15230 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUI LDI NG PROD CT I DENTI F,CATION .PERMIT NUMBER -
go,oirElN o APPLICATION & PERMIT 1 `r�//� /S�
IrnA pO BUILDING-ELECTRICAL-PLUMBING -MECHANICAL 15230
VA b- 7 13
OWNERS lI /./r r�t �• PLAN CHECK VAUp
� "AME T' r 10 CITY. ELECTRIC PERMIT FEE
3 LLf I 4�'> E 3 0202 7
CONTRAcrO , OUTLETS-SWITCHES-RECEP 10.00/1.00
NAME p
ELAx) 61Z 46WTRk.NO. /0?836A LIGHTING FIXTURES 10.00/1.00
CONTRACTOR S .5 _APPLIANCES-RESIDENTIAL 4.00
AD
�-- OREss /
o A��] )�
oosowoE `U 0rvE7$!'(,Ib PANELS 10.06 DATE OF APPLICATION
ARCHITECT .{ PANELS (OVER 200 AMP) 20.66 PLAN CHECK FEE P.C.NO.
OR ed sly,r .
ENGINEER r / [J SIGNS TRANS. 3.00
ARCH.OR N 4 P41 gs" SPECIAL CIRCUIT 5.06 PERMIT VALIDATION
ADDRESS
PLr 14.tir LJ TEMP. METER OR POLE INS. 20.00
APPLICANT' MOTORS SEE FEE SCH,
ADDRESS �fI N �2 V CLf Sc.A �Yt C3" p
7 SERVICECHANGE 20.00 ' / Or
woo LICENSE'CONTRACTORS DECLARATION ((�� [ t C
ar U 1 hereby affirm That 1 am licensed under pmvisime of Chapter 9 ISSUANCE DATE
a2w
Uonunencing with Section 70001 of Division 3 of the Business anJ BLDG. ELECT_ PLG. MECH,
o rd
i~o Profcssi"11� license is in full farcy allyl.yfJrct,._.� AP ❑ ❑ ❑
z0y-- Liccnsc77Class Lic.Numbcrl�-145- ,• -_pC-
Date Contracmr
a y s BUILDING PERMIT
IS c w¢ OWNER-BUILDER DECLARATION
o aMISC.- REFER TO ORD It1R0NFORMATION V $/FT.
w i a y I hereby affirm that I am exempt from the Contractor's License
aoa Law l'nr the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 VALID
Cale:Any city or county which raslmiresu permit toconstruct.alter, Q
a o improve,demolish,or repair any structure,prior to its issuance,also FLED.CONTR. LIC.NO. ELEC.
-CIC requires the applicant for such permit In file a signed statement that TOTAL PERMIT TO
he is licensed pursuant to the provisions of the Contractor's License
F z a
Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe
Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
f c the basis for the alleged exemption.Any violation of Section 7031,5 STORIES TYPE CONSTR.
ate - by any applicant for a permit subjects the applicant o a civil penalty gLTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred dollars 15500).1:
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00
their sole compensation,will do the work,and the structure Is not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law docs not apply to an owner of
property who builds nr improves thmeon,and who fees such work FIXTURES-PER TRAP 5.00 so.FT.FLOOR AREA TOTAL ACR EAGE
himself or through hisown employees,provided that such improve-
mentsarcnotIntendedmofferedforsale.it,however,the building GAS-EA.SYSTEM-I INC.40UTLETS 6.00
or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
builder will have the burden of proving that he did not build or im-
I/ RES IND CON PB ower
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
O 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and professions Code I'hc C'ontractor's License Law docs not apply
to an owner of property who builds or improves thereon,:cod who LAWN SPRINKLERS-OVER 5(EA.) 1.00
eine Cons ctor'shcense Lwithan>niraewrts)IicerocJ fondant to SEWER-SANITARY-STORM EA.2001t/10.00 TRACT NO. PARCEL NO.
the Contractor's h projects
is w.
❑ lam exempt under Sec .B.&I'.C.for this WATER HEATER W/VENT 6.00
eason
Owner Dale WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORK ERS'COMPENSA'JION DECLARni'ION WATER TREATING EQUIP. 5.00
1 hereby affirm(tut 1 Ir ve aautlhQ,of consent to sel Ginsur, 20NING
certifier, of Wo 0 on Insurance,or a.voificd ENG.SITE NO.
te
-_
copy[lie co
PoCompanyyTty MCC/-
0 o iledpys hereby fami,hed.
FIRE SPRINK ENERGY T-24
Z Z- ❑ Ccrt if' d copy is thud w' , the city inl'ectiun divrsion. MISC.- REFER TO ORD.
