16480I
IN
`a.
APPLICANT TO FILL IN INFORM,#TI ITHIN RED LINES - USE BALL POINT PEN ONLY
BUI LDI NO PROJECT I DENT( FICATION
APPLICATION & PERMIT' 'a
- ELECTRICAL- PLUMBING - MECHANICAL
PERMIT NUMBER
'
16480
ooass T
flooBUILDING
ZDEE Ul'
OwNER'S ropj I p -
NAME { f/WN C6 �R
PHONE 4o8 738•
QTY. ELECTRIC PERMIT FEE
PLAN CHECK VALIDATI N
}-� -,P
A`i V PLA4
P CHFK•k
$7_152.CONTRACTORS
CONTRACTOR
NAME �
NAME
LIC.NO.
OUTLETS - SWITCHES -RECEP 10.00/1.00
LIGHTING FIXTURES 10.00/1.00
Rms
ADESSS
APPLIANCES 4.00
PANELS 10.00
PHONE
DATE OF APPLICATION A'
ARRCHITECT JeWA+v_HEN MI
ENGINEER `. -�/ 0�9
uc. No.
PANELS 200 AM20.00
P(
PLAN CHEEKFEE P.C`NO..
SIGNS TRANS. 3.00
ARCH, OR ENG. 74 / ,f � c7 TO ST.
ADDRESS T LT••i
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
I
544J PRAAJGf bC-O C4,14/03 ZIP
TEMP. METER OR POLE INS. 20.00
/ -'Q
�j J /
ADDRaSS E -
ADDRESS
Aoom
MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
T SII
J J4. Wro y(VC O.(
LICENSED CONTRACTORS DECLARATION
ZyyO•
1 hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business andBL
Professions Code, and my license Is In full force and effect.
License Class Lie. Number-
ISSUANCE DATE
11,,
tl
DG.
ELECT.
PSL
PLG. ECH.
r-xrrvr
Contractor
/A��
YY
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the inessacl Pr License
a, Business and Professions
Law for the following myreason.wh (Sec. requires
Code; Any city or couNy which requires a permit to construct, aaeq
BUILDING PERMIT
INFORMATION
MISC. - REFER TO ORD
VA 10 3C
'
b $lFT
PERMIT ISSUANCE 10.00 ILOO
ELEC. CONTR. LIC. NO.
ELEC. �f Z
TOTAL 2�
improve, demolish, or repair any structure, prior to its issuance, also
requires the applicant for such permit to IIIc a slglled Statement that
he is licensed pursuant to the provisions of the Contractor's LicenseI
Law (Chapter 9(commencing with Section 7000)ol' Divislon3ofthe
Business and Professions Code) or that he is exempt therefrom and
PERMIT TO
e / U,M tii h�
( b p L
I
QTY. PLUMBING PERMIT FEE
STORIES
TYPE CONSTR.
the basis for the alleged exemption. Any violation of5ection 7031.5
by any applicant fora permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500).):
ALTER -DRAIN -WATER IEA.) 5.00
❑ 1, as owner of the property, or my employees with wages as
their sole Compensation, will do the work, and the structure is not
BACK FLOW PROTECT. DEVICE 4.00
OCC. GROUP
RES. UNITS
DRAINS -FLOOR, ROOF, AREA, COND. 5.00
intended or offered for sale fSec. 7044, Business and Professions
Code: 'rhe Contractor's License Law docs not apply to an owner of
property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improve-
ments are not intended or offered for sale. IL however, the building
FIXTURES - PER TRAP 5,00so.
FT. FLOOR A
u0 �
/
TOTALnACREAGEE�_
Gu 1(7 QQO
GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion, the owner -GAS
builder will have the burden of proving that he did not build or am-
prove for purpose of sale.).
CII, as owner of the property, am exclusively contracting with
. ..
- EASYSTEM -OVER 4 (EA) 200
BUILDING USE
RES IND CDN PEI Omer
❑ ❑ ❑ ❑ ❑
INDUSTRIAL WASTE INTER. 30.00
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 -
ASSESSORS PARCEL NO.
