13530 POST THIS CARD NEAR FRONT OF BUILDING
PERnuT NUMBER
CITY OF CUPERTINO 13530
INSPECTION DIVISION
l JOB INSPECTION RECORD
PERMIT EXPIRATION
' JOB ADDRESS 11601 SEVEN SPRINGS DRIVE uN1T4tLOT#
PERMIT EXPIRES IF WORK
OWNER GREGORY GROUP. CONTRACTOR GREGORY GROUP IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION _
UFER LASTCALLE D INSPECTION.
I
PREGUNITE PERMIT VALI CATION
I'
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -
UNDERGROUND /SLAB
PLUMBING ;z i
ELECTRICAL - ISSUANCE DATE
MECHANICAL Bloc. ELECT. PLc. MECR,
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION SIFT.
PLUMBING
MECHANICAL
PERMIT TO
' ELECTRICAL _
FRAMING
STORIES TYPE CONSTR.
IN L'ATION � '
l
OCC)GROUP RES,UNITS
r PLACE NO SUBFLO R UNTIL ABOVE HAS BEEN SIGNED - ,I Y
ROOF SO.FT,FLOOR AREA TOTAL ACREAGE
DIAPHRAGM
_ BUILDING USE
Y RES IND CON PB Olnr,
APPLY NO ROOFING UNTIL ABOVE HAS;BEEN SIGNED - El ❑ ❑ ❑
ROUGH ASSESSORS PARCEL NO.
PLUMBING - n �OT .
TRACT No. PARCEL No
GAS TEST .
b,�a -dam �AcFtG4uJ 7, 'z
MECHANICAL �/3' A! lLtD ACO,DATE ACC FILE No,
ELECTRICAL -! FINALS DATE INSP.
FRAMING SAN * �a- ZONING ENG.SITE NO.
INSULATION PLUMBING . �
GAS 20 -.pt
MECHANICAL FIREBPRINK ENERGYT24
NE]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING -.jp,
FLooD zorvE A.L.u.C.
LATH-INTERIOR v. ELECTRICAL
LATH-EXTERIOR FIRE DEPT. Y❑ "❑ Y N❑
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR u "' - BUILDING - `� _
SHEAR EXTERIOR NcLlli -6--L-5-8F2TEMPORARY APP OVALS BUILDING /
FIRE ALLS ELECTRIC ]... PLAN CHECK
-� - GAS . FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BE N SIGNED OCCUPANCY SEISMIC FEE X
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM
I
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
z PLEASE GIVE JOB ADDRESS WHEN PHONING.
C: — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL '
L '
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
BUI LDI NG PROJECT IDENTIFICATION PERMIT NUMBER
BUILDING APPLICATION & PERMIT
„40 '(1� -�' 13530
BUILDING -ELECTRICAL-PLUMBING-MECHANICGl.
uwNEBS - PLAN CHECK VALIDATION
Gregory'GLoup, Inc. OTY. ELECTRIC PERMITF - FEE
ypf PHONE 59ir_
CONTRACTORS - UTLETS-SWITCHES-RECEP 10.00/1.00 o
NAME Gregory Group, Inc.
uc.No. 43QQ27 26LIGHTING FIXTURES 10.00/1.00 as
CONTRACTORSPPLIANCES-RESIDENTIAL 4.00
ADORE55 220 Twin Dolphin Dr. , "C"N6WQyd City, CA _ -
PHONE 595 2100 PANELS 10.00 DATE OF APPLICATION
PLAN CHECK FEE. ,C.N0.
• °R Aram Ba550nian, A.I.A. & PANELS (OVER 200 AMPI 20.00
ENGINEER
LIC.No. LL SIGNS TRANS- ' 3.00 '
ARCH.OR Erf�990 Westerly Pl. , #170 - PERMIT VALIDATION
ADDRESS SPECIAL CIRCUIT 5.00
t (7 APIP EMP.METER OR POLE INS. 20.00
AouREss 22
APPuc rs 0_ Twin dolphin DR. , "C" MOTORS SEE FEE SCH. 7
SERVICE.CHANGE 20.00
o o LICENSED CONTRACTORS DECLARATION
G v w 1 hemhy affirm Thal I em licensed under provisions of Chapter 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Business and BLOC. ELECT. PLG. MECH.'
wi Professions Code, id my license is iIi full for- t n
O m - License Cl Liu Numbs
9 H Date Contract
< r Zi j _ - _ _ BUILDING PERMIT
a Q w vrvcR-Bu1LDER nCCL ATION _ INFORMATION
" 0 '
u m
1 heby affirm that 1 am exempt Crum the Contractor's Licerue MISC.- REFER TO ORD
3 es VALUATION S/FT.
