14998•' POSTTHISCARD•NEAR FRONT OF`'BUILDING
.:CITY OF' CUPERTIN-G,,
INSPECTION -DIVISION
JOB INSPECTION RECORD .'
,• r --u — - -'
'JOB ADDRESS' 10 IhYn' (UNIT# ' _ _LOT#' -7w
- /'
OWNER' '(y' 2 L G il,, - CONTRACTOR" r('," , � �
PERMIT NUMBER
14998 ,.
I
PERMIT EXPIRATION + ",
t.
PERMIT EXPIRES IF WORK
IS NOT STARTED WITHIN
180 DAYS OFPERMIT ISSU
ANCE OR 180 DAYS FROM
LAST CALLED INSPECTION..
INSPECTION .DA E INSPECTOR
4NSP8CTlON RECORD
FOUNDATION -1 .9 A•"'
NOTE:
ALL GRADING AND DRAINAGE SHALL, BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF
'CUPERTINO STANDARDS.,
-
UFER
PREGUNI?E„ ••
•' PERMIT VALIDATION
-
ISSUANCE DATE
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
' UNDERGROUND /..SLAB
PLUMBING
-
ELECTRICAL w.ti
MECHANICAL
ELECT.
al
PLLGG., "M LCR.
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
-
-
BUILDING PERMIT -
INFORMATION i
'WOOD FLOOR
VALUATION SIFT.
2AI
w�MIT To
PLUMBING'
MECHANICAL ` "179
ELECTRICAL6'I
FRAMING
INSULATION'•'
-
sTwaes
12
ryPE CONSTR.
MR
-
J.- '
OCc.GROUP
IT ES, UNITS
PLACE NO SU BFLOOR UNTIL ABOVE HAS BEEN SIGNED
-ROOF
NOTE: NO FINAL INSR SHALL BE MADE BEFORE
THE'CONSTRUCTION TAXIS PAID
"••f
" '';-
so FT. FLOOR AREA
To*AL ACREnr.E
•• •-:
DIAPHRAGM ,K
ROOF SHEATHING ;P •• 9, 1 E. iTi!�{. -
BUILDING USE
HES IND CON PB bmf-
El❑
APPLY NO ROOFING UNTIL•ABOVE HAS BEEN SIGNED
FINALS DATEINSP.
ASSESSORS PARCEL NO,
ROUGH F�
SAN.N
PLUMBING" B J -
ELECT. ENERGY
TRACT No.
'W7
Anap ACC.
PARceL NG..
ACC. FILE No.
-
B SHOW PAN 5 W�
PLUMBING ENERGY
MECHANICAL-
MECH.ENERGY.
ELECTRICAL
BUILDING ENERGY
FRAMING
.ELECT. FINAL TEST
zorvlrvc
ENG. SITE No.,
'
INSULATION
PLUMBING
GAS TEST
GAS
FIRE. SPRINK
r ❑',N❑
ENERGY T 24
: ❑" N❑
_
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED-
HEATING
ELouu zUNE
v❑ N❑
n. L.0 c,
rL N❑
EXTERIOR SHEAR.'• •_'
ELECTRICAL REL EASE
INTERIORSHEAR
FIRE DEPT.
- FEE SUMMARY
SHEETROCK -
GRADE
EXTERIOR LATH'
BUILDING. - -
INTERIOR LATH 'f
TEMPORARY "APPROVALS
SCRATCH'COAT T
ELECTRIC ' Lf �
.00
GASNO
FE
62 00
TAPEOR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY- ! "
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BU ILDING INSPECTOR.12.53
Lu ARRANGE FOR INSPECTION BY PHONING:252-4505,
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
E'GIVE JOB ADDRESS WHEN PHONING
0 PLEAS_ .
z
—SEE PERMIT FOR'EXPIRATION DATE,—.
-
PLUMBING
MECHANICAL
j
CONST. TAX^
IMPORTANT.!
PLEASE READ REVERSE SIDE BEFOREb
CALLING FOR FINAL INSPECTION.
TOTAL
"
OFFICE COPY
.4
ELECTRIC SERVICE NOTICE P.G aE. COPY,
BUILDING INSPECTOR'S NOTICE
QTY OF :UPERTINO ry,
To 1 4 .1979
You ore hereby authorized to Conned electrical service for
Owner a, Tenant (2\1-ciWo Jr— �ry�
No. of Wires
Size of Wires Size of Swech
�
Motor Load
Voltage Phase
lieoting Lood
No. of Meters
�s-//,-�KK..�Wp. Voltage
90'O Se.vice
Reconnect
1--1-120 _Three Wire
More Service
No. of Add. Metersr
Power Three PPPhau
ELECTRICAL INSPECTOR
Move.Merer.
