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13820 (2)
POST THIS CARD NEAR FRONT OF BUILDING •- Pf RMI T.NUNIBER - CITY OF CUPERTINO` 13820 ' - INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS IIb-1� SEy c'1� '{`�I"�1� � UNIT# LOT# 11`-' //!!.�R JJ�r,, PERMIT EXPIRES IF WORK DINNER `-T y &` , CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION LAST CALLEDINSPECTION. LEER PREGUNITE PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED `r PAII 1) UNDERGROUND /SLAB PLUMBING z: - DEC2 4 �� •" ELECTRICAL +d ISSUANCE DATE MECHANICAL cm ELECT. PLG. MECR. 0 NOT POUR FLOOR UN IL ABOVE HAS BEEN SIGNED BUILDING PERMITv INFORMATIO WOOD FLOOR - VALUATION $/FT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL ti _•, ,,L FRAMING STORIES TYPE CONSTR. " INSULATION ,az_ .645 OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - - SO,FT.FLOOR AREA TOTAL ACREAGE ' ROOF DIAPHRAGM BUILDING USE IAc . RES IND CON PB OIM1fI Ll 11 El El 1-1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO. ROUGH ild _ . ,11 �/ PLUMBING `L2 TRACT NO. PARCEL NO- GAS TEST MECHANICAL ACC.DATE ACG FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING p- _ SAN ♦ t2" I ZONING ENG.SITE NO. INSULATION PLUMBING (M ttAe GAS FIRE SPRINK ENERGY T24 MECHANICAL � -' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v E] NE] r ❑ rv❑ FLOOD ZONE A.L.U.C. LATH-INTERIOR 2 ELECTRICAL LATH-EXTERIOR FIRE DEPT. v "❑ Y N❑ SHEETROCK IQ-m- GRADE FEE SUMMARY SHEAR INTERIOR' 7 BUILDING SHEAR EXTERIOR - 7 -a7-$8 TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS. ' FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR" MICROFILM WARRANGE FOR F (INSPECTION BY PHONING 252-4505, ELECTRIC � " - ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX r' PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY CITYTF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE Date ......... 19..1/...- Building Permit Nol3i The Building Located at .,., . (!� 7 G . :Pj A----!3 S--- 4L, Z�................ Owned by ..........(S;/26 40-67/-V.. ........ Has Been (Altered) For Use As: .......... .......................................................................................................................................... ........ ........................................................................................................... ............ ....................—...............:........ ............................................. ... .................... ............. PD-7 BUILDING INSPECTOR APPLICANT TO FILL IN INFORMATIPN WITHIN RED LINES — USE BALL POINT PEN ONLY BUILDING PROJECT 1 DENTI FICATION PERMIT NUMBER tlUILDISG 11693 Seven SpriPla ngs Court APPLICA�101� $ PERMIT ADOREss 13820 _ BUILDING—ELECTRICAL—PLUMBING—MECHANICAL (Lot 118 OWNER'S PLAN CHECK VALIDATION NAME QTY. ELECTRIC PERMIT FEE Gregor Group InGHoee 595-2100 CONTRACTORS NAME UTLETS-SWITCHES-RECEP 10.00/1.00 Gregory Group, INc:LIC.ND. 43QQ97 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 ' ADORES$ 2 0 C Twin Dolphin Dr. Redwood Clt Ca PHONe PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMPI 20,00 PLAN CHECK FEE P.L.NO. OR Aram Bassenian, A.I .A. & ENGINEER Associates sec.No. SIGNS TRANS. 3.00 AARCH.OR DDRESS ENG. 1 SPECIAL CIRCUIT 5,00 PER MIT VA LIGATION 990 -lde +yerly Place f PAID New Ort each !1 nr EMP.METER OR POLE INS. 20.00 APPLICANTS 220 C Twin D 1 hln Dr-. - MOTORS SEE FEE SCH. Edy,I'e'fMMpp7L - ' ADDRESS City, CA 9406 SERVICE CHANGE 20.00 w o O LICLNSED CON'IRACI'ORS DECLARATION yi1 pyy.,y,.6�1{Nss1��F a v U I hereby affirm that I am licensed under provisions of Chapter 9 IBsu NC/. E DATE (commencing with Section 7000)of Division 3 of the Business;and BLDG. ELECT, I PLG. MELH. Professions Code,ark m license is in full fury gr}(1,(f,({t. i o License Classn_Lie.Nlunber µ31)1J y./ © �, 2= Ha, Date Contractor ¢ y BUILDING PERMIT ¢ re OWNER-BUILDER DECLARATION INFORMATION u, wa> MISC.