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R
Tn
No. 802 /�
Wrtif tratt of Orrupaury
(pity of Tuprrtino
' +Ervartmrnt of Viti[ling 3noVrrttott
This certificate issued pursuant to the requirements of Section 307 of the
::.. Uniform Building Code certifying that at the time of issuance this structure was
& in compliance with the various ordinances of the city regulating building rrl
construction or use. For the following: t
Use Classification Interior Remodel 17873
Bldg. Permit No.
Group B-27ypeConstruction V–N Use Zone Planned Development
`. Ownerol'Building JMAProperties Address 20863 Stevens Creek Blvd. Suite 200
Phase
Suite 200 /, 1
$ Building Address 20863 Stevens Creek Blvd. Locality Cupertino, CA 95014 /
By:
Joe Vandeveer '�
Date: 8/21/89 •i
Building Official ,a
POST IN A CONSPICUOUS PLACE
' s@ —
�
.+� . . ��. moi;��' -`-''r:ll;>�.4p�• ItuIm - � r art' .. , r.� / �
-_T .t19/}'. /� ,+-T^ 0.2 !� �,� /JH �U`k^!i•,'^� > //�`��\\R• //// Pik\t !//'���' �' /A�7 I�y1a y�!//
_ nJh � i i x✓//:$ -`•�F n ���1. ? �� 1 '.. ' i ���n ' ..awe \`. //
•/4��tf�a a s S \ /� lhe�'':: l-.. .;.i,NF.T °t - ^/ (/ t'k t,- /,� y t �p��
. �. - / __. %-�/i 'i.ij_ �' �� - /I/7j Ali' - 1/fJ,AC. .:�1:)� - ,. p//� � 3 i - /ff 4�,�'`i. '6/i� /h •t �::
r POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMBER
CITY OF CUPERTINO 17873
INSPECTION DIVISION
JOB INSPECTIQN REC-O
• F{irI♦ S�Li� M
Q� S •� �1 � UNIT# _LOT# 1� ?ERMITY icl•TION 1 '
JOB ADDRESS //�yy�� `` ""//y���/fP J�/jj� _ PE�1 EXPIR SIF ORK
OWNER ' // 4 r�`�• �/9.9 CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATION ANCE OR 180 DAYS FROM
NOTE:
LIFER - � � � ALL GRADING AND DRAINAGE SHALL BE INSTALLED• LASTCALLED INSPECTION.-
PREGUNITE• TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS" - ---�—'4
POURNO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -
UNDERGROUND /SLAB •'x�VeU�CZ�-(
PLUMBING ' MAW
ELECTRICAL ISSUANCE u
MECHANICAL II Its BLuc. ELEc*. PLG., mECR
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED City Of.CuD IRO BUILDING PERMIT
INFORMATION
r WOOD FLOOR
.. PLUMBING SIFT.(�,?A ""'"-
_ MECHANICAL {{�
BR
ELECTRICAL - � - U� Ilk.I
FRAMING - -. �Y• I
INSULATION - ; 1 I :C N IL -
. i47 �Ci17�J1 /7jc6> /fa C�C.GHOUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEENSIGNED 5E.
S(D ET�IREA TOTAL.ACREAct
ROOF NOTE:NO FINAL'INSP.SHALL BE MADE BEFORE
DIAPHRAGM - THE CONSTRUCTION'TAX-ISPAID
BUILDING USE
ROOF SHEATHING RES IND CON PB 0"..•,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El D ❑
ASSESSORS PARCEL NO,
ROUGH SAN.0
PLUMBING - ELECT.ENERGY _
iRACI NO. PARCEL NO
TUBS&SHOWER PAN PLUMBING ENERGY ,D*^
MECHANICAL ='7- J MECR ENERGY
ELECTRICAL " BUILDING ENERGY - ACC DATE ACC FILE NO
FRAMING Z5?-� ELECT.FINAL TEST.
ZONING lENG.SITE N0.