, /�
W
A
APPLICANT TO FILL INANFORMATIONVITHIN RED LINES - USE BALL POINT PEN ONLY
BUI LDING PROJECT IDENTIFICATION
-
APPLICATION, & PERMIT
CAL
BUILDING - ELECTRICAL- PLUMBING - MECHANILot
PERMITNUMBER
14 9'9 8
bJI DING Olive Spring:
AOORE55 2A Court
257
OWNER'SI,-&&
NAME Gre�os Group 4�595-2100
Ahmanso v.' E
OTY. ELECTRIC PERMIT FEE t
PLAN CHECK VALIDATION
'
DATE OF APPLICATION
CONTRACTORS
NAME
p
Gregory Group,Inc. LIC.NJ'-430097
OUTLETS - SWITCHES -RECEP 10.00/1.00 -
LIGHTING FIXTURES 10.00/1.00
CONTRACTORS220-L.Nlln O p In r.
ADD
'94065 .4x,55..-595-2100
PPLIANCES- RESIDENTIAL 4.00
APPLIANCES
PANELS. 10.00
OR '
OR Aram Bassenian, AIA & Assoc.
ENGINEER 0-8395
C. NO.'
200 AMP) 20.00
PLAN CHECK FEE P.C. NO.
_PANELS
SIGNS TRANS. ' ' 3.00
ARCH OR ENG., Of1O1� rc rd DrA00
"�aEnsta An Rtg. ��•
_ 92707'
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
•
EMP. METER OR POLE INS. 20,00
APPLICANTS -
ADDRESS
220-C Twin Dolphin,Dr. 'WC
MOTORS - 'SEE FEE SCH. '
SERVICE CHANGE 20.00
LICENSED CONTRACTORS DECLARATI , 065
DEC
T
/
that I and licensed under provisions of Chapter 9
I hereby g with
(commencing with Sen ion 7000) of Division 3 of the �Bqusiness and
Pnlfcssiuns Code, and ,I� Iiccnso is in full force r{ `1/
License Class Lie Number_4���rrrrr]]]{{pppyy9������JJJ���jjjyyyJJJ���`1
.ISSUANCE DATE'
t.
'l
BLDG.
ELECT.
1�1
LQ-'
vLG. -
PLG
LL'i-
MECN.
EC
IiL.I.,
-
Date-Coltractor
BUILDING PERMIT
OWNER -BUILDER DECLARATION
I hereb affirm that I um cxcnt r from the Contractor's License'
Y' I
Law for lire following reason. (Sec. 7031.5, Bettors,' Dd Professio
Code: Any city or county which rerlairesa permit to construct, alter,
improve, demolish, or repair any structure, prior to its issuance, also
rerluires the applicant for such permit to file a Signed statement that
e is licsed puumd to the provisions of the Contractors License
hrnn
Late (Chapter 9(conlmrncing with Section 7000)o fUi,nim, 3 ofthe
Business and Professions Code) or that he is exempt therefrom and
the basis for the alleged exemption. Any, violation of Section 7031.5
INFORMATION
MISC. - REFER TO ORD
VALUATION
1J8,Z8ns
p1
-
$/FT.
'
PERMIT ISSUANCE 10.00
ELEC. CONTR. LIC. NO. -
x
ELEC. '
TOTAL'
PERMIT TO '
SFDII
-
OTV.. PLUMBING PERMIT FEE
STORIES
TYPE CONSTR.
by any applicant for a permit subjects the applicant toleivil penaltyALTER
of not axon than five hundred dollars (5500).): •
-DRAIN&VENT-WATER (EA.) 5.00
- -
2
"5WR -
O I, as owner of the property, or my einployces with wages as
their wlc compensation, will do the work, and the structure is not
intended or offered for sale (See.. 7044, Business and Professions
BACK FLOW PROTECT. DEVICE 4.00
OCC. GROUP
R-3
RES. UNITS
I -
- • DRAINS -FLOOR, ROOF, AREA, COND. 5.00
e: *file Contractor's License Law does Trot apply to an owner of
property who builds or improves thereon, and who does such work
FIXTURES - PER TRAP 5.00
SO, FTFFLOOR AREA
TOTAL ACREAGE
himself or through his own employees, provided that such improve-
menu are not intended oroffered for Sale' If, however the building
ZJZ6
,
GAS-EA.SVSTEM-11 NC. 4 OUTLETS 6.00
or improvement isprovesold within one year of completion. the owner-
,
balder WIII have tum ba rdciT Fproving that lie did not build or Im-
prove for purpose of sale.). -
❑-,I, as owner of the property, am excontracting with
licensed contractors to construct the project (Sec:.7044, Business
and Professions Code: The Contractor's License Law does not apply'
property who builds or improves theren. and who
to an owner of o
GAS - EA. SYSTEM -OVER 4 (EA.) 2.00
BUILDING USE
RES IND CON PB Omer
El ❑clusively
❑ t El
INDUSTRIAL WASTE INTER. 30.00
LAWN SPRINKLERS 71 INC 5 V.B. 6.00
- -
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
ASSESSORS PARCEL No.
