Loading...
13796I� POST THIS CARD NEAR FRONT OF BUILDING ♦ CITY OF CUPERTINO PERMIT NUMBER ' 13T96 INSPECTION DIVISION JOB INSPECTION RECORD _ PERMIT EXPIRATION 1 V�L7'`— JOB ADDRESS —g"—'` UNIT# _ LOT# PERMIT EXPIRES IF WORK OWNER (.CLd9C/� 649—mL r CONTRACTOR IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM INSPECTION DA INSP CTOR INSPECTION RECORD FOUNDATION LAST CALLED INSPECTION. LIFER PREGUNITE PERMIT VALIDATION p �{ �QQ1 D v STST�riNCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING D ELECTRICAL MECHANICAL BLDG. ELECT. PLG. yMECR, ❑' 6111) 3 DONOTPnURFIOORIINTII ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION /~ J PLUMBING MECHANICAL' ELECTRICAL PERMIT TO FRAMING STORIES TYPE CONSTR. INSULATION OCC. GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF 50. FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM I —J l � BUILDING USE RES IND CON PB Otl.rr ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED A55ESSORS PARCEL NO, ROUGH PLUMBING _ _ TRACT NO. PARCEL NO. GAS resr - MECHANICAL f- p� — ELECTRICAL I) INSP. FINALS DATE ACC.DATE ACC. FILE NO. FRAMING SA I SU CATIO N PLUMBING ZONING ENG. SITE NO. GAS FIRE SPRINK ENERGY T-20 MECHANICAL f,� Y ❑ N C:)Y [:]N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH—INTERIOR ELECTRICAL FLooD zoNE Y "❑ A.L. U.C. Y Ij N❑ LATH—EXTERIOR / FIRE DEPT. SHEETROCK �6flffl GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ELECTRIC ARRANGE FOR INSPECTION BY PHONING 252-4505, o�ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. Z —SEE PERMIT FOR EXPIRATION DATE — il MECHANICAL coNsr.Tnx • IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL - CALLING FOR FINAL INSPECTION. �y OFFICE COPV CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO e DATES�r, 22 19'-2)L BLDG, PERMIT NO. 11 '' (��k'( T E BLDG. LOCATED AT JJ S I WF -7u- S 6 G `� q OWNEDBY�LG����/ HAS BEEN COMPLE FOR USE AS �� I J NZF ALTERED) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .. BUILDING PROJECT IDENTIFICATION APPLICATION &PERMIT BUILDING - ELECTRICAL -PLUMBING -MECHANICAL PERMIT NUMBER 137 96 ADDRESS115,11 a Spring Court ADDRESS (Lot 94 - Plan 2B) OWNER'S NAME Gregory Group, Inc. PHONE 595-2100 DTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION CONTRACTORS NAME Gregory Group, Inc. L,C.NG.430097 UTLETS- SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00' CONTRACTOR 'a 220 Twin Dolphin Dr., GC° ADDRESS CON PHONE _PANELS PPLIANCES-RESIDENTIAL 4.00 I a 10.00 CI ARCHITECT OR Aram Bassenian, A.I.A. ENGINEER uc. No. - PANELS (OVER 200 AMP) 2000 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH.OR ENG. 3990 Westerly Pl., #170 AOORE55 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 ZIP n ' w,� l!./?N-�.r✓ APPucnrvr As tlDu ooREss 220 Twin Dolphin Dr,. , MOTORS SEE FEE SCH. '% SERVICE CHANGE 20.00 Rpdwnnd CitY, CA 94065 ®` LICENSED CONTRACTORS DECLARATION n 1 hereby affirm that 1 am licensed under provisions of Chapter 9 V ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and rA y}p1.fk4. License Gla Co e, and my license is in Number License Class- se c. Nufull to `.,iUll4/ BLDG. PLG. MECH. �■1 �1� �I Date Contractor �T BUILDING PERMIT OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of die Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 INFORMATION MISC. - REFER TO ORD VALUATION /L[ ,Lips .l/V:� s� S/FT. PERMIT ISSUANCE 10.00 ELEC. CONTE. LIC. NO. ELEC. TOTAL / y' PERMIT TO n ^ 0, / V /1-3 w /i OTY. PLUMBING PERMIT FEE STORIES TYPE,CrO�N�S/TR�. ALTER -DRAIN & VENT -WATER (EA.) 5.00 by any applicant for a permit subjects the applicant toe civil Penalty of not more than five hundred dollars ($500),): p�� ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4,00 Dec. GROUP R 3 RES. UNITS / DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code: The Contractor's License Law does not apply to an owner of properly who builds or Improves thereon, and who does such work himself or through his own employees, provided that Such improve menta are not intended or offered for sale. If, however, the building FIXTURES -PER TRAP 5.00 S SO, FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner. builder will have the burden of proving that he did not build or im- prove for purpose of sale.). - ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, BusinessLAWN and Professions ode: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE rRt yEELSr IND CON PB Other YSL ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSOHS PARCEL NO. ,3 G 6 - %-3 31, �3 contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. ❑ lam exempt under Sec. .B.&P.C.forthis SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE N0. WATER TREATING EQUIP. 5.00 WORKI!RS'COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent In self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copyPlicthereof (Sec 3800 No- Lab by itejd-P3C�lie-l-l.d71 FIRE SPRINK Y ❑ N ❑ ENERGY T 24 Y ❑ No ❑ Certified Copy iSuacb furnisUfl& CX Certified co a on division. Applicant MISC. - REFER TO ORD. ERTIFIA60F0FLOOD CE RTI FICA :OI EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the Permit is for one PERMIT ISSUANCE 10.0 0 20NE Y ❑ N ❑ A.L. U.C. Y ❑ N ❑ PLG. CONTE. LIC. NO. AL / OTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or less.) I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Data Applicant BUILDING ALTER OR ADD TO MECH. 5.00 NOTICE FO APPLICANT: If, after making this Certificate of Ex- emption, you should became subject to the Workers' CompensationAPPLIANCE 5.00 PLAN CHECK 3 provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. FEE J AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIRHANDLING UNIT(OVER 10)1300C.EM.) 6.00 SEISMIC FEE /Q CONSTRUCTION LENDING AGENCY I 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.MICROFILM 3097, CN.C.). 3 Lender's Name_�e.G.L.r Lt .PBC1_f�C Lender's Addressa.If-FT•a.n.Cr.f.$.CO-CA I certify that l have read this apphcatlon and state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating, to building construction, and HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT IDV ER 100,000 B.T.U.) 9.50 VENTILATION FAN (SINGLE) 4.00 ELECTRIC F it u PLUMBING BOILER-COMP(3 H.P.Or 100,000B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL �, hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. CONST. TAX / 6 (We) agree to Save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the grantS rmi ,%��.`/ U� 1i PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL �r� Signal fApPlicanl/Con Vactor Ua OFFICE COPY