14936 POST THIS CARD NEAR FRONT OF BUILDING
_ - PERMIT NUMBER -
CITY -OF CUPERTINO . . . . 14936
'INSPECTION DIVISION. • ' •
'JOB INSPECTION RECORD -4
`� - •. •I - - PERMIT EXPIRATION
JOB ADDRESS_�IC90 L.�K� -'U ��1/G—. G� UNIT# -LOT#J pERM1T EXPIRES IF WORK,,
OWNER, . R., G/GOU CONTRACTOR ��S ' d 'IS NOT STARTED WITHIN
j INSPECTION DATE, INSPECTOR INSPECTION REC D 180 DAYS OF PERMIT ISSU-
ANCEOR 180•DAYS FROM '
FOUNDATION NOTE'
UFER- ' ALL GRADING AND DRAINAGE SHALL 13E INSTALLED LAST CALLED IPISPECTION.
PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PE"NUT VAIJOAtION
CUPERTINO STANDARDS.
GARAGESLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN,SIGNED.
UNDERGROUND /SLAB Ar
PLUMBING ��
ELECTRICAL , - .Q UANCE OAT
MECHANICAL BLD(- CT, PLG MECR.{
ae.�.re aIL
0
2,L0J • O
DO NOT POUR FLOOR UNTABO HAS BE SIGNED .. NG PERMIT
C INFORMATION
�. WOOD FLOOR L
VALUATION , 'v F.T.
PLUMBING
MECHANICAL
- ELECTRICAL vegaln TO
.FRAMING - I
INSULATION STORIES IYPECONSTR.
o-C:IN.Ul' RIM UNTIs•-
PLACE NO SUSFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE S"'`r FL cnE CE
,I:A lu*AL
DIAPHRAGM - THE CONSTRUCTION TAXIS PAID
W LUiNG USE
ROOF SHEATHING RES i ,U CON PB O
`APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE IN SP. 0 0 0 11
ASSESSORS PARCEL NO.
ROUGH SAN.#
PLUMBING Q ELECT.ENERGY _ -
MM
SHOWER PAN (bzp® 1;y7`'� PLUMBING ENERGY TRACE NO, • PARCEL No.,
MECHANICAL MECH.ENERGY -\ J A TE AGE.FILE NO.
,ELECTRICAL (j_ BUILDING ENERGY \-\j-jq
r I
FRAMING ELECT.FINAL TEST
ZONING ENG.SITE NO,
INSULATION PLUMBING
GAS TEST •Z .fig �cJ GAS
MECHANICAL
FIRE SPRINK ENERGY T 24
9L
: _\'�.-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING _ - IF] NL r'❑ NQ
EXTERIORe)'SHEAR ELECTRICAL RELEASE _ _ FLOOD zomc A.Lu.c..
INTERIOR SHEAR FIRE DEPT. v� NQ. vL NL]
SHEETROCK - GRADE FEE SUMMARY
EXTERIOR LATH BUILDING -1 -
INTERIOR LATH_ TEMPORARY APPROVALS BUILDING
SCRATCH COAT Z•/S 621' ELECTRIC PLATEEN CHECK 15•50
- GAS .
._ . .. :NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY � SEISMIC FE OCCU PANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILMLU
ARRANGE FOR INSPECTION BY PHONING 252-4505, . ELECTRIC
ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
z PLEASE.GIVE'JOB ADDRESS WHEN PHONING.w 60.35
r
— SEE PERMIT FOR EXPIRATION DATE — MECHANICAL
- ' IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION. -
OFFICE COPY' _.
CITY OF CiTERTNO —
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
Date ZT1143... ...C4z............... 19-5.7.. Building Permit No.
The Building Located at ----- ......
Owned by . ... ........
.............................................................................
Has Been ��For Use As: ....�SFM.........................................................v---
(Altered)
.......................... ------------------------------------------------------------- ---------------------------------------------------------
...............................................................................................................................
...........................................................................................................
WDR �-US
..................... . .........
PD-7 BUILDING INSPECTOR
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY '
PERMIT NUMBER
BUILDING PROJECT IDENTIFICATION - :.:..
BLILDING 590 Lake Spring CoLrrt APPLICATION-,& PERMIT n n
ADDRESS Lot 152 Plan 36 y b
BUILDING ELECTRICAL-PLUMBING-MECHANICAL
OWNER'S PLAN CHECK VALIDATION
NAME Greyory Group, InC. & Nuanson OTV. ELECTRIC PERMIT FEE �.
Developoents PHOR415-595-21
CONTRACTORS
NAIVEOUTLIGET&=SW'TC
HES-RECEP 10.00/1.00
1 Gregory Group, InC. LIC.No. 6-43DD9] LHTING FIXTURES' 10.00/1.00
CONTRACTOR'S 220-C Twin Dolphin Dr. RWC PPLIANCES RESIDENTIAL 4.00
ADDRESS /I(y[ n
ICA. 94065 P 415-595-2100 -PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECKFEE P.C:NO.
DR Aram Bassenian, AIA & Associates
ENGINEER
I:Ic.NO. SIGNS TRANS. 3.00
ARCH.OR ENG. J` PERMIT VALIDATION
ADDREss 2D3hard Dr. #100 SPECIAL CIRCUIT 5.00
Santa Ana kits, CA. 92707 TEMP.METER OR POLE INS. 20.00
APPLICANTS MOTORS- SEE FEE SCH. -
ADDRESS 220 C Twin Dolphin Dr. WC -
SERVICECHANGE 20.00 O ._
WR Z.
