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17701 POST THIS CARD NEAR FRONT OF BUILDING • . PERMIT NUMBER CITY OF CUPERTINO 17701 INSPECTION DIVISION JOB INSPECTION RECORD ® (� �`�7, PERMIT EXPIRATION :� JOB ADDRESS ✓� / _ HA!► r ' SAC1416 'f 7— UNIT# _LOT# - v PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION NOTE: UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. .� GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ::L1J' UNDERGROUND /SLAB 1•"rti PLUMBINGV)4j / !�Al' 2 'HUJ ELECTRICAL //' ISSUANCE UATE MECHANICAL 1 G11Y.of Cuperfino R 1, PLO M Ix i j r DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR �� .tel/ 'y1 `� INFORMATION VALUATION SIFT. PLUMBING MECHANICAL ELECTRICAL a PERMIT TO FRAMINGgm IA ;-'A INSULATION +�...-/. `��f x srowes TYPE CONST. 2 Et3-it \i occ GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED Y�� L SCRUR.0 -IrY'�c a' c R-3 I S() FT FI,U(IRARLA TOTAL ACREAGE• - ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2917I " 1 , I� ROOF SHEATHING Q RES IND USE D COG N Pe O'n. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. IN ❑ ❑ ❑ ❑ ROUGH SAN.N ! _ _ AASSSSEESSOFISPARCELNO PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL No MECHANICAL60 MECH.ENERGY. ELECTRICALBUILDING ENERGY ACC DATE ACC.FILE NO FRAMING - ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG.SITE NO. GAS TEST GAS ' MECHANICAL FIRE SPRINK ENERGY h24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v ❑ N❑ ` ❑ NO EXTERIOR SHEAR Z ELECTRICAL RELEASE FLOODZONE AL UC INTERIOR SHEAR FIRE DEPT. v ❑ N❑ ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING �•C.A SCRATCH COAT JELECTRIC PLAN CHECK GAS FEE 62.OD NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE 18.02 OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 70.3E Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX .C2 PLEASE READ REVERSE SIDE BEFORE TOTAL E� CALLING FOR FINAL INSPECTION. .O9 OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDINAPPLICATION & PERMIT 1 7701 ADORES 11843 Sha Court Lot 348 ADDRESSIn 3.90 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL O OwNEn'S Gregory DTV, ELECTRIC PERMIT FEE gory Group, Inc. PLAN CHECK VALIDATION NamE PHONE 415/595-21 CONTRACTOR NAME Gregory Grasp Inc. OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No. B-430097 LIGHTING FIXTURES 10.00/1.00' CONTRACTOR'S Tenn Dolphin Drive APPLIANCES-RESIDENTIAL 4.00 ADDRESS r�/I/�[ RWC, r� 94065 P...E415/595-21 PANELS 10.00 DATE OF APPLICAtION ARCHITECT Bassenlan Lagan APChltect5 PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.NO C-.8395 SIGNS TRANS. 3.00 ARCH.OR ENG. 2591 M..LawJ fMiVe / .W SPECIALCIRCUIT 5.00 PERMIT VALIDATION ADDRESS LLVVJJ VI 1.11 I U D Santa {InaHeights, CA ZIP92707 EMP.METER OR POLE INS. 20.00 APPLICA$ (�NTS�C Twin Dolphin Drive MOTORS SEE FEE SCH. TW(yx ADORES RedNoOd City, CA 94065 SERVICE CHANGE 20.00 tact osiI Foo LICENSED CONTRACTORS DECLARATION - a tau I hereby affirm that I am licensed under provisions of Chapter 9 y a u (Commencing with Section 7000)of Division 3 of the Business and �n IBSUANCE DATE H m 2 Professions Code,aµ1 my license is in full foreh',,y��JfI�y•cL ftl o I U BLDG_ ELECT. PLG. MECH. Z o m- License Class_D Lie,Number 4.7111J:1� ® ® LaV MAY 4 w Date Contractor ryry�{,Dr ot It rt w a OWNER-BUILDER DECLARATION �Bu CUpethnQ BUILDING PERMIT o a D INFORMATION X ; n m I hereby affirm that I am exempt from the Cmumictar's License MISC.- REFER TO ORD LLo< Law for the following reason.(Sec.7031.5,Businessand Professions VALUATION $/FT. - PERMIT ISSUANCE 10.00 Code:Any city or county which requiresa permit to construct,alter, O� p� o improve,demolish;or repair any structure,prior to its issuance,also ELEC.CONTE. LIG N0. ELEC. 165 865 o a, requires the applicant for such permit to file it signed statement that TOTAL w m he is licensed pursuant to the provisions ol'tile Contractor's License PERMIT TO H z as Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe _VDU i D Business and Professions Code)or that he is excnhpt therefrom and OTV. PLUMBING PERMIT FEE g the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. d ; by any applicant for a permit subjects the applicant toRcivilPenalty ALTER-DRAIN IEA.( 5.00 2• of not more than five hundred dollars($5001): 5" of 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 struclu re is not occ.GROUP REB.UNITS tended or offered for sole (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 R_3 1 property who builds or inn proves thereon,and who does such work FIXTURES"PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACREAG Mansell or through his own employees,provided that such improve- 2334E ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INE.4ouTLETS 6.00 2917 Go improvement is sold within one year of n urpletitm, the owner GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or ire . - BUILDING USE Prove for purpose of sale.). INDUSTRIAL WASTE IN TER. 30.00 RES IND CON Pe Omer ❑ I,as owner of the property,um exclusively contracting with licensed contractors to construe the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Cont.acme'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 O�0l../ contracts for such projects with a contractors)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 reason WATER HEATERW/VENT 6.00 Owner Lute WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure. or a certificate of Workers•Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(See 3800,Lab.C.)�.1 I Policy No. Company' P ac>_fic__ O (,y� Certified Copy is hereby furnished. Z Z f]t Certif, a is filed with 1 • city tnspcclion division- FIRESPRINK ENERGY T24 F O Applicant / MISC.- REFER TO ORD, Y❑ N[J Y ❑ IN Cr N CI[RTIFICAIIi OF EXLMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 C. UJ > COMPENSATION INSURANCE: PLG.CONTE. LIC.NO. PLG CZ (This sectino used not be completed if the permit is for one TOTAL Y[] IN V F] Nr U O hundred dollars(S 100)or less) I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to Ow become subject to the Workers'Compensation Laws of California. a Date AB,l1at ALTER OR ADD TO MECH. 5.00 BUILDING 940 50 >_ 0. NOTICE TO APPLICANICAN T:: If,alter making this Certificate of IN- s Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you most forthwith comply willr enhption,you should become subject to the Worker U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=1C.F.M.) 4.00 FEE /Energy 62.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=11 EM.) 6.00 SEISMIC FEE 13.02 1 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. 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Lender's Address Z-COW(3 IT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that l have read this application and state that the above FAN (SINGLE) 4.00 information n correct. I agree to comply with all city and county PLUMBING 70.35 ordinances and state laws relating to building construction, and (3 H.P.or 100,0006.T.U.) 6.00hereby aulhorie representatives of this city to enter upon the P (Over 100,000 BTU(BEE FEE SCH.above-mentioned property for inspection purposes. MECHANICAL (We) agree I. save, indemnify and keep harmless the City'of REFER TO ORD.upertino against liabilities,judgmmats, costs and expenses which CONST.TAXay in any wayaccrueagainst said City in consequence of the NCE 10.00 i-V2.02rant this permit MECH.CONT. LIC.NO. MECH. lg� TOTALTOTALigna arc of App want/Contractor Uute .09 OFFICE COPY