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15124 (2) POST THIS CARD NEAR FRONT OF BUILDINGPERn+IT NUMBER _..� CITY OF CUPERTINO 1`15124 INSPECTION DIVISION JOB INSPECTION RECORD l t b9a W(Whbre Cf. ^�T PERMIT EXPIRATION JOB ADDRESS `7 �I/j11// /' UNIT# _LOT# �( V yyyyyy PWEYfP1RES IF WORK OWNER -CJI C„ V vI VIS' CONTRACTOR 't/�t� V IS NOT STARTED WITHIN INSPEtTl DATE INSPECTOR INSPECTION RE ORD 180 DAYS OF PERMIT ISSU- .. -- FOUNDATION _ ANCE OR 780 DAYS FROM NOTE:' LASTCALLED INSPECTION.. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY.OF NJIMIT VAUDATTON CUPERTINO STANDARDS. w ^E;T GARAGE SLABS PAItD 1 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED '!L-Y'(✓sr-.( UNDERGROUND /SLAB AUG 9 - 1966 if �f, PLUMBING City Of CBperGRO L ti{ I ' ELECTRICAL ISSUAIINCE DATE 'MECHANICAL - eLDe, ELECT.I PLG. mscR b _ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR vnLUATTON $;FT. PLUMBING MECHANICAL ELECTRICAL - .KNIT TO FRAMING STORIES TYPE CONSTR INSULATION OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED rSO f -OR AREA LOT ACHf FGL ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID -WBWLUIUSE ROOF SHEATHING I+esirvo CON Pa Om., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ASSESSORS PARCEL No ROUGH SAN.q 8F PLUMBING ELECT.ENERGY TRAGI NO PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY tt MECHANICAL MECH.ENERGY Tt ELECTRICAL BUILDING ENERGY ACC OnTe ACC FILE No FRAMING ELECT,FINAL TEST INSULATION - PLUMBING It 2GIVING ENG.SITE NO. v GAS TEST GAS MECHANICAL fIHE SPRINK ENERGY T24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Q "� ❑ NEI EXTERIOR SHEAR ELECTRICAL RELEASE FLOODIONE A,L UC INTERIOR SHEAR FIRE DEPT. Y Y 0 N� SHEETROCK . GRADE FEE SUMMARY EXTERIOR LATH' 3. a ALJ BUILDING e'' BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK GAS '. FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FE OCCUPAN CY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ------------------------- uj ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 6036 ONE WORKING DAY.BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESSWHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE- MECHANICAL IMPORTANT! CONST.TAX 28805 PLEASE READ REVERSE SIDE BEFORE TOTAL 1383.21 CALLING FOR FINAL INSPECTION. OFFICE COPY 4PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY\ BUILDING PROJECT IDENTIFICATION I ..PERMI NUMBER. -- BUILnING 11692 Westshore Court APPLICATION & PERMIT q 5 1 n 4 ALot 280 Plan *3B BUILDING-ELECTRICAL-PLUMBING-MECHANICAL I (, OWNER'S - PLAN CHECK VALIDATION NAME Gregory Grou Inc. & DTV. ELECTRIC PERMIT FFEEAhmanson Dev. p4�,�,E595-2100 CONTRACTOR 5 �� NAME p OUTLETS-SWITCHES-RECEP 10,00/1.�s IGregory Group, Inc.LIc.NGB-430097 LIGHTING FIXTURES 10.00/1.CONTRACTORS4 ADOREss pp0-C Twin I n APPLIANCES-RESIDENTIAL 4,RWC 94065 44�,��%Yk PANELS 10, DATE OF APPLICATION' OOPCHITECT ram assenian, ssoc. PANELS (OVER 200 AMP) 20. PLAN CHECK FEE P.C.NO. ENGINEER LIC.NO. ISIGNS TRANS. 3,00 ARCH.ORENG PERMIT VA LIGATION ADDRESS 2031 Orchard Dr. #1 SPECIALCIRCUIT 5.00 Santa Ana Hts. CA. 707 EMP.METER OR POLE INS. 20.00 T APPLICANS MOTORS SEE FEE SCH. ADDRESS 220-C.Twin Dolphin Dr. RWC SERVICE CHANGE pmuo.00 o �I I I � w O LICENSED CONTRACTORS DECLARATION a v v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE vHi st w (commencing with Section 7000)of Division 3 of the Business and¢ H BLDG. ELECT. PLG. MECH. H z Professions Cole,1" license is in full fort ' e,(f ® ®= ®, License Class _• Lic.Number: LI City,01 u�.L.a g z r� Oalc / Contractor_ 1. IY a YBUILDING PERMIT ¢ ¢ ¢ OWNER-BUILDER DECLARATION ¢w O INFORMATION is ;a 1- I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD y VALUATION $/FT: uo ¢ Law for toll owingnty whchnaliTela Business PERMIT ISSUANCE 10.00 l52 727 ac Code: e,dem Y demolish, county whiny