15148 POST THIS CARD NEAR'FRONT OF BUILDING
��.,.-% e '' - ', •' 1'F:I'C.11T NUhiB,i
'CITY OF CUPERTINO
15148
" INSPECTION DIVISION
JOB INSPECTION RECORD
/ `.��,, rY . _'_ - PERMIT EXPIRATION
JOB ADDRESS . I �B OII U� 101'L!'��'-r F UNIT# LOT#I � ' T'
_ _ .1 - ' ' PERMIT EXPIRES IF WORK
' OWNER �U CONTRACTOR �r 1 -,'2. IS NOT STARTED,WITHIN
INSPECTION DATE INSPECTOR INSPECIONOECOPID 180 DAYS OF PERMIT.ISSU-
• FOUNDATION. ' t-], -99 C NOTE: ANCE OR 180 DAYS FROM
'
UFERALL GRADINGANDLAST CALLED INSPECTION.
:;DRAINAGE,SHALL BE INSTALLED '�
'.TO COMPLY WITH THE APPROVED PLANS AND CITYOF - vET+mIT vnuon nory
PREGUNI?E - CUPERTINO STANDARDS:GARAGE SLABS
, r
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED '
UNDERGROUND /SLABn. DEC131988''
.:PLUMBING �' V U' i _ -
ELECTRICAL,-- - "City Or,cupB1tIR0 ISSUANCE DATE
MECHANICAL - - BLDGI' ELECT PLG. VLCH,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUI ING PERMIT INFORMATION IX .,
..WOOD FLOOR- ,'' -` ', VALUATION SIFT,
PLUMBING
MECHANICAL '194,540
ELECTRICAL PeNnur TO
FRAMING
STORIES SF@tjTYPE NSTH.
INSULATION,
•'OCC.GI UP 511plaa UNITS
• PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED +. }
' ROOF _ NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so,r T r I AI+EA TOT ACN LACE i
DIAPHRAGM t THE CONSTRUCTION TAX IS PAID 3047
ROOF SHEATHING Kp w euuolOus
NES IRU CNNN ' I
E uu,
G
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE `INSP. SE - ❑
ASSESSORS PARCEL NO
• ROUGH .• SAN.N 7 -
T PLUMBING
ELECT.ENERGY 7 -'
TUBS BSHOWER PAN' _ PLUMBING ENERGY' TRACT NO Pn RCLLNO
MECHANICAL. _is�• -�G. MECH.ENERGY
ELECTRICAL ArE ACC FILE No
BUILDING ENERGY
FRAMING _ �, ELECT.FINAL TESY
ZONING ENG,SI1 E NO.
INSULATIONPLUMBING •
GAS TEST GAS - - - - T-
FIRESPRINK ENERG_'T,}G
. MECHANICAL ❑ NO. ❑ ,N❑
COVER N6 WORK UNTIL ABOVE HAS BEEN SIGNED HEATING '
' EXTERIOR SHEAR,' CO-wELECTRICAL RELEASE -1.00070.NL A.L.0 C.
INTERIOR,SHEAR FIRE DEPT. - Y'0,
N[:] s L' NEl
SHEETROCK • - _ ,55 cI GRADE FEE SUMMARY
EXTERIOR' LATH. .St^f�°7• _ BUILDING BUILDING
; -
INTERIOR' LATH 531, c -TEMPO RARY-APP O AL
SCRATCH COAT : '• ELECTRIC rl , FEEN'CHECK ..15.50
G'AS
NO TAPE OR PLASTER'UNTIL ABOVE HAS[EEN SIGNED OCCUPANCY SEISMIC FE
OCCUPANCY OF BUI LDING IS NOT PERMITTED UNTIL'BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM'
ew ' ARRANGE FOR.INSPECTION BY PHONING 2524505; ELECTRIC
N H
ONE WORKING DAY BEFORE'REQUIRED INSPECTION. PLUMBING
i' O� I PLEASE GIVE'JOB ADDRESS.WHEN PHONING : 73- 13
I
�r Z — SEE PERMIT FOR EXPIRATION DATE:— MECHANICAL
L ,a
' IMPORTANT! CONST.TAX _
PLEASE READ REVERSE SIDE BEFORE TOTAL •I
mCALLING FOR FINAL'INSPECTION.
