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8460 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY /'BLII LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER � RUILOING APPLICAYION 8i PERMIT 8460 , AooRE55 a a BUILDING-ELECTRICAL-PLUMBING-MECHANICAL Y Ow ERPLAN CHECK VALIDATION NAME CITY. ELECTRIC PERMIT FEE CONTRACTORS JF40OUTLETS-SWITCHES-RECEP 10.00/1.00 ,J3- X NAME l / K6t)s-/G Lie No. LIGHTING FIXTURES 10.00/1.00 p cONTRACTORS PPLIANCES-RESIDENTIAL 4.00C3,er -� AOOREss R,ONE�ii -;?Z(}O �/ PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.NO. SIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POL 'INS: 20.00 �� ADDRESS rs MOTORS SEE FEE SCH. ADDRESS SERVICE CHA GES p ;j ,,''2�: 20.00 o E o LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 a v U I hereby affirm that 1 am licensed under provisions of Chapter 9 1[y Of CUperfino ISSUANCE DATE N rt N (commencing with Section 7000)of Division 3 of the Business and BLDC. ELECT. PLG. MECH. O z Fy Professions Cod e' p1nse is in full for of - z o w y��(` License Cess F((:: Lic.Number ❑ ❑ ❑ Date p•$� Contmctor P Y I BUILDING PERMIT ¢ ¢ wc OWNER-BUILDER DECLARATION INFORMATION o a " MISC.- REFER TO ORD S w U.0 E- I hereby affirm that I am exempt from the Contractor's License nos Law for the following reason.(Sec.7031.5.Businessand Professions PERMIT ISSUANCE0 VALUATION §/FT. Code:Any city or county which requiresa permit loconslructalteq 2 R s- improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELIC. , ``•-� R D¢ requires the applicant for such permit to file a signed statement that TOTAL V J PERMIT TO A m a- he is licensed pursuant to the provisions of the Contractor's License F z i Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe G a Business and Professions Code)or that Ie is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. aim by any applicant for a permit subjects the applicant Ica civil penalty ALTER-DRAIN -WATER IEA.) $.00 of not more than five hundred dollars(5500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself m through his own employees.provided that such int ildive ng mems are through or offered employees. or provided thathowever,the building GAS-EA.SVSTEM-11NC.4 OUTLETS 6.00 or improvement is sold within one year of completion, . .) 2. the owner- GAS-EASYSTEM-OVER 4 (EA.) BUILDING USE builder will have the burden of proving that he did not build or int- RES IND CDN PB Other for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OV ER 5(EA.) 1.00 contracts for such projects with a contmcto ns)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ 1 am exempt under Sec. B.&P.C.for this WATER HEATER W/V ENT 6.00 reason Owner Dale WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPBNSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificale of Consent to self-insure, ZONING ENG.SITE NO, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.0 Policy No. Company.y_ roll'$ X'yS O ❑ Certified Copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z O Certified coy _ Jed with the yxey inspection division. MISC.- REFER TO ORD. O pphcant L r Y ❑ N❑ Y N CC T CERTIFICATEOF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD20NE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO, PLG. CL O 1'This section need not be completed if the permit is for one TOTAL Y❑ NE] Y❑ N❑ D 2 hundred dollars(5100)or less.) U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY UL I- nit is issued, I shall not employ any person in any manner so as to U become subject to the Workers Compeasat ion Laws of California. 