15804 (2) POST'THIS CARD NEAR FRONT OF BUILDING PERF,TNUM 3EF
kCITY OF CUPERTINO 158Q4 '' .
INSPECTION DIVISION
1 l/n JOB INSPECTION RECORD
I, `•T ��(1'���r �'{7Q�{���1 ��,.-. - � P ERMIT EXPIRATION
JOB ADDRESS_, `_T�-'h ^ ' „"_i v� - 2Zy' ;, _
Y �i PtxaP UNIT# _LOT# PERMIT EXPIRES IF WORK
OWNER CONTRACTOR '1��� �TVJ�/' IS NOT�STA RTED WITHIN.'
INSPECTION - DATE INSPECTOR INSPECTION RECORD . `1BB 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 OFnn
, PERMIT VAL, AnNl•
CUPERTINO STANDARDS. -
GARAGE SLABS,.
' POUR NO.CONCRETE UNTIL ABOVE HAS BEEN SIGNED (/
UNDERGROUNDISL'AB' - - At
' PLUMBING "'A�✓ �J�C
7,.
ISSUANCE DATE
ELECTRICAL, ...,p' O� '
MECHANICAL • , - - ,, BLDG., eLecT.I PLC. wecR.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BuaowG PERMIT ,;•
INFORMATION
.WOOD,F LOO R' s
r
VALUATIONSIFT.. I
PLUMBING
MECHANICAL' - 154 22,J
ELECTRICAL - PT:Rnn ra .
FRAMING.. L-
STORIES TYPE CONSTR. j
INSULATION'
- V UCC.2AOUP TS. ,
PLACE NO-SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
�• 'ROOF NOTE:NO FINAL INSP,.SHALL BE MADE BEFORE• sn. ,F. oR A.+EA TOTAL CRLAGE
DIAPHRAGM
THE CONSTRUCTION TAX IS PAID
.BUILDING use
ROOF SHEATHING 10 1 - Tas INGEl CON: P6, oro..
0 El
APPLY NO ROOFING'UNTIL ABOVE HAS BEEN SIGNED ' FINALS DATE INSP., t L
. nssessORs PnI+CEL NO. ,
ROUGH SAN
PLUMBING ELECT. 6
GY !, f,
�iRnCl NO. PARCEL NO
TUBS&SHOWER PAN.` — (y) PLUMBING ENERGY Y $ -
MECHANICAL �0 MECH.ENERGY '
ELECTRICALBUILDING ENERGY
Q , Acc.OAie Acc,PILE rvo.
FRAMING - gyp,- ELECT.FINAL TEST • `
ZONING ENG.SITE NO.
INSULATION -71>_eq �, PLUMBING
` GAS TEST GAS -
FIRE SFFINK ENERGY iQJ'
-'' •" MECHANICAL vL NO L ' 'NQ
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING*
FIOVU ZONf: A _U C.
EXTERIOR SHEAR.' •3 ELECTRICAL RELEASE
INTERIOR SHEA 'e FIRE.DEP.T. YL NL '.YL NQi
SH EETROCK - �I(..0 GRADE + - - FEE SUMMARY
EXTERIOR LATH BUILDING
�- .INTERIOR LATH �Z� TEMPORARY APPROVALS. BUILDING
SCRATCH COAT . Z — ELECTRIC ' e - PLAN CHECK 15.5c
FEE
c GAS
r' NO•TAPE OR PLASTER UNTIL ABOVEMAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING ISNOT PERMITTED UNTILBUIL DING FINAL ISSIGNED BVBUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
F- 'ONE WORKING—DAY.—BEFORE REQUIRED INSPECTION. PLUMBING,
O�. ;PLEASE'GIVE JOB ADDRESS.WHEN PHONING'.
z MECHANICAL
- SEE PERMIT FOR EXPIRATION DATE”
IMPORTANT! CONST. TAX ; a?:9/.' �^
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.- - 1"392:QO
OFFICE COPY
• V T � _ �`Yr�x> 1,
APPLICANT TO'FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DENT]FICATION .PERMIT NUMBER '
eiy mG .-4 APPLICATION'&PERMIT - 158-04 ADDRESS o - an , 1 5 8-0 4
11635 Oak Spring Court BUILDING-, ELECTRICAL7 PLUMBING-MECHANICAL
GWNER'S Li - II �rA PLAN C HECK VALIDATION
" hmdn S�nr6evroupb.l5HONE 16O ' QTY. ELECTRIC PERMIT FEE. .i
.. PHONE - ^
LDNrRAcrGR s' - '• OUTLETS-SWITCHES-RECEP 10.00/1.00
"" : Gregory Group;. Inc. B-430097
^ - I.C.No. LIGHTING FIXTURES 10.00/1.00
RorvTRALTons06Wln 0 p In r. PPLIANCES-RESIDENTIAL 4.00 `
�PCE�s 945 ,' . ' 415=595.2100 PANELS 1: 10,00 DATE OFAPPLICATION ^'
ARCHITECTAram .Bassenian,AIA� &ASSOC PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE F.C.- NO.
ENGINEER C-8395 " SIGNS TRANS. 3.00
NO.
AHGh.OR ENG. // - ' PERMIT VALIDATION
ADDRESS- -2031 Orchard. Dr.' 100 SPECIALCIRCUIT 5.00
~ 'Santa Ana Hts'. CAL 927Q/ EMP.METER OR POLE INS. 20.00 .
APPLICANT'S2o MOTORS SEE FEE SCH:
ADDRESS
nSDr./ 100SantaAa . . 9270701 -
SERVICE CHANGE -20.00
r 00 LICENSED CON'I'RACI ORS DECLARATION L,% - -L" - p'
/(J
a o�. PI hereby affirm that Pum licensid under provisions of Chapter 9 u V O $DANCE DATE
H a H (Commencing wish Section 70001 of Division 3 rf the Business and - BLDG. ELECT. PLG. MECH.