3 6 y-313 X J 1 3
contracts for such Projects with a. contractor(,:, licensed pursuant to
the Contractor's License Law.
❑ I aln exempt under Sec: ,B,&P.C. for this,
SEWER -SANITARY -STORM EA. 200ft/10.00
TRACT NO.
18098
PARCEL NO,
'
WATER HEATER W/VENT' - 6.00
mason
-
Owner - Uute
WATER SYSTEM 5.00
.ACC. DATE
ACC. FILE N0.
WORKERS' COMPI.NSATION DECLARATION
WATER TREATING EQUIP. 5.00
• I heorhy atfinn that I have a certificate of cdneenl to sell'-insum.
or a certificate of Workers' Compensation Insurance, or.a'6cuLl'led'
-
ZONING
ENG. SITE NO.
-
copy thereof (Sec. 3800, I.A.C.)United Pacific
Policy No.' Company
'
D. Cc,lificdc.py is hereby furnished.
Certified copy is flerVlvith the city inspection division.
App )Cant_ i'
X
FIRE SPRINK
y ❑ N ❑
ENERGY T-24
y ❑ N❑
MISC, -. - ,. REFER TO ORD.
PERMIT ISSUANCE 10.00
FLOOD ZONE
A.L.U.C.
• CERTIFIL, Hi OF li XEMPTION FROM WORKERS
PLG. CONTR. LIC N0.
PLG. "
TOTAL
CO\IPF,NSAT'ION INSURANCIi -- r
(This section need nut be completed if the permit is for one
v [:JN ❑
v ❑ N❑
OTY. MECHANICAL PERMIT FEE.
- --
FEE SUMMARY
hundred dollars ($100) or less.) '-
I certify that in the performance of the wnrk for which this per-
mit is issued, I shall not employ any person in any manner so as to
become subject to the Workers'Compensation Laws of California.
Date r Applicant
BUILDING
916.00
ALTER OR ADD TO MECH. 5.00
NOTICE TO APPLICANT'. If, after making this Certificated nix.
emption, you should become subject In the Workers'Compensation'+
provisions of the Labor Code; you must, forthwith comply with
such provisions or this permit shall be dcemwd revoked
APPLIANCE' , 5.00
PLAN/ HECK
FEE
15.50
AIR HANDLING UNIT (TO 10=C.r.M.)4.00
AIR HANDLING UNIT (OVER 10=C.F.M.) 6.00
SEISMIC FEE
12.53
CONSTRucfION LENDING AGENCY
EXHAUST HOOD WITH DUCT) 5.00
MICROFILM
1 hereby affirm that there is a construction lending agency for
the perlurman B he.vk',(or whTI this permit is issued (Sea
3097,CIs.C.)uC ".
HEATING UNIT TO 100,000 B.T.U.) 8.00
HEATING UNIT (OVER 100,000 B.T.U.)9.50
ELECTRIC
6.8.58
_
Lender's Nante-.
Lender's Address _ jq'���y}=�
VENTILATION PAN (SINGLE) 4.00
PLUMBING
68.58'
I Certify Ota, l haveruad niapphcai l'tEiund state that (ho ubme
information is correct. I agree to connply with all city and county
ordinances and state'Iaws relating m building <onstrudtion. and
BOILER - COMP 13 H.P. Di 100,000 B.T.U.) 6.00
BOILER -COMP (Ovai 100,000 BTU) SEE FEESCH.
MECHANICAL
-
68.58
hereby aathoriee representatives-ol this city to enter upon the
above-mentioned property for inspection purposes.
MISC. - REFER TO ORD.
CONST. TAX
7
(We) agree to save, indemnify and°keep harmless the City of
Cupertino against liabilities, judgments, costs and expenses which
may in any way, acere against said City in crinscrl yore of the
mnlingoflhi- en /y
-/'il/I
PERMIT ISSUANCE - 10.00
MECH. CONT. LIC. NO. MECH.
_ t TOTAL
TOTAL'
-t -
6GO. 72
t/Conlraor Dat�
Signature pp ic, d
f
OFFICE COPY