14977 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER
CITY OF CUPERTINO :-
•
" w P INSPECTION;DIVISION 1497.
„ JOB INSPECTION RECORD
PERMIT EXPIRATION ,y
JOB ADDR S � " UNI -L0 J" ' � PERMIT EXPIRES IF WORK
OWNER CONTRACTOR IS NOT STARTED WITHIN
INSP 10 DATE INSPECTORPE O RECOR 180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
FOUNDATION 7 CO - '`
LIFER _ NOTE:ALL GRADING AND DRAINAGE SHALL BE INSTALLED 'LAST CALLED INSPECTION.
PREGUNITE - _ TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VnL1UarION
CUPERTINO STANDARDS. -
GARAGE SLABS - ? •, " ,
POUR NO CONCRETE'UNTIL ABOVE HAS BEEN SIGNED ton veP� s
UNDERGROUND /SLAB
�i _ • _rjY ,
PLUMBING - '•�7_DO.
ELECTRICAL IssualvcE uarE
MECHANICAL - - - BLDG. .ELECT_. PLG, mecH.-,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED • - BUILDING PERMIT -
INFORMATION
WOOD FLOOR - VALUATION .siFT.
. . . - . .. •PLUMBING . , . '.- •-;.+, :.
MECHANICAL nAlps 000
ELECTRICAL 'v - PERm,T TO,
FRAMING
.OWLS TYPECUNSTH.
INSULATION
I
OCC:GROUP
`PLACENO SU BF LOOR UNTI L ABOVE HAS BEEN SIGNED r R-3 WI
- ROOF - - - NOTE:NO FINAL INSP.SHALL-BE MADE BEFORE 50.FT'FLOOR AREA TOTAI aCR.EaBE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID 2445
BUILDINGUSE
ROOF SHEATHING HES - IN 'f ON PB • Go-,
•APPLY'NO.ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. L' L ' L L
ASSESSORS PARCEL NO.
' 'ROUGH - SAN.k
PLUMBING _ 'ELECT.ENERGY
TUBS&SHOWER PAN "PLUMBING ENERGY rRncT NoPARCEL No.
. -
MECHANICAL .!/ 'MECH.ENERGY - 'W67
/O—// -a ACC.DATE ACC.FILE NO.
-- ELECTRICAL _//• BUILDING ENERGY
FRAMING jPer COVVr < 10-12- (' ELECT.FINAL TEST 0zoNwc -ENG.SITE No.
INSULATION Q \Skl) PLUMBING • y?GAS TEST GAS ' '
MECHANICAL " FIRE sPrnrvrc ENERGY T.74•,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED. HEATING �t Y "� ,` N❑
' OD/ONE • A.I..U.C.
' EXTERIOR SHEAR �" "" ELECTRICAL RELEASE ,L L•O
INTERIOR SHEAR FIRE DEPT. ' y N�Ej YL NL
SHEETROCK - I - �� ' GRADE FEE SUMMARY '
. . EXTERIOR LATH _ BUILDING I
INTERIOR LATH - _ TEMPORARY APPROVALS BUILDING 97240
SCRATCH COAT —/' ELECTRIC. FEE 15.50 CHECK 1550
GAS -
MIT
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY, - SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGN ED BY BUILDINGINSPECTOR. ,MICROFILM
8 ARRANGE'FOR INSPECTION BY PHONING 252-4505; 2313gLECRI
L" , ONE WORKING DAY BEFORE REQUIRED, INSPECTION. PLUMBING
PLEASE GIVE JOB.ADDRESS WHEN PHONING. 73
z - 11
SEE PERMIT FOR.EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST TAX
ate' PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.-
OFFICE
NSPECTION.OFFICE COPY
APPLICANT TO FILL-IN INFORMATION WITHIN RED LINES,- USE BALL POINT PEN ONLY -
_w PERMIT NUMBER
„-
BUILDING!PROJECT I DENTI FICATION _ 14977
B
UILDING
APPLICATION
115�JI Lake Spring Court BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
45 Plan 4 B
PLAN CHECK VALIDATION1' egory Group, Inc. & Ahmanson OTV. , ELECTRIC PERMITFEE
is 416m695-2100
r NgM>ERAcraRs OUTLETS-SWITCHES-RECEP 10.00/1.00 -
Gregory Group, Inc. 13-430097
I LIC.No. - LIGHTING FIXTURES 10.00/1.00
CONTRACTOR s, 220 C Twin Dolphin Dr. APPLIANCES-RESIDENTIAL 4.00ADDRESS -
�I RIC CA. 94065 4167695-2100 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINEER Aram-Bassenian AIA & Assoc.
^ LIC NO. - SIGNS TRANS. 3.00
ARCH OR ENG. - `PERMIT VALIDATION
AGOREss 2031 Orchard Dr. 1{100 . SPECIAL CIRCUIT 5.00
Santa Ana Hts..CA. 92A7 TEMP.METER OR POLE INS. 20.00
APPLI is 220 C Twin Dolphin Dr. RWC MOTORS SEE FEE SCH.
