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15881 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15881 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS �� a p /+4 Sfie/HG l UNIT# LOT# PERMIT EXPIRES IF WORK OWNER - CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED _ PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF - PERMIT VALIDATION GARAGE SLABS CUPERTINO STANDARDS. > i -1 �y� � 0 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 41� UNDERGROUND /SLAB MAYPj 3 1S;;_I PLUMBING V p ,L1�p � ELECTRICAL Lill yDperfiRO ISSUANCE OAT E MECHANICAL BLDG ELECT I PLG. MecR. 1F DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING - I VALUATION SIFT. MECHANICAL ELECTRICAL PERMIT To FRAMING INSULATION �. STORIES TYPE CONSTR \N I`V[�s�-.'CV�C.0 T-� `-QS V• OCC GROUP HES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE: FT FLOOR AREA TOTAL ACIiEAGL NOTE:NO FINAL INSP.SHALL BE MADE BEFORE .DIAPHRAGM THE CONSTRUCTION TAX IS PAID t ; — _ I I\ I )\ ROOF SHEATHING Itorls BUILDING use HES IND CON PB Co.- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. a ❑ ❑ ❑ ❑ ROUGH SAN.N I arj 2A�sse/ssORWARCRO PLUMBING ELECT.ENERGY 5,601- 156 :.40 TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT No PARCEL Nur MECHANICAL MECH.ENERGY - em ELECTRICAL BUILDING ENERGY ACC.DATE ACC FILE NO FRAMING ELECT.FINAL TEST INSULATION !HE UMBING zoNiNc ENG SITE No. GAS TEST S CHANICAL EIRE BP"" ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED ATING Y ❑ N❑ Y ❑ N❑EXTERIOR SHEAR 0 ECTRICA ASE , rLOOD ZONE ALUC INTERIOR SHEAR FIRE DEPT. Y❑ N❑ Y I] N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING M.00SCRATCH COAT ELECTRIC PLAN CHECK 15.50 GAS FE 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 w ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 60.90 ~O� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 60,50 Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL 60.90 IMPORTANT! CONST.TAX .(2 PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL 1,Q05,Q] OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ' BUILDING PROJECT IDENTIFICATION PERMIT NUMBER gDILOING11 W3 �� APPLICATION & PERMIT 15881 AOOREss BUILDING-ELECTRICAL-PLUMBING-MECHANICAL t-a CLt OWNER'S PLAN CHECK VALIDATION NA _gory GrOUp, IrC, 415/595-2100 QTY. ELECTRIC PERMIT FEE P.ON CONTRACTOR E(�,�,.ry Group 1nC. OUTLETS-SWITCHES-RECEP 10.00/1.00 v' yy](� /� LIC.NO.B-Q LIGHTING FIXTURES 10.00/1.00 NONRESSTORL.LI/-l� Twin Dolphin Drive PPLIANCES-RESIDENTIAL 4.00 RWC CA 94065 I..N415/595-21 W PANELS 10.00 DATE OF APPLICATION ARCHITECT BaSSenian/Lagoni Architects P_ on 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.N/O.(Cy-��95 SIGNS TRANS. 3.00 ADDRESS ENG,2031 Orchard Drive 1/100 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ARCH.OR LV 0rchard UI Santa Ana 11-1 t5 CA z1P92707 TEMP.METER OR POLE INS. 20.00 r ' r�j/J•'y APPLICANT'S q ADDRESS 220-0 Twin Dolphin Drive MOTORS SEE FEE SCH. I Redwood City, CA 94065 SERVICE CHANGE 1 20.00 ] woo LICENSED CONTRACTORS DECLARATION �l Q�[/11 ,,i w I hereby affirm the, 1 am licensed under provisions of Chapter 9 q T+ n, �� V J ISSUANCE GATE (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. t,w z Professions Code,pnA my license is in full foreppgqppl�),,r�,((ff��d. Z o w- License Class_D Lie.Numbcr 4.SlA QL � � O o _O Date- ContractorCity F F J BUILDING PERMIT a y E J ¢ m w a OWNER-BUILDER DECLARATION o A " INFORMATION y 1 hereby affirm that I am exempt from Ole Contractor's License MISC.- REFER TO ORD LL O ¢ Law for the following reason.(Sec.7031.5,Businessand Professions VALUATION $/FT. - J PERMIT ISSUANCE 10.00 m Code'Anyntyor County pair any requires ep ilottmCOnSLIdnealter, H } ELEC.CONTR. LIC NO. 1 C/I flg0 rc ¢ ¢e, improve,demolish,or repair any structure,prior n its iatement also ELEG JJYY JLL o u he virus the applicant for such permit to file a signed statement that TOTAL PERMITTO A w m m he is licensed pursuant to the provisions of the Contractor's License rzQ Law(Chapter I)(commencing with Section 7000)o f Division 3 of the SFDU Y O Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ I-m the basis for the alleged exemption.Any violation of Suction 7031.