structur e permit riot o is issuance, also ¢ ¢ 4 G improve,de111DI15M1,or repair any MNCIOrI',prior t0 It31iSrlanCe,aI50 ELEG CONT,,. LIC.NO. ELEC. D LL requires the applicant for such permit to filen signer)statement that TOTAL - PER MIT TO e w m m he is licensed p"mumo to the provisions of the Contractor's License SFDU H, Law(Chapter 9(commencingwilh Section 7000)of Division 3 ofthc ¢ Business and Professions Code)or Ihat he isexempt therefrom and DTV. PLUMBING PERMIT FEE ¢ r o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. e_ by any applicant for a permit subjects the applicant ton civil penalty ALTER-DRAIN -WATER IEA.) 5.00 2 SNHR of not more than five hundred dollars(5500).1: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 400 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-'3 1 Code:The Contractor's License Law does not apply to an owner of properly who bullas or improves IIICM011,and who does Such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees.provided that such improve- GAS 6.00 menu 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 IEA.) 2.00 - BUILDING USE builder will have the burden approving that Ito did not build or im- proveforpurposeol'sale.)' INDUSTRIAL WASTE INTER. 30.00 RES 7 IND CON PB Omer O 1,as owner of the property,am exclusively contracting with W ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.8. 6.00 ASSESSORS PARCEL NO. and Professions Cade:The Contractor's License Law docs not apply R, an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 - contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.2001t/10.00 Rhe Conlocton s License Law. TRACT NO. PARCEL NO. C3 I am exempt under Sec.-,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Dale WATER SYSTEM 5,00 ACC.DATE ACC.FILE N0. WORKI:RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(See,3800,Lab.C.).united PACIFIC Policy No. Company , ❑Y Certified copy is hereby furnished , - FIRE SPRINK ENERGY T.24 Z p Ap'1¢en`bficA Py til 1 tic.city inspection division. MISC.- REFER TO ORD. y N Y N Cr va ,l PERMIT ISSUANCE 10.00 ❑ ❑ ❑ ❑ Cr - CIL,, CCOFP I°RATION ION FROM WORKERS' FLOOD ZONE A.L.u.C. W COMPIiNSAT10N INSURANCE PLG.CONT,,. LIC.NO. PLG, G, O (This section, need not be completed if the permit is for one TOTAL v❑ N❑ V [:] N❑ ::) Z. hundred doll.,,($100)or less.) UO 1 certify tat in the performance of the work lot which this per DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL 1- mit is issued I shall not employ any person in any mannerso as to O y ALTER OR ADD TO MECH. 5.00 Q become subject to the Workers'Cunlpunsution Luwsol'Cilifo,ria. Uutc Applicant } W NOTICE TO APPLICANT: If,after making this Certificate of fix. BUILDING 825.0 ? coalition,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 0:88�jo provisions of the Labor Code, you must forthwith comply with FEE Ener 6 00 U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY - AIR HANDLING UNIT(OVER 10SWC.F.M.) 6.00 SEISMIC FEE 10.71 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.). Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVEfl 100,0008.T.U.19.50 Lender's Address Fr- " er_-O.T-- T. ELECTRIC 60.35 I certify that I h e I{1 hcetion and swot that the about VENTILATION FAN (SINGLE) 4.00 information is Correct. I agree to comply with all city and county PLUMBING 60.35 ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.1 6.00 hereby euthorim representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTUI SEE FEE SCH. MECHANICAL 60.35 above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. 11 11i": Perrino against liabilities,judgmntes, costs mW expenses which pERM1T ISSUANCE 10.00 CONST.TAX y in any way accrue against said City in consequence of the2Q895 ofing Of Ibis p' nil �LL MECH.CONT. LIG NO. MECH. TOTALTOTAL1383.21 nat a tractor Date OFFICE COPY r