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13730 (2) POST THIS CARD NEAR FRONT OF BUILDING . PERMITNUMBER CITY OF CUPERTINO 1373D INSPECTION DIVISION JOB INSPECTION RECORD /✓� PERMIT EXPIRATION JOB ADDRESS' UNIT$ LOT# Z ^ - - PERMIT EXPIRES IF WORK. OWNER �ll N� corvTRAcroR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION ECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - 7_I . 8 'ANC. OR 180 DAYS FROM o LASTCALLED INSPECTION. LIFER - 7-P9-02, PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I 1 UNDERGROUND /SLAB PLUMBING _13- ^ ELECTRICAL PAID ISSUANCE DATE. MECHANICAL BLDG. ELECT. PLG. MECH. OEC 3 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED B IAORMATIONLDING PERMIT - WOOD FLOOR VALUATION S/FT. PLUMBING I MECHANICAL - 109 000. ELECTRICAL I PERMIT TO FRAMING INSULATION STORIES TYPE CONSTR. S- s: occ.GROUP RES,urvlrs PLACE NO SUB LOOR UNTIL ABOVE HAS BEEN SIGNED - fie ROOF SO.IT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM I BUILOING USE 17-1q_Bsj RES IND CON PB Olney APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ 11 ❑ ❑ 0 ASSESSORS PARCEL NO. ROUGH PLUMBING I GAS TEST TRACT NO, PARCEL NO. - � _ MECHANICAL , J . . ELECTRICAL FINALS DATE IN Sp. ACC.DATE ACCFILE NO FRAMING SAN It INSULATION PLUMBING - ZONING ENG.SITE NO. GAS _ FIRE SPRINK ENERGY L1a MECHANICAL v � ru 0� v NE]COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - _ _ (+� Z LATH-INTERIOR - 6 � ELECTRICAL � p- i FLOOD ONE A.L.U.C. LATH-EXTERIORLw- FIRE DEPT. Y❑ NC Y ❑ No SHEETROCK GRADE FEESUMMARY SHEAR INTERIOR _ BUILDING (3 SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING411 FIREWALLS ELECTRIC I PLAN CHECK ,296.08 GAS Iuvquu NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC149 00 .� F� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. 92 00 - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! I CONST.TAX 282,158 PLEASE READ REVERSE SIDE BEFORE I TOTAL CALLING FOR FINAL INSPECTION. 11 ,497.69 OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER , "ILDING APPLICATION & PERMIT 13730 -DRESS Lot 64 Pl an 2BR 1. mcreekprinn BUILDING - ELECTRIC9L-.PLUMBING -MECHANICAL OwNe ' PLAN CHECK VALIDATION 415 NAME GREGORY GROUP, Inc. QTY. ELECT IC PERMIT FEE ONE CONTRACTOR 0 OUTLETS-SWITCHES-RECEP 10.00/1.00 90.00 NAME TORS Loc rA. ZD�LIGHTING FIXTURES 10.00/1.00 4.00 "°DRESS 330=C Twin Dol phi n' Dr CA C140155 415 PNONE PPLIANCES-RESIDENTIAL _. PANELS 10.00 DATE OF APPLICATION ECT PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE . .No OR . ENGINEER ARAM BASSENIMLHANIA & ASSOC< SIGNS TRANS. 3.00 ARCH.OR ENO. PERMIT VALIDATION ADDRESS ` 3990 Westerly Place#170 SPECIALCIRCUIT 5.00 w� za, EMP.METER OR POLE INS. 20.00 ASD AD°NEss 220-C Twin Dol phi n Dr. MOTORS SEE FEE SCH, n O RWC CA 94C65 SERVICE CHANGE 20.00 J woo LICENSED CONTRACTORS DECLARATION MU u I hereby affirm that I am licensed under provisions of Chapter 9 V1 NCE DATE z (commencing with Section 7000)of Division 3 of the Business and a� BLDG. ELECT. I PLG. MECH. R ¢ Professions Code,andBoy license is in full force O i D LicenseClass Lic.Number Dale Conimct _ r a BUILDING PERMIT a,6 OWNER-BUILDER DEC ATION INFORMATION wI- I hereby affirm that I om exempt from the Contractor's License MISC.- REFER TO ORD .. o a Law for the fi lowingreason.(Sec.7031.5.Busimessand Professions PERMIT ISSUANCE 10.00 VALUATION S/FT. t - Code:Any city orcounty which requiRia permit to construct,alter, IO.00 ac au Q Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. $109.000.01 ca - ¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO K he is licensed pursuant to the provisions of the Contractor's License 49.00 F z a Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe S/-r� IAJL Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE the Buis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. i ; _ by any applicant fora permit subjects applicant pplicaea taecivil Penalty ALTER-DRAIN -WATER (EA.) 5.00 J11 of not more than fore hundred dollars the ): . ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure Is not intended or offered for aide (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not applY to an owner of property who builds or improves thereon,and who does such work 11 F IXTUR ES-PER TRAP 5.00 5 09 So.FT FLOOR AREA TOTAL ACREAGE himself or through his own employm,provided that such improve- mentsare not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-l1NC.4OUTLETS 6.00 cis 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 nm build or im- BUILDING USE prove:for purpose ofsule.). INDUSTRIAL WASTE INTER. 30.00 Rs IND CON PB Omer ❑ 1,u 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 does not apply / to an owner of property who builds or improves thereon,and.who LAWN SPRINKLERS-OVER 5(EA.) 1.00 I�b 6 - -3/ ��--3 the Cont forsu License Lwithacontracmr(s)licenxd pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 10.0 TRACT NO. PARCEL NO. ' the Contractor's Liccnx Law. p ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 7ea'CIr reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPENSA'IION DECLARATION WATER TREATING EQUIP. 5.00 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compemation Insurance,or a certified Policy Nocof(Sec.3Aoomv..Ybnited PACIFIC_ 2� 0 ❑ Certified cop is her by fun a FIRE SPRINK ENERGY T-24 �y Certifred led spection division. Z p Applicant MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ CC y CERTIFICAK OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. 1 Y❑ NEI Y ❑ N❑ Z (This section need not be completed if the permit is for one TOTAL Q2 nn hundred dollen IS I DO)or less.) U Q 1 certify that in the performance of the work for which this per QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any persdn in any manner so as to O L) become subject to the Workers'Compensation Laws of California. BUILDING a Date-Applicant - ALTER OR ADD TO MECH. 5.00 } a NOTICE TO APPLICANT: If,after making this Certificate of Ex 455.50 F. eruption,you should become subject to the Workers'Compewtion APPLIANCE 5.00 20 00 PLAN CHECK provisions of the labor Code, you must forthwith comply with FEE 296.08 U such provisions or this permit shall be decreed revoked. AIR HANDLING UNIT(TO l0=1C.F.M.) 4.00Finer 00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IO)000G_EM.) 6.00 SEISMIC FEE ��Fj [-r I hereby affirm that there is a construction lending agency for I EXHAUST HOOD(WITH DUCT) 5.00 the ,Civ.C.L Sof the work for which this permit is issued(Sec. MICROFILM 30nder's .CJ. $acrdment0 S&L HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Add wry s�s,s �p�5�s qqq c� 1-01- HEATI NG UNIT(OVER 100,00)B.T.U.)9.50 ELECTRIC Lender's y Him dZ,Zc re. is yf. I certify iia rca e p nand all cit and county 3 VENTILATION FAN (SINGLE) 4.00 00 information n retrial 1 agree to comply with all city end county PLUMBING ordinances end state laws relating to building construction, and BOILER-ODIaP(3 H.P.or 100,000 B.T.U.) 6.00 92 00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL / above-mentioned property for inspection purposes. (We) force to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. 55.99 Cupertino against liabilities,judgmmlls, costs and expenses which CONST.TAX may In any way accrue agaiconsequence nst sai City in cquence of the PERMIT ISSUANCE 10.00282.68 grantingo u nniL / MECH.CONT. LIG NO. OTAL Mcar sigram plA cat/Contractor D e -7 55.01 TOTAL 1 497.891 OFFICE COPY