15125 POST THIS CARD NEAR FRONT OF BUILDING RMIr.N UMREa
CITY OF CUPERTINO
51,25
INSPECTION DIVISION
JOB INSPECTION RECORD r`
�»aa WeS��hare Cbu ��7 PERMIT EXPIRATION
JOB ADDRESS UNIT# _LO T#
r � ✓ CONTRACTOR &vO PERMIT"�� ORK
OWNER G
IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INtPaTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION - - ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS. WD
GARAGE SLABS -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED AUG 9 - 1988 '
UNDERGROUND /SLAB •�
PLUMBING /^. ,.{, ;)�� }
ELECTRICAL LI� ^of�Uperuno ISSUANCE DATE
MECHANICAL eLOO ELECT PLG. MECH
• L 'Q� 0 88 � W O ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUI DING PERMIT
,WOOD FLOOR INFORMATION
I ' VALUATION s/FT.
PLUMBING
MECHANICAL
ELECTRICAL PERnm ro
FRAMING
INSULATION STORIES TYPE CONSTR
OCG 5HOUP UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE sn Fr.PLOOH AREA +Or L ACREAGE
DIAPHRAGM - THE CONSTRUCTION TAX IS PAID
9UUOwN use
_ ROOF SHEATHING RES IND CON Pa ou,,.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. iP ❑ 71ROUGH SAN.q '
ASSESSO RSPAHCEL NO
' � b
PLUMBING / ELECT,ENERGY
TRACT NO PARCEL-NO
TUBS 8 SHOWER PAN PLUMBING ENERGY - -
MECHANICAL py. fo. gt MECH.ENERGY
ELECTRICAL BUILDING ENERGY ACC DATE ACC FILE NO.
FRAMING - ELECT.FINAL TEST
ZONING ENG.SITE NO.
INSULATION PLUMBING
GAS TEST GAS
'MECHANICAL FIRE SPRINK ENERGY T 14
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y Q_—N. ` N[]
EXTERIOR SHEAR - C",LL— ELECTRICAL RELEASE _ FLOOOZONE IA.L Uc
INTERIOR SHEAR / FIRE DEPT. - Y'❑ N❑ Y ❑ ' N❑
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH 92 /. BUILDING — "1j� C,
.INTERIOR LATH �'� TEMPORARY APPROVALS BUILDING
SCRATCH COAT ELECTRIC FLAN CHECK 2540
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 10.71
OCCUPANCYOF BUILDING ISNOTPERMITTE D UNTILBUILDING FINAL IS SIGNED BV BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 60.35
H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
60.35--,�i 0 PLEASE GIVE JOB ADDRESSIAHEN PHONING.
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE.SIDE BEFORE TOTAL 1383.21
CALLING FOR FINAL INSPECTION.
OFFICE-COPY
CITY OF CUPERTINO
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
Date ..................2.—.—.c.;.�--7.......... 1 Building Permit No.
... . .. .. --- .. ......
The Building Located at ..... ckkb
.............................
Ownedby ........G. ----G oup................................;**------........
Has Been (Altered)
For Use As: .. ..............................................
,(Altered)
................................................................................................................I.................................
...........................I...........................................................................................................
..............................I................................................................................................................
..............!� ..........................................
PD-7 BUILDING INSPECTOR
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BU I LDING PROJECT I DENTIFICATI ON PERMIT NUMBER. "
Bu N011NG APPLICATION & PERMIT 151 �5
- ADDRESS o an ,
11722 Westshore Court BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S
NAME
Gregory Group, Inc. & QTY. ELECTRIC PERMIT .-' FFE PLAN CHECK VALIDATION
Ahmanson Dev. P4-16-595-2100
NAAMERACTORs UTLETS-SWITCHES-RECEP 10.00/1.00
Gregory Group, Inc.LIC.NO. B-430097 LIGHTING FIXTURES 10.00/1.00
r,,RAC c; - win 0 p In r. APPLIANCES-RESIDENTIAL 4.00
AO FsS� 94065 41,5oN595-2100 PANELS 10.00 DATE OF APPLICATION
ARCHITECTra assenJan, SSO PANELS 200 AMP) 20.00 PLAN CHECK FEE .NO.