0 a Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } m NOTICE 'TO APPLICANT: If,after nuking this Certificate of Ex- F ? eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code. you most forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 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 permit is issued(Sec. MICROFILM 3097,CYC.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Add. H EATI NG UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC ss 1 certify that 1 have read this application andstate that the shove VENTILATION FAN (SINGLE) 4.00 information a correct 1 agree tcont ordinances and slate laws relati b with all city and ",only PLUMBING ng to building construction, and BOILER-COMPI3 H.P.or 100,0008.T.U) 6.00 hereby authorize representatives of this city a Lnter upon the BOILER-COMP I0.,100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, cost,and expenses which PERMIT ISSUANCE 10.00 CONST.TAX ms ay in any way accrue agar t,S�Iid Clty In consequence of the grant oft it. / ) / r METH.COM NT. LIC.NO. ECH. . TOTAL . TOTAL - Slgnolurc o'Appricanl/Contmctor Date OFFICE COPY �.- CITY OF CUPERTINO INSPECTION RECORD ; (OFFICE COPY) y 6 10258-10272 Danube Dr. PEO D SS 8 t Condos-SFD C t PROJECT T Rnter PERMIT ISSUED DATE ELECTRICAL DATE INSP: Building Electrical Plumbing Power Pole Mechanical ergroun e as ec oiag ring = So ara1�ls Fire S r—inF—Ferei�'Tin i fixtures Int/Ext ,Rotors Misc. GroundUthuig _ Temp mower er FINAL INSPECTIONS DATE INSP, o1 of Approver Gas y_ z� es Electric lum in _ PLUMBING D INSP. g� �c ianical 'plar Backflow 00 F r roundd Gradin er oor Planning rtial Rough -q-� Fire: e t. -i- 19 Kou3zh Conplete =y eH al e t. ou ui �naW tom, insulation Other o rain —. Gas ter NoL'�G DATE INSP, of rove Pad Certification 7-oun ation ELECTRICAL DATE INSP. Pre- unite la - - Underfloor S.M. Bond Isemn Ducts & Insulation Underfloor Girders Fire D ers Floor Steel ire ace - ie owns Grease J Lc4 Hood is rams P One Hour Shatt eismec BracingCon ensate Drain WallWall-mssEquipaent Anchorage Frame Flues 4 Comb. Air �tFirewa _ Ot er ar s xt a co - i of rove 'Firewalls -k t er Net prove %e'f� BUILDING -� 5-(-ssf {'div-T �r� ,rk7- car � ✓ '--•-- (v260 ,1. 102-O/ 2✓Mi �r�l/ . . ELECTRICAL PLUMBING • I MECHANICAL MISCELLANEOUS 1 � BUILDING INSPECTOR'S OFFICE - CITY OF CUr,ERTINO Bldq.Dept. Office copy ❑ Backflow Device Sanitary Permit No. �0. Sewer Connection Plumbing Permit No. -5 JrIJ 0' Plumbing Final �+ Lot No.�J%,t�i� (� Owner or Tenant r Ar /lrL Tract Date Connected 19_�ote Final7�r.,— I PLUMBING INSPECTOR l BUILDING INSP'ECTOR'S OFFICE ' " CITY OF CUPERTINO Bldg.Dep,. t Office Copy ❑ Backflow Devices Sanitary Permit No. Sewer Connection Plumbing Permit No. `; �r Plumbing Final -a �- ( Lot No. i1 I Owner or Tenant Lr144;il I+ Tract Date Connected 1 gcJS�Dare Final /7 19 PLUMBING INSPECTOR ------------ ELECTRIC SERVICE NOTICE r P BUILDING Ii;SPECTOR`S NOTICE OFFICE COPY r a CITY OF Cl ERTINO J 9 To 9 � _ You are hereby toothizin,ed to Connectelectrical service for ,L 'Owner or T /l—'��."'7• enanr 5} At /6a.