15813 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY_ .. - . "
"��� � BUILDINGPROJECT IDENTIFICATION - " reAMirr+umaea
�. a�,�p,„� o a� APPLICATION & PERMIT � q [O q �
"° I J 0 I
'P���7 Cedar Spring Court BUILDING -ELECTRICAL-PWMBING-MECHANICAL r''
OWNFa'S P�AN CHECK Vl LIDATION
� rvnMe Gregory Group II1C. � pTy. ELECTRICPERMIT FEE ' ,. �
Ahmanson Dev. 4�,�„�95-2100
I CONTRACTOR3' •
Hnme OUTCETS-Stl01TCHES-RECEP 10.00/1:00
Gt'egol^y 6roup, Inct;�.NoB-430O9� LIGHTINGFIXTURES �o.00n.00
r,aHrnncron�s - Wlll 0 lll P. PPLIANCES-RESIDENTIAL 4.00 '
AOO�C 94065 4,d�E595-2100 pqNELS �O.00 DATEOFAGVUCPTION.�
ARCNITECT PANELS (OVER 200 AMP) �� 20.00 PLAN CHECK FEE : P. .NO.
oA Aram Bassenian, AIA�_�3��so
ENGINEER . ' '
uc.rvo. SIGNSTRANS. "� 3.00
�J.00 PERMIT VPLIOATION -
"R`" °"E"° 2Q31 OrQHARD DR. //100 saean�ciacuir • ,
°°°�anta Ana Hts. CA.• �z707 EMP.METER OR POLE INS. 20.00
nvrucnr+rs MOTORS � SEE PEE SCH.
°°°R�C`20-C Twin•Dol hin Dr. RWC 940 .
P SERVICE CHANGE ' 20.00 p���
�o O LICENSEU CON'PRACTORS DGCLARATION /l�L�Q 3 -
Q twi u ���ereAy affirm �ha� I am licenxd unJer provisions of Chupter 9 ' ISSUANCE OATE
y Q y (communciny with$Cetion 7000)of Division 3 of�he Business and . . 999����� ELECT. PLG. .'MECH.
r o z Pmfessions Code,a�yl my lirense is in lull furce� y(fqc�-� ' � � � �
0 2 u°'i o LicenseClass D Lic.Number��lV7_� �
Oale Conhac�or py�
Q y P J ' O ��yry�DING VERMIT
rc¢ OWNER-IlU1Ll)1>R DECLARATION 4�4�
a o d � r�vrORMATION
W �LL h 1 hercby a(fi�m thal I am exemp�from the Convactor's Licensc MISC.- REFER TO ORD '' �q�unno�u $/FT.
F u o� Lnw for the followi�g reason.(Sea 7011.5,HusinessundPmfesaions pERMIT ISSUANCE 10.00
Code:Anycilyorcountywhichrequiresapermi[wmnslmcl,alteq t ���� �
Q Q¢p impmve,demolish,or repair any stmc�ure,prior to ils issuance,ulso ELEC:CONTR. UC.NO. ELEC. ��
- � K requires�he applicanl for such permit�o Iile a signeJ staeemen[Ihat TOTAL � PERMIT TO
� w m he is license�pursuant m�he pmvisions of�he Contrnc�or's License
fii Law(Chapter9(rommencingwith5eaion7000)ofDivision3of�he SFDUX.-
a Business and Pmfessions Code)or tlmc he is exemp�Ihercfrom�nd QTV. PLUMBING PERMIT FEE '
¢r � [hebasisfortl�eallegedexemption.Anyviolu�ionofSeclion7031.5 STORIES TVVECONSTR.
d;_ byanyapplicun�forapermi�subjec[s�heapplicaniroacivilpenalty qLTER-DRAIN& VENT-WATER �EA.) 5.00 2 5NHR
of not morc tltan five hundred do0urs(E500).1:
❑ 1,as uwner of Ihe property or my employces with wayes as gqCK FLOW PROTECT. DEVICE 4.00 OCC.GROua aES.uWTS '
�heir sole compensalion,will Jo[hc work,und tlie slmc�ure is no�
iNendeJ or olfered for mle (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON�. '5.00 {Z-3 1.. '
Code:The Contmclor's Licensc Law does nut apply m an uwner of �
pmpetlywhobuildsorimproveslhercon,andwhaJocssuchwork FIXTURES-PERTRAP � . 5.00 SO.FT.FLOOPAREF TOTPL�ICRE�IGE
. himsellorihmughhisownemployees,provided�ha�suchimprovc GAS-EA.SVSTEM-11NC.40UTLETS 6.00 �
ments ure mt imended or offered for salc.If,howevee�he builJing 2726
or improvement is sold within one year of compiction,the owner GAS-EA.SVSTEM-OVER 4 (EA.) 2.00 BUILOING USE
� builder will have the burJen uf pmving thut he di�w�build oq im- RES IND CON PB O�ner
proveforpurposeofsulo:l. INDUSTRIALWASTEINTER.. 30.00 ' �' � � ��- �
❑ I,as owner of�he property,am exclusivety confracling wiih
� licensed contractors tu consimc� ihe pmjea lSec. 7044,Business �qWN SPRINKLERS-1 INC 5 V.B. - 6.00 ASSESSORSPARCELNO.
anJ Professions Code:The Con[ractor's Licenm Luw Joes not apPly
�o an owner ol,pwperty who builJs or imVwves Ihereon,und who LAWN SPRINKLERS-OVER 5(EA.) 1.00 ' �r
� commc�s for such projec�s wi�h u cantrucmrts)licensed pursuant m SEWER-SANITARY-STORM EA.200ft/10.00 �
lheConhacfo!'sLiCCnStLaw. , TRACTN . PARCELNO.
