28413 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO B ILDINO-ELIIC'I RICAL PERMITNG.
PLUMBING-MECHANI
gO-MeDI
•BUIiti1NGDIVISION APPLICATION/PERMIT IUILUING1PHdEQf IDENTIFICATION 28413 pp13
BUILDING ADDREEa (A'] Sc
's�/�: r/— I QV SANITARY NO. APPLICATION SUBMITTAL DATE
�O s UNIT# IAT#
OWNERS NAME:: IONE:_��a_ _ CO ACTOR'S Mli: LIC NO:
ON
RO
f\ `Srf,�1'Il JG 4y tj 0:6.
NIC CO///sssN...TR///O��sL p
kCHI'MCT/ENGINEER: LIC NO: ADDRESS: ❑ �1—��
CONTACD PHONIC fff ER
S10-407-4M QTY. ELECTRIC PERMIT EE BUILDING PERMIT INFO
BLDG PLUMIL M[Cl2
LG �� _71N(so PRRMIT ISSUANCE.
LICENSED CONTRACTO SDE LARATTON APPLIANCES-RESIDENTIAL
qqmz I hereby affirm that lam licamedunder provlsionsofChupmf 9(c mmurur,with wJOBB DP.SCRIPI'[ON
ttl 0.0 Section7000)of Division 3 of the Business and Professions Code,and my Nomine is in PANELS T�
FFy V� full force and effect. PT02W AMPS
Q (y License Class Lia.#
,,U Uam Contractor 201-IUM AMPS
F•E y ARCHITECTS DECLARATION SQ.IT.FLUOR AREA S/SQ.I9'.
-0 y OVA-R'I(100 AM.'
z- IundersmnAmyplans shall h,used aspublic records. P ���Geo
,mf—[zl SI NS IlECTRIGA
Syfj Licensed Profesvional
C fE6 OWNER-BUILDER DECLARATION S I CIRCUIT S .
I hereby affirm that 1 con escmpt from the Contrecuir's License Law mr,the P
Y 31+•y following reason.(Second 1031.5.Business and Professions Cade:Any city or county TEMP.METER OR POLIi(NSI'.
�a which Mimics a North to Construct,alter,improve,demolish,or repair any structure
pum m im issuunce,alsnrcquires lheapplicam for such permit In filen signMstatemem POWER DEVICES
yQ<0z rM1at he is licensed Pursuum,o the provisions of the Cn c v Liana Law(Chapter
aLL 9(commencing with Section 7")of Division 3 of Basin sand Pmfessiotn Code) SW M GPDGLELECDtIC - VALUATION
or that he is exempt and the haste fort allacappl prion.Anyviolad000f SWITCHES-PIXTTIRFS �e /♦L� �
Gz} no, o c,h.5by mve odredcanrforupennir jwrx the appli anuoocivil penally ofironV �/
€G not mI.roawnfiaOlha,rcddollarn($5 NEW RESIDENT'JAL ELECIR —SQ,FT.
5E� ❑ oche wok,and
n thramat on ployecswithwagesast eir ,eolecom.1busi essI'ORII?S TYPE CONSTRUCTION
y will Jothewon,Cdthenroc, not inLndnse Low
(Sec.to44.Business
and Professions C. r ontroeon,License Low rch not ply m an owner of
mraccuProperty nmpmvesth imprornrn;cna cArm'pork mseradfraehis OCC.GROUT' RLS.UNITS
owneer,t sddinprogoeJ rbatsuchimpuss Id ,are ten intended oHermthe tuns,
however.the uildingorimpravemem ise l ain nn yrar5fca IetionJhe owner- T
milderwillh erarlandenif pfovinitthath� IiA-nibiditfM m vel'orpnrpnuof
sale.). r . .
❑ Lmowner tithe pro , lu ♦ tru, g t cern contractors,o QTY. PLUMBING PERMIT I°EE MOOD ZONE nPN
comsvuct the pro o Sea ii d Prnf' t ode:)ne Contractor,
Lice nu Lawtlaes t I t fpno dy, td srnimprovestherenn,and PERMITISSUANCE
whocoatmcu fms hp le trnan li osedpursuanttothe Cmttracons ALTER (FA)
license Law. f-:�, .' FEE SUMMARY
❑ I um exempt,un err Sera. ,B&P C far this reason BACK FLOW PROTECT.DEVICE SANITARY UTY 1 I.F N
Owner Vyf.i,,had.