F w z Professimu Codc,and iy license is in full for. 31Y}ry' t� -
z z,n a License Class B Lic.Ndnhber 43UU5/ - _ L`ItY f'b� 1tl®
o Date Contractor
BUILDING PERMIT
IS ¢w a OWNER-BUILDER DECLARATION ^
w S u w 1 h ey'aflinn that'l am'exempt from BieCm1 actors License
M ISC.- REFER TO ORD INFORMATION
.L
0< Law for the follo mgreaun (Se 70315 B ,inessmlP lesions PERMIT ISSUANCE - 10.00 vgLUATION S/FT.
- C d Any city ill oantywhich, p s permit[ strut t,alter, 't{XRX 154 92
¢ ¢ Q
improve,demolish. r repair any tnh Fur ,prior to its issueme,also ELEC.CONTR. , LIC.NO. , ELEC.
D¢ requires tire Applicant for such permit to file a signed statement that • TOTAL '� PERMIT TO
K
m he is licensed pursuant to the Provisions Iibthc Contractor's License .1
H z i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe SFDUJL
4_4 Business and Professions Codc)or that he is exempt thereffom and QTY. PLUMBING PERMIT FEE
¢ H$ the basis for the alleged cxelnption.Any,violation of Section 7031.5 1 STORIES TYPE CONSTR.
a ; - by any applicant for a permit subjects theapplicant to a civil penalty - ALTER-DRAIN -WATER (EA.1 5.00
of not mofc than five hundred dollars($500).): 5NHR
O 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; 13.,nnss and Professions DRAINS-FLOOR,ROOF,AREA,COND., 5.00
Code:The Contractor's LicenseLaw does not apply to an owner of - R73 1
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP' 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employ....Provided that such improve
ments are not intended or offered for sale,If,however.the building GAS-EA.SYSTEM-11NC.4OUTLETS 16.00 2400 .
' or improvement is sold within one year of completion, the owner- GAS-EA.SVSTEM,-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or ire- -
prove for purpose ofsale.). - I NDUSTR IAL WASTE'INTER. '30.00 RES IND CON Pa Omer
Cl 1,as owner of the property,mn,exclusivcly contracting with ❑ ❑ ❑ ❑
licensed contractors to conome, Ole project:(Sec. 7044,BusinessLAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code-The Comracmr's License Law does not apply -
toonnwnerol'property who builds or improves thereon, and who LAWN SPRINKLERS-OVER 5.(EA.)- 1'.00
contracts for such projects with a aontractons)licensed pursuadt to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
the Contractor's License',law.
D "I am exempt un do,See ,B.&P.C.for this WATER HEATER W/VENT 6.00 8098
reason - -
Owner Date. WATER SYSTEM., 5.00
- ACC GATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARA:nON. WATER TREATING EQUIP. -'5.00
hCrotty affirm Ilial 1 have a'ce'liln'tc of consent ro wit-insuic. ZONING
or a iCRifhcate'of Workers'Compensation Insurance or a certified 'I ENG.SITE NO.-
cop,thooml(Sec.3800,Lab.C.)United Pacific I•
Policy No. Company -
O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z ZXt Certified copy is filed with tileisi
city inspection divon. -
O Applicant' - MISC.,+-. REFER TO ORD. Y ❑ N❑ Y ❑ N❑
rn CERTIFICA'f li OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE , 10.00 FLOOD ZONE A.L.U.C.
LU > "COMPI!NSATION'INSURANCE PLG.CONTR. LIC.NO. PLG.
d O ,'Phis seoidn need not be complched if the permit is for one s. _ _ TOTAL Y❑ No , Y ❑ N❑
Z - hundred dollars IS 100)or less.)
U Q 1 certify that in the performance of the work for which this Per- GTY. MECHANICAL PERMIT FEE - FEE SUMMARY
LL I- mit is issued,1 sImll nor employ any Pero)"in any manner so as to
W
become subject to the Workers'Compensation Laws of California. -
a D'.ac 'Applinamt ALTER OR'ADD.TO MECH. 5.00 BUILDING
O 832.0
} m NOTICE TO APPLICANT: If,lin or.racking this Cefrflemo of fix-.
n
Z cininu ,you should beconhe subject m the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
. provisions of,the Labor Code, you mart forthwith cmnply wire FEE /energy 62.0
U such provisions or this"'I'll Shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONST'Rucr ON CENDINC AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 10.8
.I hereby affirm that there is a construction loading agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance orhe work rr wNOT Mow is issued,Sec. � MICROFILM '
3097,Civ CA iJeCUrl by ^Yacl'�lc HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name--�-[rR�T T-adero-4t HEATING UNIT(OVER 100,000 B.T.U.)9.50 - ELECTRIC
Lender's Addres's_[emL Fj 60.9
l certify that l have Rooadd thiis.,ppl,c,ccmion and state that the above VENTILATION FAN (SINGLE) 4.00
infornhatlnn is correct.'1 agree to comply with all city and county PLUMBING 60.9(
ordinances and state laws.rclating,to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
01 hereby entionr c representatives ec This city es enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL 60.9
herebymcntinncd property for inspo i this
p City to
(We) agree tosave„indemnify and keep harmless Ore City of misc.- REFER TO ORD.
upertihm agast liabilities,judgments, Costs and Cxpenses which CONST.
may iinn any way ut�eroyyy^���raga�s t 'd City in Consequence of the - PERMIT ISSUANCE 10.00 Q3
ranting of this per` MECH.CONT. LIC.NO. ^ MECH.
TOTAL TOTAL
Signature of ApPli t ontractor Date
OFFICE COPY ��00)