INSULATION, - � PLUMBING
GAS TEST GAS
MECHANICAL -
FIRESPRINK, ENERGY T-2A
- �9 ,: $-7��/ -•+3.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y Ej NC] r ❑ No
EXTERIOR SHEAR ELECTRICAL RELEASE . ' ROOD ZONE A L U.C'
INTERIOR SHEAR - FIRE DEPT. Y[:] N❑ YL N❑
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING .� .
INTERIOR LATH - - TEMPORARY APPROVALBUILDING
SCRATCH COAT ELECTRIC
GAS
PLAN CHECK
FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
OCCUPANCY sE1SMIGFEE y,0
OCCUPANCYOF BUILDING IS NOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
'ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
A F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
o PLEASE GIVE JOB ADDRESS WHEN PHONING.
4 a'
_ Z -,SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
. 1MPORTANT!
CONST,rnx
PLEASE READ REVERSE SIDE BEFORE TOTAL SO
CALL'ING.FOR FINAL INSPECTION.
OFFICE COPY
,,APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUI LDI NG PROJECT I DEN ATION PERMIT NUMBER
a ILGING _ _ APPLICATION & PERMIT 17873
AOORESSMYZ 0
�1p,50(IC BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
OWNER's PLAN CHECK VALIDATION
NAME A�1F ''/I�Ey/yy. y/p���� �T�V� 'JARR QTY. ELECTRIC PERMIT FEE y�
.M•I I, E I��p Vl�.r l FHONE bl?ft j,� I QI t✓
CONTRACTOR'S r`I+ft`, D
NAmEOUTLETS-SWITCHES-RECEP, 10.00/1.00 7
LIGHTING FIXTURES 10.00/1.00 /
CONTRACTOR
APPLIANCES-RESIDENTIAL 4.00
I ONE q4(_•CyM PANELS 10.00 DATE OF APPLICATION
ARCHITECT PLANCHECKFEE, P.C.NO,
oR PANELS (OVER 200 AMP) 20.00
ENGIrrN'-'
WjjN Lie.No.�.'aA7� SIGNS TRANS. 3.00
ARCH OR ADDRRE/SS ENG. C�/G' SPECIAL CIRCUIT 5.00
,, PERMIT VALIDATION
07 N o/�'IC lr. WE xIP �� EMP.METER OR POLE INS. 20.00
vuc
AvA r5 MOTORS ' SEE FEE SCH. •
ADDRESS '
5 M11 LfY, SERVICE CHANGE 20.00 . 1'
0 2 LICENSED CONTRACTORS DECLARATION V
a ca I hereby affirm )hat I am licensed wider poovisipns of Chapter') ISSUANCE DATE
H z w (commencing with Section 7000)of Division 3 of the Business and
m a > BLDG. ELECT. PLG. MECH.
F N z Professions Codl ldtmy license is in lull 6 I f
p i w W Licc / I.ic.Numbel0� -_.� _ lyl El 0 0
Date 1-����SS�777111 Contractor 1 Cin_;2L U
P:
a m BUILDING PERMIT
¢ ¢w a OWNER�BUILDIiR DIiCLARA'PION '
D U INFORMATION
R
; ¢ y I hereby affirm that I am exempt from the Contractor's License MISC.- RE ERT ORD
LLoa Law for lite followingmason.(Sec.7031.5,Businessand Pmfcssimds VALUATION $/FT.
H _ .PERMIT ISSUANCE - - - 10.00 D
Ew0P Code:Any city orcounty which requires a permit 101dnptraet,alter, QW
Be IT Q D Improve,demolish,or repair any structure,prior 10 Its Issuance,also ELEC.CONTR. LIC.NO. ELEC.