. ❑ IumexemplunderSea ,fi.&P.C.lorthis yyqTERHEATERW/VENT . 6.00 . 8098
rwson
�"'"B� ��+�e ' WATER SVSTEM � 5.00 .
. - NCC.OATE ACC.FILE NO.
woRKFRsmMPfNSATION UIiCLnRAT�ON WqTER TREATING EQUIP. 5.00
_ � , I hercby u(firm Ihal I have a tct�if¢atcofcnnsenl tosell-idsure. ZONING ENQSITE NO. �
ar a certificate of Workers'Compensvtion Insuranee,or a certificJ
�o�Ymenor�se�.�aoo,�an.c.tU�lt@d PACIFIC
Poliry No. Company . .
.Q ❑- Ce�li(ied topy is 6e�¢by fu�ni5hed. FIPE SPFINK ' ENERGY T-29
Z Z .�(Certified copy is filed wilh Ihe ci�y inspmtiun Jivision.
p A��������� MISC.• FEFER TO ORD. v �. r�0 v ❑ N❑ ,
� y � ' CERTIFICATIiOF li%GMPTION F'ROM WORAtiRS' : PERMIT ISSUANCE 10.00 'FLOOOZONE n.L.U.C.
� �yJ > , COMPF:NSATION INSORANCIi ' PLG.CONTR. �IC.NO. PLG. '
a � IThis uction neeA nol be completeJ if tbe permi� is Ibr'une TOTnL • �❑ N❑ ' � ❑ N❑
� Z hundreJ Jollars(81001�r IessJ �
U O I certi(y iha� in the pedom�nnce af tlm work for which�his per pTV. MECHANICAL PERMIT FEE PEE SUMMARV
, �y F mit is issued, I shall not employ any persun in any manner so us�o
U become subject m�he Workers Compcnsution faws ol Cnlifomia.
� a �atc nppli<ant . ' qLTER OR ADD TO MECH. 5.00 BUILDING 916.00
�i } m NOTICIi TO APPI.ICANT, If,af�er muking this Certificale of lix�
� z emption,you shoulJ become subjec��o�he Rbrkers'Compensution qpPLIANCE 5.00 PLAN CHECK •
. provisions of tbe Labar CoJe, you mus� lor[hwith cnmply with FEE�Q�ep 6'z.�0
U su<h Orovisions or�his permil shall bc dcemed revokcJ. AIR HANDLING UNIT(TO 10,000C.F.M) 4.00 9
CONSTRUCTIONLf;NDINGnGeNCY � AIRHANDLINGUNITIOVER10A00GEM.16.00 SEISMICFEE 1Z.53
1 hereby alfirm �hut therc is u rons�mc�ion IenJiny aKency fnr EXHAUST HOOD(WiTH DUCT) 5.00
the performance of the work for whioh Ihis permit is iswed(Sec. MICROFILM
7o97,Civ.C.1. SO�PdC1f1C HEATINGUNITITOt00,0006.T.U.) 8.00 '
Lender'sName HEATINGUNITIOVER100,0008.T.U.19.50 ELECTRIC 68.58
LenJcr's AJdress �'_0.
� . I certil'y Iha�I hav ead u cWion and state�hat�he ubuve VENTILATION FAN �SINGLE) � 4.00
information is mrrect. I aS«��o comply with ull city end coimry PLUMBING 68.58
ordinances and stute laws relating ro building constmction, and BOILER-COMP(3H.P.or100,0008.T.U.) 6.00 p p
6ercby au�horize rcpresenW�ives of �his ci�y �o entcr upon Ihe BOILER-0OMP Io�.100,000BTU�SEE FEESCH. MECHANICAL.� 60.50
abwe�meneioned property for inspec�ion purpous.
(We)�agree ro save, intlemnify and kcep harmless the City of MISC.- REFER TO OflD. '
upertino against Gabili[ies,judgmenls, cosls and ezpenses which CON .T
ay in wy way ace v ai t suid '�ty in conscyuena of the PERMIT ISSUANCE 10.00
ren�ingof�hispe 11� MECH.CONT. , LIQNO. MECH. -
� � TOTPI TOTAL �
$ignatureo! pD' I�onlraclor Date '
' OFFICECOPV . I���
, POST THIS CARD NEAR FRONT OE BUILDING , _ ' ,EqM„N„MaEq
,�- �-. � . CITY OF �CUPERTINO � 15813
— ; � • INSPECTION DIVISION • '
� � JOB'INSPECTION RECORD �
�" `� � � , ' . . '� ': � • : � � . 1 . ~ �' . • : . PERMIT E%PIHATION
� JOBADDRE55 � � ��� CE��'R S�R�'NCr CTjN1T# LOT#a�/ �� " � � � !
