14975 (2) POST THIS GARD,NEAR FRONT OFBUILID ING �. PERMIT NUMBER
CITY°',OF CUPERTINO :14975
_ INSPECTION DIVISION.
JOB INSPECTION RECORD
. / - (�/;J //�/ PERMIT EXPIRATION. �sd
,JOBADORE �6ot� - -+-r"-�LLOd.C!' UNI LO '�
i - PERMIT EXPIRES IF WORK
owmeR coNTRAcroR - IS NOT STARTED'WITHIN
NSP I DATE- INSPECTOR XOP&510N RECORD -'180 DAYS OF PERMIT ISSU-
" ANCE OR 180 DAYS FROM
:FOUNDATIO - - NOTE: LAST CALLED INSPECTION.
UFER - - ALL GRADING AND DRAINAGE SHALL BE INSTALLED '
- TO COMPLY WITH THE APPROVED PLANS AND,CITY OF PERMIT VALIOATIUN-
PREGUNITE f,UPERTINO STANDARDS.
GARAGE-SLABS
POUR NO NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - ^
UNDERGROUND /SLAB - - /� ;• ,.^ti1�.;v
PLUMBING
ELECTRICAL _ - ISSUANCE DATE i
ELECT. PLa,
MECHANICAL MECR.
❑r , t❑
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT pA�p INFORMATION
WOOD FLOOR` }" AwAuuN $ivr .
PLUMBING . 8195 ��O 1
MECHANICAL.. V
ELECTRICAL - - PB IRO - . vERMn To
FRAMING Cit, of'CP
$�
STORIES TYPE CONSTR. i
- dNSULATION -
OCC.GROUP RES.UNIis
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED R R-3.
SO,i T.FLOOR AREA TOTAL ACRf.AGE
ROOF NOTE:NO FINALINSP.SHALL BE MADE BEFORE
DIAPHRAGM • ' , `r,, THE CONSTRUCTION TAX IS PAID, 2445
.. - ❑UILO USE
ROOF SHEATHING dQi � I+Es IND CON
n...
oN
vR o .I
"APPLY NO ROOFING UNTIL ABOVE HAS BEEN.SIGNED, FINALS DATE 'INSP.
-A SSESSURS PARCEL NO. �
-ROUGH ' SANA
PLUMBING' - ELECT.ENERGY - - '
TRACT NO. PARCEL NO.
TUBS B SHOWER PAN - PLUMBING ENERGY p+, t
MECHANICAL MECH.ENERGY
ELECTRICAL' 9% BUILDING.ENERGY• ' AM DATEACC.PALE No.
•
FRAMING ELECT.FINAL TEST
. ZONING. ENOSITENO.
INSULATION v PLUMBING -'
GAS TEST -/- - r GAS
FIRE SPRINK ENERGY T 24
MECHANICAL
COVER NO WORK.UNTIL ABOVE HAS BEEN SIGNED HEATING - / Y N❑ N❑
F 100D ZONE A.L.,C.
EXTERIOR SHEAR �- �$��p ELECTRICAL RELEASE
INTERIOR.SHEAR '�-`Tj1�00 FIRE DEPT. Yo ❑ .N❑
• SHEETROCK ' - GRADE'; FEE SUMMARY
EXTERIOR LATH - BUILDING-
BUILDING 972.00
.INTERIOR LATH; ' � � � TEMPORARY APPROVALS
SCRATCH COAT //-I`C'Y ELECTRIC, /'.�� FEEPLAN CHECK ' 15.50
I�niarqk 69-on
GAS •.C��(
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN,SIGNED OCCUPANCY. ' SEISMIC FEE 13 figi
-�- OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED By BUILDING INSPECTOR: MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC' 73.13
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING'
O� PLEASE GIVE JOB ADDRESS,WHEN PHONING. ,
7 .13
Z MECHANICAL
- SEE'PERMIT FOR EXPIRATION DATE — 7-2
IMPORTANT,! , coNST.TAX
PLEASE!READ REVERSE SIDE BEFORE '. . TOTAL 1570.78
CALLING FOR FINAL INSPECTION.
