14926 v
APPLICANT TO FILL IN INFORMATI D LINES - USE BALL POINT PEN ONLY .
• BUILDING PROJECT IDENTI FICATIDN PERMIT NUMBER
FI.Lit s entree ring CATION'& PERMIT" ��'��
Lot 159 Plan 2A ICAL-PLUMBING -MECHANICAL
Owen ERS regal y ,, Inc. & fY mnson PLAN CHECK VALIDATION
developments 415 595-2100 CTRIC PERMIT FEE
PHONE
CONTRACTOR TS-SWITCHES-RECEP 10.0011.00
NAM yv�
�y Group,
Imo' LIC.NO.B-430097 TING FIXTURES 10,00/1.00
°DNT"^GTO _C Twin Dolphin Dr RWC APPLIANCES-RESIDENTIAL 4.00
AOORE 5 5
PHONE�l 95-2100 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE P.C.NO.
OENGINEER ' Aram Bassenian, AIA & Associates PANELS (OVER 200 AMP) . 20.00
LIC.No. C-8395 SIGNSTRANS, 3.00
ARCH.OR ENG PERMIT VALIDATION
'NM Ana2041,(`'��y�.�'aY'd Dr. ��1W ZIP SPECIAL CIRCUIT 5.00
E+t• 9270 EMP.METER OR POLE INS. 20.00
ADDRESS rs C yllq,. In MOTORS SEE FEE SCH. �•>�l A ,.
ADDRESS `!4th
SERVICE CHANGE 20.00
o ¢ z
F D O LICENSED CONTRACTORS DECLARATION
a v I hereby affirm that.I am licensed under provisions of Chapter 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the 13uiiness and
m Q H - BLDG. ELECT. PLG. MECH.
Hoa Professions Cm1e,and mylicense isNfull luneand_300effect.
0 L=a License Cluss_B Con N,,toot C�7
H Date Cmttrmmr •
m fBUILDING PERMIT
¢ w'u OWNCR-BIIILDISR DGCLA ION
w ;n y 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD RMATION
HUDJ''
Law l'of the following reason. 7031.5.Busincssand Pmfcsions PERMIT ISSUANCE 10.00 ION S/FT.
N Code:Any city or county which requiresa permit townstrucl,alter, -
EE ¢'0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. - ELEC. 1391 O
0 ¢ requires the applicant for such permit to file a'signed statement that TOTAL
n w m n he is licensed pursuant to the provisions of the Contractor's License villiI PERM
SFDUL T TO
r Law(Crime,Ilcommencing with Section 10001of Division 3 oldre
fi sit Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE
¢ H the basis for the alleged exemption Any violation of Section 7031.5 STORIES TYPE CONSTR.
n3 - by any applicant for a permit subjects the applicant to a civil penalty. ALTER-DRAIN&VENT-WATER (EA.) 5.00 .2 5NHR
of not more than five hundred dollars(5500).1:
❑ 1,as owner of the properly,or'my employees with wages as BACK FLOW PROTECT.DEVICE 400
their sole compensation,will,do the work,and the structure is not . OCC.GROUP RES.UNITS
intended or offered for sale (Sec.-7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of R-3 I
property who builds or Improves theROn,and who does such work FIXTURES-PER TRAP - 5:00 SO.FT.FLOOR AREA TOTALACREAGE
himself or through nte his own employees,provided that such improve-
'mems are nor intended or offered for sale 11',ed thathowever.the building GAS-EA.SYSTEM=1 INC.4OUTLETS 6.00 1740
or improvement is sold within one,year of completion,the owner/
builder will have the burden of proving(list he did not build or im- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
prove for purpose of sale.). RES IND CON PB Omar
' ❑ 1.as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ® El ❑ ❑ 0
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
•
ho,un owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a contractor(s)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCEL NO.
O lumexemplunderSee. - B.&P.C.lor this WATER HEATERW/VENT 6.00 8067
reason
Owner Dare WATER SYSTEM 5.00 ACL.DATE ACC.FILE NO.
WORK I-RS.COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have u certificate of consent to self-insure,
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Labe.E -United Pacific
Policy No. Company
O ❑ Certified copy is hereby urnished. RE BPRINK ENERGY L29
Z Z IX Certified copy h'ti a city inspection division.
P: 0 Applicant iMISC.- REFER TO ORD.
V�, Y 0 N Y N
CC CERTIFICATE Of EXEMPT0 PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
L > COMPENSATION I NSII RANCE PLG.CONTR. LIC.NO, pL(-,.
O. 0 (This section need not be completed if the permit is for one ITOTAi. Y❑ N❑ Y ❑ N❑
D Z - Imndred dollars 1$100)Cr less.)
'U O I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE �r FEE SUMMARY
LL Imil is issued,I shill not employ any person in any manner so as to
O L) become subject to the Workers'Compensation Laws of California.
