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13792 (2) POST THIS CARD NEAR FRONT OF BUILDING . PFRMIT NURSER .. CITY" OF CUPERTINO 13792 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS //ra 9' c,� cS,aR.�ti'� C-7 UNIT# LOT# U PERMIT EXPIRES IF WORK 9 OWNER �llee R 6—i2p U- n/G CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCEFOUNDATION �_I ct_88 w OR 180 DAYS FROM LASTCALLED INSPECTION. UFER lxc PREGUNITE .. PEHMIT VAUDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING 71.073 ELECTRICAL P ISSUANCE DATE MECHANICAL BLDG E PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION SIFT. PLUMBING MECHANICAL ' ELECTRICAL - -vERMlr ro J is y' FRAMING INSULATION sroRiEs TYPE consrR. - OCC GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF .^(1.FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM -I BUILDING USE ' - RLS IND CON. PB Other APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH r _ s PLUMBING _ ,y. - GAS TEST TRACT NO. PARCEL NO. - MECHANICAL -/9_fop' Acc.DATE Acc.FILE no. ELECTRICAL FINALS DATE INSP. FRAMING 17 1 'JSAN # 1A ,3 INSULATION PLUMBING ZONING ENG,SITE No. y� GAS MECHANICAL FIRE SPRINK ENERGY T44 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I HEATING Y F] NE] "[j . ' LATH—INTERIOR ELECTRICAL FLOOD ZONE A.L.0C. LATH—EXTERIOR - FIRE DEPT. Y❑ NEl Y I] N SHEETROCK - GRADE - - FEE SUMMARY SHEAR INTERIOR BUILDINGI I BUILDING SHEAR EXTERIOR TEMPORARY.APPROVALS FIREWALLS ELECTRIC PLAN CHECK / C GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY I SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM uJ ARRANGE FOR INSPECTION BY PHONING 252-4505, - ELECTRIC U ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE— MECHANICAL ' IMPORTANT! coNsT.Tnx PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY -BUILDING PROJECT IDENTIFICATION PERMIT NUNgB R APPLICATION & PERMIT ADDRES$ DRESSILDING 11529 Rock'<Spring C4AJourt 13792 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NnME OTY. ELECTRIC PERMIT FEE Gregor Group, InCrHONE 595-2100 NAME crOR's OUTLETS-SWITCHES-RECEP 10.00/1.00 NAME Gregory Group, Inc.L,G,NG, 430097 a LIGHTING FIXTURES 0.00/1.00 aq CONTRACTOR ONs '2'20 C Twin Dolphin ,Dr. APPLIANCES-RESIDENTIAL 4.00 Redwood City, CA 'HONE 595-21'00 PANELS 10.00 DATE OF APPLICATION ARCHITECTPLAN CHECK FEE P.C.NO. EOR NGINEER Aram Passenian, A.I.A. & PANELS (OVER 200 AMP) 20.00 Associates LIC.NO SIGNS TRANS. 3.00 ARCH.DD,ESS ENG. 3990 Westerly Place, #17 SPECIALCIRCUIT 5.0Q PERMIT VALIDATION ADDRESS Newport Beach CA ZIP 9266 EMP.METER OR POLE INS. 20.00 APvn .. 2 win Dolphin Dr. MOTORS SEE FEE SCH. a AppEss Redwood City, CA 94065 SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARA'PION ¢ u u 1 hereby affirm that 1 am licensed under provisions of Chapter 9 - - 1 CE DATE N c m (commencing with Section 7000)of Division 3 of the Business and PLG. MECH. o Professions Cco and m license is in lull force.'yyJ PJj��j o i=W License Class Lic.Number 43.1j 11`U.7 F y H J ])are Contractor st Y E -+ BUILDING PERMIT se ¢ ¢ OWNER-BUILDER DECLARATION ¢ W - INFORMATION D aMISC.- REFER TO ORD X ; ¢ n 1 for the affirm that I am exempt from the messContractor's License uO¢ Law for the following reason(Sec.703L5,Business Professions PERMIT ISSUANCE 10.00 /O VALUATION S/FT. ~ N Code:Anycity orcounty which requires a permit to construe(.alter, ELEC.CONTE. LIC.NO: ac ¢o improve,demolish,or repair any structure,prior to its issuance,also ELEC. ¢ wD ir requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO $ he is licensed pursuant to the provisions of the Contractor's License ��u// Hzi Law(Chapter 9(commencing with Section 7000)o f Division 3 ofthe SCJ ¢ Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢1-$ the basis for the alleged exemption.Any violation of Section 7031.5 t STORIES TYPEs.C/O�NJSTR. by any applicant fora permit subjects 5000.licant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 6.00 3-/0" l of not more than fore hundred subjects tiro applicant ❑ I,as owner of the property,or my enployees with wages as BACK FLOW PROTECT. DEVICE 4.00 OC GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOfl,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 I FIXTURES-PER TRAP5.00 50.