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15822 (2) ` POST THIS CARD NEAR FRONT OF PUILD4NG PERMIT NUMBER ,. � - - CITY OF •CUPERTINO ' 1582 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION IDS ADpRESS � �"'—'^+ ^1 "t UNIT# _LOT# �« PERMIT.EXPIRES IF WORK OWNER ,Q(\) N'p coNrRACTOR ^�"x� IS NOT.STARTED WITHIN, INSPECTION DATE INSPECTOR INSPECTION REC RD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM 'NOTE: LAST CALLED INSPECTION. UFER - 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 � c( UNDERGROUND /SLAB rp1 PLUMBINGTk� {,'ff ELECTRICAL' - • ISSUANCE DATE - BLDG ELECT PLG. -MECH MECHANICAL - ® 0 DO NOT POUR•FLOOR UNTIL ABOVE HAS BEEN SIGNED ¢�I�}DING PERMIT WOOD FLOOR `� \l\11�FORMATION VALUATION S/FT. PLUMBING 'MECHANICAL.' , 185,865 PERMIT TU ELECTRICAL FRAMING 'INSULATION STORIES TYPE CONSTR. __TCC,_GHaUP S UNITS .- I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SC.iT FLDDP AREA TOTAL CREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID I VIl a BUILDING ROOF SHEATHING o�cr lnw ' .3 3 HES INC CON USE PB ov— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. '❑ 11 0 ❑ ASSESSO RS PAHCEL NO PLUMBING St3• ROUGH SAN,N 7Q {)W,5 ELECT.ENERGY TRACT NO. PARCEL NO .TUBS&SHOWER PAN S-bb-sot QW5 PLUMBING ENERGY 80g8 - MECHANICAL- MECH.ENERGY ELECTRICAL BUILDING ENERGY ACCDATEACC.FILE No FRAMING - ( �� T, ELECT.FINAL TEST INSULATION Krb � (,�7 PLUMBING zowNc ENc.SITE NO, GAS TEST 2 - GAS FIRE STRINK ENERGY T@4 MECHANICAL y�• NE 'Y ❑ NO COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEARatc t o 89 ELECTRICAL RELEASE a000 zoNE ALuc. INTERIORSHE AR �13 FIRE DEPT. v� N� vL N❑. SHEETROCK- )$I .,Tij. GRADE FEE SUMMARY EXTERIOR LATHBUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCHCOAT —2 a ELECTRIC FEE 15.55 CHECK 15.58 GAS . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIPAPfJOCCUPANCY SEI IWffl ` 00 OCI CUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM `• ' - ARRANGE FOR'INSPECTION BY PHONING 252-4505, ELECTRIC Il' ONE WORKING DAY BEFORE-REQUI REDINSPECTION.,. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. . . .— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST:TAX AMA PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION.. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY BLJMJDING PROJECT IDENTIFICATION - .PERMIT NUMBER , APPLICATION & PERMIT AOOR655 an 1146 Cedar Spring Count;, BUILDING - ELECTRICAL-PLUMBING-MEMECHANICAL OWNER'$ Greg Ory Group Inc. & PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE Ahmanson Dev. 44,rLE595-2100 CONTRACTORS NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 Gregory Group, Inc.,,,Na, B-430097 LIGHTING FIXTURES 10.00/1.00 ' f,ONrRAcTOR' PP0-C Twin �1}i( krkrl6(71�rPr7 ��y PPLIANCES-RESIDENTIAL 4.00 Alq � 94065 Y pJJJ-L1OO 'PANELS 10.00 DATE OF APPLICATION ARCHITECT - PLAN CHECK FEE P.C.NO, GR Aram Bassenian, AIA & Assoc. PANELS IOVER 200 AMP) 20.00 ENGINEER LIC.NO. C-8395 ISIGNS TRANS. 3.00 ARCH OR ENG. rc ar r. - SPECIAL CIRCUIT 5.00 PER MIT VALIDATION A Santa Ana Hts. CA. �g707 TEMP.METER OR POLE INS. 20.00 AMICANT's MOTORS ' SEE FEE SCH. ADDRESS 220-C Twin Dolphin DR.. SERVICE CHANGE 20.00 0 0 Z. LICENSED CONTRACTORS DECLARATION6![ ed a v w 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE ' ,e Q ¢ (commencing with Section 7000)of Division 3 of the Business and BLDG ELECT. PLG. MECH. f w i Professions Code,and license is in full force xylyl ff[@vI� SW 0 z m W License Class Co ractor _4..TUU LJ./ I( m Date' - Contractor t CUp81,{_I�,p NG PERMIT ¢ ¢o a OWNER-BUILDER exempt DECLARATION RMATION wg aa 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORO VALUATION $/FT. F u O< Law for the following reason.