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13684 r-- POST THIS CARD NEAR FRONT OF BUILDING .. rERr,nr Nu • CITY OF CUPERTINO 1366841 INSPECTION DIVISION 'JOB INSPECTION RECORD r PERMIT EXPIRATION JOB ADDRESS U;�7/ �G`Ya-'✓SO.f IA16Ld Ae' UNIT# LOT# 'v - 64' `` PERMIT EXPIRES IF WORK OWNER 64'(/ CONTRACTOR `-' IS NOT STARTED WITHIN INSPECTION ATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION 13ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PREGUNITE .PERMIT VALIDATION - g, POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING -3 Aff Adf ELECTRICALD.L�P ISSUANCE DATE MECHANICAL ELECT. I PLG. MECH. i DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT NFORMATION WOOD FLOOR wf VALUATION 7 S/FT. PLUMBING E`� MECHANICAL ELECTRICAL PERMIT TO` �Z_ FRAMING N CATION STORIES TYPE CONSTR. 710 � OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF 1 SO,IT,FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE - HES IN CON PC O,n , APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ 0 ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING -d GAS TEST TRACT NO. PARCEL NO. - �a • MECHANICAL ' ACC.DATE ACC.FILE NO. ELECTRICAL FINALS LZ TE INSP. FRAMING ,rj-) - SANq a.z� ZONING ENG SITE NO. INSULATION PLUMBING 2 GAS ' FIRE SPRINK ENERGY T-2< MECHANICAL Z Y ❑ N� Y ❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - LATH-INTERIOR - _ ELECTRICAL PLOOD ZONE - A.L.U.c. LATH-EXTERIOR C' FIRE DEPT. Y❑ NYI] IN SHEETROCK - _ GRADE FEE SUMMARY SHEAR INTERIOR $ BUILDING SHEAR EXTERIOR ..I5-aa, TE M PO RAR APPROVALS BUILDING FIREWALLSELECTRIC PLAN CHECK o FEE (� r GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H ONE WORKING DAY BEFORE REQUIRED INSPECTION. . PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL �-- IMPORTANT! CONST.TAX C PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE > •Date ........7..-...... 19.. Building Permit No. The Building Located at .... ............. .......... .... Ownedby ...... ........( V./b......1......................................... Has Been Completed Use As: Completed ...... .... .................................................. ................................................................................................................................................. .................................................................................................................................................. ................................................ ............ ................ .................. PD-7 BUILDING INSPECTOR OFFICE CITY OF CUPERTINO COPY COPY GAS SERVICE NOTICE ,Lam 3 3 I 9J�—P "To You are hereby authorized to connect the GAS service for Owner or Tenant I n f O d II 10 rZ 1Cr3 At // E7( 5 P Q i!� In New Service !� No:of Meters ' Reconnect No. of Add. Meters Move Service Move MeteJr PLUMB#§INSPECTOR �CL.4 M ~- • - BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg.Dept. Office Copy ❑ Backflow Device Sanitary Permit No, 12 2-ZC7 ❑ Sewer Connection Plumbing Permit No. 3 6-WV '© Plumbing Final /' Lot No. ?3 Owner or Tenant G-k'-e 4./9 11-1/ I -,j i/ h IF At 1/4--7 1 Sey�ln -rQ�r� wos O1- Tract ��!! y � Date Connected — 3 19 Ca Dyate Final / - Z �— 19 s o. UI /! PLUMBING INSPECTOR � V ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO To You are hereby authorized to Connect electrical service for Owner or Tenant 5- k- e q 0 1r V r., L h At i 111- 71 S- I ' _ n No.of Wires Size of Wires Size of Switch V l T Motor Load Voltage Phase . Heating Load K.W. Voltage,/ ILight 110New Service Y Reconnect No.of Meters Heat - 170 Three Wlre More Service_ No.of Add.Meters Power - three Phase-Move Meter �" • ELECTRICAL