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jPOST THIS CARD NEAR FRONT OF BUILDING f^ ' � - PFflA11T NUMBER CITY OF CUPERTINO 13776 INSPECTION DIVISION JOB INSPECTION RECORD • 1 A�,�, - - PERMIT EXPIRATION JOB ADDRESS 1 UNIT# LOT#��I' ���G2T ! � PERMIT EXPIRES IF WORK OWNER Com, CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 18oDAYS OFPERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. LIFER • PERMIT VALIDATION PREGUNITE - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB -f PLUMBING q�l* ./' �C ELECTRICAL - D NCE DnGE ME HANICA T. PL . MECR.� ' o o a, . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN IGNEO - BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION S/FT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL FRAMING STORIES TYPE CONSTR. INSULATION 6 OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED !Z, T.FLOOR AREM1 TOTAL ACREAGE ® ROOF DIAPHRAGM BUILDING USE RES IND CON PB Unn•i APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED © El ❑ Cl ASSESSORS PARCEL NO. ROUGH PLUMBING GAS TEST _ 3 TRACT NO. PARCEL NO, MECHANICAL ACD DATE ACC.FILE NO. ELECTRICAL FINALS DATE I IN P. FRAMINGSAN'* Zz/�. ZONING ENG,SITE NO. INSULATION - l�-� - PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY T2 YE]COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING (f ry NE:) LATH-INTERIOR(I- -13- ELECTRICAL 'Z vo NO Y❑ . N❑ LATH-EXTERIOR ..1p.�� FLOOD zorvEA.L.u.c. FIRE DEPT. _ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING - SHEAR EXTERIOR TEMPORARY APPROVAL BUILDING FIREWALLS - ELECTRIC PLAN CHECK ... - GAS FEE �J_ NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE l OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC . H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING • 2 O PLEASE GIVE JOB ADDRESS WHEN PHONING. z — SEE PERMIT FOR EXPIRATION DATE —. MECHANICAL IMPORTANT! CONST.TAX ;ter e'• PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICECOPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER APPLICATION & PERMIT A..RE,,. 3 Seven Springs Lane 13776 ppREss Lot 71 - Plan IG BUILDING - ELECTRICAL-PLUMBING -MECHANICAL ' OWNERS PLAN CHECK VALIDATION • NAGE OTY. ELECTRIC PERMIT FEE Gre or Grou Inc.PHONE 595-2100 CONTRACTORS NAME 10LUTLETS-SWITCHES-RECEP 10.0011.00 /Q AlN Gregory Group, Inc. LIC.NO 430097 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR' 220 Twin Dolphin Dr. , "CII 3 PPLIANCES-RESIDENTIAL• 4.00 a ADDRESS Redwood City. CA PRONE PANELS 10.00 D DATE OF APPLICATION ARCHITECT Aram Bassenian, A.I .A. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE PC.N . OR ENGINEER LIC.(,(, c.NO. SIGNS TRANS. 3.00 AARCH.OR DDRESS ENGPERMIT VALIDATION .3990 Westerly Pl , #170 SPECIALCIRCUIT 5.00 ,IP Q266n TEMP.METER OR POLE INS. 20.00 APPucANrs 220' Twin Dolphin Drive, nC MOTORS SEE FEEJOREDT `7C ADDRESS Redwood City, CA 94065 SERVICE CHANGE p w o a LICENSED CONTRACTORS DECLARATION U v I hereby affum that I am licensed under provisions of Chapter 9 - r ISSUANCE DATE v,a a (commencing with Section 7000)of Division 3 of the Business and LDG. ELECT. PLG. MECH. F H i Professions C,��Ic,and my license is in full for5��egq99{{1,kf e}. rEC z o Y, - License Class.[5 Lie.Number 43UUcJ./ J� ®_ .NM Q y iso Date Contractor a ¢ OWNER-BUILDER DECLARATION BUILDING PERMIT a ervINFORMATION wI hereby affirm Thal I am exempt from the Contractor's Licnse MISC.- REFER TOLLolaw for the following reason.