therefrom and CITY. PLUMBING PERMIT FEE w It f D 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 -WATER (EA.) 5.00 of not more than five hundred dollars(55000.): 0 1,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,COND. 5.00 R�3 Code:The Contractor's License Law does not apply to an owner of 55.0 • property who builds or improves thereon,and who does such work FIXTURES.PER TRAP 5.06 SO.FT.FLOORAREA TOTALACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,the building I GAS-EA.SYSTEM-I1NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB other prove for purpose of sale.). INDUSTRIAL WASTE INTER3000 0 1,as owner of the property,am exclusively contracting wi . . th ❑ ❑ ❑ ❑ 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,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 346-9-21 3 J 33 contracts for such projects with a contractm(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT No. PARCEL No. 0 lam exempt under Sec. ,B.&P.C.forlhlg WATER HEATER WIVENT 6.00 reason Owner Date 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-insum, ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.Ca)In)ted Pacific �,IZZ Policy No. Company U O 0 Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z 11( Certified,4y is filed s't the city inspection division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ PO Ji Y N Y N ' rnrOp PERMIT ISSUANCE 10.00 .O FLOOD ZONE A.L.U.C. LU CERTI FIC COMPENSATION INS FROM WORKERS' UJ _ COMPENSATION INSURANCE PLG,CONTR. LIC.No. PLG. CL (This section need not be completed if the permit is for one TOTAL 92. Y❑ N❑ Y❑ N❑ hundred dollars(E 100)or less.) U O 1 certify that in the performance of the work for which this per. CITY. MECHANICAL PERMIT FEE FEE SUMMARY U. - mit is issued,I shall not employ any person in any manner so as'to U become subject to the Workers'Compensation Laws of Calilornix. wDate Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 455.50 >_ ran NOTICE TO APPLICANT: If,after making this Certificate of Ex- F 2 emp!i.n,you should become subject to the Workers'Compensation 4 APPLIANCE 5.00 20.0 PLAN CHECK 296.08 provisions of the Labor Code, you must forthwith comply with () such provisions or this permit shall be deemed revoked, AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 FEE /energy 160.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.FM.) 6.00 SEISMIC FEE 7 G,P I hereby affirm that there is a construction lending agency for 1 EXHAUST HOOD(WITH DUCT) 5.00 the performanp pf a wo k fyr wh,'eq{his permit is issued(Sec. MICROFILM 3097,Civ.C.). JOC�a m6n'LO JNL HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name300 Brad ford C+ ELECTRIC 149.0 Lender's Address' al- HEATING UNIT(OVER 100,000 B.T.U.19.50 1 certify that I have rest this application 3017 state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING 92.0 ordinances and state laws relating to building construction, and BOILER•COIV1P13H.P.Cr100,000B.T.U.) 6.00 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. 55.0 (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX t may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 granting of 9p it. MECH.CONT. LIC.NO, MECH. TOTAL Signature o plicenl/Contractor U� 55.00 TOTAL =1.,.49T.89•� OFFICE CQPV JOB ADDRESS //r�2 rG'��'!nl s�ie/.