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15806 (2) POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO ' PE RMIT NUMBER INSPECTION DIVISION 15806 JOB INSPECTION RECORD y Q JOB ADDRESS_.L.L o /I�C�� '�Q/ /�• - - G�UNIT# _LOT# o � PERMIT EXPIRATION " �K U PERMIT EXPIRES IF WORK OWNER. - /y coNrRAcroR 8�-0v IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECT N RECORD`__ 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM UFER NOTE: LASTCALLED INSPECTION. Z" ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CIN OF ?eRMlr—VALIDATION GARAGE SLABS CUPERTINO STANDARDS. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED !'• r' { UNDERGROUND /SLAB - 1 -'• PLUMBING - 1+ ELECTRICAL ' ` r ISSUANCE DATE MECHANICAL " BLDG ELECT PLG. MECH xo pF:l+ � � �❑ DO NOT POOR FLOOR UNTIL ABOVE HAS BEEN SIGNEDW "O Q BUILDING PERMIT OOD FLOOR v INFORMATION PLUMBING J� 1CATION S/FT. MECHANICAL -J 1_ $q�-1Nh=..�'.`brL-2�k` ot�G Welt ELECTRICAL Co Yk� ICA nmn IIT ro FRAMING I INSULATION STORI YPE CONSTR. OCC ROUP UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 'OFT.FLOOR AREA IOTA ACREAGE DIAPHRAG I THE CONSTRUCTION TAX IS PAID ROOFSHEATHING lei -ZBDILDING USE lits IND CON PB OOn•. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ - [:] ❑ E)• ROUGH SAN.N ASSESSORS PARCEL NU PLUMBING _� - LQ ELECT.ENERGY -- TUBS 8 SHOWER PAN Yi Q PLUMBING ENERGY rRAcr Nu PARCEL No MECHANICAL I!A- Q11� MECH.ENERGY " ELECTRICAL - _Q - BUILDING ENERGY oArE ncc.FILE No FRAMING —Z ELECT.FINAL TEST , INSULATION _ _ Q PLUMBING zoN'NG ' ENG"SITE NO. GAS TEST GAS MECHANICAL FIRE SPRINrc ENERGv T.11 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 1 ❑ N❑ V ❑ N❑ EXTERIOR SHEARZ ELECTRICAL RELEASE FLOOOZONE ALUC. INTERIOR SHEAR FIRE DEPT. V❑ N r L7 N❑ SHEETROCK GRADE - FEE SUMMARY - EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT �,hj ELECTRIC PLAN CHECK GAS I FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCYsAKi�rF4Y 65.00 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ' ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING •90 z PLEASE GIVE JOB ADDRESS WHEN PHONING. -.SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANTI CONST.TAX . PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY /`7400 � - 1 PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY 1BUI LDI NG PROJECT IDENTIFICATION .PERMIT rvOf , aOILDING Lot 205 Plan 1B_ APPLICATION & PERMIT 15806 A11638 Birch Spring Court BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK Of NAME Gregory Groupp, Inc. & OTY. ELECTRIC PERMIT - FEE ' Ahmanson Dev. 4151595-2100 U°P°�gory Group, Inc. B-430097 OUTLETS-SWITCHES-RECEP 10.00/1.00 uC.No. LIGHTING FIXTURES 10.00/1.00 CONTRACTORS - win Dolphin Dr. APPLIANCES-RESIDENTIAL 4.00 �O� E 94065 4154415-2100 PANELS 10.00 DATE OF APPLICATION AA CCH(IITECT ram assenian, Q • pgNELS (QUER 200 AMP) 20,60 PLAN CHECK FEE P.C.NO. OR ENGINEER C-8395 uc.No. SIGNS TRANS. 3.00 AARCH.OR DDRESS ENG. 2031 Orchard Dr. #100 SPECIAL CIRCUIT 5,06 PERMIT VALIDATION Santa Ana Hts. CA. 92707, TEMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. AD 220-C Twin Dolphin Dr.RWC 9065 SERVICE CHANGE 20.00 r[/r w ,C2 LICENSED CONTRACTORS DECLARATION 0 I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE NQ'y (commencing Willi Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. H N Z ics910n8 Code,and m IICCn9C Is In toll fDICR,taI y, z O - LLicenense ClassLic.Number_yyUU y.( - p �IYgI{ r Dale Contractor - [- 'a it E -1 BUILDING PERMIT it w a OWNER-BUILDER DECLARATION INFORMATION odU MISC.- REFER TOO O \ E I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. r u o J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10. Code:Any city or county which requires a permit to construct,alter, L O a ¢¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIG N0. ELEC. p�r1 6i C erfjh54 f 922 n - 0, requires the applicant for such permit to file a signed statement that - TOTAL C11Y PERMIT TO x $ he Is licensed pureuanl t0 the pfovlsions Of the Contractor',License Uzi Law(Chapter 9(commencing with Section 7000).