15831 POST THIS CARD•NEAR FRONT OF,BUILDING , eamlr.Numeea
r� r.. ..
- 'CITY OF CUPERTINO
- - . ,- I - 15831 .:
INSPECTION DIVISION ••
JOB INSPECTION RECORD
OAK
PERMIT EXPIRATION
i-•^ 1 ��—\� OA 5k'� UNIT# LOT#-`Z
taP JOB ADDRESS PERMIT EXPIRES IF WORK
-- & ,< Q720u ..
OWNER ?nQwN R /CONTACTOR L{vmoe C7 JS NOT STARTED WITHIN
INSPECTION DATE .INSPECTOR INSPECTION RECORD 180 DAYS.OF.PERMIT ISSU
FOUNDATION .NOTE: e " ANCE OR 180,DAYS FROM,'
- r LAST CALLED INSPECTION. I
UFER" .� ALL GRADING AND DRAINAGE SHALL BE INSTALLED I
TO,COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION'
r PREGUNITE' `- 1
- CUPERTINO STANDARDS.
GARAGESLABS"'. - •��
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED r�, �,, < •-r ''w7
..
UNDERGROUND /SLAB,!,PLUMBI - - �
p♦
ELECTRICAL �• !•„T. '..:' I ,p PP ISSUANCE DATI:
MECHANICAL'- .p` ISIGNED
El_ECT. vul. MECR, t
T z� °DO NOT-POUR. LOOR UNTIL ABOVE HAS Ba 6jk% UILDING PERMIT
WOOD FLOORpINFORMATION
VALUATION S/FT,�PLUMBING � � - � -MECHANICAL ' 1849540
ELECTRICAL - '- - , PERMIT TO .
FRAMING ' •i ' - - SFI)Jlt.
INSULATION t STORIES TVPECONSTR.-
• OCC GROUPt RES UNITS
PLACE NO SUBFLOOR'UNTIL ABOVE HAS BEEN SIGNED ' ' -
.- ROOF - su.r .R LIR'AREA turn nu E cE
1
T� - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE" 3047
DIAPHRAGM - THE CONSTRUCTION TAX IS PAID -
1' BUILDING USE
ROOF SHEATHING - -21—.�4 �Q - RES IND CON PIT OP—
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS - JDATE •INSP. � � � !
ASSESSORS PARCEL NO.
ROUGH SAN:a PLUMBING y- � ELECT."ENERG� rRncT No. rnnceu NOTUBS&SHOWER PAN LUMBING ENERGY MECHANICAL '��Q ECH:ENERGY -' 8098ELECTRICAL '�j_� uILrJ BUILDING ENERGYAcc.GnrE Acc EaE No.
FRAMING • S-Qf{• pll�S ELECT.FINAL TEST ENG.SITE NO.INSULATION &t�q PLUMBINGGAS TEST GAS•
F IRE SPRINK ENERGY.T.PG
MECHANICAL COVERAO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ,N❑ �•NaEXTERIOR SHEAR _FM, ELECTRICAL RELEASE FLOOD ZONE A.L.u.C.
INTERIOR SHEAR - FIRE DEPT. v� N� ❑ N�
SHEETROCK GRADEFEE SUMMARY
EXTERIOR LATH - U0 BUILDIN
BUILDING
' INTERIOR LATH ` TEMPORARYAPPROVALS - 972.00
SCRATCH COAT" ELECTRIC PLAN CHECK
GAS , FEE/energy. 15.50
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 13.65
+ OCCUPANCYOF BUILDING ISNOT'PERMITTED UNTIL BUILDING•FINAL IS SIGNED BY BUILDING INSPECTOR: MICROFILM
ARRANGE FOR'INSPECTION BY PHONING.2524505; ELECTRIC 73.13,; '
Iw— ONE WORKING DAY BEFORE REQUIRED INSPECTION.. . PLUMBING 73.13'
' O� PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z MECHANICAL
= SEE PERMIT FOR EXPIRATION.DATE - 3
IMPORTANT! - , CONST.TAX Y6$ fJ's,
� .
