00110116CITY
•
lorNG DIVISIONPERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS
20833 STEVENS CREEK BLVD
PERMIT' NO
001.1.0116
OWNER'S NAME:
STEVENS CREEK OFFICE CEN
ER AS
APPLICAHON SUR IIT)• /�_ �ZI�
1 i
PHONE.
SANITARY NO. CON FRO]. NO,
ARCHITEC1'4iNGI7i
BUILDING PIiRMI'1' INFO
BLDG ELECT PLUMB MECH
1=1
LICENSED CONTRAC'I()It S 1 FChA1NT[ON
Description
1 hereby afAmuhat 1 am IiceneJ under pmvkions of Chapmr 9lrnmmencing
with secctionnxx„nrlivi.nnanrroeBuous. atm VI ... ion, Code.: duty Keeneis
,lob
.
Lie.x.S�ErS�
area c...and a/3_ '7
Date, _�—_2QpContrera-
iF NO
CONDITIONS *
ARCHIIECr'SDECLAR, ON
1 undenland'I'y plaro.hull he used a, puhlic record.
/
Liocnsal Pontr signal
OWNER -BUILDER IUagpu f DECLARATION
I hcrehy .fare nl 1 cacnlpt from Inc
,int, o Licemc Low for ,hc
station 1. Ilu.incssand he
deaien.Qnlu:Aarcityor cia,uy
i,r acmon.
O
.followhiN scrour]or i5.
which upii oe, fire any.nuaum
pewit re euinumr, pilar, irfor
delnrunit
'J
such t a sir
pr on f .I q ,I s11'., Il I I 11 11 :'g LrI nen
su n
Sq. Ft. Floor
Area
Va1}�4patioq
,hit, Ire licensed pi to bepn f i Card.notL - Lantz (Cnprer9
ta,maeu'ywmS"Iat710W)ofD,.ion lot the Buv'ne., and lntuxa,n, Gale)
S`ji=10Cf0 '
or fled he is exempt he,eRmn and the Irl for the alleged exemption. Any violation
ofSaOiun 7011.5 by airy applicant In a start, adde,o the ipph,ad h, a civil pxnalty
ofnor more than five bmrdred dollar, ($500)
APN Number
Occupancy Type
326322050.00
❑I,aa,Wrronne , Inee.Wlmw,I•t,n.mci,salccrr„cnoar„Ir_
snrpel y.onlry 5 6
Re aired Inspections
is
Will J m o I la t , , r J B J for Ile Nev.7194,
Buv J r 'o, ( J rel tractor', 1 drcsno,eek apply
r ed hieef
nwrknded
Who b ddarovid e.hicalsuch
ugh
101
— FOUNDATION
nrentens re or
his owe
orthroughnifl own ho,eveece. provided InI wtb irpmd is sol are sur ....ended or
.ale.IL the lhaveto,urrenof prrn sola whom or rc:ld or
102
— PIERS
ranoWevel;
couldifor
ilJer will time me M1UNen of proving that he did fir buil) or
immrple,ion, the o...v
of
prove l'..r purpose of.ale,l.
103
— UFER
❑ _Wowintir or the prFeny. a exclusively contracting with Kane d eaunnaaa r
104 —
REBA R
cower be pngm, (Sec. 71464. Ruane.,, and ❑ntl'cssinns Gxte) The Cn,n aacmte
License I.awacts not apply to an owner of prpeny who Wild% or inipmre, thereon.
