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15112 (2) POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15112 INSPECTION DIVISION h JOB INSPECTION RECORD JOB ADDRESS I�I Sod+!/W re `/ ORH - �UPIRATION UNIT# _LOT# j� //��//''��{� �1[' A✓ /' I'-/1'I PERMIT EXPIRES IF WORK OWNER (gre 1/r L/I DVS CONTRACTOR r DI (,7I LVL IS NOT STARTED'WITHIN INSPECTION DATE INSPECTOR INSPECTION N RECORD 180 DAYS OF PERMIT ISSU FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHPT IkISTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLA_N'S AND CITY OF PERMIT VALIDATION GARAGE SLABS CUPERTINO STANDARDS. AUG 1968 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED— UNDERGROUND /SLAB IGNEDUNDERGROUND /SLAB Clltl Of CUPertinD PLUMBING ELECTRICAL Issunrvce DATE MECHANICAL - 8106 ELECT PLO, MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING / VALUATION $SFT. MECHANICAL ELECTRICAL - nuT ro FRAMING INSULATION STORIES 11 WUECONSTR ([ On-Gr /N7�«.oy cHauP N UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE soDR AREA CREAGe TOTAL THE CONSTRUCTION TAX IS PAID "" DIAPHRAGM h[ BUILDING use ROOF SHEATHING Res INu CON PB ppwi . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH SAN.q 45 3 nssessoas Pnacel No PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY -TRACT No. PARCEL NO MECHANICAL MECH. ENERGY III ELECTRICAL BUILDING ENERGY _ D, ACC.DATE ACC FILE NO FRAMING a _ 5 ELECT.FINAL TEST - INSULATION _ _ PLUMBING Q ZONING ENG SITE NO. GAS TEST GAS E MECHANICAL _ FIRE SPRINK ENERGY raa COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Q ` ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE PLDOD ZDNE ALuc INTERIOR SHEAR FIRE DEPT. v ❑ N❑ v ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH _ 'TEMPORARY APPRO/ LS BUILDING SCRATCH COAT ofz. ELECTRIC PLAN CHECK GAS FEE 15:50 NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY - SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY-PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. 55 1 \• - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL r IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE 988 95 CALLING FOR FINAL INSPECTION. TOTAL. 318.88 OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USS BALL POINT PEN ONLY PERMIT NUMBER BUILDING PROJECT IDENTIFICATION ATION APPLICATION & �ERMIT - 1 51 1 2' ' 'A.DRENG Plan *2A An11711 Southshore Court BUILDING -ELECTRICALlF1 UM ING-MECHANICAL OWNERSGregory Group, Inc. & PLAN CHECK VALIDATION Ahmanson DeV. JAPPLIANCES ELECTRIC PERMIT FEE <DNTRACTORS ��`-595-2100 � diX%XN NAE TLETS-SWITCHES-RECEP 10.00/1.00 Gregory Group, Inc.L1C N(P-430097HTING FIXTURES 10.00/1.00 noo Ess TORS 220-C Twin Dolphin Dr. -RESIDENTIAL 4.00 RWC 94065 P14r1b-595-2100NELS 10.00 DATE OF APPLICATION ORCRITECT Aram Bassenian, AIA & NELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ARC EA'995ciaTES Oc.No. C-8395 SIGNS TRANS. 3.00 ARCH.ORENO 2031 Orchard Dr. #100 SPECIALCIRCUIT 5.00 PERMIT VALIDATION A'§anta Ana Hts. Ca. zl02707 EMP.METER OR POLE INS. 20.00 noo essTs MOTORS SEE FEE SCH. J- , 220-C Twin Dolphin Dr. RWC 94065 SERVICE CHANGE 20.00 °¢�'CI P%R_ 1 LO LICENSED CON DECLARATION a ND I hereby affirm that I am licensed under provisions of Clmpler s) - y z w ISSUANCE DATE (commencing with Section ons,l a Division 3 of the Business and ,- y z Professions Code,and,my license. In full 1 y�{07 BLDG. ELECT. PLG. MECH. ' o.; License Class D Lic.Number 4 Vuy/ ❑ ❑ o N � Datc �.�Contructor�� X X XLRLI X a w a OWN[R-BUILDER DECLARATION BUILDING PERMIT ' °n MISC.