,.' PLEASE READ REVERSE SIDE BEFORE �
.. :CALLING FTOTAL
OFFICE
FINAL INSPECTION.'
OFFICE COPY - �� 7�Y
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
t4 - , `
BUILDING PROJEC7IDENTI FICATION PERMIT NUMBER
AooAEss�ot 11+226 Plan 4A APPLICATION & PERMIT 1 C�� 1 ,
11595 Oak Spring' Court BUILDING - ELECTRICAL-PLUMBING_MECHANICAL - I J I .
NAME a PLAN CHECK VALIDATION
Nome Gregory Group, Inc. & CITY. ELECTRIC PERMIT FEE
Ahmanson Dev. 415-595-2100
CONTRACTOR UTLETS`-SWITCHES-RECEP 10.00/1.00
NA
"'Gregory Group, .Inc. B-430097
LIGHTING FIXTURES 10.00/1.00
CONTRACTDR'3 -220-C Nin Dolphin r'. - APPLIANCES-RESIDENTIAL 4.00
ADDRESS RWC 94065 A15-595-2100 . PANELS. 10.00 DATE OF APPLICATIONI '
ARRCHITECT ram Bassenlan,AIMASSOC PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P,C..NO.
o
ENGINEERILIC.NO. C-8395 SIGNS TRANS. 3.00
ARCH OR ENG. 203 OrC11HI,,1aard Dr. pp SPECIAL CIRCUIT .S.00 PERMIT VALIDATION
ADDgEVnta Ana �ts. l.A. 2707,. TEMP.METER OR POLE INS. 20:00
Jd ZIP
APPLICANT'S _ - MOTORS - r SEE FEE SCH.
ADDRESS 220-C Twin Dolphin DR.RWC '
p SERVICE CHANGE '20.00 1-� '
o o LICGNSEU CON'(RACIORS DECLARATION ID Id/0 l�
a u o I hereby affirm that I ata licensed under provisions of Chapter 9 - SUANCE DATE ai
a $ (,mann, rung with Section 7000)of Divnbim 3 of the Business and - - D ECT. PLG. •-MECH.
H m z Professions Code,an y liccnsu is in full(orcr�Igt�,�j yµ�1 . -71 1�
z o w - ' License Class_ Lia Number_4JUU 7.�
Q w Uatc ' Contractor
a ,2 ., City DING PERMIT
tr: ec w¢ OWNER-BUILDER DECLARATION
o a " MISC.- REFER TO ORD - INFORMATION
w 3 n n I hereby affirm that I am exempt from the L'OnlmetOl s License ,VALUATION $/FT.
H x. Oal Law for the following reason.(Sec.7031.5,Bisinessand Professions PERMIT ISSUANCE 10.00
Cade:Any city or county which requiresu permit toconstruct,alteT, .194 540
SE ¢Q improve,demolish,or repair mry structure,prior to its issuance,also ELEC.CONTE. , - LIC.N0, ELEC.
O In requires the applicant for such permit to lilt,a signed statement that TOTAL PERMIT TO
a
.c .- al e is licensed pursuant to the provisions ol'the Contractor's License 11,L
FiLaw(Chapter9(commencingwithSection7000)ofDivision3ofthe SFDU►
¢ he is exempt thcrcl'rom and
QTY. -PLUMBING PERMIT FEE
Business and Professions Code)or that
¢ o the basis for the alleged exemption.Any violation of Section 7031.5 - STORIES a TYPE CONSTR.
ca by any applicant for a permit Subjects lire applicant toa civil penalty ALTER-DRAIN -WATER IEA.) 5.00 2 ',SNHR
of not more than five hundred dollars(S5001J:
❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the stnmlur,is not
intended or offered for sale (Sec. 7044, Business Sold I'rofessions, DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:'Pile Contractor's License Law does not apply to an owner of R-3
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT,FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
meats are not intended or offered for Sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS'6.00 3047
. or improvement is re b within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) • .2.00 BUILDING USE
builder will purpose
the burden of proving that he did not build or im- - RES IND CON PB Omer
prove for purpose of the.). - INDUSTRIAL WASTE INTER. .30.00 X1�
❑ L as owner of the property,ante exclusively contracting with - try ❑ ❑ ❑ ❑
licensed croons od to construct tiro project(Sec. does,Rosiness LAWN SPRINKLERS-1'INC 5 V.B: 6.00 _ ASSESSORS PARCEL No.