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code: The Contractor's License Law docs not apply
to an owner of property who builds or improves thereon, and who
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
contracts for such projects with a contractor(s) licensed purswnt to
the Contractor's License Law.
SEWER -SANITARY -STORM EA. 200ft/10.00
TRACT NO.
PARCEL NO.
❑ lam exempt under Sec.-, B.&P.C. for this
reason
WATER HEATER W/VENT 6.00
Owner Date
WATER SYSTEM' 5.001
ACC: DATE
ACC. FILE NO,
WORKF.RS'COMPI'NSATION DECLARATION
WATER TREATING EQUIP. 5.00
I hereby atria, that I have a certificate of consent t0 self-insure..D
or a certificate of Workers' Compensation Insurance, or a certified
ZONING
ENG. SITE N0.
copy thereoffSee. 3800, Lub.CJ.
Policy No. Company
FIRESPRINK
Y ❑, NO
ENERGY TQ4
Y ❑ No
$Certified Copy is hercb ILr (shed.
❑ Cert '•d c py is `r1 d' the Ch�-in ection division.
Applicam `r,.Kk
MISC. - REFER TO ORD.
CLT FICA1'EOF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
he
(This Section need not he completed if the permit is for one
PERMIT ISSUANCE 10.00 ,Z•PD
PLC. CONTR. LIC. No. PLG, S 7 e
TOTAL G�
A FLOOD ZONE
v ❑ ❑
Y N
A.L.U.O.
Y N
❑ ❑
QTY. MECHANICAL PERMIT FEE
FEE SUM A V
hundred dollars (S 100) or
I certify that in the performance of the work for which this per.
mit is issued, I shall not employ any person in any manner so as to
BUILDING
aeF 11
become subject to the Workers' Compensation Laws of California./
Date Applicant
NOTICE 'r0 APPLICANT: If, after making this Certificate of Ex-
ALTER OR ADD TO MECH. 5.00
APPLIANCE. 5.00
PLAN CHECK
emption, you should become subject to the Workers' Compensation
provisions of the Labor Code, you Most forthwith comply with
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT (TO 10=CF.M.) 4.00
FEE
AIR HANDLING UNIT (OVER 10=C.F.M.) 6.00
SEISMIC FEE
. CONSTRUCRON LENDING AGENCY
1 hereby affirm that there is a construction lending agency. for
EXHAUST HOOD (WITH DUCT) 5.00
the 3097, Civ.0 )nee of the work for which this permit is issue) fSec.
HEATING UNIT (TO 100,000 B.T.U.) 8.00
MICROFILM
HEATING UNIT (OV ER 100,000 B.T.U.) 9.50
ELECTRIC �Z
Lender's Name
Lenders Address
I certify that I have read this application and state that the above
information is correct. I agree to comply with all city and County
ordinances and state laws relating to building construction, and
VENTILATION FAN (SINGLE) 4.00
PLUMBING
BOILER - COMP (3 H.P. or 100,000 B.T.U.) 6.00
BOILER -COMP (Over 100.000 BTU) SEE FEESCH.
MECHANICAL
hereby authorize representatives of this City to enter upon the
above-mentioned property for inspection purposes.
MISC. - REFER TO ORD.
)
AX3
(We) agree to'save, indemnify and keep harmless the City of
operon. against liabilities, judgments, Costs and expenses which
may in any way accrue against said City in consequence of the
PERMIT ISSUANCE 10.00 Z.e/
ran 'ng o f this permit.
• _ 30 -
MECH. CONT. - LIC. NO. MECH.
TOTAL (r r
T
TOTAL c
Sign u • of Appli ant/Con ac r Date
v OFFICE COPY ` `�
v POST THIS CAFi.D..WEAR FRONT OF @QUI LDyNG''
CITY' It.OF CUPERTINO
PERMIT NUMBER
164$'0:
INSPECTION DIVISION
JOB INSPECTION RECORD
1
PERMIT EXPIRATION
O bo �e
�L�1
JOB ADDRESS:'/ C� UNIT# _LOT#
"
PERMIT EXPIRES IF WORK
OWNER .D w CONTRACTO'Hwb e_ �. ''
IS NOT STARTED,WITHIN
180 DAYS OF PERMIT ISSU-',
ANCE OR 180 DAYS FROM
• NSPECTION DATE I INSPECTOR
- INSPECTION RECORD
FOUNDATION
NOTE:
ALL GRADING AND DRAINAGE SHA L BE INSTALLED
TO COMPLY WITH THE APPR�V�NS AND CITY OF
CUPERTINO STANDARDS.
