13532 (2) POST THIS CARD NEAR FRONT OF BUILDING PEHNITNUMBER
CITY. OF CUPERTINO � s53ZV
INSPECTION DIVISION
JOB INSPECTION RECORD
PERMIT EXPIRATION
_ JOB ADDRESS 11631 ,SEVEN SPRINGS UNIT# LOT# 24
PERMIT EXPIRES IF WORK
OWNER GREGORY GROUP CONTRACTOR GREGORY GROUP. IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF,PERMIT ISSU.
ANCE OR 180 DAYS FROM
FOUNDATION L
LIFER LASTCALLED INSPECTION.
.j(ff
PREGUNITE / - PERMIT VALIDATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -%
UNDERGROUND /SLAB .P-� X
PLUMBING
-
ELECTRICAL ISSUANCE DATE
MECHANICAL - BLDG I ELECT. PLG. MECH.
O 2 cl
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR VALUATION $/FT.
PLUMBING
7
MECHANICAL _ '
ELECTRICAL .PERN+rt TO L..
v
FRAMING
. STORIES TYPE CONSTR.
IN ULATION
J ✓
OCC.GROUP RES.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED S ,
- $O,FT.FLOOR AREA TOTAL ACREAGE
ROOF
DIAPHRAGM S
.� '- D ILDCON CON
RESINPB Oros'
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED O• O El O O
ASSESSORS PARCEL NO.
ROUGH
PLUMBING .1Z
TRACT NO. PARCEL NO.
GAS TEST r•
MECHANICAL -
DATE ALC.FILE NO
ACC. .
ELECTRICAL FINALS DATE INSP. -
FRAMING SAN k
ZONING ENG.SITE NO,�/
INSU CATION Qpm --� PLUMBING
Ma.. GAS GAS
FIRE SPR INK ENERGY LO<
MECHANICAL '
COVER NO WORK UNTIL ABOVE HAS BE N SIGNED j HEATING Y.O NO v O NO
. .
LATH-INTERIOR - ELECTRICAL FLOOD ZONE AL.0C.
LATH-EXTERIOR - FIRE DEPT. - YE] NO Y O NO
SHEETROCK - GRADE - FEE SUMMARY
SHEAR INTERIOR Pc� U+ BUILDIN
SHEAR EXTERIOR 2"1VAiLS - BUILDING
-Z - TEMPORARY APPROVALS .
FIREWALLS ELECTRIC PLAN CHECK
GAS
OCCUPANCY
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED - SEISMIC FEE IGS
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
0
F'•� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBIniG —
PLEASE GIVE JOB ADDRESS WHEN PHONING.
+ zl
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL.
CONST.TAX r
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE �-
TOTAL -.
CALLING FOR FINAL INSPECTION. -
OFFICECOPY 4 -^ y
AP?_ CANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
;,/BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
BUILDING . + T APPLICATION & PERMIT
V76tADDRESS _ •�'��'J' BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 13532 '
OWNER'$ PLAN CHECK VALIDATION
"AME Gregory Group, Inc. QTY. ELECTRIC PERMIT FEE
E PHONE rj
ANT S
NAME
UTLETS-SWITCHES-RECEP 10.00/1.00
NOME
L\,
Gregory Group, Inc-.uc.No, 430097 LIGHTING FIXTURES 10.00/1.00
ADDRESsroR3 220 Twin Dolphin. Dr. , [APPLIANCES-RESIDENTIAL 4.00
REdwood Cit CA PHONETj L9rj-2 PANELS 10.00 DATE OF APPLICATION
PLAN CHECK FEE P.C.NO.
OR
- PANELS (OVER 200 AMP) 20.00
DR Aram Bassenian, A.I.A.