,: - OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY" .
Y
`-d!* T! BUILDING PROJECT I DENTIFICATION .PERMIT NUMBER
'e APPLICATION & PERMIT
BUILD,"` 11658 'OLIVE SPRING COURT _ 15148
ADDRESS
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL -
OWNER'S UOT 255 411
PLAN CHECK VALIDATION
NINE Gregory Group, Inc. & OTY. ELECTRIC PERMIT - FEE
Ahmanson Dev.. AU-595-2100 `
'V4W. coN7RAcrORs. OUTLETS=SWITCHES-RECEP 10.00/1.00
NAAME Gregory Group, Inc. B=,-430
` r Lm.NO. LIGHTING FIXTURES .. 10.00/1.00
CONTRACTOR'$ 220-C Twin DO1 hits Dr. PPLIANCES-RESIDENTIAL .4.00
ADDRESS RWC 94065 '25-595-210 PANELS 10.00 DATE OF APPL ICATION
ARCHITECT - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE .C.NO.
DENGINEER Aram-.Bassenian,AIA & Assoc. - -
uc.No. _ SIGNS TRANS: 3.00
- - '
PERMIT VALIDATION
ARCH.OR Erva.,2031 Orchard Dr. 1/l0O - SPECIAL CIRCUIT ' � 5.00
AnpRE55Santa Ana -Hts. CA. 92707
EMP.METER OR POLE INS. ' 20.00 '
APPLICANTS MOTORS SEE FEE SCH.
" 220 C Twin -Dolphin Dr. RWC 94D65 SERVICE CHANGE 20.00 t;p
C o LICL'NSEU CON'1'BAC'IUPS DECLARATION '
u L I hereby ufl'i nn,that Ian licensed under provisions ol'Chapter 9 198 ISSUANCE DATE
3 y trotnn,enemg wit Section 7000)of Division 3 of the Business and • BLOG. ELECT- PLG. MECH.
D z N c License Clacna,gw Sar Beeaae Iain null rrnre,a rre-97- j(
o License Class Lie.Nwnber__ ' y Ot CUpeflip
Date Cnnlmctor /
a y f BUILDING PERMIT
re Ie w a OWNER-BUILDER'DECLARATION INFORMATION
A o A " MISC..- REFER TO ORD
w g LL H I hereby affirm ,hal I so cxengv from tl,c Contractor's Professors
VALUATION /FT.
r• uoa LawFor nmity orinureason.(Sec.7irese permit
Prafessions pERM1T ISSUANCE `/10.00
Code:Any city or county which structure,
uirn a permit to construct,clue, 194,540
2 Q'4 improve,demolish.or repair any structure,prior to issuance,also ELEC.LDNTR. LIC.N0. ELEC.
w
- D¢ requires the applicant for such hermit to file a signed s0tement that TOTAL pER MIT TO
h
w$- ,is licensed pursuant to the provisions of the Contractor s License
H z a I-uw(Clmplc,9(commencing with Seelion 7000)of Division 3 of the SFDU '
ZZ theiness'and Professions Code)'or that he is exempt lherefron,and OTY. _ PLUMBING PERMIT FEE
¢ F O the basis for the alleged exemption.Any violation of Section 7031.5 .- STORIES ,TYPE CONSTR.
by any applicant for a permit subjects to applicant to a civil penalty ALTER-DRAIN&VENT-WATER IEA.) 5.00
DI'not more than five hundred dollars 155001.1: - 2 5NHR
• C I,as owner of the properly,or my employees with wages as BACK F LOW PROTECT. DEV ICE 4.00 OCC.GROUP ,RES.UNITS
their wh compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 R-3 I
T Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 50,FT.FLOOR AREA TOTAL ACREAGE
himself or through his Own employees.provided that such improve- 3047
ments are not intended or offered for sale If.however.the building, GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner, GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
holder will have the burden of p,,,vi.g that he did not build or int- -
Ipfovefor purpose ofSale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON pe omen
Cl' I,as owner of the property,am exclusively contracting with ® ❑ ❑ ❑ El
_ IiccawA cnntmctors to,consUuct tha priljcct(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code.The Contraclor's Liecnse Law does not apply.