(Sec.7031.5,Busimessimd Professions PERMIT ISSUANCE VALUATION s/FT. L - Code:Any cityorcountywhichrtquiresapermittoconstruct,alter, xrt Q 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC CONTR. LIC.NO. ELEC. / O u requires the applicant for such pertrit to file a signed statenwnt that TOTL / fs PERMIT TO w licensedrs he licensed pursuant to the provisions of the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 offs 1 P O Business and Professions Code)or that he nexempt therefrom and QTY. PLUMBING PERMIT FEE ¢r the basis for the alleged exemption.Any violation of Section 7031.5 I STORIES TYPE CONST T ; - by anyapplicam for a permit subjects theapplicent toacivilpenalty ALTER-DRAIN -WATER (EA.) 5.00 Of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 Dee.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-FLOOR,ROOF,AR EA,COND. 5.00 �- 3 Code:The Contractor's License Law does not apply to an owner Of property who build,or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments am not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 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 prove for purpose of salt.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON Pa Other ❑ 1,as owner of the property,am exclusively contracting with E D El El licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00ASSESSORSPAR CELNO. and Professions Code:The Contractor's License Law does not apply p � to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 3 �_'� 3/ `{L rU contracts for Much projects with a enntmetm(s)licensed pursuant to SEWER-SANITARYV-STORM EA.2001t/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ l am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Dale WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPENSA'I ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby Atirm that I have a certiflcate cf corset to self-insure. - ZONING ENG.SITE NO. , or a certificate of Workers'Compenvtion Insurance,Or a certified copy thereof(Sec.3800,Lm.C, Policy No. Company.),❑]_ted-Pa c_4RPS ce O ❑ Certified cop he py fern It al. FIRE SPRINK ENERGY T.20 Z 2 05 Certified .A le I the city inspection division. O Applicant MISC.- REFER TO ORD. Y❑ No Yo NL] 0 W CERTIFI TE OF EXEMPTIONFROM WORK ERS' PERMIT ISSUANCE 10.00 / FLOOD ZONE A.L.U.o. Ju > COMPENSATION INSURANCE PLG.CONTR. ❑C.NO. PLG_ v N v N CL Z (This section need not be completed if the permit is for one TOTAL hundred dollars IS 100)or It.) U O I certify that in the performance of the work for which this per, OTY. MECHANICAL PERMIT FEE FEE SUMMARY (y {- mit is issued,I shall not employ any person in any manner an as to Obecome subject to the Worker,Compensation Laws of California. 0. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 3 } to NOTICE TO APPLICANT: If,after making this Cerlificate of Ex- F 2 emplion,you should become subject to the Worker,Compensation APPLIANCE5.00 PLAN CHECK provisions of the labor Code. you must forthwith comply with FEE 3� U u ch provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10DWC.EM.) 6.00 SEISMIC FEE I 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.Civ.C.). ` HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lendcr'a Namc Security Pacific HEATING UNIT(OVER 100,000 B.T.U.19.50 Lender's Address San Fra a-isco�GA ELECTRIC /&� ✓ • I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is comet. I agree to comply with all city and county PLUMBING Ordinances and state laws relating to building construction, andB0ILER-C.ONP(3H.P.or100,000B.T.U.) 6.00 �0 hereby authorize representatives the city enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. E (we) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. / Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10,00 CONST.TAX an may in y way accrue against mid City in comunuer" of the gmn[in hispermIL MECH.CONT. LIC.NO. MECH. /gam TOTAL TOTAL jY,�/8/ Signat Applicant/Contactor ate OFFICE COPY CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY_[�OF-C-UPERTINO DATE_.._, 14BLDG. PERMIT NO. i ,THE BLDG. LOCATED AT • OWNED BY ,HAS BEEN OMPLETEDI FOR USE AS '♦< (ALTERED) -,BUILDING INSPECTOR