- 7U �� o rtm J ^< it No.of Wires ------— Size of Wires v Moloy Load ��—Size of Switch Voltage_ — Heating Load K W Phase Voltage NO,of Meters / ( Lighi IO J — (I(1 —Newrvice Service Reconnect No.of Add,Meters— 120—Thee Wire Power More Service Qi M Thr a Phase ELECTRICAL INSPECTOR '�"TO°e Mete. _ J ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF C'�PERTINO I You are hereby au�horizedurh°rued tj °CO^nect electrical service for 'Owner Cjr ienont No.of Wires Motor Load Size of Wires;—�Size of Switch Voltage I• Phase Heating Load K.W, S Voltage No of Meters / Light AI 10__New Service_ �— Reconnen Hem 120�Three W- No.of Add.Meters "e More Service Power ee Phase Move Mete. OI M ELECTRICAL INSPECTOR � I ELECTRIC ARVICE NOTICE OFFICE COPY o BUILDING INSPECTORS NOTICE 4 CITY OF CUPER71N0 19 Fj You are hereby authorized TO Connect electncoi service for 'Owner or tenant (",I� No.of Wires U Size of Wires Size of Switch Mob,Load ��— �� Voltage �— Phase Healing Load_ K.W. Voltage y/ No.of MetersLlghi 110__New Service Hear Reconnect 170—ihree Wire More Service No.of Add.Meters Power. •�ee Phase (-�`rv.`/lf�,{'i`� Move Meter ELECTRICAL INSPECTOR A ELECTRIC SERVICE NOTICE OFFICE COPY I Q BUILDING INSPECTOR'S NOTICE 7H CITY OF CUPERTINO t�1Y y �•7 I Y To / — A �^. 19 lT d I) You arehereby outhrized to Canner electrics{service for �c rn 'Owner or Tenant �� ��Y1 ` ^ _ `B'•— i No.of Wires Size of Wires J Size of Switch 1 Motor Load Voltage —�� Phase Heating Load K.W, Voltage No.of Meters / ( Light-]10-New Service se V Remnnea ill) Heat 120_Three Wire More Service No.of Add.Meters Power ...�//le.�.Th r¢1/e Phase_ Move Meter �� ELECTRICAL INSPECTOR �./�q / �._a._�y�•O Z O ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR S NOTICE { 0 CITY OF CUPERTINO < G n To You are hereby authorized to Conne�cctt electrical service for 'Owner or Tenant -�*-ITS-�C'--r ��• ` C o,,, (/. At 10-16g Alga ,, f BD / No.of Wires�- 611 Size of Wires Size of Switch Maar Load Voltage - Phase Healing Load K W t — Voltage No.Of Meters / 1 L�qh� IIONew Service X 1/}T Reconnect No.of Add.Meters leo,-]20-ThO,Wire More Service Power hree hose Move Meter 0 ELECTRICAL INSPECTOR v � ELECTRIC SERVICE NOTICE OFFICE COPY i BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO To 19 a JJJ You are hereby authorized to Connect electrical service for z� s 'Owner or Tenant 1&1-4 7- No,of Wires�� Size of Wires Size ofswitch Molar Load Voltage phase Heating Load K W Voltage No.Of Meters �_ Light TIO—_New Service Reconnect No.of Add.Meters Heat 120—Three Wtre More Service Power eePhase Move Meter 0• ELECTRICAL INSPECTOR t �/ ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO a To 9 �J— You ore hereby authorized to Connect electrical service for + 'Owner or Tenant / Ttr.w.� dJAt No.of Wires Size of Wires / Size of Switch Motor Load Voltage Phase Heating Load K,W. Voltage No.of Meters Lghr 110—New Service x' Reconnect Heat 120_Three Wire More Service No.of Add.Meters Power •e Phase Move Meier & ELECTRICAL INSPECTOR � ° ELECTRIC SERVICE NOTICE OFFICE COPY e BUILDING INSPECTOR'S NOTICE +.r CITY OF CUPERTINO To 19 You are hereby authorized to Connect electrical service for t • 'Owner or tenant_ At 3 No.of Wires Size of Wires $'ae of Switch j Motor Load Voltage Phase 1 Heating Load K.W. Voltage` INo.of Meters Lgh1 110_New Service x Reconnect Heat I20 Three Wire More Service