14942 POSTTHISCARD NEAR FRONTOF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO
L
INSPECTION DIVISION 14942_
JOB INSPECTION RECORD
'- - PERMIT EXPIRATION
JOB ADDRESS S /�.QEi� s�R/-M& UNIT# _LOT#
/ q � PERMIT EXPIRES IF WORK
OWNER v CONTRACTOR c1C.c,d 14IS NOT STARTED WITHIN '
INSPECTION DATE INSPECTOR INSPE ION RE ORD 180 DAYSOF PERMIT ISSU.
FOUNDATION ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
U FER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALUATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 'ppJD
PLUMBING
UNDERGROUND /SLAB ISO
- 9•�(/' rAA� 2`U
ELECTRICAL ISSUANCE O
MECHANICAL BLDG E CH
yr ei a cif El El !�
00 NOT POUR FLOOR UNTIL ABO V HAS BWIN SIGNED BUILDING PERMIT i•
INFORMATION
WOOD FLOOR VALUATION $IF
PLUMBING. -
MECHANICAL
ELECTRICAL PERMIT TO
FRAMING, smi
STOWE IYPECONSTR..
INSULATION /47-2� -
OCC. ROUP .R TS
IP,LA'CE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE -PLOOR AREA TOTA ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID_ Isis
BUILDING USE
' ROOF SHEATHING O - IIIA IND CON PB0n,1.,
"APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP S, L 0 L
_ ASSESSORS PARCEL NO
ROUGH SAN.a /
PLUMBING D— — ELECT.ENERGY
THACI NO. PARCEL NO
TUBS&SHOWER PAN � -7- PLUMBING ENERGY '
MECHANICAL• '�p..j�:�/' MECH.ENERGY Ac�c�nrE ncc FILE No
ELECTRICAL ,� laT7BUILDING ENERGY
FRAMING 104fjn 1 %3 ELECT.FINAL TEST
ZONING ENG.SITE NO.
INSULATION PLUMBING ti
GAS TEST 0I 3p,�+ - GAS
MECHANICAL FIRE,SPRINK ENERGY Tau
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATINGY L No , YE] NL
' FLOOII ZONE. A UC,
EXTERIOR SHEAR ELECTRICAL RELEASE
L
INTERIOR SHEAR FIRE DEPT. L NL YL ry
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH - BUILDING BUILDING.
INTERIOR LATH TEMPORARY APPROVALS71C Im
SCRATCH COAT2 '- &b ELECTRIC, 3• FPLA
EEN CHECK 15.50
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC F » +
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS.SIGNED BY BUILDING INSPECTOR. 0
I MICROFILM
' uJ . ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 4948 '
H-� ONE WORKING DAY BEFORE.REQUIRED INSPECTION. PLUMBING
z ' "PLEASE GIVE JOB ADDRESS WHEN;PHONING. 4
- SEE-PERMIT FOR EXPIRATION DATE - MECHANICAL
. , IMPORTANT! coNST.Tnx 28BZ
PLEASE READ REVERSE SIDE BEFORE TOTAL 12$0.42
CALLING FOR FINAL INSPECTION.
OFFICE COPY
CITY OF CUPERTINO
i CERTIFICATE - Or-' COMPLETION
BUILDING-INSPECTOR'S OFFICE
G.OT' /5"? i
i
QiAgj Date ._h.-.Z7................. 19. Building Permit No.
Qf The Building Located at
�f11i1J II, V di Owned by ..... .?.LPY!-..C-��aGL .................._..................................
l� m lete For Use As: ..5:�. •.
I Has Been .....". .... .\!.✓...................................._........
U
(Altered)
...........
..............
........................._....................
.....................................
........._..................................
1 .. .
-Rte........................... „
BUILDING INSPECCOR
op ej
' ' ` •. '��
' - , .; x� _ �:�;• ...'�, � ' 's5 , _..tet '.7 ' 5• .!1 - -. -
iPPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
6UI LDI NG PROJECT IDENTI FICATION PERMIT NUMBER '
BGILo1NG "APPLICATION & PERMIT
AO RES in ree ,ring 14942
y �o 158 Plan *lB BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
OWrvER'S Gregory Group, Inc. fV lllOnson PLAN CHECK VALIDATION
nAME OTY. ELECTRIC PERMIT FEE
' peACTOR S errts 415-595,E2100
NAME ACTOR'S
NAME Gregory Group, Inc. UTLETS-SWITCHES-RECEP 10.00/1.00
I.C.NG. B-430097 LIGHTING FIXTURES 10.00/1.00
CONTRACTORS APPLIANCES-RESIDENTIAL 4.00
AGGRESS 220 C Twin Dolphin Dr. M CA
P"45-595-2100
H _ _ PANELS 10.00 DATE OF APPLICATION
OPRCRRECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER Aram Bassenian, AIA & Associates -
q /y,�h r�,.uc./ C- SIGNS TRANS. 3.00
ARCH.OR ADDRESS ENG. 2031 Orchard UI • #100 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
Ana EMP.METER OR POLE INS. 20,00
A
APPt:cANrS 220 C Twin Dolphin Dr. M CA MOTORS SEE FEE SCH.