INSPECTOR �A� �'� AkPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LDING PROJECT I DENTI FICATI ON PERMIT NUMBER RUILDI"° APPLICATION AUDHESS Lot .33 Plan x 2A 136844 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNERS PLAN CHECK VALIDATION NAME Gregory Group, Inc. - CITY. ELECTRIC PERMIT FEE PHONE NAIVE CONTRACTORS 10 UTLETS-SWITCHES-RECEP 10.00/1.00 "AME Gregory Group, Inc. 90 LIC.Ro.430097 20 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 ADOREss 220 Twin Dolphin Drive, #C 3 PHONE _ / IPANELS 10.06 ,d PATE OF APPLICATION AROHITEcr PANELS (OVER 200 AMP) 20.00 PLAN CHECK E PG.NO. °R Aram Bassenian & A.I.A. F; AqqnriAITP_q NGINEER LIc.NO. SIGNS TRANS. 3.00 ARCH.ON EN. . SPECIAL CIRCUIT S.QQ PERMIT VALIDATION ADDRESS 990 Westerly Pl. , #170 Npwport Beach, CA zap 92660 TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEEIF,EEJSCH. 7 r ADDRESS 220 'Twin Dolphin Dr. , #C �,; IWdwood City. CA 94065 SERVICE CHANGE 20.00 ,a )c (7iL X o LICENSED CONTRACTORS DECLARATION U 1J J f /' y of bU0 rtino ¢u U I hereby affirm that 1 um licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000)of Division 3 of the Business end B(,DG. ELECT. P^LG. MECH. ri Professions Cod e d mglicense is in full fore f c t. Ljof Ope Inc Q z o - License C Lic.Number. R O Z H O ate Contractor `a y BUILDING PERMIT 2 x w ¢ OWNER-BUILDER DEC ARATION MX A H I hereby affum than 1 am exempt from the Contractor's Lecruc MISC.- REFER TO ORD INFORMATION we- Law for the following name.(Sec.703 1.5,Business and ProfessionspERM1T ISSUANCE 10.00 /0 VALUATION S/FT. � - Cade:Any city or county which requiresa permit to construct,alter, QQ Q 0 improve,demolish,or repair any structure,prior to Its issuance,also ELEC.CONTR. LIC.NO. ELEC. O¢ requires the applicant for such permit to file a signed statement that TOTAL /9 PERMIT TO wa- he is licensed pursuant to the provisions of the Contractor's License n i U.(Chapter 9(commencing with Section 7000)of Division 3 ofthe ¢ Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ =$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CON d � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 '- SFS of not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 a GROUP RES.UNITS sole compensation,will do the work,and the structure h not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 -3 Code The Contractor's License Law docs not apply to an owner of property who bWds or improves thereon,and who does such work /I F IXTUR ES-PER TRAP 5.00 S"�C' SC.FT FLOOR AREA TOTAL ACREAGE himself or through his own employees.provided that such improve- meatsare not intended or offered for sale.If.however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 /7L0 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or am- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 rJl 1:1 El 1-1 110 1,as owner of the property,am exclusively contracting with IK licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Cale:The Contractor's License Law does not apply to an owner of property who builds or improves thereon.Brad who LAWN SPRINKLERS-OVER 5(EA.) 1.00 .3 6 contracts for such projects with a contractorls)licensed pursuant to SEWER-SAN V-STORM EA^200ft%10.00 /� TRACT NO. PARCEL NO. the Contractor's License Law. - ❑ l am exempt under sec. .B.