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15823 (2) POST. THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER . . - CITY -OF CUPERTINO 15823" INSPECTION DIVISION JOB INSPECTION RECORD \ 2t< PERMIT EXPIRATION JOB ADDRESS a co `^_- , UNIT# _LOT# ' CY�J�C7 L•T �' ,QayP �I / �p��_,,, . . PERMIT EXPIRES IF WORK 'v.- OWNER Qtly 1/ny CONTRACTOR l.- Qyy��( GeDu IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR - INSPECTION RECORD ISO DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS'FROM . • NOTE: LASTCALLED INSPECTION. ' UFER ,�- �L�/, ALL GRADING AND-DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION - . CUPERTINO STANDARDS. GARAGE SLABS ` POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED z _ r " UNDERGROUND /SLAB ,.�c r, PLUMBING ,BIv' Gt ry �' •., (, ELECTRICAL - ISSUANCE DATE MECHANICAL - n Et SLOG. ELECT PLC. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED `I 1 BUILDING PERMIT WOOD FLOOR INFORMATION u B VALUATION SIFT. PLUMBING City et P U MECHANICAL - ELECTRICAL PERMIT TO * 1 - SPUU1— FRAMING ' STORIES TYPE CONST H. INSULATION 2 OCC.GHOUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF NOTE:NO FINAL.INSP.SHALL BE MADE BEFORE , so IT.FIOIIRAPEA TOTAL C.EAGE ' DIAPHRAGM THE CONSTRUCTION TAX IS PAID ' a BUILDING USE ROOF SHEATHING � '�.�,rl�j ` \11� RES IND CON PS o...., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. IP ❑ ASSESSORS PARCEL NO. ROUGH - SAN.M PLUMBING C%J7 ELECT.ENERGY7 5E ' Lr•I TRACT NO PARCELNO NUBS&SHOWER PAN - PLUMBING ENERGY MECHANICAL Lt4 MECH.ENERGY- ArE ACC.FILE NO ELECTRICAL \ BUILDING ENERGY _ FRAMING 4-0 ELECT.FINAL TEST ' INSULATION PLUMBING zoNlrvG ENG.SITE No. . GAS TEST (� •vu, GAS ' FIRE SPRINK ENERGY T 24 MECHANICAL Y ❑ N[ Y E] 'N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A U.C. EXTERIOR SHEAR aj- ro ELECTRICAL RELEASE INTERIOR SHEAR , FIRE DEPT. ' �' N� Y ry0 SHEETROCK ITIL . GRADE FEE SUMMARY EXTERIOR LATH i BUILDING " INTERIOR LATH TEMPORARY AP ROVALS BUILDING 940.50 SCRATCH COAT - ELECTRIC PLAFEE 15.50 CHECK IS�SQ GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEI OCCUPANCY OF BUI LDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED 8Y BUI LDING INSPECTOR. 113.02 MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 10.35 `U ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z -PLEASE GIVE JOB ADDRESS WHEN PHONING. 70 146 — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST....TAX PLEASE READ REVERSE SIDE BEFORE TOTAL. Q . CALLING FOR FINAL INSPECTION. OFFICE COPY -- -- ------ -------- AP2LIOANT TO FILL IN INFORMATION WITHIN RED LINES - USE BACt POINT PEN ONLY'. BUILDING PROJECT IDENTIFICATION - APPLICATION $t'PERMIT PERMIT NUMBER - � [�� tio Elot 215!jP1 an 3C NJ 116,16 Cedar SpringCourt BUILDIG,ELECTRICAL-PLUMBING-MECHANICAL OWNER'$ PLAN CHECK VALIDATION NANE - Gre 0 Group �}1' & TY. ELECTRIC PERMIT FEE Ahmansogi 6h. Pojjy+ =595-210 COONTERACTORs UTLETS-SWITCHES-RECEP 10.00/1.00 NAMGregory Group, Inco. B-430097 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS 220-C Twin Dolphin Dr. PPLIANCES-RESIDENTIAL 4.00 ADDRESS RWC 94065 415ph5a5-2100 PANELS 10.00 DATE OF APPLICATION - ARCHITECT PLAN CHECK FEE P.C.NO. OR Aram Bassenian, AIA & Assoc. PANELS (OVER 200 AMP) 20.06 ENGINEER C-8395 uc,No. SIGNS TRANS. 3.00 ARC. OR ENG. //1��1 PERMIT VALIDATION ACg9 to An�C)AjsOrEh� rd DC2f/,1QD• SPECIALCIRCUIT 5.00 y /ZIIP/ TEMP.METER OR POLE INS. 20,00 APPLICANTS MOTORS SEE FEE SCH. . ADDRESS 220-C Twin Dolphin Dr.RWC SERVICE CHANGE' 20.00 // w o o LICENSED CONTRACTORS DECLARATION !�fw� aI hereby affirm that I am licensed under provisions of Chapter 9 ISSUAN[[[CE DATE N¢N (commencing with Section 7000)of Division 3 of lire Business and BLDG. ELECT. PLG. MECH. F z Professions Code,and s license is in full force and effect. ��J1I License Class Lie.Number-430097 ® RL. 9 m r w Date - Contractor - ¢ m s BUILDING PERMIT at at.M U OWNER-BUILDER DECLARATION ID .INFORMATION w ;u N 1 hereby affinn that I um exempt from the Contractor's License MISC.