13765 POST THIS CARD NEAR FRONT OF BUILDING
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CITY OF CUPERTINO PERMIT NUMpEH13765
INSPECTION DIVISION
JOB INSPECTION RECORD
Wort
//"Z AM41w� �P�� ! 5 I PERMIT EXPIRATION
JOB ADDRESS UNIT# _LOT# I PERMIT EXPIRES IF WORK
OWNER CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION REC D 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION '-�g� S^L^^� LAST CALL ED I NSPECTI ON.
LIFER (p"z�- JYI
PER ON ry
PREGUNITE WL�QQ
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED DEC,3 01%7 Y
UNDERGROUND /SLAB CityCUj�
PLUMBING at
ELECTRICAL ISSUANCE DATE
MECHANICAL BLDG. ELECT. PLG. MECH.
Ae,4A ❑ ❑ ❑ El
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION
WOOD FLOOR VALUATION $/FT.
PLUMBING
MECHANICAL 61239000.00
ELECTRICAL p PERMIT TO
FRAMING e, If UL
STORIES TYPE CONSTR.
INSULATION �vHe
02
OCC.GROUP RE$UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ /
ROOF SO,FT.FLOOR AREA TOTAL ACREAGE
DIAPHRAGM `- BUILDING USE
RES IND CON Pp O,h.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ® ❑ ❑ E) El
ROUGH ASSESSORS PARCEL NO
PLUMBING _ 366-,g 3i, 3'x,3.3
TRACT NO PARCEI-NO
GAS TEST _ 7.9 9S
MECHANICAL -
ACC DATE ACC.FILE N0.
ELECTRICAL y.1pe ula FINALS I DATE INSP.
FRAMING - SANS
e ZONING ENG SITE NO,
INSULATION 0y Q � PLUMBING
i a 0b [GAS .
MECHANICAL FIRE SPRINK ENERGY LY4
,1 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING C] "❑ C] "❑
LATH-INTERIOR r ELECTRICAL FLOOD ZONE A.L.U.C.
LATH-EXTERIOR FIRE DEPT. Y❑ N❑ Y ❑ N❑
SHEETROCK - GRADE FEE SUMMARY
SHEAR INTERIOR -'Yjl-�6 - BUILDING
SHEAR EXTERIOR5-31-AS TEMPORARY APPROVALS BUILDING 490.50
FIREWALLS GA9CTRIC FPLA
EEN CKg
? _ filer 160.00
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 9.19
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDINU13NAL ISSIGNED BY BUILDING INSPECTOR I MICROFILM
ARRANGE FOR INSPECTION BY PHONItG 252-4505, ELECTRIC 159.00
LU
ONE WORKING DAY BEFORE REQUIRED INSPECTION. I PLUMBING 97.00
1 z PLEASE GIVE JOB ADDRESS WHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MEc"^NICAIr 55.00
IMPORTANTI I CONST.TAX 1a 282.68
PLEASE READ REVERSE SIDE BEFORE TOTAL 1$571.16
CALLING FOR FINAL INSPECTION.
OFFICE COPY
I
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDPNGPROSECT IDENTIFICATION PERMIT NUMBER
BUILDING LOT35 PLAN 3B APPLICATION & PERMIT 13765
ADDRESS11582 MorningS ria Court
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
NAME (415) QTY. ELECTRIC PERMIT FEE
GREGORY GROUP, INC. 2100
yy/ PRONE
I CONTRACTORS
NAMEUTLETS-SWITCHES-RECEP 10.00/1,00 99,00
Same LIC.ry 8-430097 1 LIGHTING FIXTURES 10.00/1.00 21
CONTRACTORS 3 pPLIANCES-RESIDENTIAL 4.00
ADDRESS 2 Twin Dolph iQ4Q�) 1 PANELS 10.00 GA TE OF APPLICATION
RWC, CA 94065 FHDNE
ARCHITECT PLAN CHECK FEE
OR ARAM BASSENIAN; AIA PANELS (OVER 200 AMP) 20.00
ENGINEER tATE S
& ASSOCLIc.No. SIGNS TRANS.- 3.00
ARCH.OR
ADDRESS E"`3990 Westerly Place, x/170 SPECIALCIRCUIT 5,00 PERMIT VALIDATION
,_/
Newport Bch CA. ZIP 92660 TEMP.METER OR POLE INS. 20.00 P
AE aMOTORS SEE FEE SCH.