0FFICE COPY " '
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL PpINPEN ONLY _
.r' r BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
BgAPPLICATION & PERMIT
AUODNEtXrc ar pring our
o151plan i4C BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 14975
OWNER'5 - PLAN CHECK VALIDATION
NAME .Gregory Group, Inc. & Ahnanson QTY. ELECTRIC PERMIT FEE
-� Develo is 416,1695-2100
NAME crony OUTLETS-SWITCHES-RECEP 10.00/1.00
NAME �1�I/•
Gregory Group, L1CRlO ,8-430097 LIGHTING FIXTURES 10.00/1.00
CONTH mna. 220 C Twin Dolphin Dr. PPLIANCES-RESIDENTIAL 4.00
ADDRESS F^I 1 '
RWC CA. 94065 , 415�96F2100 PANELS- 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO,
ENGINEER Aram Bassenian•; AIA & Associates
uc.No. SIGNS TRANS. 3.00 1
ARCH.OR ENG. 1'5.00 _ PERMIT VALIDATION
ADDRESS 2031 Orchard Dr. #100 SPECIAL CIRCUIT
a 99707 EMP.METER OR POLE INS. 20.00 '
APPucaNr$ MOTORS SEE FEE SCH.
94O
FDDREBS 220 C Twin Dolphin Dr. , �, ._.:
' SERVICE CHANGE 20.00 .•-
0 LICENSED CONTRACTORS DECLARATION ' D
"02,
�-. _
Q U t~i I hereby affirm th1�I all,licensed mtdcr pn,visions of Chzpt Cr 9 - - ISSUANCE DATE '
y G w (commencing Willi Section 7000)of Divismrt J of the Boelneo and BLDG. E PLG. MECH.
F w z Professions Code,and my license in in full force and effect _ -
2 O m License Class_B_Lic.Numbs
O Z'f w Dale Contradm "
WA a
OWNER-BUILDER DECLnR TION j ^u U_ Ifg{uplG PERMIT
A o A ° MISC.- REFER TO ORD I 1 li (�N{�Q1�MATION
w 3 u w I hereby affirm Ihat I an,exempt limon the Contractors License' VALUATION S/FT.
uoa Law for the following reson.(Scc.7031.5.Businessand Professions PERMIT ISSUANCE 10.00
W Code'.Any city or County which rcluires a permit to construct.alter,
R ¢Q 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. 195,GOD
ELEC.
E O ¢ requires the applicant for such permit to lite a signed statement thin .r TOTAL PERMIT TO
n w w he is licensed'pursuant to the provisions of the Contractor's License
Fza Law(Chepler9(cummencingwith Section 7000)ofDivision3ofthe- - SFW and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
¢ I$ the basis for the alleged exuntplion.Any violation of Section 7031.5 STORIES TYPE CONSTR.
w. by any applicant for a permit subjects lire applicant to a Civil penalty ALTER-DRAIN'&VENT-WATER IEA) 500
of not more than five hundred dollars 15500).1: • . . 2 5M-Q2'.
❑ I,as owner.1 the property,or my employees Willi wages as BACK-F LOW 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 Prul'cssimu DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 R_3 1 ,
Code:The Contractor's License Law dos not apply to an owner of
property who builds or reproves(hereon,and who dos such work FIXTURES-PER TRAP 5.00 So.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that such improve- GAS-EA.SYSTEM-11NC.40UTLETS 6.00 " 2445
meals are not intended or offered for sale it,however,the building
i or improvement is sold within one year of completion, the owner. GAS-EASYSTEM-OVER 4 (EA.) 200 . BUILDING USE
builder will have the burden of proving that he did not build or ire . .
- IND CON PB Omer
i prove far purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
❑ I,as owner of the property,am exclusively contracting Willi RES t Ijltl ❑ ❑ ❑ ❑
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 dues not apply
to an owner mf p,.,city who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts I'or such projects with a ennlractorls)licensed pursmnl to
the Commmor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ lam exemptmWerSc<. .H.&PG.Rn(his WATER HEATERW/VENT - 6.00 6067 ` '
reason
Owner Late WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARATION- WATER TREATING EQUIP. 5.00
1 I erchy affirm Ilml 1 have a certificate of consent to WINIIsure. - ZONING ENG.SITE NO.-
or a cerifi,me of Workers'Compensation Insurance,or a certilled
copy thereof(Sec.3800,Lah.C..United Pacific '
Policy No. Company
O ❑ Certified copy is llcmhy,linnislted. FIRE SPRINK,- -ENERGY T 24
_z Z )Q Certified Wd with the city inspection division. MISC.- REFER TO ORD.U Applicant Y ❑ N❑ Y ❑. .N❑
F- N PERMIT ISSUANCE - 10.00 FLOOD ZONE . A.L.U.C. -'
CISR'rl A'rli OP IAA MPTION FROM WORKERS'
LU > COMPF.NSA'r10N INSURANCE • PLG.CONTE. - LIC.NO. PLG. ,
d O (This section need nm he cont Plettd if the permit is li,r arc TOTAL. V❑ NE] ..Y E] N❑
Z hundred do11ars($100)or less.)