No.of Add.Meters Power. f/—Thr a P.hose Move Meter �� ELECTRICAL INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY 1 4 BUILDING INSPECTOR'S NOTICE 1 CITY OF CUPERTINO To You are hereby authorized to Connect electrical service far ' 'Owner or Tenant 4 At �U :��— 6a.y,.t—"l i No.of Wires Size of Wires Size of Switch Motor Load Voltage phase Heating Load K.W. Voltage X/ 1 No.of Meters / light 10—New Service l< Reconnect {+ HIOI 120_Three W' More Service Na.of Add, Meters ire Power. hree Ph.u, Move Mew ELECTRICAL INSPECTOR CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE ! CITY OF CUPERTINO �--c- DATE 7—Lel 19–ss�- BLDG. PERMIT NO. J / THE BLDG. LOCATED AT /n GCJ c` /)A OWNED BY C� ,P I �I HAS BEEN Q-TL EDFTEIDI OR USE AS 'i' w r�- �C �U JA cI D� J i / ©• q BUILDING INSPECTOR CERTIFICATE OF COMPLETION �- BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO DATE — ,.19—� BLDG. PERMIT NO. E '--i� THE BLDG. LOCATED AT 0 2-6 s OWNED BY V T) Z HAS BEEN O MPLETED) FOR USE AS IACT EDI - { I I I � O• �SWILDING INSPECTOR II BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg. pi. I ` Office Copy ❑ Backflow Device - Sanitary Permit No. Ils�h ,Q Sewer Connection Plumbing Permit No. / \ I _x❑`Plumbing Final Lot No. 7 S Owner or Tenant_ `-/�Y w./.L/�� At iTract pp''//� Date Connected �Q "' 19-NDote Final PLUMBING INSPECTOR 1 CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE w CITY OF CUPERTINO � ` DATE / 19�.0 BLDG. PERMIT N/ � ) { O. SO � THE BLDG. LOCATED AT [� 7- �cP �In tJ P OWNED BY V -7` C e LA T HAS BEEN (COMPLETEEREDIDI OR USE AS U/1 r0i) V\-0/0 (ALT4 I BUILDING INSPE TOR CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO DATE?L� 19�� BLDG. PERMIT NO. �6 THE BLDG. LOCATED AT d L�i la OWNED BY CTd "(J U C O HAS BEEN( (— O LETED FOR USE AS S`FA / LCid In �a (ALTERED) i OM I BUICDIN INSPECTOR I BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg.Dept, Office Copy 7��� El Backflow Device Sanitary Permit No. i�71, I '0"Sewer Connection Plumbing Permit No. T g Final `Q Plumbing Lot No. Owner or Tenant l t ..+�_ At �� �� V J Gam. Tract Date Connected //� —1 Date Final �- ��1 - 19.F C �• �� PLUMBING INSPECTOR BUILDING INSPECTOR'S OFFICE ' CITY OF CUPERTINO Bldg.Dep,. Office Copy I i ❑ Bockflow Device Sanitary Permit No. ©r Sewer Connection - Plumbing Permit No. i Plumbing Final Lot No. n�J Owner or Tenant Tract Date Connected �� _ �� 19 v'Date Final 7 - �� 19 Y . pp . PLUMBING INSPECTOR I BUILDING INSPECTOR'S OFFICE I -CITY OF CUPERTINO Bldg Dept. Office Copy ❑ Backflow Device - Sanitary Permit No. 41-,—A-, Sewer Connection Plumbing Permit No. ,t, # - �❑ Plumbing Final Loi No. ! Owner or Tenant F, � n U At /�S a (oD a��c f'� e 01, Tract Date Connected /— 19z Dare Final —���— 19 ES ©" PLUMBING BUILDING INSPECTOR'S OFFICE Bldg.aepf. CITY OF CUPERTINO Outs Cop y ❑ Backflow Device Sanitary Permit No. Sewer Connection Plumbing Permit No. 5`G 5 1 t tO Plumbing Final Lot No. &// " i C i Owner or TenantAt I Tract Date Connected �!1 — 19Fr— ate Final 19 =r S pM PLUMBING INSPECTOR i I BUILDING INSPECTOR'S OFFICE Bldg,Dept. CITY OF CUPERTINO Office Copy Q Backflow Device Sanitary Permit No. Sewer Connection Plumbing Permit No. sGs� Plumbing Final ,y Lot No. IOwner or TenantAt 4F J- I � i Tract t� I Date Connected /r — �— 19 i?L Date Final 7—✓`/- 19��� OO M PLUMBING INSPECTOR