15812 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
G 4;t4CITY OF% CUPERTINO
` INSPECTION DIVISION . �81
JOB INSPECTION RECORD
T - PERMIT EXPIRATION
JOB ADDRESS 1 -7 C�Cb9-k 191PIZ 1ANGCl 11N 1T# _LOT#tl2-0 •�
C—;—& -OR U f] PERMIT EXPIRES IF,WORK.I
OWNER Q / CONTRACTOR � 0 rJ IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECO D 180 DAYS OF PERMIT ISSUz
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 STANOARDS.
GARAGE SLABS — !
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
!� PLUMBING
'y ELECTRICAL ISSUANCE DATE
MECHANICALaluc. ELEcr Fw. MECK,
,p
DO NOT POUR FLOOR UNTIL'ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR `\Ov INFORMATION
PLUMBING - Dt Clpeltl UAT ION SIFT.
MECHANICAL - C1ty C
��vERMlrro
ELECTRICAL
FRAMING - - SFDLP
STORIES ,TYPE CONSTR.
INSULATION •< ,
OCC GROUP RES UNITS
3 PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED R'3
$O.FT.FLOOR AREA TOTALACREAGE
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE'
DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2726
BUILDING USE
,. ROOF SHEATHING3 Rgs 'IND— CON Pa om].
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. SOpS PApCEL O '
ASSESNO.
ROUGH SAN.# !.
PLUMBING Eye- thK ELECT.ENERGY t r I rTRACT ND. PARCEL NO
TUBS&SHOWER PAN L PLUMBING ENERGY ,. •
MECHANICAL MECH,ENERGY
ELECTRICAL BUILDING ENERGY .Acc.DATE ACC,yLENO
FRAMING -_2 ELECT.FINAL TEST
2DINING. ENG.SITE NO.
INSULATION � _2 PLUMBING 1 _
GAS TEST - — — ' GAS
• - MECHANICAL` FIRE svRINrc ENERGY T.aa
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - "F ` C] Nq
FLOOD ZONE A LUIC.
EXTERIOR SHEAR ELECTRICAL RELEASE '
INTERIOR SHEAR Q FIRE DEPT. Y[j NE] v 0 N❑
SHEETROCK GRADE - - - FEE SUMMARY
EXTERIOR LATH — - �. BUILDING
INTERIOR LATH TEMPORARY APPROVALS BuILDiUG
SCRATCH COAT ELECTRIC PLAN CHECK.:
GAS lemargy
FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE Z. g
OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGN ED BY•BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
• F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 68 5g
Z PLEASE GIVE JOB ADDRESS WHEN PHONING.
- SEE PERMIT FOR EXPIRATION DATE - MEGHA"ICAC 68.5$
IMPORTANT! F�TOTAL
3.105PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION'. ZOO
OFFICE COPY
dO
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUI LDIXA{R NCT I DENTI FICATION -PERMIT NUMBER
BUILDING of an APPLICATION & PERMIT 15812
t 11637 Cedar Spring Court BUILDING-ELECTRICAL=PLUMBING-MECHANICAL
OwNER'S Gregory Group, Inc. PLAN CHECK VALIDATION
NAME QTY. ELECTRIC PERMIT FEE
Ahmanson Dev. 41,5,,7595-2100
CONTRACTOR'S
NAUTLETS-SWITCHES-RECEP 10.00/1.00
Gregory Group, Inc-LIG,No B-430097 LIGHTING FIXTURES 10.00/1.00
CDNTRACTOR's 220-C Twin Dolphin Dr.' APPLIANCES-RESIDENTIAL - 4.DO
A `
RE 94065 415-5951.2100 PANEL'S 10.00 DATE OF APPLICATION I
ARCHITECT PLAN CHECK FEE P'C�NO.
DR Aram BassenianAIA & As oc PANELS (OVER 200 AMP) 2000
I
ENGINEER C-8399
uc.NO. 4 O J SIGNS TRANS. 3.00
ARCH.OR ENG. 2031 Orchard Dr. #100IPERMIT VA LIGATION
ADDRESSSantaAna HtS. CA. 292707 TEMP!METER OR POLE INS. 20.00
APPLICANT'$
Ao s MOTORS SEE FEE SCH.
