14949 POST THIS CARD NEAR FRONT OF BUILDING
I •- , : PERMIT NUMBER
' T C_ ITY- OF . CUPERTM- ' 1494
INSPECTION DIVISION 1.t
JOB INSPECTION.RECORD
1 / /A�/ + PERMIT EXPIRATION
JOB AD DR ESS�1_�SL Aex PO•Pot 6, d/L�t'c—UN I T# LOT#Is - , PERMIT EXPIRES IF WORK
OwrvE N CONTRACTOR � lyrQQ!(P IS NOT STARTED'WITHIN
INSPECTLON - DATE INSPECTOR INSPI54CTION RECORD 180 DAYS OF. PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION �I NOTE: LASTCALLED INSPECTION. '
UFER - 7 (p ALL GRADING AND DRAINAGE'SHALL BE INSTALLED -
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS. _
GARAGE.SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED IO— ow
.UNDERGROUND /SLAB - - :
f
PLUMBING
ELECTRICAL ` ISSUNNCE DATE
MECHANICAL - BLDG ELECT. PLG. MECR
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR n INFORMATION '
r VALUAIION SIFT
- PLUMBING -
MECHANICAL
ELECTRICAL _ p PERnIn Tu
FRAMING Cu of •"
INSULATION STORIES TYPE CONSTR� I
2
OCC GROUP RES.UNITS
.PLACE NO SU�BFLOOR UNTIL ABOVE HAS BEEN SIGNED R-3. I
r' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE 5O'"'F'.00a AREn TOTAL ncREncc
DIAPHRAGM.,, THE CONSTRUCTION TAX IS PAID
4 9 UII.DINC USE
ROOF.SHEATHING 2' + IN., FON PB 0,n.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED '.FINALS DATE INSP. SE EL
nssessons PARCEL NO
- ' ROUGH SW
PLUMBING - ELECT.ENERGY - TRACT NO, PARCEL NO
TUBS&SHOWER PAN y o V/� PLUMBING ENERGY 7,
MECHANICAL '0 - p MECK ENERGY
ELECTRICAL BUILDING ENERGY ACC DATE, Acc.FILE No
FRAMING - - ELECT.FINAL TEST
ZONING ENG SITE NOi -25c .
INSULATION - PLUMBING
GAS TEST Z,/: GAS - j2,+
FIRE SPRINK ENERGY T-]4
MECHANICAL 'N� v .N�
COVER NO WORKUNTIL ABOVE HAS BEEN SIGNED HEATING '
EXTERIOR SHEAR cl_Z7J 11ELECTRICAL RELEASE ,S, - .FL000 zorvE n.l.uc.
INTERIOR SHEAR- - FIRE DEPT.' Y❑ No Y ❑ No
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING -
BUILDING
•, , 'INTERIOR LATH � !.: . � ' TEMPORARY APPROVALS
SCRATCH COAT ELECTRIC �- PLAN CHECK.
GAS FEE [ �y' C�
j NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY .. . IC'PEP SEIS •w
I " OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ,
I
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELEcrBlc
LID
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
OPLEASE GIVE JOB ADDRESS WHEN PHONING. '
Z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
.35
IMPORTANT! CONST.TAX 288.24
PLEASE READ REVERSE SIDE BEFORE'
CALLING FOR FINAL INSPECTION: TOTAL 1590.31
OFFICE COPY
CITY OF CUPERTNO
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
Z-0
Date ..........
Building Permit
The Building Located at
Owned by
�_f .(;;r ,f�>.. ...... 0 .. .... ....... . ..................
Com fete
Has Been � For Use As:
(Altered) . .............
.. ........ ..... .. . . ........ .. ............... . ...... .......... .
......................... ................................................................................................................
................ ...................................................................................................................
PD-7 ................................... ..........................
BUILDING INSPECTOR
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
♦ •r• UPROJECT IDENTI FICATION PERMIT NUMBER
BILDING
' DIL BU APPLICATION & PERMIT 14949.
� (�
.b ' t ADDRESS 11551 Lake Spring Court BUILDING - ELECTRICAL-PLUMBING-MECHANICALPlan 3A J J
D 'SPLAN CHECK VALIDATION
NAME GregoryGY+OUp, If1C. Rt QTY. - ELECTRIC PERMIT - FEE
rJpVeJnpMEntq PHON415-595-2100
CONTRACTORS
NAME UTLETS-SWITCHES-RECEP 10.00/1.00.Grolp '
LIC.No. LIGHTING FIXTURES 10,00/1.00
r.OrvTRAC R' PPLIANCES-RESIDENTIAL 4.00 _
ADDRESS 220 C Twin DoIng RWC
ON PANELS 10,00 DATE OF APPLICATION
415 595 21136
APANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.c.No.
OR
ENGINEER ARAM &AMIAN •ALR.8D.ASSTIATES SIGNS TRANS. 3.00
nooHESS ervc C-Q3(35 SPECIALCIRCUIT 5.00 PERMIT vnuonnoN -
2031 Orchard Dr.#100
zlv. TEMP.METER OR POLE INS. 20.00
APSMAs _ MOTORS SEE FEE SCH. �-1,rJaLgv
ADDRESS
220 C Twin Dolphin Dr. M 94065 SERVICE CHANGE 20.00
0 0 o LICENSED CON'T'RACTORS DECLARATION Q a
u o I hereby affirm that I am liesmonfunder provisions of Chapter 9 ISSUANCE DATE
m a (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. PLG. MECH.
