13739 (2) r POST THIS CARD NEAR FRONT OF BU LDING
,:- POST
., PFRMIT NUMBER
CITY OF CUPERTINO 13739
INSPECTION DIVISION
I JOB INSPECTION RECORD
OO/ PERMIT EXPIRATION
JOB AD DR ES OJ .Q A.'" UNIT# _`,LOT#
PERMIT EXPIRES IF WORK
OWNER CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE I INARECTOR r�INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION - 7_2��06 Z - LIQ ANCE OR 180 DAYS FROM
LASTCALLED INSPECTION.
UFER
PREGUNITE PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -
UNDERGROUND /SLAB PAW
PLUMBING •-•
ELECTRICAL
11kt1ANCE DATE
MECHANICAL ELECT. PLC. MECH.
til. ❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING
VALUATION SIFT.
MECHANICAL $971,000.00
ELECTRICAL f�J ^^''PERTq
FRAMING J Z,
INSULATION STORIES TYPE CONSTR.
S T
S p/ OCC GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
7M=ECHANICAL
ROOF SO.FT.FLOOR AREA TOTAL ACREAGE
2 . E LIZBUILDING USE
RES IND CON PB Ober
IL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑
OUGH ASSESSORS PARCEL NO_ TRACT NO. PARCEL NO.
9.2ff 00 - ^
ELECTRICAL �/, FINALS DATE ACCDATE ACC,EILENO.
INSP.
FRAMING It i SAN * a�
INSULATION PLUMBING m.Cf ZONING ENG.SITE NO.
GAS
MECHANICALFIRE SPRINK ENERGY T 24
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Ipy� Y ❑ N❑ Y ❑ N❑
LATH—INTERIOR �( ELECTRICAL FTOO o zoNE- A.L.UC.
wnr
LATH—EXTERIOR I FIRE DEPT. - Y❑ No Y ❑ N❑
SHEETROCK GRADE
SHEARINTERIOR BUILDING FEE SUMMARY
�IH� p� OD�f
SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING
FIREWALLS ELECTRIC PLAN CHECK
,9 � C I'NL z�y GAS FEE 275.60
NO TAPE OR PLASTER UNTIL 80VE HAS B SIGNED OCCUPANCY 160 no
SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR.
MICROFILM r
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
"� ONE WORKING DAY BEFORE REQUIRED INSPECTION.
142.00
z
PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
si 40
IMPORTANTI . CONST.TAX pap fiR
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. ,434.07
OFFICE COPY
APPLICANT TO-FILA_ IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
r BU L'DI NG PROJECT I DENTI FICATI ON PERMIT NUMBER
9UILDING APPLICATION & PERMIT 13739
ADDRESS LOT# 54 PLAN 1 B BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
O " PP5 Evening spring Cour*0 415 PLAN CHECK VALIDATION
"=,ME QTY. ELECTRIC PERMIT FEE
GREGORY GROUP', INCNHONE
TONNAMERAc7oRs 86 UTLETS-SWITCHES-RECEP 10.00/1.00
26 of)
Same Loc.NOB-430097 LIGHTING FIXTURES 10.00/1.00
D
AORs -48.00
APPLIANCES-RESIDENTIAL 4.00
ADDRESS
DBEs, 220-C Twin Dol phi n Dr.
PH12.00
ONE PANELS 10.00 DATE OF APPLICATION
OR T PANELS 200 AMP) 20.00 PLAN CHECK FEE P.C.No.
ENp1NE" ARAM BASSENIANk,cAlA z ASSOC. SIGNS TRANS. 3.00
ARCH.OR ENG.9!)fl SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
NepADDREE/SS G ;J,J, 99q We erl P ce 1/170
CH. I,P EMP.METER OR POLE INS. 20.00
APPLICANTS6 MOTORS SEE FEE SCH.
^°°REa..a--'-220-G Twin- Gol phi n_ Dr.,')-'
I - 6-00
y SERVICE CHANGE 20.00
w o o LIC17NSED CONTRA(;TORIE)ECLARATION P �,
a u w I hereby affirm that I am h�cj��"nsed under provisions of Chapter 9 NCE DATE
vFi a e. (commencing with Section 7ljGV)Of DIVIs1p0 3 Of[he Business and BLDG. EOCILECT. MECH.