- PO INFORMATION X o Icy I hereby affirm that I um exempt from the Contractor's License F LL o ¢ Law I'or fico following reason.l5ce.]031.5.Business and Professions VALUATION $/FT. Code:An 't orcount PERMIT ISSUANCE 10.00 O hay y it my struiture p riot t o is issuance, also 136 306 R 0 a improve,demolish or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. , 6 requires the applicant for such permit to file a signed statement that TOTAL w m he s licensed pursuant to the provisions of the Contr:¢tor's License PERMIT TO F z a Law(Chapter 9(commencing with Section 7000)of Division 3 of the SFDU E 4 o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢I- the basis for the alleged exemption.Any violation o'Section 7031.5 a 3 $ by any applicant for u permit subjects the applicant too civil Wealth STORIES TYPE CONSTR. of not more than five hundred dollars(55001.): ALTER-DRAIN&VENT-WATER (EA.) 5.002 SNHR ❑ 1,as owner of the property.or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 their stilt,compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 l Code:The Contractor's License Law does not apply to an owner of R-3 property who builds or improves thereon,and who Anes such work FIXTURES-PERTRAP 5.00 s0� AREA TOTAL ACREAGE mmshimself re of rote his own mored for, le.If,ed that such improve- orimpTvernenntendedorofl' oneyaro If, the the owner- GAS-EA-SYSTEM-11NG4OUTLETS 6.00 or lder will have rs sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have fico burden of proving that he did not build or im- BUILDING USE Prove for purpose of sale). INDUSTRIAL WASTE INTER. 30.00 RES I❑ ❑N FlyEl 1:1❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 and Professions Code:The ContruClor's License Law docs lint apply ASSESSORS PARCEL NO. to all owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts far such projects with a contmclorfs)licensed pursuant to fila Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. rca❑ml am exempt under Sec. ,B.&P.C.tin this WATER HEATERW/VENT 6.00 Owner Dale WATER SYSTEM 5.00 ACC.DATE ACG FILE NO, WORK fiRS'COMI'ENSATION DECLARATION WATER TREATING EQUIP. 5.00 - I hereby affirm 111-11 have a Onlificme of conecnl to self-insure, or it certificate of Workers'Compmisation Insurance.or a certified ZONING ENG.SITE NO. eopythereof(Set.3800,Lab.C.).United Pacific Policy No. Company O ❑ Certified copy is hereby furnished. Z Z X'fJ� Certified y is II•d with he city inspmlion divixion, FIRE SPRINK EN ERGV T44 FO 41lliczmt_,/r CA, _ MISC.- REFER TO ORD. yYEJ NEI Y NE] � N CERT FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPENSWION INSURANCE. PLG.CONTR. LIC.NO. PLG CLO 11 his section need not be completed if the permit is for one TOTAL Y[:] N[JY C] N U O hundred dollars IS 100)or less.) I ratify that in the performance of the work for which this per- QTY MECHANICAL PE RFd1T FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. 1 Dal` APPLICANT. ALTER OR ADD TO MECH. 5.00 BUILDING } 2 NOTICE TO APPLICANT: 11;after orating(his Certificate al' iEx-on 776.00 empt(_ Or visions you the L become Code, Youtli the Workers'Commensal ion App LIANCE 5.00 PLAN CHECK provisions of the Labor itsh you dost drevoke comply with FEE Ener C..) such provisions or this permit Shull be Deemed revoked. AIR HANDLING UNIT(TO 10,000GF.M.) 4.00 9Y 62.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.F.M.) 6.00 SEISMIC FEE 9.73 1 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.). :VENTILATION =(SINGLE) 100,000 B.T.U.) 8.00 Lender's Name;,: e u it Pacif�i� Lanier',Addm � �_ rU, 4th�1T'. ER 100,000 B.T.U.19.50 ELECTRIC 55.50 1 certify Ilia,I have read Ihis application and sale Ihm the above N (SINGLE) 4.00imnmalion is correct. I agree to comply with all city and countyPLUMBING 55.50 ordinances and state laws relating to building construction, and ,of 100,000 B.T.U.) 6.00hereby authorize representatives of Ihis city to enter upon theabove-mentioned property for inspectionpurposus. 100,000 BTU)SEE FEE SCH. MECHANICAL 55.50 (Wc) agree to save, indemnify and keep harmless the City of REFER TO ORD.upertino against liabilities,judgments, costs and expenses whichTAX ay in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 CONST. 288.95 ranting oft s mit. - / MECH.CONT. LIG.NO. MECH. Sign ore p nUactor Date oma/ TOTAL TOTAL 1 ,318.68 OFFICE COPY //