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15883POST THIS CARD NEAR FRONT CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION JOB ADORESS,.�.f _ � �L'"�JO Lam` OWNER G�fG O�7 C^v`O' P CONTRACTOR OF BUILDING RECORD UNIT# _LOT - PERMIT NUMBER 15$$3 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE I INSPECTOR INSPECTION RECORD FOUNDATION�j NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. Pr-Liw ' LIFER Ej PREGUNITE • PERMIT VALIDATION L�jVU��' t j-a.zh ISSUANCE GATE GARAGE SLABS ,. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED MAY 9 3 1989 - UNDERGROUND/SLAB PLUMBING City Of Caperun ELECTRICAL MECHANICAL Bwc, ELECT PLG. MEG", BUILDING PERMIT INFORMATION 5 F-4147, 1 l� DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED WOOD FLOOR vAwAiorvz 154,52 4 � SIFT. PLUMBING v MECHANICAL ELECTRICAL / / - PERMIT TO so FRAMING INSULATION BLORIES 2 TYPE CONSTH. OCC GROUP R-3 'RES UNITS i PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHAtOgelMAPE BEFORE THE CONSTRUCTION TAX IS PAT)-.' sa Fr.a AREA III ;5a TOTAL ACREAGE. DIAPHRAGM ROOF SHEATHING5051 1 BUILDING USE RES IND CON PB G,I No ❑ ❑ ❑ ❑ APPLY NO ROOFING'UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. �^ a ASSESSORS PARCEL NO ZG(pr 1JrJ"- ml PLUMBING O�ROUG� ELECT, ENERGY TUBS &SHOWER PANl 01 $d,PLUMBING ENERGY T RACT NO mm PARCEL NO MECHANICAL 6 1- MECH.ENERGY ELECTRICAL,O '.1 BUILDING ENERGY ACC DATE ACC, FILE No FRAMING (0ELECT. FINAL TEST .INSULATION to.p PLUMBING ZONING ENG. SITE No. GAS TEST GAS MECHANICAL FIRE SPRINK ❑ N❑ ENERGY 'T@4 Y N❑ COVER NO WORK UNTIL AB E HAS BEEN IGNED HEATING EXTERIOR SHEAR- ELECTRICAL RELEASE FLOOD LONE Y❑ N❑ ALUC. Y❑ N❑ INTERIOR SHEARFIRE DEPT. SHEETROCK _�,q GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING PLWCHECK FE 4 INTERIOR LATH -TEMPORARY APPROVALS SCRATCH COAT ELECTRIC - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE IDA OCCUPANCY OF BUI LOING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. ARRANGE FOR INSPECTION BY PHONING 252-4505, ��. ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MICROFILM ELECTRIC WAD PLUMBING MECHANICAL CONST. TAX 3M.( IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL TOTAL OFFICE COPY APPVCANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY . . BU LDI NG PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL 'PERMIT NUMBER 15883 'TIN11 &32 PI ER.acer ri ALT" 1.. IPS OWNER '$ NAME Gregory Group, Inc. OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHON NAMERAcroR s�sl,eg ory gyp, Inc. OUTLETS - SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 Lie. No. " CONTE ACTORy_C Dolphin Drive PPLIANCES- RESIDENTIAL 4.00ADDIRSS RK CA PHONE qaS_21 PANELS 10.00 DATE OF APPLICATION ' ORRCHITECT Bassenian/Lagoni Architects ENGINEER .r :! . O PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. ISIGNS TRANS. 3.00 ARCH. OR ENG ADDRESS 2031 Orchard Drive #100 - ISPECIAL CIRCUIT - 5.00 PERMIT VALIDATION CA -92707 0i . TEMP. METER OR POLE INS. 20.00 APPucarvr's 220-C Twin Dolphin Drive AooREss MOTORS y I SEE FEE SCH. SERVICE CHANGE 20.00 R r II 1 Gj 23 LICENSED CONTRACTORS DECLARATIONMAY 2 - City of CIIPArt fla- 1 hereby affirm that I am licensed older provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, �qlua) my license is in full forevaand•eff effect. License Class -I) Lie. Number _43009 ISSUANCE GATT BLDG. ELECT. PLG. MECH. Date. Contractor Contractor OWNER -BUILDER DECLARATION I hereby allirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Business and Professions Code: Any city .,County which requirese permit to construct,, alter, improve, herapplic or repair any structure, prior to its issuance, also for the permit 10 file a Cont statement i risehat he is licensed pursuant he uiresis tic tredp pursuant the provisions of the Contractor's License BUILDING PERMIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION p� 154,922 E/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO en of Division 3 of the Law (Chapter 9 (commencing with Section is exempt Business and Professions Code) or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE �ty� SFW Any violation o tooction 703L5 thenyapor the a ora ermit subjects by any applicant fora permit subjects the00.): ant loucivil penalty .1 not more than floc hundred dollars (my SrOfl1Es 2 TYPE CONSTR. 