105
— ANCHOR BOLTS
and who routines Gtr such projects with n conlracrnrlr) licensed sur, ain u, the
1.0E
— SEWER & WATER
Contractot,Licen.eU.,
❑1sur e,erplmwe,See ,B&11Clbrmisreason
202
UNDERFLOOR PLUMBING
Owner
�LNSAf]ON
P03
— UNDERFLOOR MECHANICAL
WORKER'S CUM DECI,ARAT ON
204
— UNDERFLOOR FRAME
Ibitrenyalfi,runder penalty 'IF perajryone 'It tile following deemnlaon„:
205
— UNDEP.FLOOR INSULATION
❑ 1 have and will inarinualn a ( cmecale of Consent it) self -insure for Workccs
Compen.aron. as provided for by Section Son of me L,m,r Code. for the
301
— ROUGH PLUMBING
sedunnunce fir IM work for which this strait i, issued
,
302
— TUB & OR SHOWER '
❑I hateandwill maintain Worker's Compcn,rion lnsunmce,asmquimdny Salton
370r or the lamas Core. for the pelronnance of fire work for Mulch mix act l,lit'I%
303
— ROUGH MECHANICAL
issued. My Worker'. Compensation Insurance carrier and Policy mmliber am:
c:r errFy1�/ r policy No. �{ //-$ (if/
304
— ROUGH ELECTRICAL
CERTIFICATION OF IiN Ed [MON FROM W(fR IERS'
305
— FRAME
COMPENSAIPON 1NSU RANCE
306
— HOEDOWNS
(I his need not be complaud llthe peaniI I, fnror in dred dollar
(annlone.,.l
307
— INSULATION
I verify that in me perGnmana of be wort for which oris .i, i. issuer. 1
308
— SHEET ROCK
,hall un ursloy any person in tiny manner so as In hone subject ,o the Wolter'
CornpenrationWwsofCalirorrfir. Franc
309
— EXTERIOR LATH
Applicant
NO[ CE To APP1.ICAN 1:11, aver making this Cclmitme or E.erpdon. you,nadd
31.0
— INTERIOR LATH
bee ram subject to me Worl.cr. Compensation provisions of the Labor Calc van Inas
IadWII fir eannplr wnhsuch prov i.iols or ork senna sholl be acerae rev liked,
311
— SCRATCH COAT
CONSTRUCTION LENDING AGENCY
313
— ROOF NAIL '
I hereby aRnn that hem is u construction lending agency bar the perl'onnance
�.
501
— FINAL ELECTRICAL ENERGY
of be work for which this permit i.i...led(See 3097, Civ. C.)
<er Addrf
502
— FINAL PLUMBING ENERGY
503
— FINAL MECHANICAL ENERGY
Icrnilr hint l have madmis:qrpliva,inn andure,ha0l, above inlrrrioo 1,
cnply Willi an city art county ordinances and .fate laws relating
correct. I agree rr
'syr
504
— FINAL BU I I_D I NG ENERGY
ofhald g d t d never, aull c epee Wlive,tall m„poI
the sibovearnsentionedp perty flat inspection purromv
505
— FI.NAL ELECTRICAL
(We) agart, it, save. indenufliv1. of
liabilities, judgments. , J pWhich Y Y cagainstvd
pON
(/ 506
�
— GAS TEST/t
City ,cnugGU rt flue g,r nrag of his PcnI,
Z
WILYLC`lainaless Wthe
ITcIIryA
-LPLOaI�NgeT
"nUppNrU�e:
Issued
— FINAL PLUMBING Date
y
Re -roofs J
— _ _
r-ntQ_oScToAn,Nr-.D<S,o'ArND �Lr�N
-�a
orDa,e
unrnauuusMATER1AlststoreGsandl
509
— FINAL GRADE
..511 drat applicant urn furor drag eecupapt lane or handle l
Type Of Roof `
ie HeaNnm ] Safety
;rade. nee by he Cnl+artint, Muldtin:Il con.., en,gnr 9.12 Inside . Health anti s°t°'r
510
— FIMAL PLANNING
Cadc.Smion 355321a1:
Dye, 0 N
All roofs shall 6elti;pel �fiRhcy StiyRlog fig Ifillfi F acing installed.
Will the applicant or future building ovcupw, use cyuiprer or devices which
If a roof is installed without
first obtaining an inspection. I agree to remove
and na.ardou, air connannnmlr as dernal by fire Buy Are, Air Qu'alilr Managerem
Dilbri tz
all new materials for inspection.
Applicant understands and will comply with
❑Yr. 0 N
all non -point source regulations.
1 have "IIIthe hvurdoua m:nerials requirements under Chapter 695 of ,he
Cruornia Ilaallh A Saha, Code. Section, 25505,25533 uad 25594. 11 krai ndil
it the building does no, curcen0y have a mmr, lar it i. ray resgr.ibilily to ro,ifY,he
cvpm or the regrli moot, whirl, "”" he fir, prig m 1.uuoee ora Ceniucme of
n
Signature ot'Applicant
Date
�Zi�aD
—authorized
All
roof coverings to be Class "B” or better
agent Da,e
OFFICE