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13791 h POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO RMIT NUMBER INSPECTION DIVISION 13791 '�. JOB INSPECTION RECORD �,.�• G � /�-�- 89 PERMIT EXPIRATION JOB ADDRESS !1s`q "'� - ^� ` 1 ' UNIT# LOT# . PERMIT EXPIRES IF WORK OWNER �V`�J-L '"�C' CONTRACTOR - ' IS NOT STARTED WITHIN INSPECTION NDATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION .•: ANCE OR 180 DAYS FROM LIFER LASTCALLED INSPECTION. ' PREGUNITE PERMIT VALIOATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED P � . UNDERGROUND /SLAB PLUMBING V I,eF I 4W ELECTRICAL V�`�P ISSUANCE LATE MECHANICAL - BLDG. ELECT. PLG. MECH. ❑ ❑ ❑ ❑\ 00 NOT POUR FLOORANTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION �$/FT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO tr FRAMING wl TTO R I-ES TYPE CONSTR. INSULATION OCC.GROUP RES.'UN ITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ° ROOF. - $O,IT 1:I00I1 MICA TOTAL`CRF.AGI, CIA'PHRAGM • �I I BUILDING USE REs IND CON P9 OIM1nr APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING f GAS TEST TRACT NO. PARCEL NO. MECHANICAL ACC.DATE ACC,FILE NO, ELECTRICAL MGAS INSP. ^. FRAMING ft,C6-UIRLGa� ZONING ENc.SITENo. INSULATION I_ RHE SPRINK ENERGY T24 ❑ N❑ v ❑ NE]COVER NO WORK UNTI ABO AS BEEN SIGNED HEATING FLOOD ZONE A.L.0 C. LATH-INTERIOR' ELECTRICAL - LATH-EXTERIOR FIRE DEPT. - °❑ N❑ y N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR 6�1 TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK i GAS - NO TAPE OR PLASTER UNTIL AB07E HAS BJPEN SIGNED IOCCUPANCY SEISMIC FEE f OCCUPANCYOF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM w ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC e o~� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING ; PLEASE GIVE JOB ADDRESS WHEN PHONING. ` Z SEE PERMIT FOR EXPIRATION DATE - MECHANICAL '? IMPORTANT.! CONST.TAX � PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LF)ING PROJECT I DENTI FICATI ON Lot PERMIT NUMBER BUILDING 11519-Rock Spring Court APPLICATION & PERMIT ADDRESS 1379 1 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL OWNER'$ PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE Gregory Group, Inc. 1UDNE595-2100 CONTRACTOR'S 101 OUTLETS-SWITCHES-RECEP 10.00/1.00 /0 y NAME Gre or Groug, Inc, LIC.N. cionw LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S ,220 C Twin Dolphin Dr. PPLIANCES-RESIDENTIAL 4.00 1 a, ADDRESS Redwood City, CA PHONE595-2100 1 PANELS 10.00 DATE OF APPLICATION ARCHITECT Aram Bassenian, A.I.A. Bl PANELS (OVER 200 AMP) ZO.00 . PLAN CHECK FEE P.C.NO. 0.ENGINEER Associates uc NO, SIGNS TRANS. 3.00 ARCH.ORENG 3990 Westerly Place, #170 SPECIALCIRCUIT PERMIT VALIDATION 5.00 ES New ort Beach CA 2IP 92660 EMP.METER OR POLE INS. 20.00 ADDRESS 220 C Twin Dolphin Dr. Morons SEE FEE SCH. , `� �., ADDRESS Redwood City, CA 94065 SERVICE CHANGE 20.00 D o o LICENSED CON'TRACT'ORS DECLARATION O < U u 1 hereby affirm that 1 am licensed under provisions of Chapter 9 UANCE DATE Z aa (commencing with Section 7000)of Division 3 of the Business and B ECT. PLG. MECH. r w i Professions Code,aRRQ4 my license is in full forcepppp{{11r({{[(e�[, 0 2! o License Class n Lic.Number 4.3dU`�-(_ w r j Date-Contractor it,H Ek -E - hING PERMIT ¢ ¢w st �OWNER-BUILDER DECLARATION - W INFORMATION w;¢ y I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD r LL o 4 Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 vALunnoN $/FT. Code:Any city orcounty whlchrecluiresaperrnitto constrnet,ulteq /� - ¢ ¢o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. 9 O ✓ `� to d wO¢ Inquires the applicant for such permit to file a signed statement that TOTAL 60 J PERMIT TO m u he is licensed pursuant to the provisions of the Contractor's License �� LVL Hii Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe - a Business uad Professions Code)or their he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢=$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. T by any applicant for a permit subjects the applicant to a civil penalty 15.00 of not more than five hundred dollars(5500).): ALTER-DRAIN&VENT-WATER IEA. e7� S N ❑ I,as owner of the 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,COND. 5.00 PC-3' Code:The Contractor's License Law does not apply to an owner of .