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1771500 POST THIS CARD NEAR FFONT ,OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD' Q// ,,1 A�f �/''//��Jj A� JOB ADDRESSN96la f�"9,4.JE'/'-416 r• UNIT# _LOT# • - - OWNER - CONTRACTOR ERMIrNRMeER 17715 PERMIT EXPIRATION r PERMIT EXPIRES IF WORK :! : IS NOT STARTED' WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION' K 0W - _ NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTIND STANDARDS. I U FER PREGUNITETO ' PERMIT VALIDATION r": 4 f ISsunlvcE untE .� � GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING . ELECTRICAL MECHANICAL _ BLDG ELECT. I PLG,MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. , PLUMBING MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION PI STORIES 2 TYPE CONSTR. - , - - OCC CHOU$' F� RES UNITS 11 ' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID so rT r1.00R AREA 2M7 TOTAL ACREAGE , DIAPHRAGM^ ROOFSHEATH NG I`�j RES INpuILOWNusEPR Ow" ❑ '❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH ASSESSORS PARCE L NO �ICJLp J'J I PLUMBING 6L)-t—U ELECT. TUBS 8 SHOWER PAN (p PLUMBING ENERGY THACT NO PARCEL NO MECHANICAL V�MECH.ENERGY RI ELECTCAL p BUILDING ENERGY ACC DATE ACC. FILF. NO FRAMING D ELECT, FINAL TEST, INSULATION PLUMBING ZONING ENG SITE NO. , GAS TEST GAS MECHANICAL EIRE SPUNK ❑ N❑ erveRGV T 2 :; ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING, EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZUNE v ❑ N❑ 'A.4 U C. ❑ rv❑ INTERIOR SHEAR FIRE DEPT. SHEETR DICK GRADE FEE SUMMARY EXTERIOR. LATH LZ BUILDING. BUILDING INTERIOR LATH '. TEMPORARY APPROVALS SCRATCH COAT ELECTRIC . PLAN CHECK FEE ' GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE i�� OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. LU ARRANGE FOR INSPECTION BY PHONING 252-4505, pail°, ONE WORKING DAY BEFORE REQUIRED INSPECTION. z°� PLEASE GIVEJOB ADDRESS WHEN PHONING. SEE PERMIT FOR EXPIRATION DATE — MICROFILM ELECTRIC PLUMBING 7U.35 MECHANICAL70.35 CONST. TAXA IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL s5m w OFFICE COPY o ¢ i F o 0 20 a2i a N D 0 W a y E J ¢ a X 3: X ; in F u 04 uaX<0 OO O4 La as ria a 3 0, Z Z CC N Woo Z)Z 0 0 LL U 0 } u F ? u • APPLICANT 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 ` 17715 ADDREa aces 1 G OWNER'S NAME Gregory Gr'o(,�p, inc, OTV, ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHON415/595-2100 ' CNAMEONTRACTORS fray Inc ��FF�� UTLETS-SWITCHES•RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 LIC. NO. CONTRA DREScrons ADDRESS D 220 -C Twin Dolphin Drive PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 M1 CA 94065 F.ONE415/595-21 DATE OF APPLICATION ARCHITECT OR Bassenian/lagoni ATChltects ENGINEER • UC.N(O4./0/0 PANELS 200 AMP) 20.00 ,PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 /�,��,a ARCH OR ADDRESS ENG. 2031 OrChard W1 U Drive �/ 100 LV CA UI I IW zip SPECIAL CIRCUIT 5,00 PERMIT VALIDATION �.y� �,� � ►+Px 11 VVII ��1��yyy��1�•�q,��pppyyyy��yyy��I�WW�,,�",,LhJI � n orm EMP. METER OR POLE INS. 20.00 APPLmANT's 220_C Twin AOOREss Dolphin Drive MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 _ Pvel� City, CA M5 I �I \ : 'Z�.y� y LICENSFD CONTRACTORS DECLARATION 1BLDG. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, aV my. license Is in full forc4eDbOcI. License Cl�ss D I.ic.Number 431A17� ISSUANCE DATE v ELECT. PLG. MECH. Y u - Date Contractor /Illy of /y.R40 YIY, 1i` ltYCWyµ1� OWNER-EUILDER DECLARATION I hereby uffum thine am exempt from the metraContractor's License Professions Law for the following rtywh(Sec.uires a,ermit to Code: e, dem y or coup putt which structure permit to amstrulCe, alalter, improve,demolish,or repairanystructure, priorne its issuance, also IO file a signed Contractor's he WItc thl'dp pursuant t theuch provisions he is licensed 9co t0 