15147 POST THIS CARD NEAR FRONT OF BUILDING �l PERMIT NUMBER
CITY OFCUPE TINO 5147
INSPECTION DIVISION ,'^
JOB INSPECTION RECORD
'• "— � PERMIT EXPIRATION
I 1., 1 251. L
JOB ADDR ESS I V IV -- 1' UNIT#k _LOT,#
PERMIT EXPIRES IF WORK "
DINNER ( +_ �'J ' CONTRACTOR y� 'I$ NOT STARTED WITHIN
INSPECTION DATE Il INSPECTOR INSPECTION REC RD 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION NOTE: •
LAST CALLEDINSPECTION. :
.. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED �•
TO COMPLY WITH THE APPROVED PLANS AND CITY OF. .PERMIT VALIDATION
,• PR EGUNITE, - CUPERTINO STANDARDS. '"' I - * J
GARAGE SLABS
-' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED. �, �n88
UNDERGROUND /SLAB DECLGV J -
PLUMBING
ELECTRICAL .. - - 'Wy Ot CUpertIRD Issunrvcc LATE.
,MECHANICAL - BLDG. ELECT.. PLG. men). ;
rvf
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
'I WOOD FLOOR.,. • " INFORMATION
VALUATION SIFT.
PLUMBING
MECHANICAL T - - - 194 5540
ELECTRICAL PLRMII TO
}.
FRAMING
INSULATION. STORIES TYPE CONSM
- ' A .
UCC.G UI' . .UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
SO.i T.FLOOR AREA TOTAL ACREAGL
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE'
DIAPHRAGMTHE CONSTRUCTION TAX IS PAID
.. ' ,•. "�• �•• _BUILDING USH
ROOF SHEATHING ,' 'RLS IND LON PB ', DR.-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE - INSP. �" E'ASSESSORSPARCEL NO
.. _.. ,ROUGH SAN.k ' �r ( rf a b "j,i•
PLUMBING aut .` - ELECT..ENERGY••
THACI NO, PARCEL_NO.
UBS SHOWE .PAN .2 PLUMBING ENERGY
CHANICAL 2y MECH.ENERGY -
ELECTRICAL' ACC.DATE ;ACC FILE NO
BUILDING ENERGY
FRAMING .SL' ELECT.FINAL TEST'-
' _ CONING ENG.SITE NO.
INSULATION 3•y ' PLUMBING
GAS TEST - Q9 GAS `
FIRE SPRINK, ENERGY T]G
MECHANICAL Y
Y
COVER NO WORK UNTIL AB VE HAS BEEN SIGNED • HEATING N'❑ � N�,
'
- FLOOD 1ONE A V.C.
EXTERIOR SHEAR, ELECTRICAL RELEASE I 'I
' INTERIOR SHEAR FIRE.DEPT. Y .rv[:] , ❑ ' N❑
SHEETROCK GRADE FEE SUMMARY 9 '
EXTERIOR LATH BUILDING 0 1L9.7 BUILDING -
INTERiORLATH.;, - .TEMPORARY APPROVALS
_ SCRATCH COAT ELECTRIC Illn.lk %I I Son PLAN CHECK
I . " GAS
v♦
NO TAPE OR-PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISM IC FE
OCCUPANCY OF,BUILDING IS NOTP,ER MITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
.. MICROFILM
ARRANGE FOR INSPECTIONBY PHONING 252-4505, ELEc7alc` is
$P F ' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
(, ��.. PLEASE GIVE JOB ADDRESS WHEN PHONING. °
—'SEE PERMIT FOR EXPIRATION DATE — ' MECHANICAL
IMPORTANT!, CONST. TAX
PLEASE READ REVERSE SIDE,BEFORE
' .CALLING FOR FINAL INSPECTION. TOTAL
`' ;, OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -,USE BALL POINT PEN ONLY _
BUILDING PROJECT IDENTIFICATION •a' ;PERMIT NUMBER
-APPLICATION &�'PERMIT
AD [q
BDIORE55 LDING 11698 OLIVE SPRING COURT 1 5 147'
_ BUILDING-ELECTRICAL-PLUMBING-MECHANICAL P'
OWNER''Gregory Groupe Inc. & PLAN CHECK VALIDATION
NAME QTY. ELECTRIC PERMIT FEE
Ahmanson Dev. 4,]DaE,595-2100 '
NAMERncroRs UTLETS-SWITCHES-RECEP' 10.00/1.00
Gregory Group,Inq,,,-- ,B-430097 LIGHTING FIXTURES - 10.00/1.00
CONTRACTOR'5 ,Win O p In r. APPLIANCES-RESIDENTIAL 4.00
ADDRESS rll l(` p 5 - 41,x,„�95-2100 PANELS 10.00 DATE OF APPLICATION 4..
ORRCWTECT 'Aram assenianjAIA & ASSOC.'. PANELS (OVER 206 AMP) 20.00 - PLAN CHECK FEE P:C.NO.
ENGINEER C-8395SIGNS TRANS. +x.. - 3.00 -
NO.
ARCH.OR ENG: 2031 NT; flan" _ ri SPECIAL CIRCUIT S.00 PERMIT VALIDATION
ADDRESS -
Santa Aha Hts. CA 927197' EMP.METER OR POLE INS. 20.00 "
APPLICANT li rs
ADDRES - - MOTORS " - SEE FEE SCH.