� property who builds or improves thereon,end who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himselfthrough his own employees.provided that such impmve- ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CDN PB One, ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ 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 amply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 3 contracts Cor such projects with a colRmetoAs)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sea ,B.&P.C.for this WATER HEATER W/VENT 6.00 -7 on Owner _ Date WATER SYSTEM 5.00 ACC.DATE ACE.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consort to self-insure, or a Certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. ropy thereof(Sec.3800,1ab.C.)� Policy Nn. Compuny11n1_ted-Pa C.ifi.C./_Ra Q ❑ Certified cop tare arm FIRESPRINK ENERGY T 24 ClCertifieJ c e a city inspection division. MISC- REFER TO ORD. Z p Applicant AY❑ N❑ Y ❑ N❑ ~ w" PERMIT ISSUANCE 10.00 Lu - CER IT COMPENSATION EXEMPTION FROM WORKERS' FLOOD ZONE A.L.U:C. W � COMI'F:NSATION INSURANCIi PLG.CONTR. LIC.NO. PLG. Z (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y F] N❑ hundred dollars(S 100)or Icss) U O" 1 certify that in the performance of the work I'.,which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued, I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. cJ Lu Date Applicant BUILDING /3J - } m NOTICE. TO APPLICANT: If,after nsnking this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 F Z emption,you should become subject to the Workers''Compensation APPLIANCE 5.00 aC� PLAN CHECK .4Z< provisions Of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,OODCF.M) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000CF.M.) 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. I HEATING UNIT IT 100,000 B.T.U.) 8.00 Lender's Name SecuritvPaClf1C HEATI NG UNIT 100,000 B.T.U.19.50 Lender's AddressUll_Qll�`.l�y «� ELECTRIC � --� . 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 1 � information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3H.P.or100,0008.T.U.) 6.00 �6p hereby authorize representatives of this city eenter upon tee BOILER-COMP(Over 100000 BTU) FEE SCHMECHANICAL above-mentioned proopertyerty xs , .for inspection purposes. w (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue,again sod City in conscquenc oft �C) granting mer MECH.CONT. LIC.NO. MECH. TOTAL �I TOTAL 411418/ Slgn p moot/ ontmctur ) OFFICE COPY POST THIS OAHU Ivor+ -. CITY OF CUPERTINO 13191 INSPECTION DIVISION L: JOB INSPECTION RECORD ` �� PERMIT EXPIRATION 2 '< UNIT# LOT¢f PERMIT EXPIRES IF WORK Til OR ESS 1 NOT STARTED WITHIN C"1�7-1 �UC CONTRACTOR 180 DAYS OF PERMIT ISSU• OWNER INSPECTION RECORD INSPECTION DATE INSPECTOR ANCE OR 1BO DAYS FROM FOUNDATION LAST CALLED INSPECTION. � li _ PfHMII VA�IOAIION UFER PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUN^D,//SLAB ,y1am��q/�►P IPLUMBING _LU '1l�E ANCE DATE ELECTRICAL Dili LOG. ELECT. PLC. MEE. MECHANICAL (3 o 13 BUILDING PERMIT DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED INFORMATION WOOD FLOOR VALUATION snr. PLUMBING PERMIT TO MECHANICAL ELECTRICAL STORIES TYPE CONSTR FRAMING INSULATION UCC.GROUP RES UNITS s .e so.rT.tLooHARtA IOTALACRtAct PLACE NOSUBFLOORUNTIL ABOVE HAS BEEN SIGNED � Br! R00F t �• A 'it —fl8 UUIfOMG USE HRAGM O YY.I' RES IND CON Pe OV�•' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED Assf ssoHS PARCEE No ROUGH PLUMBING �[, TRACT NO. PARCELNO .3� GAS TEST 7+Y7 OA+• Y��'� �/ MECHANICAL .ddv - ACC.DATE ACC.FILE NO. ELECTRICAL '7 FINALS DATE INSP. FRAMING pev COj}Tc � - ��+ SAN u bz zONINc. ENG.SITE rvo. l PLUMBING, INSULATION T12-L.�ci GAS FIRE SPRINK ENERGY T.]C MECHANICAL v ❑ N❑ Y ❑ N❑ .il COVER NO WORK UNTIL ABOVE HAS BE EN IG ED ' T HEATING aooDZONe ALuc. LATH,INTERIOR i II ELECTRICAL Y❑ N❑ v ❑ N❑ LATH_EXTERIOR / FIRE DEPT. FEE SUMMARY GRADE ;` SHE3TROCK �� SHE INTERIOR IBUILD]NG„ BUILDING SHEAR EXTERIOR — TEMPORARY APPROVALS PLAN CHECK FIREWALLS ELECTRIC FEE GAS' T OVEHA$,BE . , SIGNED OCCUPANCSEISMIC FEE Y < T "`T ?�jNGEINALIS SIGNED BY,BUIL-0ING INSPECTOR. MICROFILM ELECTRIC