the provisions of the) of[)License (Chapterant] de) ., Section 7000) of t there fi.n o of the Business and Professionsxempt or that he is tom and Business Professions BUILDING PERMIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION pp�� p� 14,865 $/FT. ELEC.CONTR. LIC. NO. ELEC. TOTAL PERMIT TO S 1 .]f W QTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. tionof ecrcl basis for the alleged exemption. Any violation of Se ctlon by any applicant fora hundred doildrr(hc 0).): am Ion civil penalty by malty of not more Than live hundred dollars (EE00).1: 2 3a ALTER -DRAIN & VENT -WATER (EA.) 5.00 ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will it. the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License law docs not apply to an owner of BACK F LOW PROTECT. DEVICE 4.00 OCC. GROUP R-3 RES. UNITS 1 DRAINS -FLOOR, ROOF, AREA,COND. 5.00 FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-11NC.40UTLETS 6.00 SO. FT. FLOOR AREA 29172.4 TOTALALRFAGE Uv property It. builds or Improves thereon, and who does such Work himself or through his own employees, provided that such improve. meats are not intended or offered for sale. If, however, tiro building or improvement is sold within one year of completion, the owner- builder will have tire harden of proving that he did not build or int- prove for purpose Dfsale.)' ❑ I, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2,00 BULDIF IG USE RES IND CON PB Other M ❑ ❑ ❑ ❑ . . INDUSTRIAL WASTE INTER3000 licensed Contractors to construct the project (Sec. 7144, Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO, - 55- contracts for such projects with a comrxetooxl licensed pursuant to the Contractors License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO, PARCEL NO. ❑ Tum exempt under Sea ,B.&P.C.for this reason 809B WATER HEATERW/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO, WORK F-RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a cerlificme of musical to sell' -insure, or a certificate of Workers' Compensation Insurance, or a certifieA ZONING ENG. SITE N0. copy thereof(Sec. 3800, Lab .C.I �LL..,� y�,,,,,,..tt pj�/� pp /� Policy No. Cnmpuny_Uni.ted_Paci. ir. 'O Certified copy is hereby furnished, ❑ Cerlifie c �py is filed with u, city 0,ection division. App Icum FIRE SPRINK Y ❑ N ❑ ENERGY T-24 Y ❑ N❑ MISC. - REFER TO ORD. CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. COMPENSATION INSURANCE ('this section need not be completed if lire permit is I'or one PLG. CONTR. LIC. NO, PLO, TOTAL Y ❑ N ❑ Y ❑ N ❑ hundred dollars IS 100) or less J I Certify that in the performance of the work for which this per mit is issued, I shall not employ any person in any manner so as to GTV MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: 11, after making this Certificate of Ex- APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 PLAN HECK FEE / BV h,Ay FF�.s��vs,,�� 11 5 emption, you should become subject to the Workers' Compensation provisions of We Labor Code, you must forthwith comply with such movisious'or this permit shall be deemed revoked. AIR HANDLING UNIT IOVER 10=1 CEM.16.00 SEISMIC FEE 13.02 CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC 70.35 1 certify Our I have read this application andstate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county ordinances and stateduws relating to building construction, and PLUMBING 70.35 BOILER-OOMP13 H.P. Dr 100,000 B.T.U.) 6.00 BOILER -COMP IOver100,000BTU)SEEFEESCH. MECHANICAL 70.35 hereby aullmrize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs unit expenacs which may in any way accrue against said, City in consequence of the MISC. • REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX 3� Taal' o ibis permit. MECH. CONT. LIC. NO. MECH. - z TOTAL TOTAL 1,544,09 Signature of Applicant/Contractor Dale OFFICE COPY