15108 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED L11)Is°K- USE BALL POINT PEN ONLY
BU I LDING PROJECT IDENTIFICATION 1- PERMIT NUMBER
AO eRr$$Lot 287 Plan *lA APPLIICR .d& PERMIT• . 15108
693 Westshore Court BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
NAME regor roup, Inc. '
Ahmanson eV. 415-595-2100 OTY. ELECTRIC PERMIT FEE
K�1 �
PHONE
CONTRACTOR Y '
NA OUTLETS-SWITCHES•RECEP 10.00/1.00 -
'�regory Group, 1ncL1C NP-430097 LIGHTING FIXTURES 10.00/1.00
CONTRACTORS 220-C Twin 0 p In r. APPLIANCES-RESIDENTIAL 4.00
AOORESVWC 94065 41,5E-595-2100 PANELS 10.00 DATE OF APPLICATION
ORAram
S� ram assenlan, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE ., P.G NO.
ENGINEER AssociatesLIC.NO,
C-8395 SIGNS TRANS. 3.00
ARCO..,0.ENG.2�11 rc ar r7_71T7 7 SPECIALCIRCUIT 5.00 PERMIT VALIDATION
AO J IT'S na Hts. (; 1P EMP.METER OR POLE INS. 20.00 _
APPucnrvrs MOTORS SEE FEE SCH.
»0 I AEOR2�0-C Twin Dollphin Dr.RWC �'y
SERVICE CHANGE 20.00 �I 1 I p�
0 . 94065
0 o LICENSED CONTRACTORS DECLARATION 1 O
1 u w 1 hereby afUrm that I um licensed under provisions of Chapter 9 ISSUANCE DATE
(commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
To-
a,
Professions Code,anti h%license is In full force' I, 17 UP 9 19
�-
z O lo - License Class C-Lie.Number
Q m L a Dute_�p$_Contractor
a r 2 _ Qh of CU lg�
BUILDING PERMIT
Ic w u OWNER-BUILDER DECLARATION - offitINFORMATION
w;LL N I hereby affirm HIM I am exempt from the Contractor's License MISC.-' REFER TO ORD
a, Law for the following reason.(Sec,7031,5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATION
- � Cade:An t or count
w� y city y whiny structure,
prior
t oconsuanc, fen 121 ,788 '
a 2 ¢ FO improve,demolish,or repair any nrucwrc,prior to its issuance,also ELEC.CONTR. LIG NO. ELEC.
ic
w0 LL requires[Ile applicant for such permit l0 file a signed Statement that TOTAL PERMITTO
m be is licensed pursuant to the provisions of the Contractor's License'
rii
Law(Chapter 9(commercing with Section 7000)of Division 3 ofthc SFDU
4 o Business and Professimes Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE
¢ r m the basis for the alleged exemption.Any violation ofsection 7031.5 -STORIES TYPE CONSTR.
u3 � by any applicant fora pemtit subjects the applicant toa civil penalty
of not more than five hundred dollars(5500).1: ALTER-DRAIN&VENT-WATER (EA.) 5.00 2 5NHR
❑ 1,as owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00
their sole 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 R_8 1
Code:The Contractor's License Law does not apply to an owner of
himself r through
builds or improves Imes,pr and who tines illi work FIXTURES-PER TRAP 5.00 EO, B.AREA TOTAL ACREAGE
himself re through Itis own employees,provided that such intprove-
orimprovnetemennimrdedor withinredenrsale.If,mpletion tile the ow er- GAS•EA.SYSTEM-11NC.40UTLETS 6.00
Or owner-
builder
will
is sold burden
o one year of lie did
the owner. GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or im RES IND CON PB Other
,rave for owner purpose or tileJ. INDUSTRIAL WASTE INTER. 30.00
❑ d as owner of the property,am exclusively contracting with
licensed contractors: construct Contractor's
project La 7044,ot apply LAWN SPRINKLERS- 1 INC5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not apply
to anowner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contrtracts for such projects with n rontrtracmr(sl lioens-d pursuant to SEWER-SANITARY-STORM EA.200tt/10.00
the Contractor's License Law. TRACT N0. PARCEL N0.
❑ turn exempt under sec. ;B.&I'.C.lin this WATER HEATER W/VENT 6.00
reason
Owner Data WATER SYSTEM 5.00 Acc.oATE Acct FILE No.
WORKI RS'COMPENSAI ION DECLARATION WATER TREATING EQUIP. - 5.00
1 hereby affirm that 1 have a cerlilicate of consent to self insure. ZONING ENG.SITE NO.
or a certificate Of Workers'Comp-tsalion Insurance,of a yertifi,d
copy thereof(Sec.3800,Lab.C.L 0n 1 tea PdC l f 1 c
Policy No, Cnmpany
Q Cy Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z 2 fd Cert il'im Cy 's tied wi OIe city inspection division.
p: MISC.- REFER TO ORD.
O Applicant Y [D NE] Y ❑ N[3
COMPE
LU CIiR'
w+ lCAT1i : 'ION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C.
- f F
Ill > ' NSATION INSURANCi PLG.CONTR. LIC.NO. PLG.
