14963 POST THIS CARD NEAR FRONT OF BUILDING
,ti / PERMIT NUMBER
CITY"OF CUPERTINO 14963
INSPECTION DIVISION ' P
JOB INSPECTION RECORD
/ - PERMIT EXPIRATION
DDR ESS_ ��G �.3 V/Nfl-1A.Q17 9Q/NG C7 UNIT# _LOT#
- PERMIT EXPIRES IF WORK
OWNER, ar�OA GR.V CONTRACTOR180 DAYS OF PERMIT ISSU-
FOUNDATION AIS NOT STARTED WITHIN
` F
INSPECTIO ATE INSPECTOR INSPE IONN REC RD ANCE OR.180 DAYS.FROM
- LI' -
NOTE: LASTCALLED INSPECTION.
UFER ,(C . ALL GRADING AND DRAINAGE SHALL BE INSTALLED '
TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT IAUDATION
PREGUNITE CUPERTINO STANDARDS.
GARAGE SLABS -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' . -
UNDERGROUND /SLAB ti
PLUMBING _ !
ELECTRICAL
. ISSUANCE DALE
MECHANICAL BLDG ELECT PLG. MECR
0
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ILDING PERMIT
WOOD FLOOR 9FORMATION
PLUMBING '1w'(lul VALUATION SIFT.
oft
ELECTRICAL PERMIT To
FRAMING '
INSULATION To TVPE CONSTR,
- OCC (IUP B UNIT$
IWME&Ni SUBFLOOR UNTIL ABOVE HAS BEEN SIGN E
5(.F FLOOHnHE4 TO ALACREAGE,
ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTIONTAX IS PAID
BUILDING USE
ROOF SHEATHING Q RES IND CON Pe 00-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
ASSESSORS PARCEL NO
' ROUGH SAN.H -S/3 '
PLUMBING (+� ELECT.ENERGY _
o TRACT NO. PARCEL NO
TUBS 8 SHOWER PAN � - g-`j �; � PLUMBING ENERGY -
MECHANICAL AIII' MECH.ENERGY -a-
A ILE NO
ELECTRICAL BUILDING ENERGY a,-
TE ACG F
FRAMING ELECT.FINALTEST '
ZONING ENG.SITE NO,
INSULATION PLUMBING
GAS TEST ,'X-2e SV "LfJ- GAS
MECHANICAL _ ` 8 FIHESPRINK ENERGY T-74
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING � ❑ E] N[]EXTERIOR SHEAR Q ELECTRICAL RELEASE _97-..a F [] ZONNEE nL Dc.
INTERIOR SHEAR - Q.ICILvM5 FIRE DEPT.
SHEETROCK Z , GRADE FEE SUMMARY
EXTERIOR LATHBUILDING t;
INTERIOR LATH TEMPORARY APPROVALS BUILDING
SCRATCH COAT ea./ .� ��/,` ELECTRIC PLAN CHECK 16.150GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEI MI E
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUI LDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC 60
.90
II-- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING '� 6p�40, O� PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL 60.90
IMPORTANT! CONST.TAX 2M.24
PLEASE READ REVERSE SIDE BEFORE TOTAL 11.29
CALLING FOR FINAL INSPECTION,
OFFICE COPY
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
j CITY OF CUPERTINO ,
DATE CO 19 BLDG,
Q BLDG. PERMIT NO. 1�'�9(0
�D
THE BLDG. LOCATED AT I C�3 I1C'yQy'd S %r�wQ C�
OWNED BY ����7�,�Y1L`�.gOY'C,� Grou
("
p
HAS BEEN IA" �EDS FOR USE AS F�w
i
i
Q.
i
� BUILDING INSPECTOR
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
„ BUI
LD ING PROJECT IDENTI FICATION PERMITNUMBER
BrLDINo
ADDREAPPLICATION &,PERMIT 14963���
Lot 125 Plan 16
BUILDING-•ELECTRICA L-PLUMBING-MECHANICAL 4
OWNER'S PLAN CHECK VALIDATION
NAME or
Greg y Group, Inc. & Ahmanson OTY. ELECTRIC PERMIT FEE
PA"@RqI#S 415-595-=ry E F UTLETS-SWITCHES-RECEP 10.00/1.00
Gregory Group, Inc. B-430097
uc.No. LIGHTING FIXTURES 10.00/1.00
CONTRACTORS
220 WW in Dolphin Dr. M CA
Ap APPLIANCES-RESIDENTIAL 4.00
PH1415-595-2100 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE P.C.NO.
