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13528 L;= POST THISCAR D NEAR FRONT ILDING PERMIT NUMBER CITY OF. CUPERTINO 13528 /�. INSPECTION DIVISION JOB INSPECTION RECORD • / ti SPRINGS - 22 PERMIT EXPIRATION JB ADDRESS_. UNIT# LOT# PERMIT EXPIRES IF WORK �� GREGORY GROUP GREGORY GROUP OWNER corvrRAcroR IS NOT STARTED WITHIN INSPECTION DATE NSIGNED INSPECTION RECORD 180 DAYS_OF PERMIT ISSU- FOUNDATION _ ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. UFER PREGUNITE PERn9lT vnuonnoN POUR NO CONCRETE UNTIL ABOVE HAS BE UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLQG. ELECT,11 PLG. MECH. ❑ `❑ ❑D 0, 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT - INFORMATION WOOD FLOOR vnwnnoN $JFT, PLUMBING - r /vim MECHANICAL PERMIT TO ELECTRICAL zi!`.- FRAMING � V STORIES TYPE CONSTR, INSULATION OCG GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGN D ROOF SO.FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM .. _ BUILDING USE `v.7"/1 � RES IND CON PB 0'1n' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - ❑- ❑ ❑ ❑ ASSESSORS PAHCE L NO, ROUGH PLUMBING TRACT rvoc.,L PARCEL No. GAS TEST MECHANICAL -/ ' - A` lI ACC.DATE ACC.FILE NO. ELECTRICAL � 3, FINALS DATE INSP. FRAMING _ _ SAN #. „'Z o2/3 ZONING ENG.SITE NO. INSULATION - g PLUMBING _ap.�f' _ - GAS .2.p_�d' T �h MECHANICAL -,.per FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING DAN gyp,yd. Y N❑ Y ❑ N� FLooD zoNE aL.u.c. LATH-INTERIOR - ft W ELECTRICAL LATH-EXTE RIO % 0 N FIRE DEPT. _ ry SHEETRGCK F,P,Do XL GRADE FEE SUMMARY SHEAR INTERIOR - g BUILDING - ]� SHEAR EXTERIOR 2' _ _ � TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC i7 PLAN CHECK _ GAS FEE.. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE !1 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 0O ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL / IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY I APP04CANT TO FILL IN INFORMATION WITHIN R �a - USE BALL POINT PEN ONLY BUI LDI NG PROJECT 1 DENTI FICATION F71R BUILDING APPLICATION & PERMIT AooREu 18-- 8 - �/ Sc BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION -Wsh NAME Gregory Group, Inc. QTY. ELECTRIC PERMIT FEE lv, PHONE 595-2100 •, CONTRACTOR'S 1 NAME Gregory Group, Inc. UTLETS-SWITCHES-RECEP 10.00/1.00 r7'•+L'- 1 LIC.NO. 430097 an LIGHTING FIXTURES 10.00/1.00 rep ADDRESCTops PPLIANCES-RESIDENTIAL 4.0012 AODRESS 220 Twin Dolphin Dr. , "C Redwood CitV, CA PHONE 595-2100 j JPANELS 10.06 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 26,00 PLAN CHECKFEE . .NO. OORlcINBER Aram Bassenian, A.I.A. & . Associates uc.NO. SIGNS TRANS. 3.00 ARL".OR F,ryC�gO Westerly Pl. , 4170 SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ADDRESS-$`J y T NeWiport Beach. A zu,9266 EMP.METER OR POLE INS. 20.00 /f APPLICANT' i '] MOTORS SEE FEE SCH. y/ ADDRESS s220 Twin Dolphin DR. , IICII Redwood City. 4 5 SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION u u I hereby affirm that I am licensed under provisions of Chapter 9 - ISSUANCE DATE m Q H (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. PLG. MECH. H y Z Professions Code, J my license is in full force red elle&&t. ry� a o� - License a Lia in mhr_ D I- I" - KL 2 v,H w Date d -�] Contractorra m a a - OWNER-BUILDER DEC L TION BUILDING PERMIT a 0 T- MISC.- REFER TO ORD INFORMATION wS , I hereby affirm that 1 am tsempt from the Contractor's License LLoa Law for the following reason.