- REFER TO ORD VALUATION $/FT. r a.o J Law for the following reason.(Sec.7031.5,Business Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requiresu permit to construct,alter, 01' 65 pQ ¢ p Improve,demolish,or repair any structure,prior to Its issuance,also ELEC.CONTR. LIC.NO. - ELEC. wO , requires lire applicant for such permit to file a signed statement that TOTAL PERMIT TO $ he Is licensed porsuamt to the provisions of the Contractor's License 1 H z a Law(Chapter 9(commencingwith Section 7000)of Division 3 ofihe Bs�y� O 'CUperf1nGFDL0L 4 o Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT PBQ a 1- the basis for the alleged exemption.Any violation of Seclion 7031.5 STORIES TYPE CONSTR. T9 by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA:) 5.00 - 2 SNHR of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 occ.GROUP PES.UNITS their Sole compensation,will do the work,and the Structure is not intended or Offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 ' I Code.The Contractor's License Law does not apply to an owner of . property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve GAS-EA.SVSTEM-11NC.40UTLETS 6.00 2917 mems are not intended or offered bor sale If,however,the building or improvement is sold within one year of completion,the owner- GAS,-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND SON PB Omer prove for purpose of sale). INDUSTRIALWASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 AS$ESSOR$PARC=LNG. and Professions Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon•and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200f1/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-,B.&P.C.fin this WATER HEATER W/VENT 6.00 8098 ason Owner - Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO, WORKF:RS'COMPENSATION DECLARATION I WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(See.3800,LaoCCnited Pacific Policy No. Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 p Certified coy is fled with the city inspection division. Z 0 Applicant p MISC.- REFER TO ORD. : Y ❑. N❑ Y ❑ N❑ -PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. COMPF EXEMPTION FROM WORK F,RS' LU CERI'IFIC UJ _ COMPIiNSATION INSURANCE PLC.CONTR. LIC.NO. PLG. 1 0 (This section need not be completed if the permit is for one TOTAL Y❑ . N❑ I Y❑ N❑ Z hundred dollars US 100)or less.) U O - 1 certify that in the performance of the work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any munnerso as to OW become subject to the Workers'Compensation Laws of Coliform.. y Date ApplicantALTER OR ADD TO MECH. 5.00 BUILDING 940.50 } N NOTICE TO APPLICANT If,after making this Certificate of F:x- F Z Sorption,you should become subject to the Workers'Compensation APPLIANCE 5.00 - PLAN CHECK D provisions of the Labor Code, you must forthwith comply with C„1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 FEE�ener 62 0 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER IQOOOC.FM.) 6.00 SEI SMIC FEE 13.02 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of he work Co hl this r-mit is issued ISce. MICROFILM 3097,Civ.C.). S`ecuri{;y `�aci `ic HEATING UNIT 170100,000 B.T.U.) 8.00 Lender's Name-i--Efftba C_ der0 44th fir. HEATING UNIT(OVER l00,000B.T.U.)9.50 ELECTRIC 70.35 Lender's Ad dress-Q- Qg - I certify that I have read[this app icahon and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING 70.35 ordinances and stale laws relating to building construction, and BOILER-COMPI3H.P.or 100,000B.T.U.) 6.00 hereby_authorize representatives of this city to enter upon the BOILER-COMP lover 100,000 BTU)SEE FEE SCH. MECHANICAL 70.35 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 03 ay,in any way accrue against Said City in consequence of the PERMIT ISSUANCE 10.00 anlingofthis er - MECH.CONT. LIC.NO. MECH. „ TOTAL TOTAL ' Signature pplicanl/Contact., Date OFFICE COPY � ��