15805 (2) POSTTHISCARD NEAR FRONT OF B�UILDNG PERMITNUMBER
-` CITY OF CUPERTINO 15805 :
INSPECTION DIVISION'
* JOB INSPECTIONRECORD
�1. 1E�� T
y�2,- •�J JOBADD SS-� ��3�' —`='+"�+'�- 5�^'y-{ C1 UNIT# _LOT# PERMIT EXPIRATION
VaulI Y dQ Q / Ip �' PERMIT EXPIRES IF WORK
OWNER " CONTRACTOR CZ _.6XDjZ C C"t ACX-( _ IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECOR 180 DAYS OF PERMIT ISSU- ;
FOUNDATION' ANCE OR 180 OAYS,FROM
NOTE: LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL.BE'INSTALLED
PREGUNITE TO COMPLYVITH THE APPROVED PLANS AND CITY OF PERMIT VAuoATION
CUPERTINO STANDARDS.
GARAGE SLABS '
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL
ISSUANCE DATEr
MECHANICAL . BLOG ELECT. Pic. MECR,
PAI 0
a ' •
DO NOT POURLOO
FR UNTIL ABOVE HAS BEEN SIGNED1 O BUILDING PERMIT
!?tUV 1 O INFORMATION
WOOD FLOOR VAEDA IION, SIFT,
_ PLUMBING '
MECHANICAL City Ot CUP'�Itl�4+'54/922
I
ELECTRICAL PERMIT To
FRAMING
INSULATION - SFDU+�-
STORIES NEE CONSTR,
- � '
2 5NHR. r
OCC.GROUP- RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED R•3
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE' sD.FT,aooR AReA TOTAL ACR EAce
THE CONSTRUCTION TAX IS PAID
DIAPHRAGM 2400 'o
BUILDING USE
HOOF SHEATHING ITS IND CON PB om., '
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. A' 0
ASST SSORS PARCE LNO
ROUGH SANA
PLUMBING D� ri
W
ELECT.ENERGY l w
TR CT NO, PARCEL NO
TUBS 8 SHOWER PANPLUMBING ENERGY I
MECHANICAL MECH.ENERGY 8098
ELECTRICALBUILDING ENERGY
ACC DATE Acc.FILE NO
FRAMING ELECT.FINAL.TEST
ZONING ENG SITE NO.
' INSULATION � - PLUMBING
GAS TEST " GAS -•
MECHANICAL FIRE SPRINK• ENERGY 1 2
' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "� v No
EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE A,L.0 C.
. � N� Y'I IN
A INTERIOR !HEA 'S 3/3 $G� FIRE DEPT.
Y
SHEETROCK GRADE FEESUMMARY
EXTERIOR LATH - BUILDINGv -
INTERIOR LATH TEMPORARY APPROVALS - BUILDING
' SCRATCH COAT - 1 ELECTRIC PLAN CHECKI5�5O �
GAS6200
FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. SEISMIC FE l
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM
LEI, ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC
I—
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
z PLEASE GIVE JOB ADDRESS WHEN PHONING60-90
.
• MECHANICAL
- SEE PERMIT FOR EXPIRATION DATE.-
. .IMPORTANT! CONST.rnx
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES jr-USE BALL POINT PEN ONLY
'"'BbI LDING PROJECT IDENTIFICATION PERMIT NUMBER
0; B,,,LLOILZ1.7Ian APPLICATION & PERMIT 15805
A11R636 Cedar Spring Court
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL I'`'
OWNER'S PLAN CHECK VALIDATION
( n NAME Gregory Group Inc. & OTY. ELECTRIC PERMIT FEE
Ahmanson Dev. 4145-,$95-2100
e�aJ CONTRACTORY
" +•� N`dregory Group., Inc. B-430097 UTLETS-SWITCHES-RECEP 10.00/1.00
LIc.No. LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S 22p_C {., - PPLIANCES-RESIDENTIAL 4.00
ADGij�f^yC 94065 Tw�75'�p�p111[1ODr. PANELS 10.00 DATE OF APPLICATION
ARCHITECT ram aSSenlan, L1 o ASSOC . PANELS (OVER 200 AMP) 20.00 - PLAN CHECK FEE -P.C.NO.
ENGINEER - '
' uc.NoG-8395 SIGNS TRANS: 3.00
ARCH.OR ENG. 2031 Orchard Dr. #100 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ADDRESS
Ana Hts. CA. 927 _
D<7P EMP.METER OR POLE INS. 20.00
APPLICANTS MOTORS SEE FEE SCH.
ADDRESS 220-C Twin Dolphin Dr.RWC94
SERVICE CHANGE 20.00
woo LICENSED CONTRACTORS DECLARATION _ A/1)Y
<U U I hereby affirm that I um licensed under provisions of Chapter 9 ISSUAN E DATE
va <"' (commencing with Section 7000)of Division 3 of the Business and - ELECT. PLG. MECH.
v, w Z Professions Code,�qd my license is in full for�p�p{��j(.,cJ, ,-ss
z O w- License Class_D Lic.Numbern.3U.11`J 7�
oN r w Data Contractor
a x t Sty Ot C BUILDING PERMIT
Ic W OWNER-Bu1 L1iER DECLARATION - INFORMATION
X;u H I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO OR VALUATION F LL m¢ Law the following reason.(Sec.7031.5,Business and Crofessions PERMIT ISSUANCE 10.00 'S/FT.
