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14980 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER " CITY OF CUPERTINO ' 14980 INSPECTION DIVISION JOB INSPECTION RECORD ° JOB ADDRESV/9 /LJ E�`�`-'��J��OS +`��T��-• UNIT 4,' LOT#, 1 -PERMIT EXPIRES IF PERMIT EXPIRATION 1 WORK owNEn�� - CONTRACTOR ,��jp.( _ IS NOT STARTED WITHIN" INSPE ION DATE INSPECTOR INSPECTION RECORD 180'DAYS OF PERMIT ISSU FOUNDATION -es ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFER `J-I �_ C - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PEHMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - UNDERGROUND /SLAB PLUMBING _ .. (4 �6 ELECTRICAL ISSUANCE DATE MECHANICAL RLuc ELECT. PLG. mecR. la .� 0. f DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - '11510UILDING N ORMATIONT WOOD FLOOR 1 VnLyATION SITT. PLUMBING p%M MECHANICAL' 921V00 •. � ELECTRICAL - PERMIT TO FRAMING - T ` INSULATION STORIES TYPECONSTR. 'EO OCC.GROUP NITS " } PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED EAGE 1 ROOF. NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so. . ..T zt TOL ACR -R•+/ DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2445 f - � ' BUILDING USE PB Om.� ROOF SHEATHING cl-- HES WU El CONEl ED 1-1 , APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. nsscssoR SPAI+C E NO. ROUGH SAN.a �Sa PLUMBING /a- ELECT.ENERGY TRACT NO PARCEL NO T TUBS 8 SHOWER. AN 1.7- PLUMBING ENERGY MECHANICAL MECH.ENERGY _ ACC.DATE ACC.PILE NO- ELECTRICAL BUILDING ENERGY FRAMING ELECT. FINAL TEST INSULATION - PLUMBING ZOT ENG.SITE NO. GAS TEST y. GAS ' MECHANICAL FIRE SPRINK - ENERGY,T-7,1COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE v ` L. NEI A.Lu.c. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR !j FIRE DEPT. "� ` L7 "� r SHEETROCK -� GRADE- FEE SUMMARY EXTERIOR LATH - Yj BUILDING - INTERIOR LATH TEMPORARY APPROVALS BUILDING 972-00 SCRATCH COAT ELECTRIC PLAN CHECK 15.50 GAS - FEE/energy 62600 NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTEDUNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY,PHONING 252-4505, ELECTRIC73 13 o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING •73.13 Z PLEASE GIVE JOB ADDRESS WHEN PHONING. IMF - SEE PERM IT.FOR'EXPIRATION DATE— MECHANICAL 73.13 IMPORTANT! conlsT.TnX 288.24 PLEASE READ'REVERSE SIDE BEFORE' TOTAL j570,78 CALLING FOR FINAL INSPECTION. OFFICE COPY CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE Date ..... ......C ................... 19-S-7... Building Permit No. Thr Building Located ...................... I Awned by ....... oiz>y......*G'—-QZ'210.. ................. ....*.... .. *...... ....... .. ... -------- Has Been Com eted CWerie )i'For Use As. -.5..F.D............................... .................................. . ... ... .... ........................................ ......................................................................................................... ............... ....................................................................... ......................................................... .......... ................ .................................................................................................................... ........\61-j ..................................... PD-7 BUILDING INSPECTOR APPLICANT TO FILL IN INFORMATION WITHIN REQ LINE-6-' = USE BALL POINT PEN ONLY ..QUI LDI NG PROJECT 1 DENTI FICATION ,-si" PERMIT NUMBER y no"'N' APPLICATION'& PERMIT 14980 . " Lot 137 Plan 4C . BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S ,�.c: a PLAN CHECK VALIDATION NAME Gregory Group, Inc. & Awnson QTY, ELECTRIC PERMIT FEE Developnents dk1N4-595-2100 COMTRACTORs -OUTLETS-SWITCHES-RECEP 10.00/1.00 � rY )ps If 0• N� 43C097LIGHTING FIXTURES 10.00/1.00 coANT9pR/6(T�O/I6220 C Twin Dl�1WI_M PPLIANCES-RESIDENTIAL 4.00 AD�iaB94065 41 2 0D PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C. 40. ENGINEER ARM84SSFNIAN, AIA & ASSOCIATES PANELS (OVER 200 AMP) 20.00 uC.ND SIGNS TRANS. 3.00 ARCHORASH SS 2031 VIUIDIU Df. #100 SPECIALCIRCUIT 5,00 PERMIT VALIDATION S z EMP.METER OR POLE INS. 20.00 APPLI DDRESS 2 0 C Twin Dolphin Dr. MOTORS SEE FEE SCH. _n ADDRESS l�-(•U-/�I'V 94065 SERVICE CHANGE 20.00 p ea¢ z /tiJl0 r r 0 O LICENSED CON]RACfORS DECLARATION < U,u I hereby affirm that I am licensed under provisiomof Chapter9 ISSUANCE DATE m A w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.' F �,z Professions Code,a my liceore is in full foyer yy1. Z 0 u, - License Clan [3 Lic.Numhur_ / 0 m w Dmc Contractor - - a Y F BUILDING PERMIT ¢ a OWNER-BUILDER Df:CLA ON s ¢ w O INFORMATION ra ;d I hereby ulfnn that am exempt from the Contractors License MISC.