LAST CALLED INSPECTION.'
i;
UFER -
PREGUNITE
PERMIT VALIDATION
`L
GARAGESLABS
/
k ✓
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLAB'
PLUMBING
molk of CuRrim:�
I, ( 4•• .:
IssUANCE DATE
ELECTRICAL `
MECHANICAL
BLDG
ELECT, I
PLG. 'MER.
'
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
BUILDING PERMIT
INFORMATION
'WOOD FLOOR -
PLUMBING
VAI.UATIUN .` t
$/ET.
MECHANICAL
ELECTRICAL
�j
PfHMIT To
(v' i t I
FRAMING
T PE CONSTR.
•
INSULATIONSTORES
47
/L
V wJ tlL6
VCC. GROUPRES
UNITS
„PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF �
NOTE: NO FINAL INSP. SHALL BE MADE BEFORE
THE CONSTRUCTION TAX IS PAID
2TtlO�AHEa
I i
raTALA
--117)1,00
DIAPHRAGM
,
ROOFSHEATHING
BUILDING USE
RES IND CON PB 00",
❑ 1:1 ❑ 1'
-'APPLY'NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
FINALS DATE INSP.
ROUGH
SAN.#,
ASSESSORS PARCEL NO
PLUMBING
ELECT. ENERGY
TUBS 8 SHOWER PAN
PLUMBING ENERGY
T IT AlfNO
PARCEL -NO
MECHANICAL
MECR ENERGY
ELECTRICALAG�STE
-
BUILDING ENERGY
..
ACC, FILE NO
FRAMING
ELECT. FINAL TEST
INSULATION � ,PLUMBING
��
ZONING
ENG. SITE NO.
,
GAS TEST
GAS
MECHANICAL'
FIRE SPR INK
"�
ENERGY T 2
❑ NF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING
EXTERIOR SHEAR-
ELECTRICAL RELEASE • r
FLOOD ?ONE'
-
° � N�
,AL IC,
° ❑ "EI
INTERIOR SHEAR
FIRE DEPT.. +-
SHEETROCK .-
GRADE -
FEE SU
EXTERIOR LATH--.
BUILDING -
v
BUILDING _ J"
INTERIOR LATH'
-:TEMPORARY APPROVALS -
SCRATCH COAT ..
ELECTRIC q
PLAN CHECK %
FEE
-
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY
SEISMIC FEE 0
OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.
MICROFILMLu ----'
ARRANGE FOR INSPECTION BY PHONING.252-4505"
ELECTRIC �Zid
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLUMBING��
O� PLEASE GIVE JOB ADDRESS WHEN PHONING. '
MECH_WICAL o2(
Z
—SEE PERMIT FOR EXPIRATION DATE —
c'0 s
IMPORTANT!
' .PLEASE READ REVERSE SIDE BEFORE-""
TOTALI -
CALLING FOR FINAL INSPECTION.
OFFICE COPY
II
II
I
%Lpr `firat-i of V/ r apK;`iry No. 840
TRY of 19upprtina
43pliarimpnf Of Vtiilthinig jInapprflon
This certificate issued pursuant to the requirements of Section 307 of the
Uniform Building Code certifying that at the time of issuance this structure mu
in compliance with the various ordinances of the city regulating building
construction or use. For the following:
Use Classification shall. Condnminin n 'ldi Bldg. Permit No. 16480
Group R-1 Type ConstructionType 1 Parking Ser neture planned D •olnpm n
V-1 HR Condomini GumpBiag.
Owncrof Building John yi dovi nh Address 101 00 Torr &Menjie
Building Address 10100 -Torre A, ansa Locality _Cunerfi no. f a1 i fnrni
By: .7pAntonnrgi
��- Date: Decemhar 78, 1990'
Building Official
POST IN A CONSPICUOUS PLACE
I....�.,