15820 POST THIS CARD NEAR FRONT OF,RUILID ING
PERM IT NU MEER
CITY. OF'CUPERT'ftb : ; 15820'
INSPECTION.DIVISION
JOB INSPECTION RECORD
Y ' - � •� •+'"� PERMIT EXPIRATION,
JOB•ADDRESS 0AKUNIT#. _LOT#. -
f�n.� / PERMIT EXPIRES IF WORK
owrvER "DLJ CorviRnc*oR `ycCx'iC4—Y-`11 IS NOT STARTED WITHIN': .
INSPECTION DATE INSPECTOR INSPECTION RECORD' ta0 DAVsoF PERMITIssu-. ,
- ANCE OR 180 DAYS'FROM.'
FOUNDATION NOTE:
LAST CALLED.INSPECTION.
'
' LIFER ALL GRADING AND'DRAINAGE SHALL BE INSTALLED
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF 'PEHMIT vn LIDATON
CUPERTINO STANDARDS.
GARAGESLABS.
POURAO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND'/SLABOle Or
-
PLUMBING
ELECTRICALS - - . . 'ISSUANCC DATE
MECHANICAL - Luc ELECT. PL, ,MECH,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED N UILDING PERMIT
WOOD FLOOR - INFORMATION .
_ VALUATION SIFT..
PLUMBING., I pBftIDO
MECHANICAL
ELECTRICAL - PERMIT TO
' FRAMING o f;FnIIlLII
INSULATION - - :STORIES TYPE CONSTR.
2
OCC,GHOUP RES.UNI TS I
A
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED " ' '
SO.FT FLOOR AREA TOTAL ACREAGE
.- ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
�• DIAPHRAGM THE CONSTRUCTION TAX IS PAID i
2
�� BUIDIN
LG USE
ROOF SHEATHING VN' - ' HES IND CON PuEl F-1
' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 'FINALS DATE. "INSP. El' �
n55E550HSPAHCEL NO. 5
ROUGH SAN.0
PLUMBING. ELECT.ENERGY Qkl 2 '
TRACT NO, PARCEL NO
TUBS&SHOWER PAN — PLUMBING,ENERGY
MECHANICAL MECH.ENERGY . - TE ACC,FILE NO r
ELECTRICAL 'j_ BUILDING ENERGY
FRAMING `-N-CLQ,-Fd ELECT.FINAL TEST '
ZONING• ENG.SITE NO. ,
' INSULATION - �_'l (13 PLUMBING -
GAS TEST GAS - `
.I • FIRESPRINK ENERGY T
MECHANICAL N❑.
-za
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - v Q v NO
EXTERIOR SHEAR �j, ELECTRICAL RELEASE FLOOD ZONE ALU,C,.
' El 1,
INTERIOR SHEAR B - N a FIRE DEPT. El EI - L N❑
SHEETROCK-.<, r Q' GRADE' FEE SUMMARY
EXTER I OR,LATH 1{—r7 BUILDING -
BUILDING
.INTERIOR. LATH 21 <T-L TEMPORARY APPROVALIII&A Pon
-
SCRATCHCOAT. _ tL ELECTRIC ' FEEPLACHECK 15�5d,
GAS ,
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEI 8R@®y 62.00;
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM 13.02
' '•. 'T•.: ••
"ARRANGE- '. .. . -•. .. ,. - - ELECTRIC
FOR INSPECTION BY PHONING 252-4505,
Lu ONE WORKING DAY BEFORE REQUIRED INSPECTION: P�uMBING .35"
O�. PLEASEEGIVE JOB ADDRESS.WHEN PHONING*.. _ -
z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TA `70:35
PLEASE READ REVERSE SIDE BEFORE TOTAL
•1 . . •` " CALLING FOR'FINAL INSPECTION. '
' OFFICE COPY f� ��
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY '
'SIU I LDING PROJECT I DENTIFICATI ON - '.PERM(TNUMBER
.'BDILDING o an . APPLICATION & PERMIT. 1 5820
11625 Oak Spring Cdurt
. BUILDING-- ELECTRICAL-PLUMBING-MECHANICAL
NOWN
AMERa Gregory roup, Inc. & PLAN CHECK VALIDATION
Ahmanson Dev. 595=2100 QTY. ELECTRIC PERMIT FEE
U.,
CONTRAcTOR s UTLETS-SWITCHES-RECEP 10.00/,1.00
NAM
Gregory Group; '.In6,, N Bf 430097 LIGHTING FIXTURES 0.00/1.00
CONTRACTOR' 220-C Twin Dolphin Dr. - APPLIANCES- '- 4.00
A°°� C 94065 41,577,595-2100 : `PANELS 10.00 DATE OF APPLICATION :
ARCHITECTAram Bassenianl AIA & Assoc PANELS (OVER 200 AMP) . 20.00 PLAN 111FEE P,C.NO.
OR
I
ENGINEER
' 1., r. /uc.rvo. !COO SIGNS TRANS. 3.00
ARH,ORENG� 2031 Orchard D ` PERMIT VALIDATION
ADOCRES' - SPECIALCIRCUIT 5.00
Santa Ana rests. CA. EMP.METER OR POLE INS.' 20.00.
