14941 (2) POST THIS CARD NEAR FRONT OF 6UI.CDING
,.♦ _.» - PERMIT NUMBER
CITY OF CUPERTINO 14841
' INSPECTION DIVISION
JOB INSPECTION RECORD
' PERMIT EXPIRATION
JOB ADDRESS � 9"'�TRCLrz�VF UNIT# - _LOT# &o
PERMIT EXPIRES IF WORK
OWNER - q DU CONTRACTOR tr"K-'�Q 6e4L • IS NOT STARTED WITHIN
INSPECTIO DATE INSPECTOR INSPE ION RECORD 180 DAYS OF PERMIT ISSU-
_ ANCE OR 180 DAYS FROM
- FOUNDATION - •NOTE:'
UFER -I - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF ' PERMIT VALIDATION
CUPERTINO STANDARDS..
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND./SLAB
PLUMBING
ELECTRICAL ISSUANCE DATE
MECHANICAL - +LOG ELEPLO. MECH-,
%
DO NOT PUR FLOOR UNTIL ABOVE HASIMS I G N E 0 BUILDING PERMIT y
WOOD FLOOR INFORMATION
PLUMBING - - VALUATION SIFT
i .
MECHANICAL imp=
ELECTRICAL PERMI7 TO
FRAMING cc III
INSULATION STOHiEs TYPE CONSTH. ,
OC .GROUP NITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN�SIGNED
5(1,4i, 'LOOK AREA IOTA REAIiP
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM _ THE CONSTRUCTION TAX IS PAID 1515
BUILDINGuse
ROOF SHEATHING � �'S'rS Res IND CON
PB. o,o,•
APPLY NO ROOFING UNTIL ABOVE HAS BEMSIGNED FINALS DATE INSP.. 1:1 1:10
ASSESSORS PAHCEL NO
ROUGH FCT.
N.N �{
PLUMBING D-`7 KK J ENERGY
TRACT NO, PARCEL NO
TUBS&SHOWER PAN p-�f MBING ENERGY r
MECHANICAL CH.ENERGY
ELECTRICAL ' A C.oATE ACC FILE NO
BUILDING ENERGY
FRAMING 'Z _ ELECT.FINAL TEST '
]ONING ENG SITE NO.
- INSULATION 0 PLUMBING
GAS TEST Ri✓ GAS
MECHANICAL FIRE SPRINK ENERGY T.za
Y
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ° L "�:
FLOOD ZONE
a L u.c.
EXTERIOR SHEAR ELECTRICAL RELEASE 1.
INTERIOR SHEAR ., - FIRE DEPT. °❑ N� .� ❑ -El
SHEETROCK GRADE FEESUMMARY
EXTERIOR LATH IBUILDING -
INTERIOR LATH TEMPORARY APPROVALS - - BUILDING
SCRATCH COAT I zI-• Y ELECTRIC' Z,. FEEN CHECK Ig��
GAS
NO TAPE-OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC F
R 53
OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BV BUILDING INSPECTOR. MICR6FILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
Iw-� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
o PLEASE GIVE JOB ADDRESS WHEN PHONING. 49.E
z MECHANICAL
SEE PERMIT FOR EXPIRATION DATE - 4
IMPORTANT! coNST.TAX
PLEASE READ REVERSE SIDE BEFORE TO �����
CALLING FOR FINAL INSPECTION. . TOTAL
OFFICE COPY
_APPLICANT TO FILL IN INFORMATION WITHIN RED LIN .S - USE BALL POINT PEN ONLY
• BUILDING PROJECT IDENTIFICATION • - PERMIT NUMBER • '-
n'LDING 11579 Raintree Spring Court APPLICATION�$i'PERMIT �� ��'
ADoLEot 160 Plan *IA BUILDING-ELECTRICAL-PLUMBING'-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
NAME Gregory• fpr Inc. & Ahmanson CITY ELECTRIC PERMIT FEE Developmnts 415-596,2100
CONTRACTORS
NAME OUTLETS-SWITCHES-RECEP 10.00/1.00
Gregory Groups, Irl.NO.
B-430097 LIGHTING FIXTURES 10.00/1.00
CONTARACTOR'S -C Twin Dolphin UI , M 9406 PPLIANCES-RESIDENTIAL 4.00
...E55
PHONE 1 - PANELS 10.00 DATE OF APPLICATION
ARCHITECT ' PLAN CHECK FEE P.C.NO.
OR Aram Bassenian, AIA & AS rates PANELS (OVER ZOO AMP) 20.00
ENGINEER
LIC.NO C- 95 SIGNS TRANS. 3.00
ARCH.ORENG. PERMIT VALIDATION
ADDRESS 2031 Orchard Dr. #100 SPECIAL CIRCUIT 5.00.
Santa Ana EttS, CA, znt92707 TEMP.METER OR POLE INS. 20.00
ADDRESS rs 220-C Twin Dol In Dr. M MOTORS SEE FEE SCH.
l.H. 94065 SERVICE CHANGE 20.00 "'- ^' e"'�" -
o a i �.(�I 9,1dT
U, o O LICENSI;II CONTRACTORS DECLARATION _/
C U U I hereby uffirn, that I am licensed under Provisions of Chapter 9 - E DATE
m< a (commencing with Section 7000)of Division 3 of the Business and - L PLG. MECH.