ADDRORFss 7 nn
0 n
SERVICE CHANGE 20.00 l/
moo LICENSED CONTRACTORS DECLARATION p'L
<u I hereby affirm that I am licensed under provisions of Chapter 9 Y Ql
w z u (commencing with Section 7000)of Division 3 of the Business and
H y i MECH.
Professions Code,amt y license is in full fort f BLDG. ELECT. PL
z o w- License CI s Lic.Number ' ®-
9 m
QH_w Dale Contractor -
y F J
¢ ¢ ¢ OWNER-BUILDER UECLAR ION BUILDING PERMIT
wcg INFORMATION
soa. MISC.- REFER TO ORD
X LL I- I hereby affirm that I am exempt from the Contractor's License
r lcoLaw forlheity or countywhih(Sec.
requires a Business to construct,
Professions PERMIT ISSUANCE 10.00 VALUATION S/FT.
a Cole:Any city or county whichrequiresapermittoconstruct,alter, $123 000.00
S a Q FO improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. f
•.n g o u requires the applicant for such permit to file a signed statement that TOTAL 159.00 PERMIT TO
x $ he is licensed pursuant to the provisions of the Contractor's License
t z a
Law(Chapter 9(commencingwith Section 7000)of Division 3 of the 1J
i m Business and Professions Code)or that Ise is exempt therefrom and OTY. PLUMBING PERMIT FEE
¢r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TrYPE.CONSTR.
i;$ by any applicant fora permit subjects the toacivilpenalty
of not more than five hundred dollars the applicant ALTER-DRAIN&VENT-WATER (EA.) 5.001:
❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RE$.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 �-3
Code:The Contractor's License Law does not apply to an owner of �r
properly who builds or improves thereon,and who does such work 12 F IXTUR ES-PER TRAP 5.00 50,FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such impmve-
IIIare net intended oroffend for sale.If,however,the building 1 GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 6 On
or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA) 200 BUILDING USE
builder will have the burden of proving that lie did not build or im . . . RES IND CON PB Omer
prove for purpose of sole.). INDUSTRIAL WASTE INTER. 30.00 9 0 0 ❑ D
❑ as owner of the property,am exclusively contracting with
licensed
contractors to construct for project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 / A55 F,SSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not apply 3 Q 6-9'3 J qq
to ft owner of property who builds fr improves thereon.nseduand who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 f .� / 2J
contracts for such projects with a conlruclor(s)licensed pursuant l0 1 Q '
me Contractor's License Law. SEWER-SANITARY-STORM EA.200tt/10.00 TRgCT NO. PARCEL NO.
❑ I"in exempt tinder Sea ,BA P.C.for this 1 WATER HEATER W/VENT 6.00 799r
reason
Owner Dale ] WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent IO self-instira, ZONING
or a certificate of Workers'Compensation Insurance,or a certified y� ENG.SITE N0.
copy thereof(Sec.3800,Lab.C.).United Pacific
Policy No.-Company-
0
o. Company0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T$4
a Z fpl Certified cD�i. led ie city Inspection division. misc.- REFER TO ORD. � E]
H Q Applicant--{y¢ � Y N v N
CCT CERTIFIC B OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 10.00 FLOOD ZONE A.L.U.C.
LU COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLO.
III. o (This section need not be completed if the permit is for one TOTAL 9 Y❑ NC] Y ❑ NF]
:D Z hundred dollam(SI00)or less.)