(Division 3 of the SFDUJL se Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ric the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONBTR. i ;�2 by any applicant for a permitsubjects the applicant to a civil penalty ALTER-DRAIN (EA.)of not more than five hundred dollars($500).): gLTER- . . : .2 5NHR ❑ 1,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,GOND. 5.00 R-3 - I Code:The Contractor's License Law does not apply to an owner of - ' property who builds or improves hereon,and who does such work F IXTUR ES-PER TRAP 5.00 SQ FT.FLOOR AREA TOTAL ACREAGE menta are not intended own employees, rsprovided ever,at th improve- GAS-EA.SYSTEM-11BIC.4 OUTLETS 6.00 2400 . - - ments are not intended or thinoffered mi for sale.If,completion, the building , or improvement is held within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have he burden of proving[hal he did not build or i.-- RES 'IND CON PB Other prove for purpose of sole.). INDUSTRIAL WASTE INTER. 30.00 [9 ❑ ❑ ❑ ❑ ❑ L as owner of the property,am exclusively contracting with and Pro contractors to construct the project(Sac. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Codeproperty The Contractor's oLicense s thereon, does not apply to frowner of u properlywho builds Orimprovesensed pursuant who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 a LP LI ,�. contracts for such projects with a c.ntractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 �--�Y the Contractor's License Law. TRACT NO. PARCEL NO. ❑ l am exempt under Sec.' ,B.&P.C.for this WATER HEATER W/VENT 6.00 ' reason 8098 Owner Dale WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 , 1 hereby affirm that I have a certificate of consent to sal&insure, ZONING ENG.SITE NO. .r a certificate of Workers'Compensation Insurance,or a certified copy thereof(See.3800,Lab.C.). United PACIFIC - - Policy No. Company O ❑ Cefllfiedcopyisherebyfurnished. FIRESPRINK ENERGY T-24 Z Z f Certified copy is fled with the city inspection division. MISC.- ' REFER TO ORD. y ❑ tv❑ v'❑ N❑ U Applicant M N CERTIFICATE OI'EXEMPTION FROM WORKERS' . -PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. Lu > COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. CL 0 _ (This section need not be .......Ivied if the permit is fat one TOTAL y[:] N❑ v❑ "N❑ Z hundred dollars($100)or less) U 0 1 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 manner so as to U become subject to the Workers'Compensw ion Laws of California. O w Date Applicant ALTER OR ADD TO MECH. 5.00 F 832.,00 } N NOTICE TO APPLICANT: If,after making this Certificate of Ex- ♦- 2 emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 15.50 provisions of the Labor Code, you must forthwith comply with 6 U such provisions or this permit shall be'deemed revoked. AIR HANDLING UNIT(TO 1Q000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IO,000GEM.16.00 2.00 10.85 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. 3097,Cw C.). Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC , 60.90 reader's Adss dre 1 certify that I have read this a ication and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING 60.90 ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL 60:90 above-mentioned property for Inspection purposes. (We) agree to save, indemnify and keep harmless the City of misc.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which" -CONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 03 ranting of this perp' MECH.CONT. - LIC.NO. MECH. TOTAL TOTAL > Signature at Contractor Date OFFICE COPY 0(