$ STORIES TYPE CONSTR. a3 _ by any applicant for a Permit subjects the applicant to a civil penalty ALTER-DRAIN (EA.) 5.00 of not more than five hundred dollars(5500).): 5 ❑ L as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 4.00 2 their sale compensation,will do the work,and the structure is not . OCC.GROUP RES.UNITS intended or offered for sale(Sec. 7044, Business and professions Code: ROOFAREACOND. 500 Code:The Contractor's License Law does not apply to an owner of , , , . . R-3 • property who builds or improves(hereon,and who docs such work FIXTURES-PE E S-PER TOTAL ACREAGE TRAP 5.00 .Fr.PLooR AREA himself or through his own employees.Provided that such improve mems are not intended or offered fou-sale.If,however.the building GAS-EA.SYSTEM-11NC.40UTLET$ 6.00 �G'/'_ 11 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 `��{{�� L•IIII builder will have the burden of proving that he did riot build or an- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other ❑ 1,as owner of the property,am exclusively contracting with AN'001 El El El licensed contractors to construct the project(Sec. 7044,Bnsinese LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 and Professions Code:The Contractor's License Law don nut apply ASSESSORS PARCEL NO. to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 Z/_r /V�/_ contracts Iorsuch projects with a contracloos)licensed pursuuN to �.7�41� CLGYJ the Contractors License Law. SEWER-SANITARY-STORM EA.200ft/10.00 pT�Ry6�p(CACT PA02,60. n lam exempt under Sea ,B.&ItC.lits this reason WATER HEATER W/VENT 6.00 OV90 Owner Date WATER SYSTEM 5.00 ACC.-DATE ACG FILE NO. WORK ERS'coMPErvsATlory DECLARATION WATER TREATING EQUIP. 5.00 ' I hereby affirm that I have a certoicareofconsent toself-insane, or a certificate of Workers'Compensation Insurance_or a certified ZONING ENG.SITE NO. copy thereof(Set.3800,Lab C) �L��}s,� t� G Policy No. Compeny vi tL E.GU_f_ad iC_ Q ❑ Certified copy is hereby furnished. z Z [Ai Ce rufied it filed with Om y inspection division. FIRE SPRINK ENERGYT24 AD REFER MISC- REFER TO ORD. v � N� CC F O PERMIT ISSUANCE W CIi RTI 171CA'I'I.'OF EXEMPTION FROM WO RK Ii RS' 10.00 FLOOD ZONE A.L.U.C. LULU 0 COMPENSATION INSURANCE PLG.CONTR, LIC.NO. PLG. (T � his section need not be completed if the permit is for one TOTAL Y❑ N� Y - N� Z hundred dollars IS 100)or less.) U O I certify Thal h the performance of the wink for which this per- VQTY. MECHANICAL PERMIT FEE FEE SUMMARY 0 U mit is issued,I tooth not employ any person in any Ina nnursn is toU Do bate suhjoct to the Workmi Cmnpunsatiun aws of 011ifornin. a n,dL nppl¢°m R ADD TO MECH. BUILDING } N NOTI CIi '1'O APPLICANT: 11,after making this Certificate of Ex. 5.00 832.00F ? emption,you should become subject to the WorkuriCompensationCE5.00 PLAN CHECK 15.50 provisions of the Labor Code, you must forthwith comply will,such pravisionx or Wis permit shall be deemed revokeJ. LING Urqy 62a) MT(TO 10,000GF.M.) 4.00 FE ErleCONSTRUCTION LENDING AGENCY LINGUNIT(OVERI0=C.F.M.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency forT HOOD (WITH DUCT) 5.00 the Perfannance of the work for which this permit is issued(Sec. 3097,Civ.C.L HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Lender's Address HEATI NO UN IT ER 100,000 B.T.U.)9.50 ELECTRIC 60,90 1 cer,he Ilia,l base read this applicat ion and ,are that the above VENTILATION FAN (SINGLE) 4.00 information is correct.1 agree to comply with all city and county PLUMBING 60,90 Ordinances and state laws relating to building construction, and BOILER H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOI LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL 60.90 (We) agree H save, indemnify and keep harmless ,be City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, Costs and expenses which CONST.TAX may in any way accrue againsl said City in conseq uente of the PERMIT ISSUANCE 10.00 ,' runt gof Ibis permit. MECH.CONT. LIG NO. MECH. TOTAL TOTAL 1,405,07 Signature of Applicant/Contractor Date OFFICE COPY