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13780 y POST THIS CARD NEAR FRONT OF BUILDING` PERMIT NUMBER CITY:. OF CUPERT(NO 13780 INSPECTION DIVISION • r' . JOB INSPECTION RECORD S"I1 PER EXPIRATION JOB ADDRESS ` N,�- `Q��� UNIT# - LOT# �� PERMIT EXPIRES IF WORK OWNER C`, � � ', i •-..CONTRACTOR IS-NOT STARTED WITHIN .INSPECTION• - DA E INSPECTOR "' - "INSPECTION'RECORD - 180 DAYS OF PERMIT ISSU FOUNDATION ANCE OR 180 DAYS FROM • LAST CALLED INSPECTION. UFER - - PREGUNITE ' PERMIT VALIDATION r .r POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ✓` ,UNDERGROUND /SLAB MP ' t :;�.,r ,• ,�;' PLUMBING - - y' �y`r' ELECTRICAL E e IGAPkE OATS BLDG. ELECT. .'PLG., MECK MECHANICAL ' a, 0 d* tai � a q. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION " WOOD FLOOR VALUATION S/ET. PLUMBING MECHANICAL ' PERMIT TO ELECTRICAL r N • 'FRAMING ', ' sTONles rvr[l CONSTR. INSULATION G , OCC.GRouP RES.uNlrs PLACE NO SUBFLOOR UNTIL'ABOVE HAS BEEN SIGNED . ' ROOF EO'FT,FLOORAREA TOTAL ACREAGE DIAPHRAGM , BUILDING USE HES INDCON PH ED Orh,, ED APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED �' E] _ ASSESSOR SPAPCEL NO. ROUGH _ PLUMBING. ` .. p. - GAS TEST TRACT No, PARCEL No. 'MECHANICAL - -8� ' - ACC.DATEACC.FILE NO. ELECTRICAL FINALS DATE INSP. FRAMINGSAN # Z'S'Z J, " ZONING ENG.SITE NO.` i . INSULATION - (p_ao_188 PLUMBING - • a 10 -MA6 GAS FIRE SHRINK ENERGY T.24 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SI t NEO I HEATING NC] N[] LATH-INTERIOR 7-a/_ ELECTRICAL FCOODZOIBE `A,L.u.C. LATH-EXTERIOR - - FIRE DEPT. . - F v v Q Nv IN[] SHEETROCK -�„-_ GRADE •w„ ' FEE SUMMARY SHEAR INTERIOR j- _8$ BUILDING - r'. - ''BUILDING �.V+�•`„ •. SHEAR EXTERIOR 5-z3_ c- TEMPO RARY.APPROVAL _ FIREWALLS ELECTRIC r - PLAN CHECK' 7� GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDINGINSPECTOR. MICROFILM .. 'Y • r ARRANGE FOR INSPECTION BY PHONING 252.4505; ELECTRIC > , 0�, ONE WORKING DAY. BEFORE REQUIRED INSPECTION PLUMBING ' PLEASE GIVE JOB ADDRESS WHEN PHONING. ; • r, MECHANICAL', SEE PERMIT FOR EXPIRATION DATE - ,*+" CONST.TAX IMPORTANT!- a 3 i PLEASE READ`pEVERSE'SIDE BEFORE41, TOTAL CALLING,FOR FINAL INSPECTION. Ole - " OFFICECOPY I , ern , , . - } ,� }� tI. .h. .,'1'. ��;P _ .. �. • r 'r 1. t-J., ,_ ? .t�'S If .' ,1', •r . .. .•�� c .qtr! ,• . . _ ..,.`� i l; I i8P1I W 1fJ 4. c ("' c7 " :ia.r'r: � ;ova_�.3„ • ,_{ o Vau LL 'tNr_t ' I:��. '�tIL,., i . f-• • , �1. � 1{ r 1 Il� [ tl. 4 ,1t'�' 4VIr. II�i. i �! APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER - BUILDING 11505 Sunset Spring Court APPLICATION & PERMIT.. ADDRESS 13780'J O 0 BUILDING -ELECTRICAL-PLUMBING -MECHANICAL I J (V' OWNER'S _ PLAN CHECK VALIDATION NAME OTY. ELECTRIC PERMIT FEE re or .Grou Inc.PHONE 595-2100 CONTRACTOR NUTLETS-SWITCHES,-RECEP 10.00/1.00 AME Gre or •Grou Inc.LIC.No-430097 LIGHTI NG FIXTURES 10.00/1.00 CONTRACroRs 220 Twin Dol n,'"'CII PPLIANCES-RESIDENTIAL 4.00, ` ADDRESS Redwood Cit SANE 595-2100 PANELS 10.00 J0 DATE OF APPLICATION ARCHITECT Aram Bassenian, A.I .A.. PANELS (OVER 200 AMP) • 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER &' ASs dated LIC.No.. SIGNS TRANS. 3.00 ARCH.OR E`43990: Westerly PI , #170 SPECT ALCIRCUIT 6.00 PERMITVA L(DATION ADDRESS e Newport Beach. CA IIP 92660 EMP.METER OR POLE INS. 20.00 1a�1 ADDRESNrs ,"Cu MOTORS SEE FEE SCH. ADDRESS 220 Twin Dolphin Dr. , -," - - Redwood City. 4065 ISERVICE CHANGE 20.00 q� o o LICENSIiD CONT'RACT'ORS DF.CI.ARA'r[ON 5 v v 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE y a "' (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. F- D i Professions Co ,and my license is in full for xW pj'(J io_ License Class Lic.Number_4..7U.VyL- Is QyL r ww Date Contractor 1 ¢ ¢.a OWNER BUILDIiR DECLARATION- BUILDING RMATIOPERMIT, - INFORMATION � � MISC.- REFER TO ORD X a.w I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. H LL O j Law for the following reason.