15819 POST THIS CARD NEAR FRONT OF BUILDING
PERMITNUMBER
... _ •
. , CITY Y OF•�CUPERTINO - �'� .
INSPECTION DIVISION,
- JOB INSPECTION RECORD
_ /�C .. •'' * •_t - -� PERMIT EXPIRATION
RESS I lwJ —. UNIT#
JOB AD ' LOT#`��_
PERMIT EXPIRES IF WORK
�.' owrvER - gpoL ` coNTRac*oq �6T-.--���'�'.- •�"�� IS NOT STARTED WITHIN
INSPECTION - DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION - ANCE OR,180,DAYS FROM
_ NOTE: - LAST CALLED INSPECTION:
UFER. =01ALL GRADING AND DRAINAGE SHALL BE INSTALLED - "
TO COMPLY WITH THE APPROVEDPLANS:AND CITY OF PERMIT VALIDATION
PREGUNITE - CUPERTINO STANDARDS.: I
GARAGESCABS '
POURAO CONCRETE UNTIL ABOVE HAS BEEN SIGNED r 4 `/ .g,.t�. �'+L-:<^^ '✓1 ,
''UNDERGROUND /SLAB
.
PLUMBING-
ELECTRICAL
LUMBINGELECTRICAL ' :,.:( .- , - -,I I ISSUANCE DATE
MECHANICALI RLUG, ELECT, PLC, MPCH.
0 4
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED. ' .i BUILDING PERMIT I
° V INFORMATION
' WOOD FLOOR - - ``O n VALUATION $IFT.
PLUMBING
MECHAN CAL - u (G\`Y Ot.CVPe.. IHS.S6S.• ..
' t ELECTRICAL• .'rL ' _ reanuT ro
FRAMING - - 'j •Ir.. SFDU '-� 1
INSULATION.- STURu:R; TYPE CONST-R.
p:. RNHR
OCC.GROUP RES,UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED I - R-3
SOFT.FLOOR AREA TOTAL'ACREAGL*
'ROOF. - NOTE.NOANAL INSP,SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION.TAX IS PAID
ROOF SHEATHING - • c - RLS IND D , COG use
NPB 'O✓w
APPLY NO ROOFINGUNTIL'ABOVE HAS BEEN SIGNED FINALS e•DATE INSP. "
• - ROUGH NI o - yrAss//E' —0lARceL No,
PLUMBING % ;, ELECT.ENERGY, `��" 10"—��
^ n,ACT NO. PARCEL NO.
TUBS&SHOWER PAN . PLUMBING ENERGY '
MECHANICAL MECH.ENERGY _
ELECTRICAL .. - .(AD - BUILDING ENERGY - ACC OarE Acc.FILE No
FRAMING 'jV - �u�' . ELECTFINALTEST •' ', '
ZONING ENG.SITE NO, '
' INSULATION - .Z PLUMBING '.
.GAS TEST - O '.t GAS '
' MECHANICAL FIRE SPRINK. ENERGY T.pa
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING'. _ •Y El 'NEI' :,El.
EXTERIOR SHEAR-. =2 J . e. ELECTRICAL RELEASE FLooD rONI: ALUC, ,
INTERIOR SHEAR '�.-�P ,n(I FIRE DEPT. Y Ej Na .v L NQ`
SHEETROCK. ' _Q,U D5 GRADE FEE SUMMARY
EXTERIOR LATH ' . --LA ILQ BUILDING
INTERIOR LATH Y ` TEMPORARY APPROVALS 9UILDING'-
SCRATCH COAT - — ELECTRIC- - PLAN CHECK
L .� FEE PJ• Q
- GAS' ' ..
