15140 'POST THIS CARD-NEAR FRONT OF'BUIL'DING
, PERMIT NUMBER
, CITY OF: COPERTINO : a 15140
INSPECTION DIVISION.
,-
:JOB,INSPECTION,RECORD'
• ,•� /� - - PERMIT EXPIRATION T
JOB ADDRESS 1 Lp +O 1 �C SIO �'1 UNIT# -'LOT# 19`�`�
, PERMIT EXPIRES IF WORK
//�� L•/ IS NOT STARTED WITHIN �I
OWNER , 2. x. �, J• CONTRACTOR ,'
INSPECTION .D TE I INSPECTOR INSPEC ION REC RD 180 DAYS OF PERMIT ISSU-
_ -NCE OR ISO DAYS FROM
FOUNDATION - NOTE:,
LAST.CALLEDINSPECTION. ; _
'UFER. . ' = ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUN ITE y: TO COMPLY WITH THE APPROVED PLANS AND CITY OF - PLHMII VALIDATION_,
CUPERTINO STANDARDS.
GARAGESLABS •t' '
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED_ I "DEC 1 3' 1988 t/�[•7�� ��� C .P.L•.
'UNDERGROUND /SLAB „
PLUMBING
ELECTRICAL - - 611y Uf �U` IRO,
ISSUANCE unre 'V
BLDG ELECT: PLG MEC.
MECHANICAL
00 NOT POUR FLOOR UNTIL ABOVE HAS,BEEN SIGNEDBUILDwG PERMIT
v - : INFORMATION- i
,WOOD FLOOR --' III .vnwnnoN slcT.
PLUMBING -Y - "r. \ ?'
MECHANICAL, V
. .. n �• �I\ PERMIT TO,
ELECTRICAL
FRAMING L"U. +� I - .' +. SFDU .
_ STORIES_ TYPE'CONSTN
INSULATION',
r 2 5NHR
.. $ - .:`C .•.. UL'L,GRDL,I• RES.UNITS
<< . R.:3 . . i
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
50,f r, LOOK ARCA TOTAL ACREAGE o
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE s
DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2917
BUILDING use
ROOF SHEATHING Lj�C{ CS IND CON .PB o ..+
APPLY.NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.
A55[SSORS PARCEL NO.
ROUGH SAN.#:,"
PLUMBING .dt� 'ELECT:ENERGY' - •� �� ^ ' :' r•
UBS SHOWER PAN - PLUMBING ENERGY TRycT No,: PARGL:L NO
MECHANICAL' MECH.ENERGY ' RON
- l� - ACc,DAT E, ACC.FILENO
ELECTRICAL
h BUILDING ENERGY..:
FRAMING jT '�J"'\, 'ELECT.FINAL TEST . -
ZONING - ENG.SITE NO.
INSU CATION �-�' PLUMBING -
GAS TEST GAS • - '
EIRE SPRINK ENERty T2
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v - "❑ p NE]
SHEAR ( $cQ ELECTRICAL RELEASE rLDOD ZONE-d aLuc.
L NL
INTERIOR SHEAR r FIRE DEPT.
SHEETROCK GRADE _ v FEE SUMMARY
EXTERIOR LATH ig - r BUILDING
BUILDING
. ,: INTERIOR.LATy' TEMPORARY APPROVALS'
SCRATCH COAT' ELECTRIC - PLAN CHECKa7f)
GASFEE uv
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCYSEISMIC FE
OCCUPANCY OF BUI LDING IS NOT PERMITTED UNTI L BUILDING'FINAL IS SIGNED BY BUILDINGINSPECTOR, MICROFILM•
.:)ARRANGE FOR INSPECTION' BY"PHONING 252-4505, E�Ecraic'. '
ONE-.WORKING
DAY BEFORE REQUIRED'INSPECTION. , PLUMBING .
�� .. :PLEASE GIVE JOB ADDRESS WHEN PHONING.
` Z — SEE PERMIT FOR EXPIRATION DATE MECHANICAL ;
•IMPORTANT! r cousr.TAx
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR-FINAL INSPECTION.
s :"OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DENT]FICATION ,PERMIT NUMBER
BUILDING 1 APPLICATION & PERMIT.