5" ALTER -DRAIN 5.00 em): ❑ I, as owner m the properly, or my employees with wages as their sole cmnpensul ion, will Jo the work; and the structure is nal BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS ROOF, AREA,COND. 5.00 intended or Offered ILL] sale (Sec. 7044, Business and Professions, Code: I lie Contractor's License Law does not apply to an owner al R-3 . 1 FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 a REA TO1T-ALACREAGE �'1rJl�)' property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- merits are lot intended or offered. for sale. Il', however, the building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build Or im prove for purpose of e.). ❑ as Owner of the property, exclusively contracting with th GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE ,qEs I❑N ❑Other❑ JIC-TJh ❑ INDUSTRIAL WASTE INTER. 30.00 licensedd contractors to construct thehe project (Sec 7044, Business and Professions Code: The Contractor's License Law does not apply to anowner of properly who builds or improves thereon, and who contracts for such projects with a contrtraatar(s) licensed pursuant to the Contractor's License Law. O lam exempt under Sec. ,B.&P.C. for this rCJSan LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS -OVER 5 (EA.) ,.00 ASSESSORS PARCEL NO. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. IM PARCEL NO. WATER HEATER W/VENT 6.00 Owner - Date WATER SYSTEM 5.00 ACL. DATE ACC. FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconsent to self -insure, ZONING ENG. SITE NO. or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab.C.)�i Pacific Policy No. Company •(] Certified'opy is hereby furnished. r�7 Certific� 10- filed with file Cltyinspecli.. dlvisi.m. Applicant- / - MISC. - REFER TO ORD. FIRE SPRINK YE] N [J ENERGY T@4 Y ❑ N0 C1, RTII• AI'Ii OI' 1 XIi`NF MPTIOOM WORKERS' j . COMPENSATION INSURANCE ('(his section need not be completed if the permit is for one PERMIT ISSUANCE 10.00 FLOOD ZONE � N� Y1:1 A.L.U.C. V� N� PLG.CONTR, LIC. NO. PLG, TOTAL hundred dollars IS 100) or less I I certify that in the performance of the work for which this per- ant is issued,.) shall not employ any person in any manner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY become subject to the Workers' Compensation Laws of California. ALTER OR ADD TO MECH. 5.00 Date Applicant BUILDING nn NOTICE'10 APPLICANT: If, after making this Certificate of Ex.AW APPLIANCE - 5.00 PLA/p�LrfT�pl yl'p�f[��K emptian' you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10,000QF.M.) 4.00 FEL+"^-' yJ O.W AIR HANDLING UNIT (OVER 10;000CF.M.) 6.00 SEISMIC FEE 1085 CONSTRUCTION L17NDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097,Civ.C.). , EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Lender's Address HEATI NG UNIT 100,000 B.T.W9.50 ELECTRIC 60.90 I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING (� (� g01LER•COMPI3 H.P. or t00,0008.T.U.) 6.00 hereby entioned representatives ins ec this city to enter upon the hereby muh.'eJ property for inspection purposes. (We) agree to save, indenuilty and keep harmless the City of BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL 60.90 T/ MISC. - REFER TO ORD. Cupertino Light against lave, judgments, costs and expenses which May may in any way accrue against said City in consequence of the Lranlin o. this penult PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL TOTAL ,405.07 Signature of A Tillman Ucon tractor Date OFFICE COPY