Date RECEIPT#
DRAINS-FLOOR.ROOF,AREA,COND.
:WORSATION DECLARATION Ia SCHOOLTAX YN❑ Ihrmbyteerofcomenuoselbinsum.oracenificateof FIXTURES-PER TRAP RIiCEIPTN
Workers Cranenili,d copy thereof(Sce.3g00hob C.)which PARK FEE V N
rs all empon co this GAS-EA.SYSTEM-I INC. OUTLETS .RECEIPT#
Policy# BUILDING DIVISION FEES
Company GAS-EA.SYSTEM-OVER 4 IRA) PLANCHLCK FEE
❑ Cenifelcupyls .
❑ CenifieJ ropy is filed with the city inspection division. ORGSMNDUSTRL WASTE INTERCEPTOR GRADING IEE
CERTIFICATE OF EXF.MPf10N FROM WORKERSGREASETRAP SOILS FEE
COMPENSATION INSURANCE
(Thissection need oat bo Completed litho permit is Ponmchundrel Aollurs(SIM) SEWER-SANITARY-STORM EA.900FIU V ENERGY ERR IL
or lass.)
I certify that in the performance of the work for whichthispc.it is issued,10.11WATER HEATER W/VENT/ELEC31
not employ any parson in any nmnner an as to become subject to the Workers PAID
' Counationlawsaf Califomia. Date WATER SYSTCM)TREATTNG Date
Z
Applicant `
Z Ir NOTICC TO APPLICANT':It,after making this Certificate of Exemption,you should NEW RESIDENTIALPIMB. SQ.FT, TOTAL:
—r V� become subjeat to the Workers Compensation provisions of the Labor Code,you must
Xj forthwith comply with such provisions or Permit shall be deemed invoked. BUILDINGFEF
yQ CONSTRUCTION LENDING AGENCY SEISMICFI'
,2 I hereby affirm that then is a construction lending agency for the prommnic,of T)T L �- F.L 1
J O the work for which this,cmi,is i.mcd(Sea.3097,Civ.C.) I W7.4
)--, lender's Name p U FE
J U Lenders Address QTY. MECHANICAL PERMIT FIEF.
1 amfy that I have read this application and state that the above information Is
�-t counsel. I agree m comply with all cit dcoun, g MECI CA PER
4 yon county ie PERMIT
(n building abose,aunswaiomand heinbyauthoriu mprtsemmivesof thin<iywemerupomhe AUIabove-mntionedpsave,ind inspection purposes. :RORAUDTOMECII. Q(Wa)agree ro save,indemnify and keep harmless the City of Cunit againtIiabilitia,judgmnE,costs and exrnus whiahmay inanyway accrue ogaimt viJ Ciry AIk fIANDLING UNIT(TO IQ(#p CFM) �#in ema,ence of the goudin,of this permit. AIR IIANDLINO UNIT(OVER 10,000 CPM)Shuman,ofA,diwm/CArnantm Date EXHAUST HOOD(W/DUCU)HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO 101,000 BTU) eipt#
Will the applicant or future hnlldingoccupant store m handle ma rdus mnredal
as defined by the Cupertino Municipal Code,Chapter 9.12,arthe lleehh end Safety HEATING UNI'I'(OVER 100,000 BTU) TOA '
Cade,Section1125533(a)? VENTILATION PAN(SINGLE RISID)
❑Yes ❑No
Will,M1eapplicantnrfuwrtbuildingoc<upantuscequipmem ordeviceswbiaM1 emir BOILER-COMP CHIP OR IW,Uq BTU) (SSU CF.DATE
AUG 251995
t zardous air comuminunts as defined by the Bay Area Air Quality Management BOIL17R-COMP(OVER 100,W0 BTU)
)isvinl
❑Yes ❑No NEW RLSIDENTTAL MECH.—SQ.Fr. CITY Ur t, bl I INU
1 have read the hazardous materials requirements under Chapter 6.95 of,he
California Health&Safely Code,Sections 25505,25533 and 2553x. 1 understand the,
if he building docs at currently have a mount,that it is myresponaihility to n rifythe
occupant of the requirements which must he met prim m issuance of a Certificate of
Occupancy.