'. Date Applicant ALTER OR ADD TO MECH. 500 BUILDING
>_ N NOTICE TO APPLICANT: If,after making this Certificate of Ex-
F'- ? 'emprion,you should become subject to the Workers Compensation APPLIANCE 5.00 . PLAN CHECK
provisions of the Labor Code, you must forthwith comply with 6l X50
U suc11 provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=1C.F.M.) 4.00 FEE/eWrgY .00
CONSTRUCf1ON LENDING AGENCY - AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 9.73
• 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. MICROFILM
3097,Civ.C.). SEcurity Pacific I HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lender's AJJress �r_4.th-.�1�r ELECTRIC 55.50
I certify thatlh c rca tin l e tion and slate that the above VENTILATION FAN (SINGLE) 4.00 :•
Information is correct. I agree to comply with all city and c.nmrY PLUMBING 55J50
�y ordinances and state laws relating to building construction, and BOILER-CDMP(3 H.P.or 100,000 B.T.U.) 6.00
q hereby authorentioni'm.rcperlYforiins of this city to corer upon rbc BOILER-COMP (Over10g000BTU)SEE'FEESCH. MECHANICAL 55.50
above-mentioned property forinspe of
purposes.
{ (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
- uperlino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10,00 CONST.TAX 288.24
my in any way acciue against said City in corse uence of the
ourbigofthis per tj/,Jr MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL 1317.97
signature of A plaofflicantract., Datc YYY��_
OFFICE COPY
POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPER N0
:r . 14926
INSPECTIONDIVI
*< JOB INSPECTIO
PERMIT EXPIRATION '
• JOB ADDRESS I�s`�' /`�--lr�% G)P12i NCS- G7NIT# _LOT#6
PERMIT EXPIRES IF WORK
OWNER � -p,e fTRp�j -CONTRACTOR �'�6lyd OU IS NOT STARTED WITHIN
INSPECTION ATE NOTE:INSPECTOR INSPEC ON RECO D - 180 DAYS OF PERMIT[SSU
FOUNDATION -�� ANCE OR 180,DAYS FROM LASTCALLED INSPECTION.
UFER ALL GRADING AND.DRAINAGE SHALL BE INSTALLED -
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF .. PERMIT VALIDATION
GARAGE SLABS
CUPERTINO STANDARDS.
- .• ' ' _
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB r '• _• '✓
PLUMBING'
ELECTRICAL aam
ISSUANCE DATE
MECHANICALa EDT PLG. MECH
LO
� MP's ❑ ❑ '
DO NOT POUR FOR IITIL A OVE HAS B N SIGNED V�"�'t ' BUILDING PERMIT
WOOD FLOOR - INFORMATION '
PLUMBING VALUATION VFT,
MECHANICAL 1394)00 T"y
ELECTRICAL PERMIT TO
FRAMING - SRW`
INSULATION STORIES: TYPE CONSTR.
2 DR
OCC GROUP RES UNITS
[PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED It-3 I
so FT FLOOR AREA TOTAL ACREAGE
fl00F NOTE:NOFINAL INSP.SHALL BE MADE BEFORE
+ DIAPHRAGM THE CONSTRUCTION TAX IS PAID 1740
ROOF SHEATHING y [2 , BUILDING USE
♦ u-5c7-$ C - - HES IND CDN Pa 0".
- APPLY NO ROOFING'UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 9 0 0 0 D
-
ROUGH SAN.# /
ASSESSORS PARCEL NO
-
PLUMBING ELECT.ENERGY
TRACT N0. PARCEL NO
TUBS 8 SHOWER PAN D- PLUMBING ENERGY '
MECHANICAL �- _ 917
MECH.ENERGY 4
ELECTRICAL BUILDING ENERGY - AEG DATE ACC FILE NO
FRAMING - ELECT.FINAL TEST -
ZONING ENG.SITE NO.
INSULATION PLUMBING -
GAS TEST .Z& GAS
MECHANICAL cIREaPRwK ot
ENERGYT.z<-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ,r, oe Y ."❑ ° "❑
EXTERIOR SHEAR
1.4(bjM ELECTRICAL RELEASEFLIODZONE. ALU.C.
INTERIOR SHEAR - FIRE DEPT. ' ' - Y❑ "❑ I Y ❑ N❑
SHEETROCK GRADE - FEE SUMMARY -
EXTERIOR LATH BUILDING
INTERIOR LATH .3 _AArxr„/ TEMPORARY APPROVALS BUILpwG
SCRATCH COAT I=L ELECTRIC( •PLAN CHECK
GAS Z FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY. SEISMIC FEE
OCCUPANCY OF,BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
MICROFILM
ELECTRIC
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, 65
1 �� ONE WORKING DAY BEFORE REQUIRED INSPECTION. . PLUMBING
0 PLEASE GIVE JOB ADDRESS WHEN PHONING. . 5�.E741
z
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL 55.541
IMPORTANT! CONST.TAX 2M.24
PLEASE READ REVERSE SIDE BEFORE TOTAL I3I7.97
`CALLING FOR FINAL INSPECTION.
OFFICE COPY ;.