15130 POST THIS CARD NEAR FRONT OF BUILDING -PERMIT NUMBER
CITY, OF ,CUPERTINO 151130
INSPECTION DIVISION
JOB,INSPFCTION RECORD
• PERMIT EXPIRATION
JOB ADDR ESS /'1'" .I �.�JVD' ILII (1`l' �J ' C� ' UNIT# '' _LOT#
PERMIT EXPIRES IF WORK'
OWNER ^ ^ ,L CONTRACTOR -9 o�yuY/II , ' 'LO ^IS' NOT:STARTED,WITHIN '
INSPECTION. / DATE INSPECTOR INSPE TION RECORD - 1,BB DAYS OF PERMIT ISSU- E
_ ANCE.OR 1,80 DAYS FROM
FOUNDATION NOTE: - LASTCALLED INSPECTION.
UFER ALL GRADING,AND'DRAINAGE SHALL'BE INSTALLED
PREGUNITE' 70'COMPLY WITH THE APPROVED PLANS�AND CITY OF PERMIT VALIDATION.
'CUPERTINO STANDARDS.
'GARAGE SLABS • - ' i'' T "- I
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED q qppOp .f ����.•---��--- - ;'i
UNDERGROUND /.SLAB .- - C 13 .17(70ij `'�Y�C07�U1C�;
PLUMBING
ELECTRICAU �dy 0 .CUA®f fl0 U ISSUANCCDATE
-
MECHANICAL - - BLuc JEFECI.I PLG., MLCR,:
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
t INFORMATION
WOOD'FLOOR VALUATION. srFT.
P CUM BI NG ' - _T
MECHANICAL_` -
VE RFtI i'IN .
ELECTRICAL '
FRAMING _ SFU
INSULATIONSTORIES TYPE CONS TR.
'OCC GROUP RE .UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - O '
'S(l MOIi AREA i0 L ACREAGE
•ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX.IS PAID
Bu uOINc uS6
ROOF SHEATHING ' Res " Ivo CON PB 'a,.•'
.APPLY,NO ROOFING UNTIL ABOVE HAS BEEN,SIGNED FINALS-, DATE INSP. .. � ' El El � [_
ASSESSORS PA RCEL NO.,
ROUGH SAN.4 `
PLUMBING 1' _ ELECT.ENERGY
TRACT NO. PARCEL NO
TUBS&SHOWER PAN - �, PLUMBING ENERGY
MECHANICAL• =2: :MECH.ENERGY " - '
TF., ACC,FILENO
ELECTRICAL BUILDING ENERGY -
FRAMING ELECT:FINAL TEST' ZONING.. ENG.SITE NO. .
INSULATION ,7 1 - PLUMBING:: .,
GAS TEST, GAS;'
' - FIRE SPHINK ENERGY T.'SA
J' MECHANICAL . :•
-COVER NO WORK,UNTIL AB VE HAS BEEN SIGNED HEATING '. - . .Y 0 �0 Y_0' N❑
FLOOD ZONE ALU'C.
EXTERIOR SHEAR ELECTRICAL RELEASE - '
" INTERIOR SHEAR - FIRE DEPT. 'v . N�Q -} �" N❑
SHEETROCK• GRADE - FEE SUMMARV'j;'';}�A,
EXTERIOR LATH O BUILDING
BUILDING' i..
' .INTERIOR LATH' - TEMPORARY APPROVALS916 00
SCRATCH COAT. .- - ELECTRIC - PLAN CHECK'
. . G . FEE
AS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED' OCCUPANCY ' ' SEISMIC FEE 12 E2
OCCUPANCY BUILDING.IS NOT PERMITTED UNTIL BUILDING'FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
1 ONE WORKING DAY BEFORE REQUIRED.INSPECTION:• PLUMBING
� • . 0PLEASE GIVE JOB ADDRESS WHEN PHONING.* '
ZMECHANICAL '
-SEE PERMIT FOR-EXPIRATION DATE - ;.