D p requires the applicant for such permit In file a signed statement that � � TOTAL
¢ r z< he is Chc licensed pursuant n the provisions office Contractor's License PERMIT,$O
Law(Chand Professions
Code)til Sealion 7000)ofDtvemboofthe
Se 4 D Business and Professions Coder or that he is exempt taro 70 and QTY. PLUMBING PERMIT FEE
¢ H $ the basis for the alum exemption.Any applicant
o to action 703L5 STORIES Tr(VPE`O•NS,TR.
by any applicant lora permit d.lotstheepplicanm tnacivil penalty ALTER-DRAIN -WATER IEA.) 5.00 I-�.�,•'jE � `7�� /�/
of not mon than five hundred dollars155001,1:
❑ Las owner at the properly,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will(S the work,and the and tTlre is nn[ ^2
Code: d e, offered fns sale (Seo. doe Business and Prnwner os' DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:ly who guild, r License Law does not apply to an owner of
propelfy who pis improves Hees,provide who hatdoes S improv
FIXTURES,PER TRAP 5.00 so
himself
AREA TOTAL ACREAGE
himselfre through his own employers,provided that such improve-
or imp rov not it is sold or within
ronefor
yearsale.of c however,lsion,he the novae
GAS-EA.SYSTEM-1 1NC.4 OUTLETS 6.00 L3
or improvement is sold within nue year of completion,the owner GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
builder will have the burden ol'ciroving that he did not build or ill, RES IND CON PB Omar
ner m si
prove for purpose of Sale.). - INDUSTRIAL WASTE INTER. 30.00 13 1:1 1:1❑ I,as owof the property,aexcluvely 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 - -
10 an owner of property who builds or indproves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a contractoroa licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractor's License Law. TRACT NO. PARCEL NO.
❑ I am exempt under See. ,Is,&PC.for Dl is WATER HEATER ANENT 6.00
reason
Owner Dale WATER SYSTEM 5.00
ACC.DATE ACC.FILE N0.
WORKERS'COMPENSATION DECLARA'T'ION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to scl&insure,
or u certificate o1'Workcrs'Compensalion Insurance,or a certified ZONING ENG.SITE NO.
copy there�,,j�..(��tyyjj800.Lab.C.).//
Policy No`A5U .QCmnpany_C1T[
U ❑ Certilied copy is hereby furnished.
Z Z ❑ Cetli(ic rs d t• inspection division. FIRE SPRINK ENERGY FZ4
FO Applicum�1571TA1_F-rl/_I MISC.- REFER TO ORD. v [3 N[E] vEl No
CC CERTIFICATE OF FXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A,L.U.C.
LU COMPENSATION INSURANCE PLC.CONTR. LIC.NO, PLG.
EL D (This section need not be completed if the permit is for one TOTAL- V[-] N V❑ N�
=� Z hundred dollars IS 100)or less.)
U O 1 certify that in the performance Of life work for which this per- QTY. - MECHANICAL PERMIT FEE FEE SUMMARY
LL f mit is issued,I site]]not employ any person in any manner so as to
U W become subject to the Workers'Compensation Laws of California,
Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING (�6�
} van NOTICE TO APPLICANT: If,after making this Certificate ul'fix-
F ? emption,you should become subject to the Workers'Compensation APPLIANCE. 5.00 PLAN CHECK
provisions of the Labor Code, you rust forthwith congdy will FEE I
U such provisions Or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)000C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE (.P -
I hereby affnm that there is a Construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 L.V
the performance oL.em work for which this permit is issumrl(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lenders Name H EATING UNIT(OVER 100,000 B.T.U.)9,50
Lender's Address ELECTRIC
) certify that three read this application and slate that mile above VENTILATION FAN (SINGLE) 4.00
information is,correcm. I agree l0 Conicity with all city and county BOILER-COMP(3 H.P.br 100,000 B.T.U.) 6.00 PLUMBING
ordinances and slate laws relating to building construction, and
hereby authorize representatives forms inspection
this city to enter upon the BOILER-COMP (Over'100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property tativsp of
purposes..
1portino
ree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
against liabilities;judgments, costs and expenses which PERMIT ISSUANCE 10.00CONST.TAX
Y waY a5crue against said City in consequence of-the T MECH.CONT. LIC.NO. MECH.!J'/6TDTAL TOTAL j'Applic t/Con Vector "Uate r
OFFICE COPY