ADLOT p;g59 RhIVE SPRING COURT 5�.4 �
BUILDING -ELECTRICAL=PLUMBING-MECHANICAL
OWNER'$ PLAN CHECK VALIDATION
NAME Gregoryy' Group, Inc. & DTV. ELECTRIC PERMIT FEB
Ahmanson ;Dev. 115E 595-2100
CONNAME TRACTOR''Gregory Group, Inc. UTLETS-SWITCHES-RECEP 10.00/1.00
•. ,.
LIc8I.430097 LIGHTING FIXTURES 10.00/1.00
CONTRACTORS 4Do 1 ppr -RESIDENTIAL 4.00 -
ADDRESS R&9486?" R -�95-2-100_APPLIANCES
PHONE PANELS 10.00 GATE OF APPLICATIO•N Y'
ARCHITECT PLAN CHECK FEE' ,P.C.•NO.
OR Aram Bassenian, AIA,& AssQ . PANELS 200 AMP) . 20.00 +
ENGINEER -8395/r
LIC.M1fa- J SIGNSTRANS- 3.00
ARCH.OR ENG PERMIT VALIDATION ..
ADD E55 2031 Orchard Dr. 100 sPECIALCIRcuIT 5.00
Santa Ana Hts. Ca. 98707 " _ EMP.METER OR POLE INS. 20.00
APPLICANTS MOTORS - SEE FEE SCH.
ADDREX520
C Twin Dolphin Dr. RWC 940 SERVICE CHANGE "20.00
0 0 o LICENSED CONTRACTORS DECLARATION, '
av v I hereby affirm that I am licensed under provisim¢of Chapter 9 ISSUANCE DATE
m BEG t3 1
rt m (Commenemg will)Section 7000)of Division 3 or Athrte Business and BLDG. ELECT. PLG. MECH.
H w z Professions Code,agl my license is in full force4507 I1R� r� ® I--n - rt
Z O m License Class + Lic.NumM1ereitlr L 1(`J
o r w Dale � CnNr ctor -
¢ s .: BUILDING PERMIT
¢ ¢ w u OWNIi R-BUILDIiR DIiCLARAT'ON INFORMATION
woA REFER TO ORD
N, 1 hereby affirm that 1 am excerpt from the Contractor's License M ISC.-
LLoa Law forthe following reason.(See.7031.5,Business and Professions -" PERMIT ISSUANCE 10.00 VALUATION E/FT.
Code:Any city m count
y it my structure,
a Lure pc or to its issuance,also 1 85 865 •
K G 0• intPmve,dcmoliah,nr.repair any structure,Pour to its issuance,also ELEC.CONTR. LIC.NO. . TOTAL
¢ requires Etta applicant fur xuch permit to lila a signed statement Iha1 TOTAL PERMIT TO
A w m- he is licensed pursuant to the provisions of the Contretor's License
H z t- Law(Chapter 9(conmencing with Section 7000)of Division 3 offle SFDU
¢ Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
E ¢ O
¢ I-o the basis for the alleged exemption.Any violation of Section 7031.5 -STORIES TYPE CONSTR.'
F,`2 by any applicant for a penint subjects the applicant to a civil penalty ALTER-DRAIN (EA.)III'not morethan tivehundred dlmars(s5oo).): 2 5NHR
❑ 1,aS owner of the property or my employees wish wages as BACK FLOW PROTECT. DEVICE 4400 OCC GROUP RES.UNITS
their Side compensation,will du the work,and tire structure is not -
intended or offered for sale (Sea 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,CONO. 5.00 R-3 I
Code-The Contractor's License Law does not apply to an owner of ,
property who huilds or improves thereon,and who does such work FIXTURES-PER TRAP ' 5.00 50,FT.FLOOR AREA TOTAL ACREAGE
In sellor through his own c.lployccs,provided Ilam such mpro
ive- 2917
areas are not intended or offered for sale.it,however,the building GAS-EA.SVSTEM-11NC.40UTLET$ .6.00
m
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) - 2.00 BUILDING USE
builder will have(he burden of proving that hn
e did not build or in
prove for purpose ofsale.).. RES IND CON PB Omer
INDUSTRIAL WASTE INTER. 30.00
❑ L as Owner of tire properly,um exclusivelyrojeSe contracting with ❑ ❑ ❑ ❑
C. licensed contractors to he
Ihe project La 7044,Businessotaply LAWN SPRINKLERS- 1.INC 5 V.B. 6.00 ASSESSORS PARCEL N0.