— REFER TO ORD I. y I hereby afftrtn that I am exempt from the Contractor's License VALUATION S/FT. H LLoj Law for the following reason. 7031.5,Businev and Professions PERMIT ISSUANCE 10-00 Code:Any city or county which requires a permit w construct,alter, A_a�s ¢ ¢ < 0 improve,demolish,ser repair arty structure,Prior to its isnuncc,alw ELEC.CONTR. LIC.NO. ELEG D u requires the applicant for such permit to File a signed statement that TOTAL y PERMIT TO ic whe is licensed pursuant Io the provisions of the Contractor's License- Esa WL U z i Law(Chapter 9(commencing with Section 7000)of Division 3 of the e� f 1 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE IS r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by my.pphaint fora permit subjects the applicant nacivil Nmilty ALTER-DRAIN -WATER IEA) 5 of not more than five hundmd dollars(5500).): . .00Y �N ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended cur offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,CONO. 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 ( F IXTUR ES-PER TRAP 5.00 SO.FT FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- GAS-EA.SVSTEM-I 6.1x) meats are not Intended or offered for sale.If,however,the building 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 sale.). INDUSTRIAL WASTE INTER30.00 RS IND CON pe Other . O 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(See 7044,Business LAWN SPRINKLERS-1 INC 5 V.B- 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 34 6 --!F— 3�3. .JJ contracts for wch projects with a contmctods)licensed pursuant to the Contractor's License Law: SEWER-SANITARY-STORM EA..200ft/10.00 / TRACT NO. PARCEL NO. O lam exempt render Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 79gS` mason Owner Date , WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 1 5.00 1 hereby affirm that I have a venificate of consent to self-Insure, ZONING ENG.SITE NO. or a certificate of Workeri Compensation Insurance,or a certified eppy thereof(Sce.3800.Lan C.l.United Pacific/Re Policy No Company O ❑ Certified Copy is herebyfumi icd. FIRE SPRINK ENERGY T-24 z = ❑ Cerlificd cop is city inspection division. MISC.- REFER TO ORD. O Applicant_ — i v V❑ N❑ Y ❑ N❑ CC w PERMIT ISSUANCE 10.00 LU CIiRT114CA' NSAiI N INS PROM WORKERS' - FLOOD ZONE A.Lu.c. W C PENSATION INSURANCIi PLG.CONTR. LIC.NO. PLG. EL Z (This section need not be completed if the permit is for our TOTAL / Y❑ N❑ Y❑ N❑ hundred dollars IS I W)or less.) U O 1 certify that in the performance of the work for which this per- QTYMECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued. I shall not employ any pmsun in any manner w as to ❑ become wbject to the Workers'Compensation Laws of California. B Dal Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING t/LQ xfa } W NOTICE '1 T:'O APPLICANT If,after nuking this Certificate of Ex- Z emption,you should become wbject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK pp provisions of Ilse Labor Code, you must forthwith comply with TEL Jf X3-3 ro U such pvisions or this permit shrillee be dmed revoked. AIR HANDLING UNIT(TO 10)bOGF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10JX10C.EM.) 6.00 SEISMIC FEE c) 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 .p Lender's Name Security PaeifiCA HEATING UNIT(OVER 100,1x)0 B.T.U.19.50 ELECTRIC /p4—dt9 Lender's Address$S —�_ranC4- _6 . 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 mol,mnces and state laws relating to building construuion, and BOILER-COfvP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of the city to enwr upon the BOILER-COMP(Over 110,1X10 BTUI SEE FEE SCH. MECHANICAL OD, ahove-mentioned property for inspection Purposes v (We) BI to save, Indemnify and keep harmless th< City of MISC.- REFER TO ORD. p Cupertino against liabilities,judgmunts, rods and expenses which PERMIT ISSUANCE 10,00 CONST.TAX O ca may in any w ccrue ogairut d City iI consequence of the granting of MECH.CONT. LIC.NO. MECH. d —/ // OTA, / TOTAL zjG�S� Slgnatum of leant/Con clor ate OFFICE COPY