(See.703 I.S.Business and Professions PERMIT ISSUANCE 10.00 VALUAT,aIOyN _ S/FT. r - 0 Code:Any city orcounty which requiresa permit toconstruct,alter, 6 pvv 2 improve,demolish,or repair any struotun,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. - DLL requires the applicant for such permit to❑e a signcJ statement that TOTAL '8 PERMIT TO K he a licensed pursuant to the provisions of the Contractor's License H z i Law(Chapter 9(commcncingwilh Section 7000)of Division 3 oflhc lJ < Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE the basis for the alleged exemption.Any violation of5ection 7031.5 STORIES TYPE CONSTR. a. M1y any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN -WATER (EA.) 5.00 e7� of not more than five hundred dollars(S500).): 4-/t//A ❑ I,aso mer 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 b not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 _,3 / Cade:The Contractor's License law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SE.TT.FLOOR AREA TOTAL ACREAGE IIIII himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-1 6.00 .9 � (p 3 I I ments arc not Intended or offered for sale.If,however,the building or improvement u 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 nnl build or im- RES IND CON PB Otho prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 llQq ❑ I,as owner of the property,am exclusively contracting with LK ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 A ESSORS 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 contmctorto licensed pursuant SEWER-SANITARY-STORM EA.200ft/10.00 Vas the Contractors License Law. TRACT NO. PARCEL NO. ❑ lam exempt under Sec.-,B&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Dale WATER SYSTEM' 5.00 ACC.D TE ACC.FILE NO, W'ORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5,00 I hereby al0rm that I have a certificate of consent to self-insure, _ ZONING ENG.SITE NO. or a certificate of workers'Compensation Insurance,or a certified - copy thereof(Sec.3800,Leb.C.). Policy No. COlnpany-Uniter1 Pacifi O ❑ Certified Copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z 2 [§ Certified n file Icy inspection division. MISC.- REFER TO ORD. ❑ ❑ O APD1lcanl-��jQ}�L FIVI-2013ZONNEF Y N CC CERTIFTCATEOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00WO- a A.LUL. Lu Q COMPENSATION INSURANCE - PLG.LONTR. LIC.NO. PLG. ❑ N❑ r❑ N❑ (This section need not be completed if the permit in for one TOTAL 2 hundred dollars IS 100)or less U O 1 certify that in the performance of the work for which this per. OTV MECHANICAL PERMIT FEE FEE SUMMARY LL U mit u issued,I shall not employ any person in any manner so u to become subject to the WUrkCI3 Compensation Laws of Cdifornu. SV LU Date-Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } w NOTICE TO APPLICANT: If,after making this Certificate of Ex- t ? emption,you should become subject tothe Workers'Comlxnsation APPLIANCE 5.00 PLAN CHECK 33 U pr roh provisionsvisionor thisof the bor perm 11.1 be deemed revoked ou must forthwith comply with AIR HANDLING UNIT(TO 10,0MC.F.U) 4.013 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IQOOOCF.M.) 6.00 SEISMIC FEE 9 � I hereby affirm that then is a construction lending agency for EXHAUST HOOD(WITH DUCT) x5.00 S the Performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,CIv.C.). Security Pacific Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address Can FranC1SG9-,-CA ELECTRIC ' y _ 1, I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-DOW(3 H.P.or 100,000 B.T.U.) 6.00 �a hereby authome reprtsenlalives of this city to enter upon the BOILER-COMP(Over 1D0,0008TU)SEE FEESCH. MECHANICAL r�'_ RJ' above-mentioned pmperly for inspection purposes. O . M •e; .F, (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 �9 may In troy way accrue against said City in.consequence of the i IVanling ofthis pe itMECH.CONT. LIC.NO. MECH. y/ 7 TOTAL // TOTAL S lgn of Applla Contractor Date �I OFFICE COPY