IMPORTANT!
CONST.TAX
PLEASE READ REVERSE SIDE BEFORE' ^�
CALLING FOR FINAL INSPECTION: TOTAL- r �800;!^Z•
. OFFICE COPY .
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -.USE'nALL POINT PEN ONLY
' BU I LDING PROJECT I DENT]FICATION - -PERMIT NUMBER
BUILDING 11688 Olive Spring,Court APPLICATION &PERMIT "
ADDRESS - 1,51 '3'0
BUILDING-ELECTRICAL-PLUMBING-'MECHANICAL ..
OWNER'S' - PLAN CHECK VALIDATION
NAME Gregory Group, InC. & OTY -ELECTRIC PERMIT FEE
Ahmanson Dev. 416,,1695-2100
DGNTRACTDns OUTLETS,-SWITCHES-'RECEP 10.00/1.00
NAE
Gregory ,Group, Inc. LIC t,�-430097 LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S - w1R LID i ph In r. APPLIANCES-RESIDENTIAL, 4.00
ADDRESS
RWC 94065 4d,E`z595-2100 PANELS 10.00 DATE OF APPLICATION' .
ARCHITECT PANELS (OVER 200 AMP)' 20.00 PLAN CHECK FEE P.C.NO,
. DR Aram Bassenian,AIA & Assoc
GINEER . '
EN -
,LIc.NoC- • SIGNS TRANS.', 3.00 '
ARCH,OR ENG 0001 Orchard Or SPECIAL CIRC61T 5,OD PERMIT VALIDATION _
ADD G 3 1 U 1 _
Santa Ana Hts. CA 92707 TEMP.METER OR POLE INS. 20.00 -
APPLICANTS MOTORS SEEFEESCH. -
ADDRESS 220-C Twin Dolphin Dr.RWC
94065 SERVICE CHANGE 20.00 - va
02 LICENSED CON'I'RACfORS D17CLARATION -
< it tai I hereby affirm Ihul I an,licensed under previsions of Chapter 9 ISSUANCE DATE
rt w (commencing with Section 7000)of Division 3 of the Business and DEC 1 BLDG. ELECT. I. ALG. MECH.
H m¢ Professions Code,any my hccnsa is in full force u4tF}t,1'O'� .
z o 1 License Class Lie.Number_ J V -
Q w H w Date Conlmnor V-+
a ,, 2 ; �/� Cay Of Cupertin BUILDING PERMIT
m w ¢ ',OWNI:R.BUILDI:R DECLARATION INFORMATION
o> ° - - misc. _ REFER TO ORD
R
LL H 1 hereby affirn, that I an; n exempt Irothe Contractor's License
.. o¢ Law for the following reason.(Sec.7031.5,Business unit Professions PERMIT ISSUANCE VALUATION 5/FT.
_ 10.00 178 281
Code:Any city or rnm1ly which rcquiresu permit to mnslnml,alter,
QQ Q improve,demolish,Or repair any structure,prior to Ib issmi ICe,also ELEC.CONTR. LIC.NO. ELEC.
LL
ca
n requires Illc applicant for shell permi1.IR fit,a Signed'statement(hal TOTAL PERMIT TO
w m he is licensed pursuant to the provisions of the Contractor's License - SFDU
rzi Law(Chapter9(connnencingwith Section 7000)of Division 3 of the - -
a Business and Professions Code)or that he is exempt therefrom and GTY- PLUMBING PERMIT FEE '
szo
H mthe for the alleged exemption,Any emiction otGinn 70315 STORIES TYPE CONSTR.