NO TAPE OR PLASTER UNTIL ABOVE'HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OFBUILDING'IS NOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 2574505, ELECTRICgr
ONE WORKING DAY BEFORE'REQUIRED INSPECTION. ;. PLUMBING
o,�•'., . .PLEASE GIVE JOB ADDRESSWHENPHONING. 70 35
= SEE PERMIT FOR EXPI.RATION DATE . MECHANICAL
l7n jr
-p
CONST. TAX,
IMPORTANT! :
''PLEASE READ'REVERSE SIDE BEFORE
CALLING FORFINALINSPECTION. TOTAL
;.OFFICE COPY
ANT TO FILL IN INFORMATION WITHIN RED LINES- USE-BALL POINT PEN ONLY
DING PROJECT I DENTI FICATI ON PERMIT NUMBER
BDIt G
AAPPLICATION'& PERMIT
. FS.SLot # 225 Plan r
11605 'Oak Spring Court BUILDING - ELECTRICAL-PLUMBING-MEMECHANICAL 1581.9[pq (
OWNER'S. PLAN CHECK VALIDATION
NAME Gregory Group, Inc. .& CITY. ELECTRIC PERMIT FEE
Ahmanson Dev. 41P -
CONTRACTORS
NAM Gregory Group, INc. UTLETS-SWITCHES-RECEP, 10.00/1.00
uc.rvo. B-430097 LIGHTING FIXTURES 10.00/1.00COINTR ,
ADDRESS-
ADrDRs -220-C Twin Dolphin Dr. APPLIANCES-RESIDENTIAL 4.00
A°°RE
RWC 94065 1416-595-2100 PANELS 10.00 DATE OF APPLICATION
AORRCHITECT PANELS 200 AMP). 20.00 PLAry CHECK FEE P.C.NO.
AEg&c asseniann AIA
ENGINEER -
LII:.N°. C-8395 SIGNS TRANS. 3.00
ARCH.OR ENG. 2031 Orchard Dr. #100 SPECIALCIRCUIT 5.00 PERMIT VALIDATION '
ADDRESS
Santa Ana ,Hts. CA; 927=07 TEMP.METER OR POLE INS. 20.00
APPLICANT s - MOTORS SEE FEE SCH.
ADDRESS
°"B� 220 C Twin Dolphin Or.RW
QlinrSERVICE CHANGE 20.00
wo o LICENSED CONTRACTORS DECLARATION (1 -
a U I hereby affirm that I ono licenwd under provisions of Chapter 9 - tI -NCE DATE
,Hn
¢z n (commencing with Section 7000)of Division 3 of the Business and
w LOQ ELECT. PLG, MECH.
H z Professions Code,and tqv license is in full force.I,�Iyt,�ff c -
a z u, o License Class D Lic.Number 4 j6'66_ City
Date ' - Commctor 7-- A
BUILDING PERMIT
¢ ¢ OWNER-BUILDER DECLARATION '
a o T o INFORMATION
w ; I hereby affirm that I•am exempt from the Contractor's License MISC.- REFER TO ORD
�n VALUATION $/FT.
F LL o ¢ Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00
Code.Any City or County which requires a permit to construct,alter, 185,865
ic ¢ ¢ improve,demolish•or repair any structure,prior to its issuance,also ELEC.CONTR. - LIC.N0. ELEC.
a to requires the applicant for such permit to file
a signid statement that TOTAL PERMIT TO
F.
$u he is licensed pursuant to Oa provisions of the Contme nr's License ` 1'1
Law(Chapter 9(commencingwith Section 7000)of Division 3 of the �' ,SFDUIL ,
E O Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
et H pN the basis for the alleged exemption.Any violation of Section 7031.5- STORIES r TYPE CONSTR.