� 7va Code:Any city or county which requiresa permit to construct,alter, 154,922
Q a a O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. - LIC.NO. TE LEC.
u -o Ie req cures the applicant for such permit to file a signed statement that TOTAL PERMIT TO
X
m'a- he is licensed pursuant to the provisions of the Contractor's License SFDtVL
Hui
Law.(Chapter 9(commencing with Section 7000)o(Division 3 ofthe
a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
r o the basis for the alleged exemption.Any violation ol'Section 7031.5 STORIES TYPE CONSTR.
rc by anyapplicant for apermit subjects the applicant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 2 SNHR
of not more than five hundred dollars(55001.):
❑,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 1
Code:The Contractor's License Law does not apply to an owner out
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 50.FT,FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve-
mentsarenotintended or offered for sale.If,however,the building GAS-EA.SVSTEM-1 INC.4 OUTLETS 6.00 2400
or improvement is sold within one year of completion,the owner. GAS-EA.SYSTEM-OVER 4 IEA) 2.00
builder will have the burden of proving that he did not build or am. BUILDING USE
prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CDN PB ' Omer
❑ I,as owner of the property,am exclusively contracting with ® ❑ ❑ ❑ ❑ -
licensed contractors m construct the project(Sec.7044,Business LAWN SPRINKLERS-I 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 huilds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projectswith a contmctorts)licensed pursuant to SEWER-SANITARY-STORM EA.20Oh/10.00
the Contractor's License Law. TRACT NO, PARCEL NO.
❑ tum exempt under Sec ,B.&P.C.Rn this WATER HEATER W/VENT 6.00 8098
reason
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC:FILE NO.
WORKF.RS'COMPENSATION DECj, RATION WATER TREATING EQUIP. 5.00 s
1 hereby affirm shut I have a certificate of cdnsent to self-insure, ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.CUnited Pacific
Policy No. Company
❑ Certified copy is herchy furnished. 'FIRE SPRINK ENERGY T-24
Z ZY] Certified copy is filed with the city inspection division.
O A'dplicant MISC- REFER TO ORD. Y❑ N❑ y ❑ N❑
�.� CERTIFICATEOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00, FLOOD ZONE A.L.U.O.
LU ? COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. y❑ N[_ Y ❑ N❑
0- D , (This-Section need not be.completed if the permit is for one TOTAL
D Z hundred dollars($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 F- mil is issued,I shall not employ any person in any manner so as to
O
U becomesubjecl to the Workers'Compensation Laws of California. 032.00
0 LU Date Applicant ALTER Ofl ADD TO MECH. 5.00 . BUILDING
} In NOTICI'-TO APPLICANT: If,after making this Certificate of Us-
F Z 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 shallm
he deemed revoked. AIR HANDLING UNIT(TO 10MCF.M.) 4.00
CONSTRUCTION LENDING AGENCY ' AIRHANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 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. MICROFILM
3097,Cn C.). Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name -1-r-
Lender's Address HEATI NG UN IT(OV E R 100,000 B.T.U.)9.50 ELECTRIC 60.90'
1 certify that I hav cad hi p 1 cation and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct.1 agree to comply with all city and county BOILER-CDMP 13 H.P.or 100,000 B.T.U.) 6.00 PLUMBING 60.90
ordinances and state laws relating to building construction, and
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 PERMIT ISSUANCE 10,00 CONST.TAXOJ
may in any way accrue against said City in consequence of the
ranting of Ih's r t MECH.CONT. LIC.NO. MECH.
�� TOTAL TOTAL 1� �
SigmtlZ .' cant/Contmetor Data
' , OFFICE COPY
0 0�L
BUILDING INSPECTOR'S OFFICE `"o; °°Soo°'y
Y CITY OF CUPERTINO
❑ BockflowDeviceI �,. b6� PF-
Sanitary Permit No.
❑ Sewer Connection Plumbing Permit No. C-10�
i �YrPlumbing Final '
/ Lot No.
Owner or Tenant l9 PiC^. R (,Pa��
_gin �
1
� At
j
rr.r tract r
Date Connected
E: 19_Date Final � : _q - 19
f PLUMBING INSPECTOR
I„ c
Y CITY OF CUPERTINO P_a.cop a .�
1; Pv
GAS SERVICE NOTICE
To
FYou are hereby authorized to connect the GAS service for
Owner or Tenant G-q 'G
At
New Service
I No. of Meters I Reconnect
No. of Add. Meters Move Service
Move Meter
h - PLUMBING INSPECTOR 0
ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S NOTICE
CITY OF CUPERTINO
3q
To 9
You ore herebyauthorizedto Connect electrical service for
Owner or Tenant G C%,
I C,3 S � S" u x C-T.
No,of Wires Size of Wires Size of Switch
Motor Load Voltage Phase
Heating Load K.W. Voltage
Light-FO
No.of MetersI10 Now Service Reconnect
Neat 170_Three Wire More Servim
No.of Add.Meters Power Three Phase Move Meter
�• ELECTRICALINSPECTOR
`V 7