OR Aram Bassenian, AIA & Assoc. PANELS (OVER 200 AMP) 20,06
ENGINEER
LIC.No. C-$395 SIGNS TRANS. 3.00
ARCH OR ENG. PERMIT VALIDATION
Amg' 2D3 rd Dr. //100 SPECIALCIRCUIT 5.00
Jtlntd And f1Ls ea, 92707 EMP.METER OR POLE INS. 20.00
APPLICANT
APPLICCA 20-C Twin Dolphin Dr. RX MOTORS SEE FEE SCH.
SERVICE CHANGE - 20.00
woo LICENSED CONTRACTORS D17CLARATION ((
a u 1 herehy affirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE
H 4 Iu (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
F w z Professions Codens
,and my license is in full force and effect. I/Y
Z O m- License Clas-B Lic.Number -
9 m r Dam Con(lacl!
Q I J
¢ ¢ w ¢ OWNER-BUILDER DEC L ATION BUILDING PERMIT
u MISC.- REFER TO ORD INFORMATION
X
;LL N I hereby affirm that I am exempt from the Contractor's s License
uo ¢
Law fertile the following reason.(Sec.70.)1.5,Business Professions VALUATION $/FT,
- PERMIT ISSUANCE 10.00
� w� Code:Any city or county which requiresa permit loconstrueLalter, .1 155,000
de K Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. JUN
ty t
s W m LL requires the applicant for such permit to file a signed statement that TOTAL V 1' ( 1980 PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License
FZQ f Law 9(commencing with Section 7000)oDivision 3 oflhe
z o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT
X 1- $ thin basis for the alleged exemption.Any violation of Section 7031.5 TYPE CONSTR.
n 3 by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred dollars($500).):
❑ Las owner the property,or my eee with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,
ion,will do the work,,and and the structure is not
intended or offered for sale (Sec. 7044, nosiness 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
property who builds Or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such irprove.
- Gents are not intended or offered for sale.If,however,the holding GAS-EA.SYSTEM-11NC.40UTLETS 8.00 1956 -
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden of proving that he did not build or im. BUILDING USE
prove purposeof sale.)' INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other
1,as o
❑ wnerer urcontracting of the property,am exclusively wish '�
licensed
as ocontractors to constructThe
the Project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 8.00 ASSESSORS PARCEL NO.
and Professions Code:The who
s Iimprov Law does.an apply
to tr owner of h projects
who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such projects with a contracksr(sl licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10,00 TRACT NO. PARCEL NO.
0 I ant exempt under Sec.-,ILATI.C.to,this WATER HEATER W/VENT 6.00
reason Q/\[7
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE No.
WORK ERS'COM PENSAI'JON DECLARA'T'ION WATER TREATING EQUIP, 5.00
1 hereby affirm that I have a certificate of consent to sel&Insu.C,
or a certificate of Workers'Compensation Insurance,or it certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.C.).United Pacifle
Policy No. Company
O �❑/ CertiOed copy is hereby furnished. FIRE SPRINK ENERGY T.24
Z Z y�,Certified'cop ed wish the city inspection division. V� N� V � N�
� O Applicant MISC.- REFER TO ORD.
c 0 CF.R'Tl ( li °I XrMP Is PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
L COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG,
0- O (This section need not he completed if the permit is for one TOTAL Y E] N E] V E] No
� Z hundreddollars(S100)odes'.)
U O I certify that in she Performance of the work for which this per. DTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,1 shall not employ any person in any manner so as TO
O Wbecome soldier to the Workers'Compensation Laws of California.
G. Dare Applicant BUILDING
>_ W NOTICE'10 APPLICANT': If,aflat making this Certificate of Ex. ALTER OR ADD TO MECH. 5.00
1- Z erplion,yon should become subject to the Workers'Compansauon APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you rust WRItwith comply with FEE 15.50
U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10,000C-F.M.) 4.00
62 00
CONS'1'RUCI'ION LENDING AGENCY AIR HANDLING UNIT(OVER 101000C.RM.) 6.00 SEISMIC FEE 10.85
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance the wprk fo which this ermit is issued(Sec. MICROFILM
3097,Civ.0.). ecurity pacific W ftaricadeln HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name_. fT.- F- -I.1- HEATING UNIT 100,000B.T.U.)9.50
Lender's AAdress 4 Y 1lS �1 ELECTRIC 60,90
` 1 certify that I 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 g01LER•COMP13 H.P.Dr 100,000 B.T.U.) 6.00 PLUMBING 60.90
ordinances and state laws relating to building cOnslruelion, and m
I
hereby above-mentioned
representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL 60.91
hereby authorize
preprese 1'orinsp of this
ion purposes.
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. o� n
Cupertino against liabilities,judgments, costs and expenses which CONST.TAX -288.24
may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00
tantiagoff MECH.CONT. LIC.NO. MECH.
�; TOTAL TOTAL 1391.29
Signatur pplicant/Contractor ate
OFFICE COPY
r