- to at,owner of property who builds or improves thereon,and who LAWN SPRINKLERS--OVER 5(EA.) -1.00
contracts for such projects with u contructots)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.'
❑ I an,cxcmpl under Set,-,B.&P.C.for this WATER HEATER W/VENT 6.00 8098
reason
Owner Date WATER SYSTEM 5.00
PCC.DATE '. ALC.FILE NO.
WORKI!RS'COMPIINSA'IION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that 1 have a certificate of cOnwat IO wi Glnsure. _ ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(See.3500,Lab.C.). United Pacific
Policy No. Company ,
O ❑ Certified copy is hcrcby fumish',d. FIRESPRINK ENERGY T24
ZZ X1 (ertified espy", 1 ed 'Ili, life city inspection division. MISC. REFER TO ORD.
C Applicant - Y ❑ N❑ Y ❑ N❑
F- rn PERMIT ISSUANCE - 10.00 -FLOOD ZONE . A.L.u.C.
CI5RT11'ICCO o I SAI[ON INS FROM WORKERS'
Ill _ COMP,:NSAI'ION INSURANCE PLG.CONTR. LIC.NO. PLG. Y❑ N❑ I Y❑ N❑
d 0 IT his section need enol be completed if the permit is for one TOTAL'
Z hundred dollars IS 100)or less.)
U 0 1 certify that in the performance of the work for which this Per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL )- mil is issued,1 shall not employ any person in any manner so as to
U become subject to the Workers'Compensation Laws of California. BUILDING 972.00
O y Dale Applicant ALTER OR ADD TO MECH. 5.00
} m NOTICE: 'f0 APPLICANT: If.after making this Certificlte,of Ex-
f- ? anptimi.you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 15.50
far visions of the Labor Code, you must forthwith comply with .FEE energy 62.00 _
6 such provisions or this Permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
�. CONSTRUCTION 1-ENDING AGPNCY _ AIR HANDLING UNIT(OVER 10=C.F.M.).6.00 SEISMIC FEE. 13.6.5
I hcrcby affirm that filer, is a cunetrualion lending agency It,, EXHAUST HOOD(WITH DUCT) 5.00
file performance r;J the wor) I'or•which thl'f[ rmil is issue)ISccHEATING UNIT(TO 100,000 B.T.U.) 8.00
. MICROFILM
3097,Civ.CA . Security Pacl•T is
Lender's Name-1 1'r-�(jET•0-4th_i:-1-P•- HEATI NG UN IT ER 100,000 B.T.U.)9.50 ELECTRIC
Lender's Address ou 73.13
t l�i
I certify that I have read t H' app,cation unit vats that life above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county 'PLUMBING 73. 13
ordinances and vale laws nelaling to building construction, and BOILER-ODMP(3H.P.or100,000B.T.U)•6.00
hereby authorize representatives of this city to eater upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL 73.13
a_y above-mentioned properly for,inspection purposes.
(We) agree to save, indemnify unit keep harmless the City of MISC.- - REFER TO ORD. 9
Cupertino against liabilities,judgments;costs and expenses which CONST.TAX
may in any way accrue against Said City in consequence'of the PERMIT ISSUANCE ' 10.00
'ranting of[I'p fermi 04' MECH.CONT.'v - LIC.N0. MECH. .
l(/-1/ Z//t /Z , '°T"` TOTAL
Signature Iicant/Contractor ,fate) '
OFFICE COPY