U O 1 certify that in the perfunnunce of the work far which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY '
LL 1- mit is issued,I slmll.not employ any person in any Inunnerso aS In
U h.....c subject to lire Workers'Compensatho Laws of California. ,97.2.00
Ed Dam Applicant BUILDING ALTER OR ADD TO MECH. 5.00
} to N01 CH *10 APPLICANT' If,after making This Ccrlificute of lix-
F. ? emption,you should become subject to the WOrkeOO Compensation APPLIANCE '5.00 PLAN CHECK
provisions of the Labor Cade, you must forthwith comply Willi FEE /energy .62.00
U such provisions or this permit shall he deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONS'rRUC'I']ON L17NDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE •. '13.65
I hereby aflion that (here is a construction leading agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance of the wprk�q yvy,,f this pennil is issued ISec. - MICROFILM
3097,CN.C.). t$ECIA"1 Ly Y�[,lT il. HEATING UNIT(TOa00,000B.T.U.) 8.00
Lender's Namc_QY1TC1tIj-f-1QOY' HEATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 73.13
Lender i Address}{' L Ll
I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) - 4.00 -
information is correct.I agree m comply with all city and county gOILERr COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING 73.13
ordinances and state laws representatives
In building Cnnslrudion, olid
hereby authorize ropertyforins of this crposes enter upon the gQILER-COMP(Over l00,000BTU)SEE FEE SCH. MECHANICAL
above-mentioned Property for inspection purpusns.
' (We) agree to sive. indemnify and keep harmless the City of MISC.- - REFER TO ORD.
Cupertino against liabilities.judgments, costs and expenses which PERMITISSUANCE, 10.00 CONST.TAX .288..24
may in any way accrue against said City in consequence of the 4
ranting of this n 't. TOTAL MECH.CONT. LIG NO. MECH. TOTAL 1570.78
Signa(ur Plicant/Contracfor ale "
OFFICE COPY
CITY OF CUPERTINO'
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
B"ding Permit No./C
Date ...........11...'.... ..:::
The Building Located at .....114�v,jq,�P --'C7_
............................................
Owned by ...
Com let
Has Been 4For Use As: ...... ..
...... ...........................
(Altered)
.............................................
....................................................................................................
........................................................................................................................................
................ ......................................................... .............................. .......................................
-
------- . .. . . ..........
PD-7 BUILDING INSPECTOR
\0 . ING INSPECTOR'S OFFICE- 0
BUILP Bldg.Dept.
CITY OF CUPERTINO offic..c.py
❑ Backflow D.'�vice Sbnitary Permit No.
0 Sewer C6nnection Plumbing Permit No./_�
Q-`Plum&ng' Final Lot No.
OwnerorTenant
7—
At
Tract
Date Connected _::� °Rqte Final-
10,
• 4
5„ PLUMBING lNbl'tUUT<
n
�Yw o CITY OF CUPERTINt ' COPYE
OO
GAS SERVICE NOTICE
t
A/nr / l lq
To .. ..
You are hereby authorized to connect the GAS service for
Owner or Tenant
At
J /
' - New Service-
No.
Service
No. of Meters I Reconnect
No. of Add. Meters Move Service
Move Meter
PLUMBING INSPECTOR 2 (D.
.e ELECTRIC SERVICE NOTICE�r' ''^icoaY
` BUILDING INSPECTORS NOTICE
CITY OF CUPERTINO
19
To
You are hereby authorized to Connect electrical service for
Owner or Tenant �_ ����l''y �Tl•'b C.�/�
At
No.of Wires Size of Wires Size of Switch
i I
Motor Load Voltoge r Phase i
Ii
I Heating Load K.W. Voltage
Lighr I10New Service Reconnect
No.of Meters Hear-120- Three Wire More Service
1; No.of Add.Meters Power Three Phase Move Meter J
I;
OO "
ELECTRICAL INSPECTOR
11