F LL 0 j Law for the following mason,(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10,00 �'
Code:Any city or county which requires a permit m construct,alter,
2improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
O u requires the applicant for such permit to file a signed statement that TOTAL 8 PERMIT TO
as 9 he is licensed pursuant to the provisions of the Contractors License
H z i
Law(Chapter 9(commencing with Section 7000)ofDrvision 3 ofthe J /J
- < Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
re the mases forthe alleged exemption.Any violation of Section7031.5 STORIES T,VPE,CONST
i ; by any applicant fora hundred
dollars
lhc0).): am toescivil penalty ALTER-DRAIN -WATER IEA.) 5.00 's-
of not mom than five permit dollars the applicant
p li r
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00
their sole compensation,will do the work,and the structure x not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00
Code:The Contractor's License law does not apply to an owner of
property who builds or impruva thereon,and who docs such workF IXTUR ES-PER TRAP 5.00 _ SO,FT FLOOR AREA TOTAL ACREAGE'
himself or through his own employees,provided that such improve- _ -
ments are not intended or offered for sale,If.however,the building GAS-EA-SYSTEM-11NC.4 OUTLETS 6.00
or improvement is sold within one year of completion, the owner- GASEA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or int- - - RES IND CON Pe Other
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑
❑ 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 apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such projects with a contractors)licensed pursuant to
the Contractor's License Law, SEWER-SANITARY-STORM EA.200ft/10.00 0� TRACT NO, • PARCEL NO.
E] lam exempt under Sec.. ,B.SIRC.for this WATER HEATER W/VENT •6.00 7yGJ
reason
Owner Date WATER SYSTEM 5.00 ACC.Da E ACC.FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. - 5.00
1 hereby affirm that I have a cunilicatc of consent to self-insure,
or a certificate of Workers'Compensation Insurance,or a certifev ZONING ENG.SITE NO.
copy thereof(Sec 3800,Lab.C.l_
Policy No. Company_Un1Ced Pacific/Rel
Q 0CerthGedcopyishrmbyfurniiher, FIRE SPRINK ENERGY T 24
Z_ 2 AAeant Certified c • city inspection division.
O MISC.- REFER TO ORD. Y❑ N❑ Y ❑ NNE]
CC
fir m CERTIFI ATEEXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L,U,C.
E
IL COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL 0 (This section need not be completed d the permit is for one TOTAL l0 v❑ N❑ Y ❑ N❑
hundred dollars(S 100)or Irvif
U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
U_ H mit is issued,1 shall not employ any perwn in any manner so as to
O become subject to the Workers'Compensation Laws of California.
y Date-Applicant ALTER OR ADD TO MECH. 5.00BUILDING
} m NOTICE TO APPLICANT: If,after reaking'this Certificate of Ex-
� ? emptier,you should become subject to the Workers'Compensation APPLIANCE5.00 PLANCHECK
provisions of the Labor Code, you most forthwl Ol comply with FEE
U such provisions or this permit shall be deemed mvoked, AIR HANDLING UNIT(TO 10,000C.F.NL) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10p00C,F.M.) 6.00 SEISMIC FEE
I hereby affum that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) - 5.00
the perforeance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(70100,000 B.T.U.) 6.00 '
Lender's Name--
Lender's
ame Lenders Add, �a-'n-Fran ClSCo., CH J HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC AOS
I certify that I have read this application and stale that the aboveI#BOI
ENTILATION FAN (SINGLE) 4,00
information a correct, 1 agree to comply with all city and county '� PLUMBING
ordinances and state laws relating to building construction, andILER-COAT(3 H.P.or 100,000 B.T.U.) 6.00
hereby amhojx, representatives of this city lo'enter upon the LER-COMP (Oser 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposic.
(We) agree to save, indemnify and keep harmless the City of ISC.- REFER TO ORD_.
Cupertino against liabilities,judgments, costs and expenses which CONST.TAX =7
may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00
granting of this permit, MECH.CONT. LIC.NO. MECH.
"pI •�� 8/,897 TOTAL TOTAL
SIg m of Applicant/ tractor 'Dat Qv_
OFFICE COPY / I,)/ 40