and Professions property who
Contractor's License Law Joon not apply
- ev a owner Of h projects
who bulb tr improvesensedthereon.and who LAWN SPRINKLERS-OVER 5 (EA.) " .1'.00 ' L r JS
contracts for such License
with a contracmrt91iccnuJ pursuant to --C �TN . /� �j w
' Ihe Contractor's License Law. � SEWER-SANITARY-STORM EA.2001t/10.00 - TRACT No. PARCEL NO.
O l.am'exempt under Sec. t BA P.C.I'Orthia WATER HEATER W/VENT 6.00 8098 '
reason
Owocr Dale WATER SYSTEM '5.00
ACC.DATE ACC.FILE NO.
WORK Ii RS'cOMPl:NSA'f10N Dl:CLARA'NON WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate or consent to self-imufe. - ZONING
or a certificate of Workers'Compensation Insurance,or a certifiedENG.SITE NO.
a,py thereat(Sec.3800,I-A.C')United Pacific
Policy No. Company '
O ❑ CeNified copy is hereby fumishtd. FIFE SPRINK ENERGY T 24
Z Z ' -Certified copy is fled � Ihq city Inspection division.
O AAP cant /�_'` / MISC.- REFER TO ORD. Y•❑ N❑ v ❑ N❑
.� W CER'I'IIICA'I'Ii OF BXIiMI'f10N 1'ROMrWORKIiRS• PERMIT'ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LU > CUh11'IiNSATION INSURANCE PLG.CONTR. . LIC.NO. PLG.,
EL O 11 his section need nor complcicd'it.the permit is for-ono TOTAL y E] N❑ v ❑ N
D 2 hundred dollars IS 100)or less) -
U 1 certify that in the performance of the work for which this per
DTV. MECHANICAL PERMIT FEE FEE SUMMARY
- LL 1- RITE is issued,I shall not employ any person in any mannersls as w
U become subject to the Workers Compcosntion Laws Of California 940.50
U w BUILDING
Date- Allplicau ALTER OR ADD TO MECH. 5.00
} Go NO1ICli TO APPLICANT: II',alcor making this Certificate of fix-
, F 2 c aplion,YOU Should become subjcct to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK .5D
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 10J100C.F.M.) 4.00 ever 62.00
CONS'I'RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
I hereby affirm that there"is a construction lending agency Ivor EXHAUST HOOD(WITH DUCT) 5.00 13.02
the performance of the.§,k for which this,[ mi11p15suxl ISec. MICROFILM
30')7,Civ.C.). JeCur),ty Yac1T 10 HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lenders Name-1---Embarcadero-4"th�i-r- HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 70.35
Lender's Address ee -
I certify that 1 have read this application and. Fu that the above VENTILATION FAN (SINGLE) 4.00
Infonnation is correct. I agree to comply with all city and county PLUMBING 70.35
ordinances and slate laws relating to building construction, and BOILER-CUMP(3 H.P.Or 100,0008.T.U.1 '6.00
hereby authorire representative of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL 70.35
above-mentioned property for inspection purposes.
(We) agree to save, imerundy and keep harndess the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgents, wsls and •xpcnPERMIT ISSUANCE 1000
ses which CONST.TAX
may in any way 'cera• againsm
I said City in cGfwque cc of IC . In
grunting of Ih is per.it //q l( MECH.CONT. LIC.NO. MECH. / .In
TOTAL TOTAL
t
Signature of Applianl ontraaor I Date 'I
•OFFICE COPY ;