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15126 POST THIS CARD NEAR FRONT OF BUILDING PERMIT,NUMBER CITY OF CUPERTINO 151 Z6 INSPECTION DIVISION JOB INSPECTION RECORD 1-70 W6fshbfe ft: X79 PER�1�XWIATION JOB ADDRESS UNIT# LOT# j� I //�' PERMIT EXPIRES IF WORK OWNER VrbAp CON'TRACTOR lJ , IS NOT. STARTED'WITHIN INSPOCTION DATE I INSPECTOR INlfPEeION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS,FROM NOTE: I LAST CALLED INSPECTION. UFER .. ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGESLABS PAIVt POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ✓`� i't-t ib L6L_ 1 UNDERGROUND /SLABAUG PLUMBING , ELECTRICAL nill of Cupertino ISSUANCE DATE. MECHANICAL BLDG I ELECT. PLG. VECH m 6 -(6.99 LLA.') ' w a t� 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING k 1526727 MECHANICAL - ' ELECTRICAL - - PERMIT TO FRAMING f - SFDU - I INSULATION _ STORIES TYPE CONSTR. 2 5NHR OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED R-3 1 ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn Fr FLOOR AREA TOTAL ACREAGE ,DIAPHRAGM THE CONSTRUCTION TAX IS PAID .2348 BUILDING USE ROOFSHEATHING HES IND CON PB G,1. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. mv EL NO ❑ ASSESSORS PARC ROUGH SAN.N J"�g f5F - PLUMBING- ELECT.ENERGY TUBSaSHOWER PAN .PLUMBING ENERGY VIVA. TRACT NO PARCEL NO MECHANICAL MECH.ENERGY 11 ACC.DATE ACC.FILE NO. ELECTRICAL BUILDING ENERGY Q• FRAMING ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING 1L GAS TEST GAS N W FIRE sPRINK ENERGY T za MECHANICAL 1A v � N� v � N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 11 & EXTERIOR SHEAR ELECTRICAL RELEASE Ii 01. LOOD ZONE A.L UC d`• v� N� v ❑ N�. INTERIOR SHEAR.' FIRE DEPT. SHEETROCK - GRADE - FEE SUMMARY ' EXTERIOR LATH - / 91P .mil/, BUILDING -INTERIOR LATH a 9 TEMPORARY'APPROVALS BUILDING5.00 SCRATCH COATELECTRIC PLAN CHECK .. __ GAS;_.._ FEE e NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY _ SEISMIC FEE 197Y0 . OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDINGINSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 69.35 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 69 35 o PLEASE GIVE JOB ADDRESS WHEN PHONING. ;. Z MECHANICAL = SEE'PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX 288.95 PLEASE READ REVERSE SIDE BEFORE TOTAL 383.21 CALLING FOR FINAL INSPECTION. OFFICE COPY 1 ' CERTIFICATE OF COMPLETION BUILDING INSPECT'OR'S OFFICE CITY OF CUPERTINO ` Date19.%�. uilding Permit No. �5..t ... The Building Located at .---\.`... Q9.1.......... ..... .... .. ... .(4.......................... Ownedby .......... .. ... ................... ................ . ........................................ Has Been omp ete For Use As: ..........c. Bred) 3 ................ ..... ...................................................................... ................................................................... ........................... ............................................... ................................................................. ...........................................................................Q.Q- . ..................................................... Q............... ........ BUILDING INSPECTOR 102 12/66-1 M APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY f ' � BUILDING PROJECT I DENTI FICATION PERMIT NUMBER EIIILDINGLot Z79 Plan 3A APPLICATION & PERMIT 11702 Westshore Court 15126 ADDRESS BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S Gregory Group, Inc. & PLAN CHECK VALIDATION NAME 9 Y P CITY. ELECTRIC PERMIT FEE Ahmanson Dpv- w's-sgs-21 OnIp yy Qy CONTRACTOR 5 XRXKKXA/1 Nam OUTLETS-SWITCHES-RECEP 10,0011.00 Gregory Grouryy, IncC:NO. B-430097 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS win Dolphin Dr. PPLIANCES-RESIDENTIAL 4.00 ADOt�E4Sregory) RWC 9406ONE4'15 PANELS 10.00 DATE OF APPLICATION' ARCHITECT PLAN CHECK FEE P.C.NO. on Aram Bassenian, AIA soc. PANELS (OVER 200 AMP) 20.00 ENGINEER LIC.NO. 0-8395 SIGNS TRANS. 3.00 ARC..OR E.G. 2031 Orchard r. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ADDRESS Santa Ana Hts. CA. 9?707EMP.METER OR POLE INS. 20.00 A f IT I I f APPLICANT'S MOTORS SEE FEE SCH. '\I`I 0.