�L20-C.Twin 'Dol'phin D C SERVICE CHANGE ' 20.00 ', "
o o LICCNSIiU CONTRACTORS DIiCLA RAT ION -
<ii U DE I
1 hereby SHIRR that 1,am licensed under provisinns of Chapter 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Business and _ - - BLDG. ELECT. PLG. MECH.
rm i Professions Code,andBny license is in full force a d4jfvs� - ❑ ❑
z o w - License Class' :Lia Nd'nnhor. _
' Date Contract.,_ 3VU77 ( y U Cupertino x x x _
¢ Y s t :� I 1•.: BUILDING PERMIT
¢ ¢•w ¢- OWNER-BUILDER DECLARATION -_ - -
INFORMATION
is LL I hcrchy SITRn Hurt 1 am cxentpl fronrfu,Contractor's License
MISC.- "• REFER TO ORD
LLa. Law forthe following rn.
easo (Sec"7031.5,Business and Professions PERMITISSUANCE10.00 VALUATIOry SIFT.
� - Code:Any city orcounty whichrequiresa permit Io,omtrR,LSIt,L - 1,94540 .
¢ Q 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO'. ELEC. s
O LL requires lite applicant for Such permit to file a signed stalcurent that TOTAL PERMIT TO
u_ism he is licensed pursuant to the provisions of the Contractor's License
F z a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe SFDU
i er Business and Professions Code)or that lie is exempt therefrom and QTY, PLUMBING PERMIT FEE
¢w- the basis for the alleged exemption.Any violation of Section703L5 STORIES. TYPE CONSTR.
by any applicant for a pe nu it subject,the applicant tD a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00
of not more than five hundred dollars(S500).): 2 5NHR
❑ I,as owner ol'tire 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.for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CONDE. 5.00 R-3 1
Code:The Contractor's License Law does not apply to an owner of • '. i
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SOL rT.FLOOR AREA TOTAL ACREAGE
himself or through his own enviloyces,Provided that such improve-
mentsarenotintendedoroffered for sale If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 3047
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 it.- RES IND CON vB Other
for purpose ol'sa1e1. - INDUSTRIAL WASTE INTER. .30.00
❑ 1,as owner of the property.am exclusively contracting with
licensed contractors to construct the project(Sce.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 - ASSESSORSPARCEL NO.
and Professions Code:The Contractor's License Law docs not apply 9
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS
-OVER 5(EA.) 1.00
contracts lin such projects with a contractors)licenwd'pursuain to
the Contractors License Law: SEWER-SANITARY-STORM EA.200ft/10.00' TRACT NO.- •. PARCEL NO.
❑. I am exempt under Sec. ,B.&P.C.far this WATER HEATER W/VENT 6.00 "8098
reason
0vmcr Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKERS'COMPFNSA'1'ION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that 1 have a certificate of consent to sell'-insure, ZONING ENG.SITE N0.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereon Sec.3e00,Lab.C.).United Pacific '
Policy No. Campany
C) ❑ Cerlifiedcopyisherebyfurnished, FIRE SPRINK ENERGY T 24
Z'Z X Certified copy i rile with Die city inspection division.
0 Applicant MISC.- REFER TO ORD. Y � N� Y ❑ N❑
~ wPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
Lu CIiRTII%CCOMPE SA 60TIFROM WORKERS'
QJ need not
be coNINSURANCE PLG.CONTR. LIQ NO. PLGA Y[] NEI Y � NE]
D. O CI his mctirim need not he completed if the permit is fora TOTAL
� Z hundred dollars IS 100)or less.) nu
U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued,I shall not emPIRY any person in any manner so as In
V become subject to the Workers Compensation Laws of Culi(ornia.
y Dam Applicant _ _ ALTER OR ADD TO MECH.. 5.00 rSEISMIC
972.00
} y NOTICE TO APPLICANT: IL after making Ihis Curtil'icate of fix-F.. ? emption,you should become subject to lite Workers'Compensation APPLIANCE 5.00
provisions of the Labor Code,.you must Jorthwith comply with 6 00
U such provisions or this permit slmll be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONS'rRUCfION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.F.M.) 6.00 13.65
1 hereby'atIinn that there is'a coiistruction lending agency ln EXHAUST HOOD (WITH DUCT) 5.00
the perfrmnce �J'the work)or w ch this�rTmil is issued(Sec:3097,Civ.C.). 'Jelc LI Yaci 1C HEATING UNIT(TO t00,0008.T.U.) B.00LenJers Name_...... ,L`a rIr- HEATING UNIT(OVER 100,000 B.T.U.)9.50 73.13
Leuler's Address 1 C���Ua -
I certify that I have read anis application and stale utas the above VENTILATION FAN (SINGLE) 4.00
art i..matlon is correct. I agree to comply with all city and county PLUMBING 73.13
p ordinances and state laws relating m building construction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00
q hereby authoriec representatives of this city to enter upon the �• BOILER-COMP(Over t00,0008TU15EE,FEE SCH. MECHANICAL O 13
above-mentioned properly for inspection purposes. 73,13 .
fix,?�'y (We) agree to save, indemnifyy h
and keep harmless the Cil of MISC.- REFER.-TO ORD.
Cupertino against liabilities,judgments, costs and expenses which IT ISSUANCE 10.00 CONST.TAX
may in any way accrue against said City in consequence of the
riatingof Oda pe RIll. MECH.CONT. LIC.NO. MECH. I 7.a "1 .
jp p lz1;,0 roTAL TOTAL /
w� 1+-p- 1 C
Signature of A ph at/Contractor -nate - t
OFFICE COPY