CC C17R'IIFICATI:OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO, PLG.
CL U This section nred not be completed if the permit is for One TOTAL Y❑ N❑ Y ❑ N❑
=) Z hundred dollars(5100)or Ica.)
U O 1 certify that in the performance of the work fur which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is maw,I shall not employ any Person in any runner so as to �Tt
U become subject to lire Workers'Compensation Laws of California. BUILDING
y Dae Applicant ALTER OR ADD TO MECH. 5.00
} to NOTICE TO APPLICANT: IC after making this Certificate of E.
2 emphm'n you should become subject to the Workeri Compensaion APPLIANCE 5.00 PLAN CHECK
PH,. of lire Labor Code, you must forthwith comply withFEE
U such provisions or this permit shall be decried revoked. AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE /Q
I 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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ.C.l.
Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC
Lender's Address
1 certify that I have read(lis application and state that the above VENTILATION FAN (SINGLE) 4.00
information is street. I agree ti comply with all city and county PLUMBING
ordinances and orae laws relating to building mitt'anion, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby autlmdae representatives 6f this city to enter upon the BOILER-COMP (Over 100.000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for inspection purposes.
(Wel ugove to save, indemnify and keep hon,less the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgramos, costs and expenses which PERMIT ISSUANCE 10.00
raCONST.TAX
may in any way accrue against said City in consalacnce of the
n' gofthispermit. MECH.CONT. LIC.NO. TOTAL TOTAL
' O
Si ure /Ap
,!,51
plicaonra
nt/Ctct 'ate
OFFICE COPY -
_ f
POST THIS CARD NEAR FRONT OF BUILDING
RMI
CITY OF CUPERTINO g5230
NUMBER
INSPECTION DIVISION
l
JOB INSPECTION RECORD 9
/ '/ l,�/ �^(J $�� /d U7 PERMIT'EXPI RATION
JOBADDRESS ( 0/A3 N. WOL-r L 31 UNIT# _LOT#
' PERMIT EXPIRES IF WORK
i OWNER LVcr / CaaKie_S CONTRACTOR E 1/ C �C� IS NOT STARTED WITHIN
` INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU-
FOUNDATIONANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS,
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING -
ELECTRICAL D ISSUANCE DATE
MECHANICAL BLDG ELECT I PLG. NIECR
-C% a❑ ❑ ❑
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ¢UI DING PERMIT
WOOD FLOOR - %ne([ CIN"
VALUATION S/FT.
PLUMBING
MECHANICAL
PERMIT LO
ELECTRICAL - R
FRAMING MT�Z dC X/y�QOVC
Sr ORI[$ TYPE CONSTR
INSULATION
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED '
SO Fl FLOOR AREA TOTAL ACREAGE
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
_ DIAPHRAGM - THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING RES IND CON Pe Om.-
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑
ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING ELECT.ENERGY -
TRACT NO PARCEL NO
TUBS&SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ACC DATE ACC FILE NO
ELECTRICAL BUILDING ENERGY
/ FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO.
INSULATION - PLUMBING
GAS TEST GAS
FIRE SPRINK ENERGY T�24
MECHANICAL Y ❑ NC) I ❑ N[:j
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD/ONE ALuc.
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT. 1 N� ❑ N❑
SHEETROCK V'� GRADE FEE SUMMARY
EXTERIOR LATH BUILDING -
INTERIOR LATH TEMPORARY APPROVALS BUILDING ��..
SCRATCH COAT - ELECTRIC PLAN CHECK
GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE QSO� '
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ELI ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
I- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
O� PLEASE GIVE JOB ADDRESS WHEN PHONING.
z MECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
r IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORETOTAL I ,
CALLING FOR FINAL INSPECTION.
OFFICE COPY
V91-11WIN
n%so—F AZJ -IF-11- 41'
No. 745
z (IT
watifiratr . of Orrupaury
Titof Tapertino
This certificate issued pursuant to the requirements of Section 307 of the
Uniform Building Code certifying that at the time of issuance this structure nus
in compliance with the various ordinances of the city regulating building
construction or use. For thefollawing:
Use Classification RETAIL SALES (INTERIOR IMPROVEMENT) Bldg. Permit No. 15230
Group B-2 Construction 2 N Use Zone PLANNED DEVELOPMENT
Owner of Building BLUE CHIP COOKIES (TENANT) — Address 10123 N. WOLFE RD. SP. 1007—B
Building Address 10123 N. WOLFE RD. SP. 1007—B Locality CUPERTINO, CALIF. 95014
By: JOE ANTONUCCI
Date: AUGUST 26, 1988
M1, Building Official
POST IN A CONSPICUOUS PLACIE