°� �-C Twin Dolphin Dr.RWC 94065 SERVICE CHANGE 20.00
O o LICENSED CONTRACTORS DECLARATION
<u 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
N rt y (commencing with Section 7000)of Division 3 of the Business and _ BLDG. ELECT. PLG. •jMECH.
r m z Professions Code,aW my license'is in full force and effect. �-7I
i ow - License Class_jf-Lic.Number_4300.C�.7 f1Cl'
4 Y I-ea Dale Contractor Ta
f L -J .
¢ m M J - P BUILDING PERMIT
It s w 4 OWNER-BUILDER DECLARATION FORMATION
o e REFER TO ORD
'xu 3 u w I hereby affirm(hat I am exempt from the Contractor's License MISC.-
H a- o ¢ Law forthe following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 TION S/FT.
E 91>f Code:Any city ,or county which requires permit to construct,alter. p
EF improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO, ELEC.' I9 B1
¢ requires the applicant for such permit to file a Signed statement that TOTAL
w 1l O PERMIT TO
K
$w he is licensed pursuant to the provisions of the Contractor's License
�I>•
Business
w(Chand Professions
Code)or Section isexemf Division Sof l he SFDUJL
¢ Business and Professions Code1 or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
M r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
n ; - by any applicant for a permit subjects the applicant toacivilpenelty ALTER-DRAIN (EA) 500
ofnot more than five hundred doll - . .
ars($500)U: 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,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 FIXTURES-PER TRAP - 5.00 SO.FT.FLOOR AREA TOTALACREAGE
himself or through his own employees,provided that such improve.
meats are not intended oroffered for sale.If,however,the building .GAS-EA.SYSTEM-11NC.4 OUTLETS 6.00 2726
or improvement is Sold within one year of completion,the owner- -
' builder will have the burden of proving that he did not build or;im- GAS-EA.SYSTEM-OVER 4(EA.). 2.00 BUILDING USE
prove for purpose of sale.). INDUSTRIALWASTE INTER. 30.00 RIyEERIS IND CON PB Other'
CI 1,as owner of the property,am exclusively contracting with (d ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.S. 6.00 ` ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not apply
to an owner of properly who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.)
contracts for such projects with i contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
C, I am exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00 p
reason 8098
Owner Date WATER SYSTEM 5.00
ACC.DATE ACC FILE NO.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that 1 have a certificate of consent m self-insure, ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy(hereof(See.3800,Lab.C.)United Pacific
Policy No. Company
0 •)7 Ceniliedcopy is hereby famished. FIRE SPRINK ENERGY T-24
Z Z a{] Certified copy is filed .with the city inspection division. MISC.- REFER TO ORD. '
O APPlicant Y ❑ N❑ Y'❑ N❑
Fy PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LU CIi RTIFICCOM OF I ATIO TINS FROM WORKERS'
W COMPIiNSATION INSURANCE ` PLG.cONTR. u0.No. PLG.
CIL Z (This Section need not be completed If Inc permit is for one - TOTAL Y❑ N❑ Y ❑ N❑
hundred dollars($100)or IessJ
0 O 1 certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mil is issued,1 shall not employ any person in any Intoner so as to
U become subject m the Workers Compensation Laws of California.
0 i Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 916
} m NOTICE TO APPLICANT: If,after making this Certificate of Ex-
F. ? emption,you should become subject to the Workeri Compensation APPLIANCE 5.00 � PLAN CHECK' ❑
Provisions of (he Labor Code, you must forthwith comply with FEE 15.50
C-) such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=r-F.M.) 4.00 enn
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10A00C.EM.) 6.00 , SEISMIC FEE 12.53'
I 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,Civ.C.). e U It P HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name pt,-' - HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50
Lender's Address E:rO�.}'-WI--11.I-.- ELECTRIC 68.58
I certify that I have rea t I p lication and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county BOILER 13 H.P.or 100,000 B.T.U.) 6.00 PLUMBING 68.58
NP 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 68.58
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 1000 CONST. X dpof
PERMIT ISSUANCE ,
may in any way accrue against Said City in consequence of the 0
ranting of[his perm MECH.CONT. LIC.NO.. MECH. ,. -
TOTAL TOTAL
Signature of AWffq,0i7Cmqmctor Dale - - -
OFFICE COPY