(Sec.7031.5,Nosiness and Professions PERMIT ISSUANCE 10.00 N Code:Any city or county which requiresa permit reconstruct,alter, QQ ¢ improve,demolish,or repair any structure,prior to It,Issuance,also ELEC.CONTR. LIC.NO. ELE0. or O LL requires the applicant for such permit to file a signed statement that TOTAL PERMI I I U n w m he is licensed pursuant to the provisions of the Contractor's License H'zLaw fChapler 9(commencing with Section 7000)of Division 3 of the ���(,[/L Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ n-Q 0 the basis for the alleged exemption.Any violation,of Section 7031.5 STORIES TYPE CONSTR. ng _ by any applicant for a permit subjects the applicant toacivil penalty " ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars ❑ 1,as owner of the property.or in,employees with wages as BACK FLOW PROTECT. DEVICE 4.00 ocC.CROUP RESUNITS their sole compensation,will do the work,and the structure is not - S.l intended or offered for sale (Sec.7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 �- 3 / Code:Thm Tire Comemr's License Law does noan t apply to owner of _ - propertywhobuildsorimprovesthereon,and who does such work J 3FIXTURES-PER TRAP .5.00 SO.FT PLOOR AREA TOTAL ACREAGE himself re of rote his own employees.Provided leve such improve- ments ' mems are not intended or employeeffered for,provided that such building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 10 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 owner' RE IND CON PB Other prove for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the properly,am exclusively•contracting with ❑ Cl ❑ ' ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. -!6.00 ASSESSORSPARCEL 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 _j4 contracts for such projects with a comractons)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 y / the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER WIVENT 6.00 7yyS� reason Owner bate WATER SYSTEM 5.00 ACC.DATE ACC.FILENO. WORKF.RS�COMPENSATION DECLARATION WATER TREATING'EQUIP, + 5.00 1 hereby affirm that I have a ctetificate of consent ro self-insure, - - ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.b�II itPA ,,11 '',�,.,,pp 1 Policy No. Company_1j.nJ_LCIl_Pat" _Re-11.3n - 0 ❑ Certified CO isI byf t bed FIRESPRINK ENERGY T 24 Z Z pl Cerhfie fit I th flf gpeceion division., MISC.- `REFER TO ORD. ❑ ❑ ❑ 0 Q : APPIiCuo( _ Y N V N CC rn � - PERMIT ISSUANCE 10.00 / � - Cli CATF:OF li%1>MI'TION FROM WORKERS' ' C) FLOOD ZONE 0.L.u.C. LU > COM PHNSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL Q (This Section need not be completed If the permit is for onC TOTAL / Y❑ N❑ Y❑ IN t.• D Z hundred dollars($100)or le".) ' 0 1 certify that in the performance of the work for which this per; QTY. MECHANICAL`PERMIT FEE FEE SUMMARY LL H mil is issued,I shall-not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. �'a y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } m NOTICE'f0 APPLICANT: If,after making this Certificate of Ex. - • Z emption,you should become subject to the Workers'Compensation APPLIANCE `• 5.00 PLAN CHECK provsiar s of the Labor'Code,,you must forthwith comply with FEE U such provisions or this permit Shull be deemed revoked. AIR HANDLING UNIT(TO 1000011F.M.) 4.00 CONSTRUCTION LENDING AGENCY, AIR HANDLING UNIT(OVERI0=CF.M.) 6.00 SEISMIC FEE '1 hereby affirm that Ihere is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued fSec. MICROFILM 3097,Civ.C.). 1 I HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lenders Name SBCL rl ty PaCl fIC HEATING UNIT(OVER 100,000 B.T.U.19.50 Lender's Address-CIH F�iic-i.sco-;C-A ELECTRIC I cerlily that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 in fonnallon is correct. 1 agree to comply with all it,and county - PLUMBING e ordinances and.seate laws relating to building construction, and , BOILER-COMPI3 H.P.or 100,000 B.T.U.) 6.00 / hereby authorize represenlalive, of this city Io enter ,Pon the above-mentioned property forinspection purpBOILER-COMP(Over 100,000 BTU(SEE FEE SCH. MECHANICAL �J / oses. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, casts and-expenses which - CONST.TAX f b may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00. r) granting of isp r it. / MECH.CONT. LI0.N0. MECH. TOTAL' TOTAL -.i Signal pp¢ant/Contractor tL b J OFFICECOPY -