+ r y Z Professions Code,and license is in full force and effect. �S
z o m - Licansu Class_B_laic.Number.
9 z =w Date Contractor
BUILDING PERMIT
c ¢o n U
OWNER-Bill'R-BUILUF:R DECLA TION INFORMATION
E:
I hereby Alum tlat I ore exempt from the Contractor s License MISC.- REFER TO OR
LL VALUATION $/FT.
_ oa- , Law for the following reason. 703L5,Businessand Professions PERMIT ISSUANCE - 10.0 -
� w Code:Anycily orcormty which requires a permit to construct,after. QQ 1� fyh
Q ¢Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. - ELEC. „� pv >Wl/
O rc requires the applicant for such permit fo file a signer)statement that TOTA ` - - PERMIT TO
oc w m a- be is licensed pursuant to the provisions of the Contractor's License "
y.zQ
Law(Chapter 9(commencing with Section 7000)of Division 3 of the p O
i O Business and 1'rolessions Cale)or that he is exempt therefromand CITY. PLUMBING PERMIT �pO SFDU
ELI-.o the basis for the alleged exemption.Any violationof Section 7031.5 STORIES TYPE CONSTR.
by any applicant fora Permit subjects the applicant toacivil penalty. ALTER-DRAIN& VENT-WATER (EA:) 5.00 2 SNHR
of not more than five hundred dollars(5500).1:
1 0 1,as owner of the property,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
r /-= intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
° Code:The Contractors License Law does not apply to an owner of R-3 I
Property who builds or improves Thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
- himself re through his own cmredfor sale,Prrv1,ho that such improve- +
menu are not through
or employees,provided
ed that s the building GAS-EA.SYSTEM,I INC.4OUTLETS 6.00
or improvement is sold within one year of completion.the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.002334
builder will have the burden of proving that he did not build or im- BUILDING USE
RES IND CON Pe ,Ome.
prove for purpose of sale.). ' INDUSTRIAL WASTE INTER. 30.00 •
-0 I,.as owner of 0m properly,am exclusively contracting with 9 ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:"Che Contractors License Law does not apply - -
to an owner Of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts forsuch projects with a contractous)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200f1/10.00 TRACT NO. PARCEL NO.;
'0 1amexempt under Sec. ,B.&P.C.tor this WATER HEATERW/VENT 6.00 8067
Owner ' [)ate- WATER SYSTEM 5.00
ACL.DATE ACC.FILE NO.;
WORKERS'COMPI-NSATION.DECLARATION WATER TREATING EQUIP. 5.00
I hereby affnm that I have"a certificate of consent m self-insure. -
or a certificate of Workcrs'Comp msatlou Insurance,o a c,rt,fi,d ZONING ENG.SITE NO.
copy thereof(sec.3800,Lob.C.).United Pacific
Policy N'o. Company
O Cerfiti,d copy is hereby furnished. - FIRE SPRINK ENERGY T 24
Zz
&Ce*is, filed with the city inspection diskiva' MISC.- 'REFER TO ORD.
O APPhcant v❑ N❑ v ❑ N❑
CC W CERTI CAI F;OF EXEMPTION I7ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LL �! COMPVNSA9'ION INSURANCE PLG.CONTR. .uc.NO. PLG.
CL O (Phis section nerd net be completed if.the permit is for ori TOTAL , Y❑ "N❑ Y ❑ N❑
Z) Z hundred dollarS($100)or les.)
U O 1 certify that in the performance of the work for which this Pur- CITY. MECHANICAL PERMIT FEE - FEE SUMMARY
U_ H mit is issued,I shall not employ any Person in any incliner so as to
U become subject to the Workers Compensation Laws of California,
La Date Applicant _ ALTER OR ADD TO MECH. 5.00 BUILDING' OAO 50
} N NOTICE TO.APPLICANT: If,after making this Certificate of I;x
umption,you should become subject m the Workcrs'Compensation APPLIANCE 5.00 PLAN CHECK
• provisions of tjie Labor Code,,you must forthwith comply with FEE
U such provisions or this permit shall be demmed revoked. AIR HANDLING UNIT(TO 10,0)0GF.M0 4.00 154
CONSTRUCTION LANDING AGENCY - AIR HANDLING UNIT(OVER 10,000 C.F.M.) 6.00 '• SEISMIC FEE
I hereby affirm that there is .'construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
the performane of the,!york,( wh Jh this permit is issued(Sec. MICROFILM
3097,,xNam -QC fdc� HEATING UNIT(TO 100,0 ,0 0B.T) 6.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)0.50 ELECTRIC
Lendrr'a Adder„ 70.35
I I certify that I.have road this application and state that the above VENTILATION FAN (SINGLE) 4.00
i ufmances ,n correct. 1 , rel to comply with all city and county PLUMBING'
ofd rcultis and emin lows relating to comply
with lconstructcitynd co and BOILER-COMP(3 H.P.or 100,0008.T.U.) 6.00
hereby authorize representatives of this city to enter upon the BOILER-COMP love,100,000 BTU)SEE FEE SCH. MECHANICAL
'above-mentioned property for inspection purposes. -
li (We) agree to save, indemnify end keep harmless the City of MISC.- REFER TO ORD. 78.35
uperlino against liabilities,judgments, costs aril expenses whlclh CONST.TAX
ay in any way accrue'against said City quence of the PERMIT ISSUANCE 10.00 288.24
'ranting of it, em MECH.CONT. LIG NO. MECH.
• / TOTAL TOTAL
Signatu o pplicant/Contractor' d to 15.T130
.3I
OFFICE COPY