a3 by anyny a applicant fore permit subjects the applicanno a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 '. 2 5NHR
of not more than five hundred dollars lSS00).): -
❑ I,as owner 6I the property,or my employees with wages its BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITStheir sole compensation,will do the work,and the structure is not -
intended or offered for sale (Sec. 7044, Business and Professions , DRAINS-FLOOR:ROOF,AREA,COND., 5.00 R-3 •1
Code The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP, a" 5.00 SO.PT.FLOOR AREA TOTAL ACREAGE
• himself or through his own employees,Provided that such improve-
ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 2726
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00, BUILDING USE
builder will have the burden of proving that he did not build or ire-
ofsale.l. RES IND CON PB Other
eforpurposeINDUSTRIALWASTE INTER. 30.00
❑ I,as owner of the property,am exclusively mnlraoting with 9 .❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec.7144,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 - A55ESSOR5 PARCEL NO.
and Professions Code:The Coal...U r's License Law dors not apply /!-
to ua owner of property who build,or improves Ihcrcon.and who LAWN SPRINKLERS-OVER 5(EA.); 1.00 Y •9
-3 ) 31. 33
contracts for such projects with a conlraelor(s)licensed pursuant to
file Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO,
❑ Icon exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00
r....),1 8098
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. "
WORK ERS'COMNiNSAt'ION DECLARATION WATER TREATING EQUIP. 5.00
I hereby of arm that I have a certificate of coueent to sell-insure, ZONING ENG.SITE NO.
ora certificate of Workers'Compensation Insurance.or a certified
copy thcrcof(Sec.3800,Lab.C.IU n i ted Pacific
Policy No. Company
.0 ❑ Certified copy is hcreby furnished, - FIRE SPRINK ENERGY T 24
Z Z IY Certified copy}� lit with the city inspection division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑
O app can't_f" Y. ry v N
~ w PERMITISSUANCE 10.00 PLOOD ZONE A,L.U,C.
� > CIiRTIPICCOI PE I AX IO I'INS UROht WORKERS'. -
IL _ COMI'IiNSA1'ION INSURANCE PLG.CONTR. LIC.NO: PLG.'
O. O (Phis section need not be completed if the count is for one TOTAL Y❑ N❑ I Y ❑ N❑
::) Z hundred dollia,IS 100)or loss,(
U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY,
LL F mut is issued, I shall not employ any Person in any numner Bias to -
O become subject to thrs
e Worke ''ConlpcnwlmR Lawsot'California.
O w Dam Applicunf ALTER:OR ADD TO MECH. - 5.00 - BUILDING 916.00
} of NOTICE '10 APPLICANT: If,uric,making This C"Iffilatc of Ex- ,
� Z emption.You should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN
provisions of the Labor Code, you most forthwith comply with - FEE ener 6 00
_ U such provisions or this permii slhall be deemed revoked AIR HANDLING UNIT(TO'10=11F.M.) 4.00 9Y
CONS'I'RUCfION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 12,53
'I hereby affirn, that there is d construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work for which this Permii is issued(Sec. HEATING•UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ.CJ' Security PACIFIC Under',Name HEATING UNIT-(OVER 100,0008.T.U.)9.50 ELECTRIC 6B.5B
Lender,nddre;r [R Qro,4th f1-r-
I certify 11 l h aU Wis, q it(n'unA slam that lhe,mvc VENTILATION FAN (SINGLE) 4.00
. information is correct. I agree to comply with all city and county PLUMBING 68.58
ances and late laws relating to huilding couslrromo, and BOILER-CUMPI3 H.P.or 100,000 B.T.U.1 6.00
hereby authorize representatives of this city Io enter upon the BOILER-COMP (Over 100,000 BTUI SEE FEE SCM. MECHANICAL
oRlln68.58
above-mentioned property for inspection purposes P
a (We) agree to eve, indencity and keep harmless the City of MISC.- ,.. REFER TO ORD. ,p
Q1•� upertino against'liabilities,judgments, Costs and expenses which CONST.TAX - 000 Oe
ay in any way accrue again. sand City in corse umli of tl a PERMIT ISSUANCE '10.00T
ranting of this pennL MECH.CONT. .LIC.NO. MECH.
•, TOTAL 1
r TOTAL ,
Signature ol'Applifinniktoaral
OFFICE COPY