(Sec.7031.5,Businessi nd Professions PERMIT ISSUANCE 10.00 , Code:Any city or.county which requires a permit to construct,alter, 185,865 QQ <Q improve,dCRI0II5I1,or repair any StrnetllrL',print LO IIS issuance,8150 ELEC.LONTR. LIC.NO. ELEC. O a requires the applicant for such permit to file a signed statement that TOTAL' PERMIT TO S: $m he is licensed pursuant to the provisions of the Contractor's License' v. Z > Law(Chapter9(commencing with Section 7000)ofDivision3ofthe SFDIUL < Business and Professions Code)or that he is exempt therefrom Hid DTV. PLUMBING PERMIT FEE 2=$ Ihe basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the appl - . .00 icant to a civil penalty ALTER-DRAIN IEA) 5 of not more than five hundred dollars($500)J: - 2 5NHR ❑ I,as owner of the property,at 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. 5.00R-,3 l Code:The Contractor's License Law docs not apply to an owner of properly who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 - Sa.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 a' improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM•OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove for purpose ofsaloJ. INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB GO., C1 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 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not applyO�- lo an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 } so contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO, PARCEL NO. ❑ IumexemptunderSec. ,B.&P.C.fwthis WATER HEATERW/VENT 6.00 8098 reason Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WO RKERS'COMPIiNSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I 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,Lab.CJ.United Pacific Policy No.-Company- 0 o. CompanyQ O Certified copy is hereby furnished. FIRE SPRINK ENERGY T.24 Z Z ' (9 Certified copy is fled with the city inspection division. MISC.- REFER TO ORD. O Applicant Y❑ N❑ V ❑ N❑ CCva PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. LU CF:RT'IIICATEPE SAI IOTINS FROM WORKCRS' W �_ COMPENSATION INSURANCE PLG.CONTR. LIC.NO. DLG, d O (This section need not be completed if Ihe permit is for one TOTAL Y❑ N❑ Y ❑ N❑ Z horded dollars(5100)or less.) U O 1 certify that in the performance of the work for which this per. QTYMECHANICAL PERMIT FEE FEE SUMMARY LL F- mit is issued,I shall not employ any person in any marcher so as to U become subject to Ihe Workers'Compensation Laws of California. 0'y Date ApplicantALTER OR ADD TO MECH. 5.00 BUILDING 940.50 } to NOTICE TO APPLICANT: If,after making this Certificate of F:x- I•" ? 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 FEEZenpr�y A9 nn U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10A0C.F.M.) 6.00 SEISMIC FEE 13.02 1 hereby affirm (hat 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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3oader'97. sam geCu it Pacif' Lender's Names [)= per HEATING UNIT(OVER 100,000 B.T.U.)9.50 •ELECTRIC Lender's Address 70.35 I certify that I he rem L.a I nation and state that the above VENTILATION FAN (SINGLE) 4.00 information is street I agree to comply with all nst and county and PLUMBING in formation and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,0008.T.U.) 6.00 70 hereby 'authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP. (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (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 1000 CO .TAX . may in any way accrue against said City in consequence of the 3' ranting of this mi MECH.CONT. LIC.NO. MECH. TOTAL TOTAL Signator and/Contractor Data / OFFICE COPY -�Im