&P.C.for this 1 WATER HEATER W/VENT 6.00 - 799 reason owner Dam WATER SYSTEM }) " 00 Ili '5. r ACC.DATE ACC.FILE NO. M'ORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. p 5.00 I hereby affirm that I have a ceV rtificate dconsent to self-insure. r;,, of Eunerhl O ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec,3800,Lab.C.bNlted Pacific SA �'Z Policy Nn. Company C) �❑{. Certifwd Copy sherebyf nished FIRESPRINK ENERGY T-24 Z Z A:AicCC11 lh the city inspection division. MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ O X61 CC w CCR IFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 D_ FLOOD ZONE A.LU.C. LU >_ COMPENSATION INSURANCE PLG.CONTR. SSC.NO. PLG. d O This section need not be completed if the permit is for one TOTAL �„ Y❑ N❑ Y ❑ N❑ Z hundred dollars($100)or less) U O 1 certify that in the performance of the work for which this Per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to UU become subject to the Workers'Compensation Laws of California. ALTER f.d'a y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING J } co NOTICI7 TO APPLICANT'. If,after making this Cenificute of Ex- F Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 2PLAN CHECK _ provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall h deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION L17NDING AGENCY AIRHANDLING UNfi(OVER I016.00 SEISMIC FEE 7G3 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. HEATING UNIT(TO 100,000 B.T.U.) 6.00 S- MICROFILM 3097,Civ.C.). / Lender's Name HEATI NO UN IT(OV E R 100,000 B.T.U.)9.50 ELECTRIC Lender's Address R I certify that 1 have read this application and state that the above VENTILATION FAN (SINGL'E)i 4.00 l� information is Correct.1 aggro to comply with all city and countyBOILER-COMP(3 H.P.Or 100,000 B.T.U.). 6.00 PLUMBING ordinances and state laws relating to building construction, and Z� hereby authorize rcpreuntatives of this city to enter upon the BOILER-COMP (Ove;t00,0008TU15EE FEE SCH. MECHANICAL f--�- above-mentioned property for inspection purposes. L� (We) agree to save, indemnify and keep harmless the City of MISC.- LV y 'REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST-TAX may in any way accrue against said City in Consequence of the PERMIT ISSUANCE,y, n4 (:11 fs,11+,,J0.00 (o- P �,+ granting of MECH.CONT. LIVAO." MECH. TOTAL �^ TOTAL /0.�pfl Signat J'ApplicargContractor Date uL� OFFICE COPY CITY OF CUPERTINO INSPECTION DIVISION 13684` JOB INSPECTION RECORD JOB ADDRESS 1I 71 `E VE:.�. Q,N� UNIT# LOT# `3.3 PERMIT EXPIRATION PERMIT EXPIRES IF WORK OWNER LFCrO CONTRACTOR IS NOT STARTED WITHIN INSPECTION D TE. INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM UFER LAST CALLED INSPECTION. PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ELECT,I PLG. MEC.. �Lv7 Pf DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR I - INFORMATION PLUMBING VALUATION $/FT. MECHANICAL ELECTRICAL „ PERMIT TO FRAMING I " IN LATI ON STORIES TYPE CONSTR. 31 IT11/C DEC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO.'T.FLOORAREA TOTALACREAGE " . DIAPHRAGM BUILDING USE RCS IND CON PB OmO 'APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ p ❑ ROUGH ASSESSORS PARCEL NO. PLUMBING _ GAS TEST _ TRACT NO. PARCEL NO. MECHANICAL ✓O- ELECTRICAL •• ��gjji2� FINALS - ACC.DATE ACC FILE NO. FRAMING DATE'- .•INSP. ') SAN t! �2 INSULATION -,.•Z�. j-1i PLUMBING 20NING ENG.SITE NO. GAS y MECHANICALFIRE SPFINK ENERGY TQ4 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED. . HEATING / / Y ❑ N❑ Y ❑ N❑ LATH-INTERIOR ELECTRICAL a FLooD ZONE ' A.L.U.C. LATH-EXTERIOR -�(�- FIRE DEPT. Y❑ N❑ Y ❑ NO SHEETROCK -a GRADE .'FEE SUMMARY SHEAR INTERIOR �I - ' BUILDING SHEAR EXTERIOR y-� -��� TEMPORARY APPROVALS BUILDING .- FIREWALLS ELECTRIC PLAN CHECK _ CrQk GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED occurgNcv SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. ® z PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX ! PLEASE READ REVERSE SIDE BEFORE TOTAL ' CALLING FOR FINAL INSPECTION. Y' APPUCANTS POSTING COPY