14981 (2) POST-THIS CARD NEAR. FRONT OF BUILDING
- PERMIT NUM1IB ER
CITY OF CPERTINO 14981
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION ~
JOB ADDR ESS��(p1_�1L1-/t CF �7��P� �� UNIT# � L T#t'- �
a �I PERMIT EXPIRES IF WORK
OWNER - (�C� •CONTRACTOR `,.�jt (1P IS NOT STARTED WITHIN TI
INSPECTI DATE INSPECTOR INSPE ION RECORD 180 DAYS OF PERMIT ISSu-
FOUNDATION - ANC. OR 1.. DAYS FROM
NOTE:
• . LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION.
PR EGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF, PERMIT VALIDATION
CUPERTINO STANDARDS. '
.. GARAGE SLABS _
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL IssunNCE DATE
MECHANICAL '97DG, ELECT. PLG. NEER:
:. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BuaDINc PERMIT
•
WOOD FLOOR ORMAnoN
PLUMBING
LUATION SIFT.
_
MECHANICAL . - 1959000
ELECTRICAL - _ PERNn 10
FRAMING , S
INSULATION STORIf.S TYPE CONSTR`,
OCO.GROUP RES.UNITS
PLACE III ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so,s r,r 4AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID - 24455 -
BUILDING USE
ROOF SHEATHING RES INO LON PB om,.,
APPLY NO ROOFING UNTIL ABGlVr HAS BEEN SIGNED FINALS DATE INSP.. 'E] L L ❑ L
ASSESSORS PAR
ROUGH � SAN.k d CELNO
PLUMBING r %o -oT. /0-.27- ELECT.ENERGY
• TUBS 8 SHOWER PAN .' / — — TRACT NO, PARCEL NO PLUMBING ENERGY W67
MECHANICAL �_ MECH.ENERGY
ACC,DATE, ACC.FILE NO
ELECTRICAL J -,� BUILDING ENERGY -
- r
FRAMING �-- T ELECT:FINAL TEST
Q
I — ZONING END.SITE NO.
INSULATION PLUMBING
GAS TEST- GAS PIKE$PRINK ENERGY T 2
MECHANICAL. _ _ Q
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING, Q Y -"� ` "[j
PLOOU ZONE A,L U.C.
EXTERIOR SHEAR ID- .88 ELECTRICAL RELEASE _ _QIT
INTERIOR SHEAR /Q— FIRE DEPT. - v L "� Y L "�
SHEETROCK GRADE - FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH may, TEMPORARY'APPRO ALS-'• BUILDING 972.00
SCRATCH COAT 0,z ,S ELECTRIC PLAN CHECK 5.5Q
. GAS - FEE/energy. 6 0 :
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE a
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL-BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION BY ELECTRIC 252-4505, 73.13 ;
I—� ONE WORKING DAY BEFORE REQUIRED INSPECTION. " PLUMBING
0 PLEASE GIVE JOB ADDRESS WHEN PHONING. 73.13•. .
SEE PERMIT FOR EXPIRATION DATE — MECHANICAL 73.13
IMPORTANT! CONST.TAX 288.24
PLEASE READ REVERSE SIDE BEFORE TOTAL 15 '0:78
CALLING FOR FINAL INSPECTION:
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALLPOINT PEN ONLY
BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER
Aooa ss even prangs Drive APPLICATION & PERMIT
. Lot 134 Plan 4B BUILDING - ELECTRICAL-PLUMBING-ME 1HANICAL 10 81
ON•NERS
r. es
F
PLAN CHECK VALIDATION
NAMEGregory Group, Inc. & Ahmanson OTY. ELECTRIC PERMIT
Rfy 11E
CONTRACTORS -SWITCHES-RECEP 10.00/1.00 Gregory "' ^uprINc• � UTLETS
uc.NV
LIGHTING FIXTURES 10.00/1.00 '
CONTRACTORS 220 C Twin Dolphin Dr. APPLIANCES-RESIDENTIAL 4.00
RC 94065 41 PANELS 10.00 DATE OF APPLICATION
ARCHITECT ARAM gAMIM, AIA & PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE .C.NO.
E N G I N E A? I 7{J uc.Na.0 8395 SIGNS TRANS. ,3.00
ADDRESS ENG. 20]' Grcnar l Dr. 00 SPECIAL CIRCUIT 5,DB PERMIT VALIDATION
ADDRESS VJ LA 1,.I IDI U UI W
Santa Ana Hts, Ca. X2707 TEMP.METER OR POLE INS. 20.00
APPLICANT'S
ADDRESS 220 C TwinMOTORS SEE FEE SCH.
g4064 Dolphin Dr.
SERVICE CHANGE 20.00 '^
Foo LICENSED CON'1'RACI ORS DECLARATION - 0.A I
a u b I hereby affirm that I am licensed under provisions of Chapter 9 1TSSUANCE OAT' "
y <m (cnntmenang with Section 7000)of Division 3 of the Busia s and BLD ELECT. PLG. MECH.