ADDRESS
CA. 94065 SERVICE CHANGE 20.00
0 0 o LICENSED CONTRACTORS DECLARATION l O d
FL,w I herebyaffinn that I am licensed under provisions of Chapter 9 ISSUANCE DATE
a u (commencing with Section.7000)of Division 3 of the Business and LDG. ELECT. PLG. MECH.
•r 7 i Professions Code,and my license is in full force and effect
i
s',
o License Class_B_Lic.Number_(I_ 7
H j Date Contractor
a Y s - ILDING PERMIT
¢ ¢ ¢ OWNER-BUILDER DECLAIRMW a o a O INFORMATION
w g¢ N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO OR
H u o¢ Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE - 10.00 t Ups TION $/FT.
ro N Code:Any city or county which requires permit to construct,alter,
195 ODO
Win, o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. +LIC.NO. ELEC. f
d-wO,0 requires the applicant for such Permit to file a signed statement that . TOTAL PERMIT TO
.m m.-. he is licensed pursuant to the provisions of the Contractor's License
rz >
Law Chapter 9(commencingwith Section 7000)of Division 3 ofthe -
- a Business and-Professions Code)or.that be isexcmpt therefrom and OTY. PLUMBING PERMIT FEE
¢ Hsu the basis for the alleged eve inplion_Any violation ofSection 703 L5 STORIES TYPE CONSTR.
ia _ by any applicant for a perm it spEjcdslhC applicant to a civil Penalty ALTER-DRAIN -WATER (EA) SOU '
of not more than five hundred doLLars(5500).0 . .
� 'L C�I�
❑ has owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
- their sole compersmium will do the work,and the structure is not
intended or offered for sale (Sec 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,CONE). 5.00 R_3 1
Code:The Contractor's License Law does not apply to an owner of
Property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACREAGE
himself of through his own employees,provided that such improve-
meats are not intended or offered for sale.If.how61n,the building GAS-EA.SVSTEM-11NC.40UTLETS 6.00 2445
or improvement is sold within one year of completion, the owner- GAS EASYSTEM OVER 4(EA ) 200
"YYY✓/ builder will have the burden of proving that h - . - . .
e did not build or im- BUILDING USE
prove for purposeof sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND - CON PS omen
1 D I,as owner of the property,am eselusively contracting with ❑ ❑ ❑ ❑ ❑
- licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.8. 6.00 ASSESSORS PARCEL NO.
and Professions Code 1'he Contractors License Law does not apply '
to an owner of property who builds or improves thereon.and who ILAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such projects with a contractor(s)licensed pursuant to
the Conlmotor's License Law. SEWER-SANITARY-STORMEA.200ft/10.00 . TRACT NO, PARCEL NO.
I ❑ Lam exempt File,Sen.-,BAPC.for this WATER HEATER W/VENT.' 6.00 8057
reason
Owner Dane WATER SYSTEM 5.00
- ACC.DATE ACC.FILE NO.
WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have it certificate of ci111sUnt tosell'-insure. ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance.or a cerrilied
copy thereof(Sec..3800,Lab.C.).United Pacific - -
Policy No. Company
• O ❑ Certified copy is hereby f umishcd. FIRE SPRINK ENERGY T-24
Z ZO �Cerificd o 'is Hf with,nc� city inspection division MISC.- .REFER TO ORD. ❑ ❑ ❑ ❑
A Cunt V N V N
y CERTIFIL E 1'1 XEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U,C,
LU �! COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. V❑ N❑ Y ❑ N❑
CL 0 ico
(This section need r he completed if the permit is for one TOTAL
hundred dollars IS 100)or less.)-
U O 1'certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
IL H mit is issued, I shall not employ any person in any Former so as to
U become subject to the Workers'Compensation Laws of California.
ii Date ApplicantALTER OR ADD TO MECH. 5.00 BUILDING 972.0
} W_ NO1'ICIS TO APPLICANT: If,after making this Certificate of Ex-
F Z emptinu,you should become subject.to the Workers Compensation APPLIANCE 5.00 PLAN CHECK 15.5
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO io=r_F.M.) 4.00 /enerov ;9A
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 109WC.F.M.) 6.00 SEISMIC FEE - 13.65
1 hereby affirm that there is a construction Ienday,agency for EXHAUST HOOD(WITH DUCT) 5.00
the performance ojihe walk for which this permit is issued(Sec MICROFILM
3097,Cis C.). p2CUrlty' P3ciflc � HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name _ HEATING ON IT(OVER 100,000 B.T.U.)9.50 ELECTRIC
Lenders Andres _ �' 73.13
I certify that haver. IIIis application and state wet the above VENTILATION FAN (SINGLE)' 4.00 '
information is correct. 1 agree to comply with all city and county PLUMBING ]3.1.3
ordinances and state laws relating to building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 6.00
hereby authorise representatives of this city to enter upon the BOILER-COMP lover 100,G00 BTUI SEE FEE SCH. MECHANICAL ]3.13
above-mentioned properly for inspection purposes.
.(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judi n enrs, costs and expenses which ECONST. AXmay in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00288-24 ranting Df this Iii MECH.CONT. UC.NO. MECH.
TOTAL AL 1570.78
Signature of can Contractor I Date
OFFICE COPY