•{"I LC�� A0°R 2207C ,Twin Dolphin Dr. RWC 11SERVICE CHANGE ,00 r o o LICENSED CONTRACTORS DECLARATION Q u U I hereby affirm that I am licensed under provisions of Chapler 9 - ISSUANCE DATE y n (commencing with Section 7000)of Division 3 Of the Business and AU ra BLDG. ELECT. PLG. MECH. F N i Professions Code,are my license o m ft II I'orc,ff yy;;n,,��d cf b)L ❑ G L w o Licalse Cl Lie_Lie.Number_µ JD�.� /,,`,of SFe� n� x wt -7Date_(�=p=Q.Q-Contractor- SII{r a x f BUILDING PERMIT ¢ ¢o OWNIi R-BUILDER DECLARATION INFORMATION w ; LL H 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD Foo¢ Law for the following reason.(See,7031.5,Businessand Professions pERMIT ISSUANCE 10.00 VALUATION $/FT. Code:Any,city or county whichrequiresa permit toc.marnet,altnr. 152,727 2 2 ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. US S a LL req uiros the applicant for such permit to file o signed statrnnrnt that TOTAL �' PERMIT TO X$m he is licensed pursuant to the provisions of the Contractor's License FZ>0 Law(Chapter 9(commeneingwith Section 7000)of Division 3 ofthe SFDU Q Business and Professions Code)or that he is exempt therehiom and OTY. PLUMBING PERMIT FEE FSO ¢F$ the basis for[he alleged exemption.Any violation of Section malty STORIES TYPE CONSTR. of not applicant fora permit d.11ms the applicant toucivil penalty ALTER-DRAIN -WATER (EA.) 5.00 2 5NHR of not more than five hundred dollrre($S00).): y i O I,as owner 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 is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 I Code: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 SO.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- ments are not intended or of fried for Salo.l f,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS EASYSTEM OVER 4 IEA) - '200 builder will have the burden of proving that he did not build or im- - . - . . BUILDING USE prove for purpose ofsalc.). RES IND CON PB Orbe, ❑ 1,as owner of the Property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 XEI ❑ El El 0 licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS 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 IEA.) 1,00 contracts forsuch projectswith a cantmctnl(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO. PARCEL NO. ❑ I am exempt tinder Sec. ,B.&PC.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a cerlilimde of consent to sal6lnsurc' 20NING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thercof(Sec.3800,Iab.CJ.United Pacific Policy No. Company O ❑ Certified Copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z t Certified cony fed ri he city inspection division. MISC.- REFER TO ORD. O AP can( - Y❑ N❑ Y ❑ N� ~ va / PERMIT ISSUANCE 10.00 � - CIiRTfFi ATE(IFEXEMPT INSURAMWDRKISRS' FLOOD ZONE A.L.U.C. W > COMPIiNSATION INSURANCE PLG.CONTE. LIC.NO. PLG, ' 0. Z (l'hfs section Deet] not be completed if the permit is for one TOTAL Y❑ N❑ Y i], N hundred dollars fS 100)or less.) U O 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 mannerso as to U become Subject to the Workery Compensation Laws of California. y Datc BUILDING Applicant ALTER OR ADD TO MECH. 5.00 825.00 >_ m NOl'IC17 TO APPLICANT': If,after making this Certificate of Ex- F 2 emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 15.50 provisions of the Labor Code, you must forthwith comply with FEE energy V such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 62.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 10.71 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. MICROFILM 3097,CP.C.). Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lenders Name F ! � - HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 60.35 Lender's Address m erth-f-l- ELECTRIC I certify that I have read this apphca on andstate that the above VENTILATION FAN (SINGLE) 4.00 infonnation is correctA agree to Comply with all Lily and county PLUMBING 60.35 ordinances and state laws relating to building consoaction, and BOILER-COMP(3 H.P.oi100.000B.T.U.) 6.00 hereby authorize representatives of this city es enabove. ter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL hereby authorize aned propertytarvespef this ion purposes. 60.35 (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' 288.95 may In any way recruit against said City in consequence of the mOling of 1 en L L ' - _ MECH.CONT. LIC.NO. MECH. TOTAL 1383.21 QSJOSJ TOTAL Sign ureo punt Ctor Date OFFICE COPY