F a Professions Code, Ll,my license is in full fare nd effect.
z o 2 - License Class_[$_Lic.Number_ IF
9 m H w Date Convector _ `
< x BUILDING PERMIT
rt wOWNER-BUILDER DECLn ION INFORMATION
'w ;LL I hereby affum that I am exempt from the Contractor's License MISC.- REFER TO ORD
al u o a Law for the following reason.(See 7031,5,Businessnnd Professions PERMIT ISSUANCE 10.00 VALUATION f/FT.
Code:Any city or county which requiresa permit toconstrucLaltcq 195 000
Ar ¢ <o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. -ELEC.
DLL requires the applicant far such Permit to file a signed xlatcmad that TOTAL PERMIT TO
w $y he is licensed pursuant to the provisions on the Contractor's License
Hi >
Law(Chapter 9(commenciagwilh Section 7006)of Division 3 oflhe 1
E i o
Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE
CS F the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
u _ by any applicant for a Permit subjects the applicant to a civil Iviially
of not more than five hundred dollars(S500).): ALTER-DRAIN& VENT-WATER (EA.) 5.00 2 SWR
❑ 1,as owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 Oce.GROUP RES.UNITS
their sole compensation,will do the work,and the structure n not
Intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 . 1
Code:The Con De tors License Law does not apply to an owner of
profwnly who builds or improves thereon,and who dos such work FIXTURES-PER TRAP5.00 SO.FT.FLOORAREA TOTAL ACREAGE
memsl re through his own employees.provided that such improve-
menuarenotiughhidoroemployes.provided that r.suhebuilding GAS-EA.SVSTEM-11NC.40UTLETS 6.00 2445
or improvmnenl is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00
builder will have the burden of proving that he did not build or ice- BUILDING USE
Poole for mrpow ofsalc.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer
❑ 1,as owner of the property,an exclusively contracting with ❑ ❑- ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Cole:The Contractor's License Law dr>Ls not apply
to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 ,
contracts for such projects with a contractors)liccoWd Portland to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑ lam exempt under Sec.-,BAP.C.for this WATER HEATERW/VENT 6.00 $067
reason
Owner Dale WATER SYSTEM 5.00 ACO.DATE ACC FILE NO.
wi7RKERS'COMPENSA'I'ION DECLARATION WATER TREATING EQUIP, 5.00
I hereby affrm that I have accrliljcate of consent mvlf-insure,
a ctifir to of Workers'Contpenwtion Insurance,or a cert it icd - ZONING ENG.SITE NO,
er
copy memof(Sec.3800,Lab.CA United Pacific
Policy No. Company
O O Cerlilied alp hereby l umished. FIRE SPRINK ENERGYT]a
Z Z ❑ Certified ed with the city inspection division. MISC.- REFER TO ORD.
O Applicant Y ❑ "❑ Y ❑ N❑
~ lin PERMIT ISSUANCE 10.00
CERTII C,\TE OP EXIT\IPl'ION I'ROhf W'ORKIiRS' FLOOD ZONE A.L.u,1,.
W > COMPENSATION INSURANCE, PLG.CONTR. LIC.NO. PLG. YE]
❑ N❑ Y C] N❑
d O (This section aced not be completed if the permit is for one TOTAL
Z hundred delturs(SWO)or less.)
0 1 eculfy that in the performance of the work for which this per, DTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL F Permso mit is issued,I shall not employ any son in any annera,to
U become object to the Workers'Com Person
Laws of Cali Tamm.
mm.a Date Applicant BUILDING 972,00
} w NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 _
? cmption,you should become sulijeei to the Workers'Compenmtion APPLIANCE "5.00 PLACHECK
provisions of the Labor Code, you must forthwith comply with N{energy 62.D0
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 FEE/ gY
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1.3.65
I hereby aft arm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the perfonnance'of the work for which thispermit is issued ISec. MICROFILM
3097,Civ.C.). Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name-
Leader's Address-�� arta -fill'- HEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC 73.13
I certify that lltrMAdiHi. It pad state that lite abuvc VENTILATION FAN (SINGLE) 4.00 73.13
information is correct I agree to comply with all city and county PLUMBING
ordinances and state laws relating m building constn¢tion, and BOILER-COMPI3H.P.or100,000B.T.U.) 6.00
hemby oulhinize represematives o1' this city m enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL73.13
O 1 3
above-mentioned property for inspection purposes. 73,l 3
'(We) agree to save, indemnify and keep harmless 0m City of MISC.- REFER TO ORD.
Cupertino against Liabilities,judgments, costs and expenses which PERMIT ISSUANCE .10.00 CONST.TAX 288.24
may in Say way accrue against said City in consequence of the
granting of this pen tit MECH.CONT. LIC,NO. MECH. 157D•7p
8 t TOTAL TOTAL
igalureof 'ant/Contractor mate
OFFICE COPY