14950 POST THIS-CARD NEAR FRONTO•F BUILDING '
, PERMIT NUMBER '
CITY OF CUPERTINO 14950
/ INSPECTION DIVISION
JOB INSPECTION RECORD
UNIT# 'LOT ✓o PERMIT EXPIRATION
-
JOB ADDF
PERMIT EXPIRESIF WORK
OWNER (7JfO /� CONTRACTORS l/�f7 IS NOT STARTED -WITHIN
INSPECTI DATE INSPECTOR INSPE ION RECORD 180 DAYS OF PERMIT ISSU
ANCE OR 180 DAYS FROM '
FOUNDATION -I NOTE: . - LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE-INSTALLED '
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF 'LR1n T,VAL DATTON I .
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL ISSUANCE DATE
MECHANICAL bLuc. -ELECT, PLGMECII.
.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - _ BUILDING PERMIT
INFORMATION
WOOD FLOOR P VALUATION SIFT.
PLUMBING
MECHANICAL N
PERmn r0
ELECTRICAL ,,{ O
FRAMING - Df B
INSULATION - - SwRreS TYPE CONSTR 2
.. OCC GROUP -RES UNITS
PLACE NO SU BFLOOR UNTIL ABOVE HAS BEEN SIGNED - R-3
SO,IT 1ILOOv ANEA TOTA�ACREAC,E
ROOF - NOTE:NO FINAL SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTIONION TAX IS PAID
BUILDING USE
ROOF SHEATHING - RCS .IND ON Pb Om..'
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED- FINALS WDATEINSP. 9 ElEl El 1:1ASSESSORS PARCEL NO
ROUGHPLUMBING ELECT.E ERGY '
TUBS 8 SHOWER PAN O-3 - PLUMBING TRACT NO. PARCEL NO
I ENERGY M' I
MECHANICAL �— MECH.ENERGY ncc.DnTE A¢,FLe No,
ELECTRICAL BUILDING ENERGY
FRAMING' .ELECT.FINAL TEST*
'ZONING ENG.SITE-NO.
INSULATION PLUMBING
GAS TEST GAS
FIRE SPRINK ENERGY T�$9
• MECHANICAL - O" Y ❑ NE-] Y E) NE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING • Iw 0`c
EXTERIOR SHEARELECTRICAL RELEASE 'FLOOD?ONE ,A.L Oc.
INTERIOR SHEAR FIRE DEPT. 0 N❑ ❑ N❑
SHEETROCK GRADE. FEE SUMMARY
EXTERIOR LATH BUILDING-
INTERIOR LATH „ Z3 PP TEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC PLAN CHECK"
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY . SEI
62.00
OCCUPANCY.OF BUILDING IS NOT PERMITTED UNTIL BUILDI NG FINALISSIGNED BY BUILDING INSP ECTOR. ' MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505' ELECTRIC
Fw ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBwG
0� PLEASE GIVE JOB ADDRESS WHEN,PHONING.
Z T - MECHANICAL
SEE PERMIT FOR EXPIRATION DATE ,—'
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE•BEFORE TOTAL
CALLING FOR FINAL INSPECTION. ' al
OFFICE COPY
CITY OF CUPERTINO
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
Date ......9----------------------- 19.Q--C(..... Building Permit No.
The goildinIg Located at ....... --------------
Owned by ... .... .......C�. UT..............................................................
.............. ---
1P�ct
Has Been k�n Idel, or Use As: -5p..............................................................
er
.............................................................................................................. ...........:......................
............. ...........................I......................................................................................................
.............................. ........................................................... ......................................................
..........................................
PD-7 BUILDING INSPECTOR
APPLICANT TO FILL IN INFORMATION-WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER
BUILDING
ADDRESS1 72 Seven firings Drive APPLICATION & PERMIT 0
ADDRESS
Lot Plan 3A BUILDING -ELECTRICAL-¢LUMBING-MECHANICAL
OWNER'$ PLAN CHECK VALIDATION
/ NAME Gregory GrcL4) Inc. & Nmanson OTY. ELECTRIC PERMIT �^' FEE
Dever 41595-2100
NAME croFs UTLETS-SWITCHES-RECEP 10.00/1.00
NAME
Grego Inc. Lm.No. B-430097 LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S PPLIANCES-RESIDENTIAL 4.00
ADDRESS 220 C Twin Dolphin Dr.
vH PANELS 10.00 DATE OF APPLICATION
T PANELS (OVER 200 AMP) 20.0 PL-ANCHECK EEE P.C.NO.
OR
ARAM BASSENIM1 AIA.&s ASKC.0 SIGNS TRANS. 3.00
PERMIT VALIDATION
ARCH,OR ENL. •]r1J1 n,,,,,l rd Dr. #100 SPECIAL CIRCUIT 5.00
AD RE55 LVJl "1 Lk'A.'t'
anta Ana Hts, ZIP 92707 EMP.METER OR POLE INS. 20.00
- APPLICANTS
ADDErSSLIC.1 220-C Twin Dolphin Dr. MC94065 MOTORS SEE FEE SCH-
SERVICE CHANGE 20.00
w
00 LICENSED CONTRACTORS DECLARATION
a o u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
w< m (commencing with Section 7000)of Division 3 of the Business and ELECT. PLG. MECH.