�r C�2T UNIT# r' ILOTr7j:' 3 PNER /'`` G/(OIJ/ //IG CPNTAAC70R '✓:•li hl . ',r r s'.. _ .IS NOT LAINSPECT ON DATE INSPECTOR INSPECTION RECORD •^� Mr6i�V FOUNDATION ANCE ORY LAST CALLED INSPECT • LIFER } PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING Y ELECTRICAL ISSUANCE DATE BLDG. ELECT. FLG. MECHANIC p ❑ O 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMT INFORMATION WOOD FLOOR VALUATION PLUMBING MECHANICAL PERMIT TO ELECTRICAL FRAMING STORIES TVPE[I ! IN CATION A ' Occ.GROUP RES L iAd q PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO IT FLOOR APEAI TUTA:A BIAPHRAfGM �-- j Buil DING usE RES IND CON Pn APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ASSESSORS PARCEL Ni ROUGH PLUMBING -0 • GAS TEST TRACTrvo PARI MECHANICAL ELECTRICALFINALS DATE INSP.^ 2- J ACC.DATE ACCFI C FRAMING �-C�• $ SAN 0 ZONING ENG SI INSULATION 0 PLUMBIf1G GAS ✓ RI FIRE SPNK ENERG ' MECHANICAL ,Y' �/ _ V ❑ N V C COVER NO WORK UNTIL AB VE HAS BEEN SIGNED HEATING ELECTRICAL FLOODZONE A.L. LATH-INTERIOR - �J LATH-EXTERIOR FIRE DEPT. J Y❑ NO V L_ SHEETROCK GRADE - FEESUMMARY SHEAR INTERIORCICF�T D, 5-31- O. BUILDING F SHEAR EXTERIOR''-�f ,Cj-jl-�� TEMPO RARYAPPROVALS✓ � BUILDING FIREWALLS ELECTRIC .- O- `PLAN CHECK e _li \ -1-5-e,,5, 9 11 IGAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. OMICROFILM � I ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC w ' '' I- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL CCONST.TAX IMPORTANT! • PLEASE READ REVERSE SIDE BEFORE 'TOTAL ISE CALLING FOR FINAL INSPECTION. t APPLICANTS POSTING COPY �'ffOUN DATIONPAID..• _ ",� . ' ?` LIFER � �;'r�-��-PC+`b I� ' PREGUNITE VE HAS BEEN SIGNED DEC 3 01987 POUR NO CONUNDERGROUND /SLAB city of c - • eLOc PLUMBING O ELECT. ❑ ❑ 1 ELECTRICAL ❑ MECHANICAL _�. BUILDING PERMIT INFORMATION �P�� SIFT. vPLUATION I 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNS t5 r r .LV WOOD FLOOR Ef ' PERMIT TO PLUMBING MECHANICAL STORIES TYPE CONST h � ELECTRICAL ' FRAMING J��Q R RES­UNll DCC GROUP INSU ATION � f $O fI FLOOR PRfP IOtPI PCRt i PLACE NO SUBFLOOAUNT"ROOF HAS BEEN SIGNED BUILDING USE PR _ RES IND CON AGM I] i �• DIA O ❑ ASSESSORS PARCEL NO APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED pPRCLI 'PACT No. ROUG a. PLUMBINGncc.P'L ' GAS TEST INSACC-DATE.P. MECHANICAL N FINALS DATE M , A fir ZONING ENG Sll ELECTRICAL V_ � .Y f.c-. SAN i+ y 'I FRAMING i30�E7� p /I�[ PLUMBING V�� FIRE SPRINK ENERG INSULATION GAS• Cl �y 'r• Y 0 No Y' MECHANICAL nooO zoNE ALI HEATING Ffr�� r O L I COVER NO WORK UNTIL ABOVE HAS BEEN IGf�D ELECTRICAL n i LATH-INTERIOR � FIRE DEPT. O " r F LATH-EXTERIOR h GRADE 1 BUILDING SHEETROCK ` C' BUILDING ` SHEAR INTERIO TEMPORARY APPRR OVALS •PLAN Cp,EC.Kr0 .y I SHEAR EXTERIOR ELECTRIC FEE \� FIREWALLSvz" GAS SEISMIC FEE Q m n EN SIGN EO OCC —I . MICROFILM NO TAPE OR PIASTER UNTIL ABOVE '- BE u OCCUPANCY OF BUILDING ISNOT PERMIT-E D U NTIL BUILDING FINALIS SIGN ED BY BUILDING INSPECTOR ,ELECTRIC �' ARRANGE FOR INSPECTION BY PHONING 252-4505, PLUA101NG`g. ` w ONE WORKING DAY BEFORE REQUIRED INSPECTION. MECHANICAL p� PLEASE GIVE JOB ADDRESSINHEN PHONING. I` Z — SEE PERMIT FOR EXPIRATION DATE — CONST.TAX I � c IMPORTANT! TOTAL C PLEASE READ REVERSE SIDE DEFORE CALLING FOR FINAL ItnSPECTION. ' :.PPLICANTSPOSTINGCOPY -__.