and n owner as Cods.The Contractor's's License Law Joos not apply
to anownerfor
ouch projects with
baiWsoactogsvccensedmt,suand who LAWN SPRINKLERS-OVER 5(EA:)'' 1.00
contracts for Such projects with a commctorts)licensed pursuant to
the Contractor's License Law. I SEWER-SAN ITAR V-STORM EA.200th/10.00 TRACT No. - PARCEL NO.
❑ 12m exempt under Sec. ,R.AP.C.for this WATER HEATER W/VENT 6.00 8098 ,
reason
Owner Date WATER SYSTEM, 5.00 -ACC.DATE .ACC.FILE NO.
WORKI:&COMPFNSA'I'ION DEC LA RATION WATER TREATING EQUIP. '• 5.00
1 hereby allirm that I have a certificate of consent to sdi-irsure, ZONING ENG.SITE NO.
or a certificate of Workers Compensation Insumnet,;or a certified .
copy thereof(Sec.3800,Lab.C.).United Pacific
Policy No. Company
Q ❑ Ceflitied copy is hereby furnished. - FIRE SPRINK ENERGY T 24
Z Z Oy ❑Certified copy is ]ilea with tiro city inspection division. MISC.- REFER TO ORD. ❑ ❑
0 Ainic:mt - v N - Y. N❑
_t
F w PERMIT ISSUANCE - 10.00 FLooD zorvE.. A.L.u.c.
X CIi R'1'll'ICA'I'li OP EXEMRIION 17ROM WORKERS'
W � COMPE-NS'WION INSURANCE PLG.CONTE. LIC.NO. PLG. Y❑ N❑ ,•Y ❑ " N E)11 0 (This section need not be completed if the permit is for one TOTAL
Z hundred dollars IS 1007.,less.)
U O- 1 certify that in the performance of rhe work for which this per- CITY. MECHANICAL PERMIT. FEE - FEE SUMMARY
IL F nt it is issued,I slmll not employ any person in any Inanner so as to
UU become subject to the Workers'Compensation Laws of C.ahlomiu. 972.D0•
ED . Date Applicant - ALTER OR�ADDTO MECH. 5.00 BUILDING (.
} W NOTICE'10 APPLICANT If,after nt liking this Certificate of Ex-
F. 2 emption,'you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN)CHECK y 15.50
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=CF.M.) 4.00 ever
CONSI'RUCfION L17NDING AGENCY AIR HANDLING UNIT(OVER 10=C-F.M.) 6.00 SEISMIC FEE . 13.65
I hereby J irm that there is a construction ending agency for, . EXHAUST HOOD (WITH DUCT) 5.00 - 1
tiro performance of the work for which this permit is issued(Sec MICROFILM
3097,Civ.C.). Se U It Pa lf1C - HEATING UNIT(TO 100,000 B.T.U.) 8.00 .
Lender's Name A.��,.-�-�.� HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 73.13.
Lender's Address - ��`L�I
I certify that 1 have read this application and State that the above VENTILATION FAN (SINGLE) 4.00 73.13
information is correct. 1 agree W comply with x11 city and countyPLUMBING
•� ordinances and state laws relating to building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.)'6.00
hereby uutorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTUI SEE FE E SCH. MECHANICAL
om
abovmdioned property for inspection purposes. 73.13
(We)'agree to save, indenmify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs and ,x penses which 'CONST.TAX
may in any way accrue agains said CA Em',qucnce of the PERMIT ISSUANCE 10.00
ranting Of this Y. MECH.CONT. UG NO. MECH. '
TOTAL TOTAL
Signatur ant/Contractor Date
OFFICE COPY" /s7/ '