H N i Professions Code,and my icense is IN full fore hL)RgLfT•kF
z O v,- License Class Lie Number
w Date--
ate Contmcto _
a Y BUI DIN .P RMIT
M w OWNER Bull- DEC 'f10N ON
K
;LL 1 1 hereby affirm that 1 am exempt ren,the Contractor's License MISC.- REFER TO ORD
FUN ] Law forthe followmgreason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION S/FT.
f ;,0E Code:Any city Or COUnty which requires a permit to construct.alter, Q'
Q Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. $97 000.00
in U. requires the applicant for such permit o file a Signed statement that TOTAL s
n m m he is licensed pursuant to the provisions of the Contractors License PERMIT TO
F z a Law(Chapter 9(commemcingwith Section 7000)of Division 3 ofthe S�Y b1/ L.-•.
f 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
M ,- the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
d ; $ by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN (EA.) 5.00
of not more than five hundred dollar,($500).):
❑ 1,as owner of the property,or my employees with wages as - BACK F LOW PROTECT.DEV ICE 4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
intended or offered for sale(Sec. 7044, Business and Professions3
DRAINS-FLOOR,ROOF,AREA,EA,CON D. 5.00 QQ p
Cote:The Contractor's License Law does not apply to an owner of /tom
Operly who builds or improves thereon,and who docs such work FIXTURES-PER TRAP S.00 SG.FT.FLOOR AREA TOTAL ACREAGE
Imself or through his own employees,provided that such In,provr
in
are not intended or offered for sale If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00
puimprovement is suld within one year of completion,floe owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00
bu.lder will have the burden of proving(hat he did not huild or int- BUILDING USE
6.0
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 R� I❑ ❑N PB❑ 0❑
❑ Las 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 ASSESSORSPARCEL NO.
and Professions Code:The Contractor's License Law does not apply
to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 'f`��_ 3 3
contracts for such projects with n eontractortsl licensed pursuant t0
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exempt under Sec. ,B.dP.C.tirrlhis WATER HEATER 7-7?,f
reason 6.00
RM
owner Dam WATER SYSTEM 5.00
ACG DATE ACC.FILE NO.
WO RKIiRS'COMPENSA'TION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to self-insure.
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sec.3800,Lab.0
Policy No. Company'In ted_PPac.i_f_i r. /3
O ❑ Certified o,yis If byf niched. RE SPRINK ENERGY
Z Z 1fX Cetlifie y i I h the cilY inspection division. 24
Fp A'dpllcanI MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑
W CERTIFI A'11:017 EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 10.00
FLOOO ZONE A.L.U.C.
W >_ COh1PENSATION INSURANCE PLG.CONTR. LIC.No. PLG.
1 O (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y ❑ ry❑
::) Z hundred dollars IS 100)or less.)
U O 1 certify(hat in the performance of the work for which this per. OTY. MECHANICAL PERMIT FEE FEE SUMMARY
W F mit is issued,I Shall not employ any person in any manner so as to
0 U become subject to the Workers'Compensation Laws of California.
a Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} to NOTICE TO APPLICANT: If,after making this Certificate of Ex- 424.00
f" ? emption,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK
U such provisirovisions of ons fie Laboror this
Cit shall
you must forthwith comply with FEE 275.60
pr permit shah be deemed revoked AIR HANDLING UNIT(TO 10,000GF.M.) 4.00
Pnprqy 160-00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE
1 hereby affirm that (here is a construction lending agency for 1 EXHAUST HOOD (WITH DUCT) 5.00
6 79
the performance of the work for which this permit is issued(Sec. "(TO
MICROFILM
3097,Civ.CJ. SRf,ramPrttp-S&L NI ((TO 100,000 B.T.U.) 8.00Lender'sName' ress �a q�� NIT(OVER 100,000 B.T.U.)9.50ELECTRIC
1�$�`,LAe399-Bradford-Sp '/'OM'y'that l have read this application and t*te kh-Rill aboveION FAN (SINGLE) 4,Opinformation is correct. 1 agree to comply with all city and county q On
ordinances and stale laws relating (o building construction, andMP(3 H.P,or 100,000B.T.U.) 6.00hereby authorize representatives of (his city (o enter upon the92.00
MP(Over 100,000 BTU)SEE FEE SCH.t above-mentioned property for inspection purposes. MECHANICAL
(We) agree to save, indemnify and keep harmless the City ofREFER TO ORD. I DOCupertino against liabilities,judgments, costs and expenses whichCONST.TAX
may in any way accrue,e• t Said City in consequence of the PERMIT ISSUANCE 10.00
granting oft 'Iry •rn' 282.68
MECH.CONT, LIC.NO. MECH.
!//� o TOTAL TOTAL l
Signa[u plicant/Contractor D e
51 .00 $ ,434.07 ,
OFFICE COPY