GORE55
SERVICE CHANGE 20.00 S_/
w O o LICENSED CONTRACTORS DECLARATION
¢ v w I hereby affirmthat I mm licensed under provisions of Chapter 9 ISSUA E DATE -
z n (commencing with Suction 7000)0l Division 3 of tire Raciness and G. E PLG. MECH.
r 40 i Professions Code,and my license is in full force and effect. -
zo m - License class-B-Lia Number7
4 m r o Dam Contractor - _ '
a ¢ w OWNFIR-BUILDER DECLA .T N B I AT ONNPOPERMIT
F:
;LL m I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
H .. o¢ Law for the following reason.(Sec.7031.5,Businessund Prolessions PERMIT ISSUANCE 10.00 UATION $(FT.
w0 Code:Any city orrounly which requires a permit to construct,alter,
¢ ce Q 0 Improve,demolish,or repair any structure,prior to Its Issuance,also ELEC.CONTR. LIC,NO. ELEC. 122 000
n w m¢ re9uires the applicant for such permit to file a signed statement that TOTAL r PERMIT TO
ec h
e is licensed Pursuant to the provisions of the Contractor's License
Hzi Law(Chapter 9(commenciagwith Section 7000)of0ivision 3 ofthe
a Business and Professions CocW or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE SFDU
¢ r$ the basis for the allu6 ed exem tion.An
P the
O fo a ri)n 703L5 STORIES TYPE DDN$TR,
by any applicant five hundred
the applicant t)ucivil penalty ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundredproperty,
dollar,(my em):
O I,as owner at the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC. OUP REB.UNITS
their sole compensation,will Jo the work,and the strucWrc is nnl
-- intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:Tim Contractor's License Law does not apply to an owner of _
piopetly who builds or improves thereon,and who docs such work FIXTURES'-PER TRAP 5.00 SO.F .FLOOR AREA TOTAL ACOEAGE
himself or through his own employees.provided thatsock intprnve-
mentsarenotintendedor)INN-ed for sale.If,however,file building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 .1515
or improvement is sold within one year of completion,the owne
builder will[lave the burden of proving that he mr-
did not build or i - GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
provelor'ro"mienfsaleJ. INDUSTRIAL WASTE INTER. 30.00 R�E5/ IND - CON PB Omer
❑ 1,as owner of the property,am exchu:ivel)'contracting with , la ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
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-OVER 5 IEA.) 1.00
contracts forsuch projects with a contractions)licensed punuanl to SEWER-SANITAR V-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO, PARCEL NO.
Cl lumexcmptunderSu. ,B.&RC.for this
assn WATER HEATER'W/VENT 6.00 8067
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO.
WORK YRS'COM PENSA1 ION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to self-insure.
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO,
copy thereof(See.3800hall C.I
Policy No.-Company-United_Padfic
O ❑ Certified COPY is hereby furnished. FIRE SPRINK ENERGY T-Z4
Z Z Certified opy with the city inspection division.
F O Applicant MISC.- REFER To ORD. V ❑ N❑ Y ❑ N❑
CCN. Cl.RpIFICA dOFIiXE:MPTIONFROMWORKERS• PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.UX.
W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL O (This section need not be completed if the permit is for one TOTAL V❑' N❑ V ❑ N❑
U O hundred dollars($100)or less.)
1 certify that in the performance of the work for which this per QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL'F , Hit is issued,I shall not a nploy any person hl any runners)it,to
Ow become subject to the Workers'Compensation Laws ol'California.
Ia. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 716.50
>_ m NOTICE•10 APPLICAN"I If,after making this Certificate of Ilx-
F Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK ICJ CJD
provisions of the Labor Code, you most forthwith comply with
U - such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.)' 4.00 FEE Leneray 62-65
CONSTRUCT'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 SEISMIC FEE
I 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. MICROFILM
3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.06
Lender's Name Security Pacific HEATING UNIT(AVER 100,000 B.T.U.) 49
-- Lender's Address_One-Erfbareadero-4-f-Ir�F-941 ELECTRIC
I certify that I have read[[its application and state that the chose VENTILATION FAN (SINGLE) '4.00 - -
ordinances is correct. I agree to comply with all city and county BOILER-DOW(3 H.P.or 100,000 B.T.U.) 6.00 .PLUMBING Q9,�
ordinances and`stale . I relating to building construction, and
hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL 49.88
herebymm�tiiori properly for inspof ion purposes.'to
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. -
- '
Pori against liabilities,judgments, costs and expenses which CONST.TAX
may in any way accrue against said City In consequence of the PERMIT ISSUANCE 10.00 - 288.24
•ranting of this 12.1[11AL. MECH.CONT. LIC.NO. MECH.
y TOTAL TOTAL 1240.42
S,,natureo icanl/Contractor Difle
OFFICE COPY