U O I certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F. mil Is issued,I shall not employ any person in any manner so as to
U become subject to the Workers'Compensation Laws of California.
y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 490.50
} N NOTICE TO APPLICANT: If,after making this Certificate of Hx-
F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 20,OD PLAN CHEQK 318.83
provisions of the Labor Code, you must forthwith comply with FEE /PnF7rgy
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10ACC.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M,16.00 SEISMIC FEE 8.19
I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 rj,DD
the perfoCiv.rmance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 8 MICROFILM
Lender's Name Sacramento S&L
Lender's Addressq�yj.7y}�ls�9r,���-'[}r�s t_�(-), HEATING UNIT(0 100,000 B.T.U.19.50 ELECTRIC 159.00
(certify thatlhave readiNlKVpplio3�state that the above VENTILATION FAN (SINGLE) 4.00 1'2,0
information is correct. I agree to comply with all city and county PLUMBING 97.00
ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.ar 100,000 B.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. 55.00
(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 282.68
may in any way acerae against said City in consequence of the PERMIT ISSUANCE 10.00
granting of th'Jaxemut. MECH,CONT. LIC.NO, MECH.
TOTAL 55.00 TOTAL $1 ,571 .16
Signal nt/ Vale
OFFICE COPY
W + r"JOB INSPECTION RECORD
JO //SBI
B ADDRESS � .L `'•' ,•r
owNER Gaeuar GQ2P UNIT# ^JS PERMIT'E%PEI
*t
LOT
INSPECTIONCONTRACTOR PERMIT EXPIRES
FOUNDATION DATE INSPECTOR ..11`` INSPECTION RECORD IS NOT SOFPEE;
UFER _ Ca- ',���EI IA-Y ION l`I ep
�LE-VI , - I��C ANCE OR 180 Of,
PREGUNITE LASTCALLED IN:.
G aE-cSC 1Y s
1 SIGNED U �� h E<wL ��,� PERMIT VgLlpn
POUR NO CONCRETE UNTIL ABOVE HAS BEEN
UNDERGROUND /SLAB PAID
PLUMBING
ELECTRICAL SEC 3 �D
M/EC_HANICAL City
i ...[.f. I - I .I I,i h�rj:
BLOC ELECT. lI
DO NOT POUR FLCon UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ _[
PLUMBING
WOOD FLOOR BUILDING PEI
'
INFORMATI
MECHANICAL VALUATION
ELECTRICAL
FRAMING ' 1E "E"�'� •��
PERMIT Tp
ENSU gT10N
•�J "L _
3 STORIES TYPi
as: �
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
OCC GROUP RE;
DIA PF7F ROOF
G
50 IT ILOORARfA IOTA1
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED RES BUILOINE USE
ROUG a. oN PP
0
N�I PLUMBING � G
. GAS TEST ABS--sPAHGEL:
MECHANICAL
ELECTRICAL TRACI NO, PAR,
FRAMING i. o FINALS
DATE- INSP• ACC DATE ACC.Ei
INSULATION SAN # / y
,76 PLUMBING
V p¢ ZONING
GAS ENG S,
f tt/
C COVER NO WORK UNTIL ABOVE HAS BEEN IGN MECHANICAL
LATH-INTERIORLl
ED HEATING % EIRE SPgINK FNERG-
LATH- n /- ELECTRICAL z LDO N� Y
EXTERIOR �
Eoo zDNE A,LU
� SHEETROCK � FIRE DEPT.
SHEAR INTERIO 'IG
qi GRADE YE] No yo
SHEAR EXTERIOR BUILDING '• FEE SUMMARY
IREWALLS
G E F
TEMPORARY p ApROVALS BUILDING 5:
r�•,^ q ELECTRIC -
Iu NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED GAS PLAN Cp ECICL`
OCCUPANCYOFBUILDING IS NO7 PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR FEE li
\ OCCUPANCY
SEISMIC FEE
HARRANGE FOR fNSPECTION BY PHONING 252-4505, MICROFILM
I� ONE WORKING DAY BEFORE REQUIRED INSPECTION. .ELECTRIC
11 Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
S;( PLU4181NG•
- SEE PERMIT FOR EXPIRATION DATE -
•� s! MECHANICAL
IMPORTANT! CONST,TAX
PLEASLE READ REVERSE SIDE O
RE "Zi'o`; -`-CAING FOR FINAL IN-SPECTION '
`.7,
TOTAL �1
-FPLICANTSPOSTINGCDPY T