Owner ar authorized agent Date T A.. SUEDBY:
OFFICE
i
f�A-0
Ce,�-70"
---------------
ai
�9
I
/✓✓
II +
• f
I � �
®V 10300 Torre Avenue
Cupertino, CA 95014
Ci(c cd'
Cupertino Building Division
(408)777-3228
(408)777-3333 (fax)
September 23, 1996
Canon Info. Systems
20300 Stevens Creek Blvd, 1st Floor
Cupertino, California 95014
SUBJECT Tenant Improvement: Permit 928413
To Whom it may Concern:
We have been cleaning out our files in the Building Department, and contacting those
people with permits which have remained "open".
. According to our inspection records, the subject permit has never been finaled. Many
times an inspector will sign the permit in the field, but neglect to report all of the
information to the clerical staff for input into the computer. If your records show the
subject permit as finaled, would you please contact us so we may complete our records?
If the permit is not signed off your permit can be reactivated and an inspection could be
scheduled for final closure of the permit
If we do not hear from you within ten (10) working days, we will dispose of the file and
remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CUPERTINO .
.Christy Akatiff, Administrative Clerk
Pnmed on Pecrcfed PaOer
Inspection Query for a Specfic Permit Print 11/5/96
�• DATEDESIRED DateDone Inspector Units Pass/Feil
7/31/95 7/31/95 CC 3P
7/31/95 7/31/95 CC 3P
7/31/95 7/31/95 CC 2P
8/2/96 8/2/95 CC 2P
8/3/95 8/3/95 JJ 2P
8/3/95 8/3/95 JJ 2 P
8/7/95 8/7/96 CC 2P
8/8/95 8/8/95 CC 2F
8/10/95 8/10/95 CC 2 P
• 8/10/95 8/10/95 CC 2 P
8/10/95 6/10/95 CC 2 P '
8/11/95 8/11/95 CC 2P
8/11/95 8/11/95 CC 2P
8/11/95 8/11/95 CC 2P
8/11/95 8/11/95 CC 2P
9/6/95 9/6/95 CC 2F
9/6/95 9/6/95 CC 2F
9/7/95 9/7/95 CC 2 P
9/7/95 9/7/96 CC 2F
9/7/95 9/7/95 CC 2 P
9/7/95 9/7/95 CC -2F
9/7/95 . 9/7/95 CC 2F
9/7/95 9/7/95 CC 2P
•
•
Page 2
Inspection Query for a Specfic Permit Print 11/5/96
• PERMIT# SITUS ST SITUS STREET AVE,CT,ST,RD Lot# INSDESCRIPT InsType
28413 20300 STEVENS CREEK BLVD CANON ELECT
28413 20300 STEVENS CREEK BLVD CANON FRAMING
28413 20300 STEVENS CREEK BLVD CANON ROUGH WALLS-1
28413 20300 STEVENS CREEK BLVD CANON DRYWALL
28413 20300 STEVENS CREEK BLVD CANON ELECT
28413 20300 STEVENS CREEK BLVD CANON FRAME
28413 20300 STEVENS CREEK BLVD CANON SCREW
28413 20300 STEVENS CREEK BLVD CANON ROUGH U/G PLMB
28413 20300 STEVENS CREEK BLVD CANON ROUGH ELECT-JB
28413 20300 STEVENS CREEK BLVD CANON ROUGH FRAME-J
28413 20300 STEVENS CREEK BLVD CANON SHEETROCK-JB
28413 20300 STEVENS CREEK BLVD CANON ABOVE ELECT
28413 20300 STEVENS CREEK BLVD CANON MECH
28413 20300 STEVENS CREEK BLVD CANON ROUGH MECH-JB
28413 20300 STEVENS CREEK BLVD CANON T-BAR-JB
28413 20300 STEVENS CREEK BLVD CANON ELECT FINAL
28413 20300 STEVENS CREEK BLVD CANON PLBG FINAL
28413 20300 STEVENS CREEK BLVD CANON ELECT
28413 20300 STEVENS CREEK BLVD CANON FINAL BLDG
2841320300 STEVENS CREEK BLVD CANON FINAL ELECT
28413 20300 STEVENS CREEK BLVD CANON FINAL ENERGY &
28413 120300 ISTEVENS CREEK BLVD CANON FINAL MECH
28413 120300 ISTEVENS CREEK BLVD CANON FINAL PLMBG
•
•
Page 1