H y i Professions Code,and my license is in full for ct.
z O W - License Class B Lia Number
y - Dam Contractor -
¢ w OWNER-R-BUILDER DECLAR ION - �Lx
ING PERMIT
ac urw ;LL H1 hereby affirm that I am exempt from lire Contractor's License MISC.- REFER TO ORD INFORMATION
u o j Law for the Iollowin reason,ISec.7031.5,Ousincss anJ Professions VALUATION $/FT.
- g PERMIT ISSUANCE - 10.00 r�r�
fIA0E Code:Any city or county which requiresn Permit to construct,after, - 122 DW
SE
¢ ¢ O Improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
i O, requires the applicant for such permit to file a signed statement that TOTAL
w es m he is licensed pursuant to the provisions of the Contractor's License PERMIT TO
r z r
Law(Chapter 9(coh,mencing with Section 7000)of Division 3 of the
f 4 o Business and Professions Code)or that he is exengn therefroln and
M I- the basis for the alleged excaq,lh n.Any violation of Section 7031.5 OTV. PLUMBING PERMIT FEE STORIES VPE CONSTR.
u g - by any applicant for a permit subjects the applicant toa civil penalty
.that more than five hundred dollar,($500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00
.'❑ 1,as Owner'If the Property,or my employees with wages us BACKFLOW PROTECT. DEVICE 4.00 OCC.GtouP ITS
their sole compensation,will do the work,and the structure is not
intended or Offered for sale (See. 7044, Business and Profcssi.aS DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:'file Contractor's License Law docs not apply to an owner of _
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 - SO.FT.FLOOR AREA TOTAL ACREAGE
Mansell or through his own employes,provided thin such improve-
ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.4 OUTLETS 6.00 1515
or improvement is sold within one year Of completion,the owner- GAS EASYSTEM OVER 4 IEA.) 2.00
builder will have the burden of proving that h - . -
e did not build or im- BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES .ND CON PB Oram
❑ I,as owner of the properly,am exclusively contractf.Ig with ❑ ❑ ❑r ❑
licensed contractors to construct the project(Sec.7049,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 '
contracts for such projects will,a cohtra,HUHS)licensed Pursuant to - SEWER-SANITARY-STORM EA.200ft/10,00
the Contractor's License Law. TRACT NO, PARCEL NO.
❑ I ton exempt under Sac. •B.B,P.C.for this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 8067
ACC.DATE ACC.FILE NO.
WORK E-RS'COMPENSAT1ON DECLARA'f10N WATER TREATING EQUIP. 5.00
I hereby affirm that I have a ceHificatc ofemise t Io self-insure.
Or a certificate Of Workers Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy thereof(Sea 3800,1 b.C.I �.,,,.I
Policy Nn. Compm,y United-United
0 ❑ Certified copy is hereby furnished.
Z Z ACertified c Iled with the city inspection division. FIRE BPRINK ENERGY T2
F MISC.- REFER TO ORD. C] [:] ❑ ❑
O Cuhl V N Y N
D PERMIT ISSUANCE - 10,00
Lu CI!RTIE ATM FNSAX ION ION FROM WORKERS' FLOOD ZONE A.L.00.
W � •COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL Z( This Section toed not be completed if the permit is for one TOTAL Y E] N❑ Y ❑ No
hundred 11011are($100)or less,)
U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F- mil is issued,I shall not employ any person in any manner so as to
O U become subject to the Workers Compensation Laws of California.
Dm, Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 16.50
>. W NOTICE'1'O APPLICANT': If,after making INN Certificate of fix-
F" ? emption,you should become subject to the Worker Compensuli.n APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE 15.50C^
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10p00CF.M.) 4.00 F;2 00
CONSTRUCT'ION LENDING AGENCY AIR HANDLING UNIT(OVER IODWC.F.M.) 6.00 SEISMIC FEE $ 5
I hereby affirm Ilia! there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance f the work for which this permit is issued(Sec. MICROFILM
3097,CiYC.). �'ecurity Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00
LenJI, .s Nan�1ne-Embarcadero-4 Ir.SE--M HEATING UNIT 100;000 B.T.U.)9.50 49
Lender's Adll41 11_ ELECTRIC
.88
J certify that I have real this application and stele that the ah.ve VENTILATION FAN (SINGLE) 4.00 �p
infernmtum is correct.I agree to comply with all city and county PLUMBING 49.88
ordinances and still, laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the gOI LER-COMP (Over 100,000 BTU)SEE FEE SCH. (19
.88
abovomentioned properly for inspection purposes. MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against bilbilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
n
may iany way accrue against said City in consequen a of file288.24
ranting of thi ./� MECH.CONT. LIC.NO. MECH.
�. se o TOTAL
TOTAL 1,240.42
Signature of ream/Contractor Da Yv
OFFICE COPY