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,[lie building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or 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 not build or im- BUILDING USE RES IND CON PB Orhar prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ d as owner of the property,he exclusively contracting B witha El licensed contractors Cod to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Cade:The Contractor's License Law does not apply / to aowner of property who builds improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 3 66- 9-3 f 3� -3 , 3 Car acts for such projects with a contrtrncmr(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 RueContractor s License Law. TRACT N0. PARCEL NO. C1Iamexemptunder Sec. ,B.&P.C.for this WATER HEATERW/VENT 6.00 799.T match Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERTCOMPENSATION 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. Poliicy No.thereof(Sec.3800 Lab C Co pany j United-3 0 ❑ CCHiOed Copy is hereby terms ed FIRE SPRINK ENERGY T 24 ^ Z 2 ❑ Certified c led w' city inspection division. 0 Applicant s MISC.- REFER TO ORD, v N� v ❑ N� ~ va PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU CIiRTIPIC OP SATI N INS FROM WORKERS' /D 0. COMPENSATION INSURE the PLG.CONTE. LIC.No.0. Z (This section need not be completed if the permit is for one TOTAL hundred dollars IS 100)or,IessJ 0 0 I certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY UL I- on, is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. W Dalc Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT: If,after making this Certificate of Ex- F Z emplion,you should become subject to the Workers'Compensation L4 APPLIANCE 5.00 PLAN CHECK -7 provisions of the Labor Code, you must forthwith comply with FEE / U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 1OJ100C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10PWC.F.M.) 6.00 SEISMIC FEE Q 9-1- 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,CN.C.). ` I HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's dSecurity Pacific LemleraAddreaa-San-Fr-ane-i-sso;GA- O �HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC 0� Address I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.DO 00,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEESCH. MECHANICAL V� above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- ' REFER TO ORD. c / Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 ranCONST.TAX a a 6 may in any way accrue against said City in consequence of the 11 5_1 gting Of 11. MECH.CONT. LIG NO. MECH. �,4�__�� TOTAL s� TOTAL Signa[ p¢ant/ ontractor )nna,, - OFFICE COPY J POST THIS CAR CITY OF ECUPONT OF B UILDI INSPECTION ERTIN pJOSNG _ DRESS SOB INSPECTION RECpRp "� "" J I / - OWNER WNEq CJ FOUNDATIONPECTIOIV UNIT.{ LEPERD E INSPECTOR RACrOR �_._�-LOT.# O PERMIT EXPIRATION PR6GUPOI/ NITE INSPECTION CO is REp ORMIT T STARTWORKS IF R NO CONCRETE UNT AN DAYS OF PERMIT IL ABOVE HAS BEE '80MIT ISSJ, PLUMBING LINDERGROUNp SLAB BEEN LA TCALI ED(NAYS FROM ' f ELECTRI SPEC71pN, CIL q '' PERMIT VALIDATIO MECHANICAL O•V P � " + DO NOT POUR F � X987 �• 100q UNTIL AB PLUMBING WOOD FLOOR E HAS BEEN SIGNED "+1� _ - MECHANICAL r' Loof c. ELEGNET DATE ELECTRICAL 0 ❑ PLG. MEER. NG RAMI � BUIL JSULATION WFODI q C'PERMIT , VA NATION LUATION 1 S/Fr i ACk SURF PERAUT ED I � LOUR UNTIL 'HReGM C ROOF BOVENAS BEEN SIGNED STORIES TYPE ODN I srq ' LYNO ROOFING UN DEC GROUP RES UNIT, / rIL LING ROUGH V E HAS BEEN SIGNED D I "DDRARIA TDTA Na��l� fST I ncr+LACL a NICAL RES INOUILDINR USE as 'ICAC _ a�0 ON Pu > Q0 G nSSL SSOPS PARCEL C7 o\ �Q ION NO Q �� oo� FINALS No E rnRCEL ND `% DATONt, PLUMBING P. 4CC DAT as GAS RR FORK UNTIL ABOVE HAS BEEN SIGNED MECHANICAL Acc.ELLE No \^\ S c HEATING _ ENG.SITE No. S, RIOR ELECTRICAL FIRE SPRINK OR FIRE DEPT. — _ rO NO ENERGY r.?A ••Cj\ 0 !r GRADE FLOOD ION, YO N❑ 1� BUILDING v NO AIU.C. OS.y� �y LAST - _ ..Y ER UNTIL ABOVE ` ELECTRICEMPORARYQPPROV4 �_ sUMMA4y -r. But DING HAS BEE SIGNEDGAS BUILDING _.I GIS NOT PERMIT ER N MITTED UNTI OCCUPANCY PLAN 'E hIV LBUILDING FI FEE CHECK WORE FOR INSPEC N4lISSIGNEDBYBUI SEISMIC FEE EASE GIVI NG DAY BEFION BY PHO LDING INSP ECTOq SE E JOB ADDRESS E REQUIR ING 252-4505 MICROFILM E PERMIT FOR EXPI E P °NTNG. TION. ELECTRIC G. ..PLF.ACE s_'_MPOR:Td.N.z.w, .._0 - PLUMBmL._.l-- .— y