- REFER 41J*VA LL0< Law for the following}anon.(Sec.7031.5,liusinssand professions LUATION S/FT. 0 PERMIT ISSUANCE Code:Any city orcounty which requires a permil to construct,alter, IS 2 improve, or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. Cup A6t 000 1, requires the applicant for such permit to IIIc a signed statement that TOTAL Cd9 �t PERMIT TO Z. S w he is licensed punuant m the provisions of the Conth, ted is License F z a Law(Chapter 9(commencing with Section 7000)of Division 3 oflhe 4 0 Bu.sincss and Professions Code)or that he is cxcmpt therefrom and CITY. PLUMBING PERMIT FEE SF1Xl ¢ I- the basis for the alleged excntplion.Any violation Of Section 7031.5 STORIES TYPE CONSTR. by any applicant roes permit subjects the applicant loocivil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 2 5U of not more than five permild dollars the ap li 0 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compeneution,will do the work,and the structure is not OCG GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code The Contractor's License Law does not apply to an owner of R-3 1 property who builds or improve,thereon,and who docs such work FIXTURES-PER TRAP 5.00 SCLHT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedoroffered for sale.If,however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 2445 or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4 (EA) 200 builder will have the burden of proving that he did not build or ins- - . - . . BUILDING USE Prove for purpose:of sale.). INDUSTRIAL WASTE INTER. 3000 RES IND CON PB _ Other . ❑ I,as owner of the property,am exclusively contracting with o ❑ ❑ 1:1 ❑ licensed contractors to consumer the project(Sec 7144,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 with a contracions)licensed pursuant to Bre Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam cxcmpt under Scc. ,B.&P.C.I'or this WATER HEATER W/VENT 6.00 806] reason Owner Date WATER SYSTEM 5.00 - ACC.DATE ACG FILE NO. WORK ERS'COMPENSAT1ON,IA-CLARA'IION WATER TREATING EQUIP. 5.00 ] hereby affirm that I have a certificate'uf consent m self-insure. ora certificate of Workers'Cumpcni='1.P Insur-tnee,nr a ttr11 fed ZONING ENG.SITE NO. copy(heomffsec.3800,Lab.C.). United NaCifiC Policy N..-Company- 0 o. Company 0 ❑ Certified copy is hereby furnished. RE BPRINK ENERGY T 44 Z Z 0 Cerlifwd c - with the city inelmetion division. O Applicant MISC.- REFER,TO ORD. Y � N[] Y � N tw 0O � ir CERI'I EOF IiNENIPTION FROM WORK17RSPERMIT ISSUANCE - 10.00 FLOOD ZONE A.L.11.c. LU > COMPFNSATION INSURANCE PLG.CONTR. LIC,NO, PLG. CL O 1 Phis wclion need not be completed if (he permit is for one - TOTAL v N Y N D Z hundred dollars IS 100)or less) U O 1 certify that in the performance of the work for which this per- CITY. - MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner s0 as to W become subject to the Workl:n'Compensation Laws of Califomia. Ua(c Appllc°est ALTER OR ADD TO MECH. 5.00 BUILDING Q_ 972.0 >_ rn NOTICE TO APPLICANT': IL after making this Certificate of Fix- emption,you Mmuld become subject to the Workers'ConlpcnsaGon APPLIANCE 5.00 PLAN CHECK 15,5 provisions of the labor Code, you mus( forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M,) 4AX) /energy I CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 13.65 1 hereby a hnn that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 Dm performance pj the wpik to hi,,l},II i,pemon is issued(Sec. - MICROFILM 3097,Civ.C.). J L �aC TIC HEATING UNIT(TO 100,000 B.T.U.) 8.00 tondo's Name One HEATING UN IT 100,000 B.T.U.)9.50 LUnderIs Address s ELECTRIC 73.13 I certify that 1 bu'C�Ocat!lfl1M u m send state that the above VENTILATION FAN (SINGLE) 4.00 inf romim, is correct. 1 agree m comply with all city and county PLUMBING 73.13 ordinances and stale laws relating m building construction, and BOILER-CCMa?(3 H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP IOwr 100,000 BTU)SEE FEE SCM. MECHANICAL 73.13 above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uwrrino against liahilitius, Judgments costs and expenses which PERMITanISSUANCE 1000 CONST.TAX L88.24 say in y way accrue against said City in consequence of The otlmg0 MECH.CONT. LIGNO. MECH. TOTAL TOTAL 1570.78 ignmure OI Applicant/Contractor D OFFICE COPY