-00 LICENSIiD CONTRACTORS DECLARATION Q� lg
v v I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
w ¢ y (comnuaming with Section 7000)of Division 3 of the Business and L ELECT. 'PLG. 'MECH.
F N z Professions Code,and my license is in full force and effect
171
Cs o m - License Class B_Lic.Number 9i. (�.
Cs
H F Dam Contractor I 7
¢ Y s LI BUILDING PERMIT
¢ s, w a OWNI:R-BUILI ER DEC ATION - INFORMATION '
OAD MISC.- REFERTOORD
X g e, m I hereby affirm that 1 am exempt from the Contractor's License VALUATION $/FT.
F .. o j Law for the following reason.(Sec.7031.5.Businessand Professions PERMIT ISSUANCE 10.00
Code:Any city Or county which requires a permit to construct,alter, --¢. 9 000 p. improve,dcmonslh,or repair any structure,prior to its issuance,also ELEC.CONTR. - 'LIC.NO.:_ ELEC. 153.000
0 a,requires the applicant for such peril to file a signed statement that TOTAL PERMIT TO
d w m w he is licensed pursuant to the provisions of the Contractor's License
F z t, Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe
Business and Pmfessipns Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE 111
¢ IOP the basis fir lire alleged exemption.Any violation o f Scdiun 703 t.5 . STORIES TYPE CONSTR.
o3m by any applicant for a permit subjects the applicant tD o civil penalty .ALTER-DRAIN&VENT-WATERIEA.) 5,00
of not more than five hundred dollars(S500f): - 2 ,1l Yfut
j ❑ I,as owner of,me property,or my employees with wages is 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, Rosiness and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Rn 1
Code.The Contractor's License Law does not apply to ant owner of =33 l
-
properly,who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE
himself or through his own employees.provided that such improve. '
ments are not intended or offered for sale.If.however,the building GAS-EA.SYSTEM-1 INCA OUTLETS 6.00 1934
or improvement is:old within on year of contpletlon,.the ownu-
• •' GAS-EA.SYSTEM-OVER 4 (EA.) - 2.00 BUILDING USE
builder will have th•burden of proving that he dIJ not hu Id or im- RES IND CON Pa - Omer
prove for.purpose of sale.f INDUSTRIAL WASTE INTER. 30.00 ® ❑ ❑' ❑ ❑
i ❑-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 ASSESSORS PARCEL NO.
and Professions Code:"f he Contractor's License Law does not apply
'ID as owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
'contracts for such projects with a contractors)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ IsmexemptunderSec. ,B.&P.C.for this WATER HEATERW/VENT 6.00 8067
reason
Owner Dale WATER SYSTEM 5.00
ACG DATE ACC.FILE NO.
.. N'ORKE"RS'COMPE6'SAfION DECLARATION WATER TREATING EQUIP. 5.00
I hereby ffir that I have a certificate of consent to self-insure. 20NING
or a certificate of Workers'Contpensatinn Insurance,ora certified ENG.SITE NO.
. copy t,ereof(Sec.3800,Lab.C.United Pacific
Policy N'O. CmnpaRy
O ❑ Cerlifiedcapyisherebyfumislmd. FIRE SPRINK ENERGY T 24
Z Z .XCertifled 's filed with tie
c city inspection division. MISC.- REFER TO ORD.
O AppliY ❑.. N❑ Y ❑ N❑
� y CER"I' CATI.'OI'EXEMPTION FROM WORKERS' PERMIT ISSUANCE - 10.00 •. FLOODZONE A.L.U.C.
W > COMPENSATION INSURANCE PLO.CONTR. LIC.NO. PLG.
CL 0 (This section need not be completed if the permit is for one. TOTAL Y❑ N❑ Y ❑ N❑
::) Z hundred dollars IS 100)or less) ' '
C) O I certify'that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued.I shall not employ any person in any manner so as to
become subject to the Workers Compensation Laws of California.
U a Date Applicant - ALTER OR ADD TO MECH. 5.00 PELECTRIC
&'S �.
} 0 NOTICE'f0 APPLICANT: it.after making this Certificale of Ex- .
♦- Z emption,you should become subject to the Workers Compensation APPLIANCE 5.00 5.50
- provisions of the Labor Code, you must forthwith comply with 62.00
_U such provisions or this permit shall be deemed revoked., AIR HANDLING.UNIT(TO 10,000C.F.M.) 4.00
CONS'T'RUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10SWC.F.M.) 6.00 10.71
I hereby affix 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(See.
3097,Civ C) SeCurlt PdCIf1C HEATING UNIT(TO 100,000 B.T-.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lendera'Aame SeCUr aPa der-o-4-fir-SFCA94 60.35
I certify that l have read his application and state that the above VENTILATION FAN (SINGLE) 4.00
information n estate I agree li comply with all city and county PLUMBING
ordinances and state laws relating to building construction,co and BOILER-COMP(3 H.P.or 100,0008.T.U.) 6.00 60.315
hereby authorize representativems of this city to enter upon the BOILER-COMP(Over 100,000 STU)SEE FEE SCH. " MECHANICAL 6D.35
above-mentioned property for inspection purposes.
(We),agrce to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which -PERMIT ISSUANCE 10.00 CONST.TAX 266.2
may in any way accrue against said City in consequence of me
' noting of ilii O MECH.CONT. LIC.NO. MECH.
1 4$0466 TOTAL 'J TOTAL 13&.50
$ignaturc Applicant/Con trawler Date---///
OFFICE COPY