A. by any applicant lot a permit subjects the applicant to a civil penalty WATER IEA.) 5
of not more than five hundred dollars(5500).1: . ALTER-DRAIN& VENT: .00 2 5NHR
❑ I,as owner or the property,or my employees with wages as
their wle Compensation;will do the work,and tileBACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP. qES.UNITS
structure is not' - ''-
intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 - R-3 l
Code:The Contractor's'License Law dues not apply to an owner of. -
propertywhobuildsorimprovesthereon,and who does such work ' FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACREAGE
himself or not hrough
orown ftcol forSle.If,providedwCvthaC,,till improve- GAS-EA.SYSTEM-1 INC.40UTLETS 6.00 2917
me nts are not t is sold
or offered far sale.If,Iwweveq the building
or improvement is sob within one proving
that
he did
the owner- GAS-EA.SYSTEM-OVER 4(EA:) 2.00 - BUILDING USE
C builder will have the burden of proving that he did not bulb or im- RES IND CON PB 'Other
_ prove forpurposes Owner at sale.). INDUSTRIAL WASTE INTER. 30.00 Mry�
❑ L as owner of the property,he exclusively. 7044. ins with yJ ❑' ❑ ❑ .❑
licensed contractor to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO+
t of a owner ns Cade:The Contractor's License Law docs not apply p
to tr owner of property who bulbs t r improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA:) 1.00 3 _Q
contracts for such cenjecL with a 4ontractortsl licensed pursuant to
. the Cnntraaar's License Lose. SEWER-SAN ITAR V_STORM EA.200ft/10.00 TRACT NO. _PARCEL NO.
❑ I an,exempt under Sec. ;B.&P.C.for this -' WATER HEATER W/VENT - 6.00 8098
Owner
reason
Date WATER SYSTEM r 5.00
ACC:DATE ACC.FILE NO.-
WORK ERS'COMPIbNSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have acerlificate ofconsent to self-insure, - ZONING
u a certificate of Workers Compensation Insurance.or u certified ENG.SITE NO.
copy O,ereor(see.3800,Lab.C.L United Pacific, - -
Policy No. Company
Q. ❑ CeITilleJ mpy ishacby funnishcJ. , FIRESPRINK ENERGY T 24
Z•Z 1Xy Certified copy is Bled with the city inspection division.
O Applicant - MISC.- "' - REFER TO ORD. - Y 0 ' N❑' Y ❑ No
CCN CER'PII7ICA'I'17OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C.
LU COMPFNSAT_ION INSURANCE PLG.CONTR. , LIC.NO. PCG. Y'❑ ,.N❑ v � N.
CL 0 f Phis Section need,ml'be c mpleled if the Peron is for o TOTAL
hundred d.11mv(Sloon or less) o -
U O 1 certify that in the periorinxncr of the work for which this per- GTY. MECHANICAL PERMIT FEE, FEE SUMMARY'
LL U mit is issued,I shall not employ any person in any manner so as to
become subject to the Workers'Cantpensation Laws of California. BUILDING -
940.50
Out Dale-Applicant ALTER OR ADD TO MECH., - 5.00
} N NO1'ICIi 1'0 APPLICANT: It,after making this Certificate of Ex-
♦- ? emptier,you slmuld become subject to Ore Woikers'Compensation APPLIANCE 5.00 PLAN CHECK 15.50
Provisions of the Labor Code, you must forthwith comply '.viol � FEE energy
U such provisions or this perinit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 62.
- CONSTRUCTION LENDING AGENCY ` AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
13.02
I hereby affurn that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) .,5.00
the performance of the work for which this permit is issued(Sec. - MICROFILM
' 3097;Civ,C.). $eCUrlt P8Clf1C HEATING UNIT(TO 100,000 B.T.U.) ' 8.00
Lender's Name HEATI NG UNIT 100,000 B.T.U.)9.50 ELECTRIC •70.35
Lender's Addr, 1 �cadeap, amch-fe ,l _ -
r 1 curt ify that I ,a, cud h s d urian and sate thm Ihu above VENTILATION FAN (SINGLE) 4.00
infonnation.is correct. I agree to comply with all city•and county PLUMBING 70.35
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 BOILER-COMP (Over.100,000 BTU(SEE PEE SCN. MECHANICAL O
abovomentioned property For inspection purposes. 70.35.
(Wey agree to save, indemnify and keep harmless the City of MISC.- REFER TO_ORD.
Cupertino against liabilities,judgments, costs and expenses which CONST:T
may in any way ac rue against said City i Consequence of the PERMIT ISSUANCE 10.00 0
naming of this 0Y MECH.CONT. LIG NO. MECH./ TOTAL. TOTAL
Signator J>t cant/Contracture Ualc � � F
OFFICE COPY