F D z Professions Code,and mBikamse is in full WON
z omLicense Class Lic.N'umbc2 w Dale Conlm �y 1 LDING PERMIT
Qw OWNER-BUILDER UECLIryF RMATION
X
;is, H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD p =JET.
F .. o j law for the following reason.(Sec.7031.5,Rusin ss anJ Professions PERMIT ISSUANCE 10.00 C !1N1
S �> E Code:Any city or econty which requiresa permit tucunstruct.alter. ELEC.CONTE. LIG NO. 18611Us/
ar u, a O improve,demolish,or repair any structure,prior to its issuance.also ELEC.
a
O LL mquims the applicant for such permit to lile a signed statement that TOTAL PERMIT TO
in m he is licemied Forward to the provisions of the Contractor's License
Fir
Law(Chapter 9 lcommencingwith Section 7000)of Division 3 of the SI
a Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
m r$ the basis for the alleged exemption.Any violation of Section-7031.5 STORIEAS TYPE CONSTR.
a3 by any applicant for a permit subjects the applicant too civil Penalty ALTER-DRAIN& VENT-WATER IEA.) 5.00 L �� -
of not mom than Odollar($5001.)::hundred dolla155001.1:
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC GROUP RES.UNITS
their Mile compensation,will do the work,and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 - R-3 1
Code:The Contractor's License law dues not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 sa FT,FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such insprove-
damtsare not intended or offered for sale,If,however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 23
or improvement is within one Year of completion, the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have thee burden of proving that he did not build or im-
purpose of sole.). INDUSTRIAL WASTE INTER. - .00 RES Ino CON PB Omer
prove for 30
❑ I,as owner of the properly,am exclusively comracting with ® ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 70,14,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 -ASSESSORS PARCEL N0.
and Professions Code:Thu Conlmoor's License Law does not apply
to an owner of property who builds or improv s thereon,and who LAWN SPR IN KLERS-OVER 5(EA.) 1.00
contracts for such projects with a contractuns)liccnwd minuend to
the Comranor's License Law. ' SEWER-SANITARY-STORM EA.200k110.00 TRACT No. PARCEL No.
❑ 1amexemptunder See ,H,AP.C.forthis WATER HEATERW/VENT 6.00 8067
reason
Owner Date - WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
_ WORK Ii RS'COMPF NSA1'ION DECLARA HON WATER TREATING EQUIP.- 5.00
I hereby infirm that 1 have a certificate of cnnwnt to sdtGinsurc-
or a cvnifcmc of Workers'Comperi,m nn Inuowreu,or u cc,tif,d ZONING ENG,SITE NO-
copy themof(Sec.3B00,Luh.C.). United Pacific
Policy No. Company
O ❑ Certified copy is h creby furnished. FIRE SPRINK ENERGY T 24
Z Z DIL Ccrtifcd "cop - with the city inspection division. MISC- REFER TO ORD.
O Applicant Y ❑ N❑ Y ❑' N❑
M = CERTIPIC .OI' EMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE aL.U.C.
W 7 luohlEX6ON INSURANCE PLG.CONTE. LIC.NO. PLG.
1 O ,ffbis section aced not be c.m,]cl,d if the permit is I'or ,tic ITOTAL- Y❑' N❑ Y❑ N❑
:D Z hundred dollars IS 100)or less.)
U O 1 certify that in the permonance of the work for which Ibis per- CITU. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mil is issued, I shall not ensp toy any person in any manner xs as to
U become subject to the Workeri Comlwmsatiun Laws of California,
C) W Date ApplicantALTER OR ADD TO MECH. 5.00 BUILDING
>., w NOTICE 'TO APPLICAN 1': IL after making Ibis Ccoificxm of rix: 940 50
Z_ eruption,you should become subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must fonllwilh comply with FEE 15.50
such provisions or this permit shall be deemed mvokud. AIR HANDLING UNIT(TO 10=C.F.NL) 4.00 "
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10)000C.6M.) 6.00 - SEISMIC FEE
r 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,C'v.C.). Sea rat PaC f1C HEATING UNIT(TO'100,ODO B.T.U.) 8.00
! Lender's Name-B�_ �C-4th_f1UUr- HEATING UNIT 100,000 B.T.U.)9.56 ELECTRIC
Lender Address (�� p��/I1 J 70.35
I certify that I have SFd IW9.pina J11 and stale that the above VENTILATION FAN (SINGLE) 4.00 -
information is correct. I agree to comply with all city and county BOILER-CCMs'P 13 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ]0
ordinances and state laws relating to building construction, and
hereby authurixe n'prexntativs of this city In ender upon the
BOILER
(Over 100,000 BTU)SEE FEE$GH. MECHANICAL
abow-mentioned property for inspection purneves.
(we) agree to save, indemnify and keep harmless the City of Misc.- REFER TO ORD. 76.35
Cupertino against liabilities,judgments,costs and expenses which CONST.TAX
may in anyW11""
t d City in consequence of the PERMIT ISSUANCE 10.00288-24
bng of lMECH.CONT. - LIC.NO. MECH.
TOTAL TOTAL
\ ' Signature of ate 1530.31
OFFICE COPY