ENGINEER LIC,NO.C-8395 ISIGNS TRANS. 3.00
ARCH 08 ENG, SPECIAL CIRCUIT S.00 +PERMIT VALIDATION
?f03A CrOard -DDr. //1Q{o�
Sana na ts. CA. � 2707 TEMP.METER OR POLE INS. 20.00
AOGRESS MOTORS SEE FEE SCH. T ./I},i�I�I,
Ali
DDREBa 220-C Twin Dolphin Dr �Y i Vl 1t
p SERVICE CHANGE .00
coo LICENSED CONTRACTORS DECLARATION I Il
c u u I herehy affum that I am licensed under provisions of Chapter 9 ISSUANCE DATE
zw (commencing with Section 7000)of Division 3 of the Business and
H. 0 u BLDG. ELECT. PLG. MECH.
H i Professions Cole,at my license is in full force and effect.
z O w - License Clasj 6 Lia Number ��p
DR
I- w
at __Z
- -_ . tmcmr_ `�� City at Cupertin
a m a ¢ - OWNER-BUILDER DBCLAN BUILDING PERMIT
A o a O INFORMATION
X ; N I hereby affirm the I am exempt from the Contractor's License MISC.- REFER TO ORD
u 00J Law for the followingreasoo.(See.7031.5,Business and Professions PERMIT ISSUANCE 10.00 - VALUATION SIFT.
� - Code:Any cityorcounty which requires a permit to construct,alter, 152 727
Q c ¢ 0 Improve,demolish,of repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. G
iiLDLL requires the applicant for such permit to file a signed statement that TOTAL
w m w he is licensed pursuant to the provisions of the Contractors License PERMIT TO
Law(Chapter 9(commencing with Section 7000)ofDivisiml 3 oflhe SFDU
a Business and Professions Code)or tlmt he is exempt therefrom and OTY. PLUMBING PERMIT FEE
M r$ (be basis for the alleged exemption.Any violation of Seclion 7031.5 STORIES TYPE CONSTR.
by any applicant for it permit subjects the applicant to a Civil penalty than ALTER-DRAIN&VENT-WATER (EA.) 5.00 2 SNHR
of not more five hundred dollars(55001.1:
❑ 1,as owner of the property,or my employees with wages as BACKFLOW 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, Rashness and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 1.
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.- LS AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve- LfhyO.•DF7gya
meats are not intended Or offered for sale.I L however,(tic building GAS,EA.SYSTEM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion, the owner GA$-EA.SYSTEM-OVER 4(EA.) 2.00
builder will base the burden of proving(bat he did not build or inn. BUILDING USE
prove for purpose ofsale.). RES IND CON PB Other
❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 �-
licensed contractors to construct the project(Sec.7044,BusinessLAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractors License Law does not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
Coll tracts forsuch projects with a cuntmctor(s)licensed pursuant to
the Contractors SEWER-SANITARY-STORM EA.200ft License Law. /10.00 TRACT NO, PARCEL NO.
IDIain exempt under Sec, ,B.&P.C.fur this
reason WATER HEATER W/VENT 6.00
Owner pate WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of Cople rt illself-insure, - ZONING ENG.SITE NO.
Eu a certificate of Workers'Compensation Insurance,or a certified
OPY thereof(Sec.3800,Lab.C.).United Pacific I -
Policy No. Company
O ❑ Certified copy is hereby lumishod' FIRE$PRINK ENERGY T]4
Z Z ��qCertllle , py n' BI the city inspection division.
O A41icant - MISC-- REFER TO ORD. Y [] N❑ Y ❑ N❑
y CE CATE N PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LU COMPENSATION INSURANCE PLG,cONTR. LIC.NO. PLG,
CL Z (This sectidn need not be completed it the permit is for one TOTAL V N V[3 NC]
hundred dollars(S 10()or less.)
U O I certify that in the performance of the work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- mit is issued,I shall not employ any person in any manner so as to
U W' become subject to the Workers'Compensation Laws of California,
0. Date ApplicantALTER OR ADD TO MECH. 5.00 -BUILDING
>_ m NOTICE TO APPLICANT: If,alter making this Certificate of Ex-
F_ Z e,option,you should hecome subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you most forthwith comply will .15.50
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 rEEenerigy
CONS'1'RUCI'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=1C.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(See. MICROFILM
3097,Civ.C.). S1curlt PACIFIC HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 60.35
Lender's Names r7ader_o h-fes ELECTRIC
n l l certify that l lm ea n e plicmion mud'late that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING 60.35
ordinances and state laws relating to building construction, and BOILER-COMP(3H.P.or10O,0008.T.U.) 6.00
hereby' authorize representatives of this city to en(er upon the BOILER-COMP I . 35
• f above-mentioned Property for inspection purposes. DVBI 100,000 BTU)SEE FEE SCHMECHANICAL
,r (We)-agree tosave, indemnify and keep harmless the City nlMISC.- REFER TO ORD.
upertino against liabilities,judgments, casts and expenses which PERMIT ISSUANCE 10.00 CONST.TAX.
ay in any way accrue against said City in consequence of the
rantingofthis enm MECH.CONT. LIC.NO. MECH. 288.95
N ^ G''M _ QS TOTAL TOTAL 1383.21
Signatu p mart for Date
OFFICE COPY