CL Z (This section need not be completed if IIIc permit Is for one TOTAL Y E] IN Y C] N�
hundred dollars(S 100)or less.)
U O I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mil is issued,I shall not employ any person in any manner'oaa to
O W become subject to the Workers'Compensation Laws of California.
Date Applicant
a ALTER OR ADD TO MECH. 5.00 BUILDING 716.50
>_ m NOTICE TO APPLICANT: If,alter making this Certificate of Ex- '
F Z emNFLption,you Should become subject to lite Workers'Compensation APPLIANCE 5.00 FEE `&ECK 5.50
62.50
Provisions of 11,L Lahor Code, you most forlllwith comply with
V such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=1C.F.M.) 6.00 SEISMIC FEE 8.54
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 perput Is Issued(Sec. MICROFILM
3097,Civ.C.). e tf Pacifl HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Nam.. 11 11 0�zith-f-1-pT HEATING UNIT(OVER 100,000 B.T.U.)9.50 99,88
LaWcr's Address I ELECTRIC
1 certify that I have read this application anti state that the above VENTILATION FAN (SINGLE) _ 4.00
information is correct. I agree to comply with all city and county - - - PLUMBING 49.88
ordinances and state laws relating to building construction, and
BOILER•OOMPI3 H.P.Dr 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon [lie BOILER-COMP (Over 100,000 BTUI SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes. 49.88
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. 288.95
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any way accrue against said City in consequence of the
ranting Of thispen?i L MECH.CONT. LIC.NO. MECH.
�(!/ TOTAL TOTAL 1 ,241.13
SiKnalu App scan for hate
OFFICE COPY
POST THIS CARD NEAR FRONT OF BUILDING
A PF.Rh11T NUMBER
CITY OF CUPERTIN015108
INSPECTION DIVISION
JOB INSPECTION RECORD IIII
1 /-(� '. /�/[�/[� Q yy R �NEXPIRATION
JOB ADDRESS f Io," �/�/LcJI( bre- Com,1 / UNIT# LOT# J"
I/n // ]� y PERMIT EXPIRES IF WORK
OWNER I (/ CONTRACTOR 0[ V 1 Oroly - IS NOT STARTED WITHIN
INSP TI N DATE I INSPECTOR INSPECTION REC RD 180 DAYS OF PERMIT ISSU.
FOUNDATION E ANCE OR 180 DAYS'FROM
NOTE:
_ UFER ALL GRADING AND DRAINAGE SHALL BE�INSTALLED LASTCALLED INSPECTION.
PREGUNITE TO COMPLY WITH THE APPROVEDfb.AIMD CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDAUG 9
UNDERGROUND /SLAB - - -. i i =
PLUMBING: Cupertino i ' 100 _
ELECTRICAL • _.ISSUANCE OAT[
MECHANICAL BLDG ELECT I PLG. MECR
6 b yoxg6sB8 twS W 6c7 F] &7
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED , BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBING
VALUATION SIFT.
� '
MECHANICAL ^1210788
ELECTRICAL PERMIT TO
FRAMING -' SI'DU-
INSULATION STORIES TYPE CONSTR.
2 SNHR
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED —3 1
SO,IT FLOOR.ARIA TOTAL ACREAGE
' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE ' . /S
'
THECONSTRUCTION TAX IS PAID
iB54EwLOION .
ROOFSHEATHING
DIAPHRAGM Q�Q, t' �. Res IND c .. PB on—
APPLYAO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ _❑ ❑ 1—]ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING ELECT:ENERGY S— NIACT NO•.,_ PARCEL NO
TUBS 8 SHOWER PAN. PLUMBING ENERGY
MECHANICAL "' MECH.ENERGY -
ELECTRICALBUILDING ENERGY ACC DATE ACC.PILE NO
FRAMING ELECT.FINAL TEST
ZONING ENG SITE NO.
INSULATION - -� PLUMBING
GAS TEST GAS
MECHANICAL FIRE SPR INK ENERGY T,24
COVER N0 WORK UNTIL ABOVE HAS BEEN SIGNED T EqT NG Y ❑ 'N E] V E) E]
" EXTERIOR SHEAR.
ELECTRICAL RELEASE PLOOD ZONE ALUs
INTERIOR $HEAR , q FIRE DEPT. Y❑ N❑ 'Y ❑ "• NE]
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH _6 TEMPORARY APPROVALS BUILDING 716.50
SCRATCH COAT _ I` ELECTRIC PLAj�I CHECK
GAS FEEknergy 62.00-
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE 8o54
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. 'MICROFILM
ARRANGE FOR INSPECTION BY,PHONING 252-4505, ELECTRIC 49.88
H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 49.88
CD PLEASE GIVE JOB ADDRESS WHEN PHONING. .
ZSEE PERMIT FOR EXPIRATION DATE - MECHANICAL 49.68
IMPORTANT! CONST,TAX 288.95
PLEASE READ REVERSE SIDE BEFORE TOTAL 1 241.19
CALLING FOR FINAL INSPECTION, f
OFFICE COPY