,- . E'6-O�(t " pcJ �4 , . � . , PERMIT EXPIRES IF,WORK {
� owNea ,p/� � CONTRFCTOP G (J ' IS NO7 S7ARTED WITHIN �
� ' INSPECTION DATE INSPECTOR INSPECTION RECORD ieo onvs oF veAMi7 isSu- '
� � FOUNDATION � - ANCE'OR,180.DAVSFROM �
�NOTE: � '� - ' � � � �qSTCALLEDINSPEC710N. �
UF,ER � _.�jv ALL GRADING AND DRAINAGE SHALL BE INSTALLED� �
' TO COMPLY WITH THE APPROVED PLANS AND CIN OF PeNnart vn�marioN
PREGUNITE �• � � CUPERTINOSTANDARDS. . � . �
i� GARAGESLABS � � ' .
' POUR NO CONCRETE IINTIL ABOVE HAS BEEN SIGNEO : M� �� ' �' 'r:� d ,
� . ' - UNDERGROUND /SLAB � ' ' " ' � , . �� `�� ' ' - - - �-� � � �
( �
� - PLUMBING ' � •, ' ; (,.•µ " . . :' i:�..
� � ELECTRICAL � � . � . � � � issunrvce uare �
" MECHANICAL � " ' . � � u�uc e�ec*. v�a. mecH.
' �+,z..✓: . � '0 4. 'p .
DO NOT POVR FLOOR UNTIL ABOVE HAS BEEN SIGNED� � � euaoiNG vEAMi7 +
� � � WOOD FLOOR• • �, � , ``�O ' 0 INPORMATION .
' PLUMBING' . „ 'C\�y � 1 VALUATION ,5/FT.
MECHANICAL � � � � 1�8 281
vEHMir ro
� ELECTRICAL � � � � '
. , . FRAMING ' . SFDU3�" � '
INSULATION . � > � � � . , sroHi�s rvicecor�srr+, �
, ' ' 2 5dHR .
. OCC.GFOUP HES �NiTS
' .PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SI6NED � • ' R�� i
�� � . • � " � ROOF' �- NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so F�.«ooa aaen ro.n�ncnencc
�' Di,4PtiRAGM . ' � . THE CONSTRUCTION TAX IS PAID , � . � " , .
' ew�oiNe use
RO(jF�S}1EATHING ' ' �Z,��j ' � � . �+Es im❑ corv na om.,
� - , �APPLY NO ROOFING.UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. � � � � ' � �
. - PSSESSOPSP/aH�ELNO
, � �.ROUGH SAN.p - � - -
. . PLUMBING "�0� Ql7C �{�"�— ELECT.ENERGY ���-� � —�� '
� , TUBSBSHOWERPAN ' ' 1.{�{ W PLUMBINGENERGY . T "L[" . P^Ace�rvo
. MECHANICAL � � MECH.ENERGY ncc. nre acc Fae mo
ELECTRICAL ' � BUILDING ENERGY .
- FRaMING ' � 7, Q ELECT.FINALTEST
' ZONING ENG.�SITE N0.
INSULATION - � PLUMBING . - �� �
� GAS TEST . . ' _ � . � GAS , •
' MECHANICAL ' . FiREsaaiNK En�Eac���Zu
COVEfl NO WORK UNTIL ABOVE,HAS„BEEN$ICNED HEATWG . � v ❑ �"� � ❑ �❑
FLOO��ONE /.L!UC.
EXTERIOR SHEAR %Z � ELECTRICAL RELEASE �
V� N� VL ry�
. INTERIOR SHEAR . '�, FIRE DEPT. '
SHEETROCK GRADE� FEESUMMARV
EXTERIOR LATH � � " BUILDING •
iN7EaiOR �nrH - - TEMPORARY APPROVALS ' BUILDING
SCRATCHCOAT' ELECTRIC - ' PLAN CHECK I5�SO
. � � - GAS FEE
ND 7APE OR PLASTER UNTIL ABOVE HAS BEEN SI�GNE� OCCUPANCV SEISMIC FEE
� OCCUPANCVOFBUILDINGISNOTPERMITTEDUNTILBUILDINGFINALISSIGNEDBVBUILDINGINSPECTOR. MICROFILM �
- - E�ECTRIC
�, ; w �. ' ARRANGE FOR INSPECTION BY PHONING 252-4505, 6� 58
F.',, ,. � ONE WORKING DAY BEFORE REQUIRED INSPECTION. P�uMsiN� 68
, �� 'PLEASE GIVE JOB ADDRESS WHEN PHONING. '
�' i2 .{ _� " ' , MECHANICAL
— SEE PERMIT FOR EXPIfiATION DATE —
IMPORTANT! , coNs .TaxG � L
� PLEASE READ REVERSE SIDE BEFORE TOTAL
� CALIING FOR FINAL INSPECTION.
OFFICECOPV /. �
�' . %���O .