�II D
APPucnrvrs MOTORS SEE FEE SCH
A°"22b C Twin Dolphin Dr.RWC94Q65 SERVICE CHANGE 20.00
M o LICENSED CONTRACTORS DECLARATION � (O/��
4 u %1 hereby allinn Ihut 1 wn licensed under provision rl Chapter 9 CE GATE
m a N (commencing with Section 7000)of Division 3 of the Business and D L PLG. .MECH.
N z Professions Code,,yid my license is in full fore,,{{gqr�1 f eQ
z o w - Licenw Cluss_D Lie
Num ber_y}U69.7 -
o F La Dutc Contractor
BUILDING PERMIT
a a, w a OWNER-BUILDER DECLARATION INFORMATION
ods - MISC.- REFER TO ORD
al g; e. N Thereby ufl Hit.*that I am exempt Irum the Contractor's License VALUATION $/FT..
F LL o a Caw for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE '10.00 _
Code:Any city or county which re,.besa permit loconxNucl,alter' 185865
2 e, r- FO Improve,demolish,Or repair any structun,prior In Its Issuance,also ELEC.CONTR. LIC.NO. ELEC. +
a
-O ¢ Inquires theapplicant for G,A permit to file a signed statement that - TOTAL PERMIT TO
w m" he is licensed pursuant In the with Provisions of the )of
License
F zi Law(Chapter 9(commencing with Section 7000)of Uivision3of the SFDWL
4 0 Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
a We basis for the alleged exemption.Any violation ol'Section 7031.5 STORIES TYPE CONSTR.
u ; m by any applicant.lora permit subjects tin applicant toacivilpenally ALTER-DRAIN&VENT-WATER (EA.) 5.00 2 SNHR
of not mum than five Imndred dollars($500).1:
❑ -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
intended or offered I'or sale(Sec.7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 �R-3 1
Code:The Contractor's License Law does not apply to on owner of
property who builds or improves thereon,and who does such work. FIXTURES-PER TRAP - '5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve- z
'• mentsarenet intendedorofferedforsele.If,however,thebuilding GAS-EA.SYSTEM-11NC.40UTLETS 6.00 2917'
` Or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER.4 (EA.) 2.00
builderwill have the burden of proving that he Aid not build or ins- BUILDING USE,prove for purpose ofsale.).: ' ' INDUSTRIALWASTE INTER. 30.00 RES IND CON PB 01h.,
❑ 1,as owner of the property,am exclusively contracting with 91 `❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. . 6.00 ASSESSORS PARCEL NO.
and Professions Code:"Che Qinlmdnr's Licenso Law does not apply
to in owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) .-1.00 3
contracts for such projects will,a contractorls)licensed pursuant to
tmContmclor'sLicenseLaw. SEWER-SANITARY-STORM EA.2001t/10.00 TRACT NO. PARCEL NO..
.❑ Iain exempt under Sac. B.&I'.C.tie oda WATER HEATER-W/VENT 6.00 6098
reason
Owner Dole WATER SYSTEM 6.00 ACG DATE, ACC.FILE NO.
WORKERS'CONIPIiNSA11h IN DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a cenilic.u,7(consent to self-inure. ZONING ENG.SITE NO.
. a certificate of Workers'Compensation Insurance;or a certified
.....thereof(See.3800:Lmr.C.).- Dna ted Pacific
Policy'No. Company
O Certified Copy is hereby famished. 'FIRE SPRINK ENERGY T 24
Z Zy�1 -Cerlified copy is Cited with the city inspection division. -
O A,(11,licant - MISC.- REFER TO ORD. y ❑ N❑ Y ❑ N❑
r� C17RI IFICATF.OF EXEMPT[ON FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE 'A.LILC.
LU > COWWENSATION INSURANCE PLG.CONTR., LIC.NO. - PLG. y0 N❑ Y ❑ N❑
CL (This action ,wed not be completed il' the perm it is for one TOTAL
0 Z hundred doll...(5100)or Icss.) - ✓
U O 1 certify that in'the performance or the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mil is issued,I sh.11 not employ any Person in any mmmer so as to
U become subject to the Workers'Compensation Laws of Calil'omiu. +'
940.50
n Dale Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} to NOTICE TO APPLICANT'. If,after making this Certificate of Ex-
f- ? emplion,you'should become subject to the Worker;Compensation APPLIANCE •5.00 PLAN CHECK
provisions of the Labor Code, you,must forthwith comply with
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 FEE /energy 62.00
CONSTRUC'I'IONLENDINGAOENCY ..• AIR HANDLING UNIT(OVER 10,OODGEM.) 6.00 SEISMIC FEE 13.02
1 hereby affum that there ism 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.). SPC rlt •� HEATING UNIT 170100,000 B.T.U.) 8.00 ',
Lender's Name =� spy..] HEATING UNIT(OVER 100,000 B.T.U.)9.50 c
Lcndds nddress �ErOELECTRIC 70.35
.1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) - 4.00 t -+
information is correct.1 agree to comply with all.city and county PLUMBING .70.35
ordinances and state laws relating to building construction, and BOILER-ODMP(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 FEE SCH. MECHANICAL
above-mmntioned property for lnSPcction purposes. 70.35
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD..
upertino against liabilities,judgments, casts and expenses which - - CONST.T X O
cony in any way acc�t ""y
is consequence of the PERMIT ISSUANCE 10.00
By of ibis pernti� MECH.CONT. LIC.NO. MECH. ITTnLTOTAL
Signature of APDlicanDate , � e
OFFICE COPY /� 9/