ENGINEER
& OREN .Associates LIC.No. SIGNS TRANS. 3.00
iooaiss ENG. 3990 Westerly Pl. , #170 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
Newport h zIP EMP.METER OR POLE INS. 20.00
ADDRESS 220 Twin Dolphin Dr. , "CII MOTORS SEE FEE SCR. /
Redwood City- CA 94065 SERVICE CHANGE 20.00 n
o a O
LICENSED CONTRACTORS DECLARATION - +r'�/�,�/a
a v G I hereby affirm that I ton licensed under provisions oCChapler 9 ISSUANCE DATE
n ar "' (eonunencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
a 'g' ProfcMions Code,a rey hear c is in full lirtc �p•Qe fly . e
Z o License Cle Lie.Number-
2 = w Date 112f, Contractor
"a a OWNER-BUILD DEC TION BUILDING PERMIT
_ d INFORMATION
X
N 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
LLoe Law for the following naw". Sac.1031.5,Rusinessand Profusions PERMIT ISSUANCE 1000 VALUATION S/FT.
L - Code:Any city or county which requiresx permit tonestmet,alter,
a Q Q Q N
Improve.demolish,or repair any stCELEC.R.from to it,oommee.also ELEC.CONTR. LIC.NO.
ELEC.
DLL requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
whe is licensed pursuant to the provisions of the Contractor's Licence
F z a law(Chapter 9(commencing with Section 7000)of Division 3 of the
5 i O Business and Profmions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
a � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER IEA.) 5.00
of not more than five hundred dollars(S500T)'.
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00OC 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,AR EA,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 FIXTURES-PER TRAP 5.00 Ba PT.FLOOR AREA TOTAL ACREAGE
himsenods Cor not intended
ownemployees,for sale.
If,
ed that however,Th improve- GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00
' menu are no[Intended or offend for sale.If,however,the budding
or improvement is sok within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving Ilial he did not build or int- RES IND CON PB Osnn
`j prove for purpose of sale.). _ INDUSTRIAL WASTE INTER. 30.00
Cl I,as owner of the property,am exclusively Contracting with ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7144,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASS OP PARCEL NO.
end 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 is contructons)licensed pursuant to
the Con tractors License Law. SEWER-SANITARY-STORM EA.20011/10.00 TRACT NO. PARCEL NO.
❑ 1 am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM'' 5.00
ACC. ATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have It certificate of consent lD self-insure, ,•• t "Y \" ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance.or a certified
copy thereof(Sec.3800,Lab.cited p `P /
Policy No. Company n gni fi rT/Ra l/Bal
O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-2e
Z ZO EX Certified - f the city inspection division. MISC- RE FER TO ORD. C-] ❑ ❑ ❑
A�{Tlicant- V N V N
ti CERTI ATE OF EXE PTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 c.
Lu > COMPENSATION INSURANCE, PLG.CONTR. LIC.NO. PLG.
CL a (Phis section need not be completed if the permit is for one TOTAL /,1r Y❑ N❑ Y ❑ N❑
hundred dollen IS 100)or I..)
U O 1 certify that in the perfomrance ol'thc work for which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued,1 shall not employ any person in any mannerso as to
become subject to the Workers'Compensation Laws of California. ,��
Is. Date-Applicant ALTER OR ADD'TO MECH. 5.00 BUILDING
} us NOTICE TO APPLICANT: If,after making this Certificate of Ex-
F_ Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith Comply with FEE a•�
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 1O=C.F.M.) 4.00 r
CONSTRUCTION LENDING AGENCY AIR HANDLING UNfT1OVER10=C.F.M.) 6.00 SEISMIC FEE �O 80
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.). ) �G HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name _�-/ HEATING UNIT(OVER 100,000B.T.U.)9.50 ELECTRIC /
Lender's Address
I certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
nh ordinances and state laws relating to building construction. and BOILER-COMP(3 H.P.or 100,000 B.T.U,) 6.00
hereby authorize representative of this city to enter upon the
�..
/ BOILER-COMP(Oxer 100,000 BTU)SEE FEE SCR. MECHANICAL
above mentioned property for inspection purposes. S
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments,costs and expenses which CONST.TAX
may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 /p
granting of this per MECH.CONT. LIC.NO. MECH.
90? 7 TOTAL TOTAL
Signatu -Applicant naactor Dat
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OFFICE COPY /dam^ •