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8611 'APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY tie BUILDING PROJECT IDENTIFICATION PERMIT NUMBER ADDRESG APPLICATION & PERMIT n ADLOT 1 b' i BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 86 OPLAN CHECK VALIDATION "AME DeAnza Group, A CalifotnidQTY. ELECTRIC PERMIT FEE • Ltd. Partnership Rory15/571-1411 CONTRACTORs UTLETS-SWITCHES-RECEP 10.00/1.00 The Alden Company . U465640 LIGHTING FIXTURES 10.00/1.00 ADDRESS DRs 411 Borel Ave, Ste. 410 ' PPLIANCES-RESIDENTIAL 4.00 CONTRACTORS San Mateo-Ca.94402 PHD 1 1-14 1 PANELS 10.00 DATE OF APPLICATION ARCHITECTOR PLAN(OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ' ENGINEER u 4 ARCH OR 1 12 SIGNS TRANS. 3.00 ADDRESS ENG' 2070 Business Ctr. #220 SPECIALCIRCUIT 5.00 PERMIT VALIDATION zIPLS EMP.METER OR POLE INS. 20.00 moo Essrs 411 Borel Ave, Ste. 410 MOTORS SEE FEE SCH. '/`p.�•J'Jj-,"rn RAn Mateo- C6. 94402 SERVICE CHANGE 20.00 /1�f Eat ¢ r TEMP.POLE 30.00 C 28 H o o LICENSED CONTRACTORS DECLARATION _ l,QRS <i w I hereby affirm that I am licensed under provisions of Chapter 9 r s ISSUANCE DATE 1 waw (commencing with Section 7000)of Division 3 of the Business and BL G` (§LECTPLG. MECH. F. w z Professions Cod"and Iny license is in full fore d t. >y j, fill) a Do o m - Cicmase Class $ Lia Number ]! rt' it; ' o w t a Uate.. 5.J717!$� Contractor ✓Y a r -+ BUILDING PERMIT ¢ a a OWNER-BUILDER DECLARATIO a o a v INFORMATION w ; I hereby uollo that I am exempt from the Contractor's Liston MISC.- REFER TO ORD LLoa Law l'ar the following reason.(Sec.7031.5,Business Professions PERMIT ISSUANCE 10.00 VALUATION SIFT. E -o Code:Any city or county which requires a permit to construct,alter, - L � � w , 2 harove,demolish,or repair an structure,prior ELEC.CONTR. LIC.NO. ELEC. p p' y or to Its issuance.also u w ora LL requires the applicant for such permit to file a signed statement that TOTAL PERM IT TO he is licensed pursuant to tlm provisions of the Contractor's License Hzi Law(Chapter 9(commeacirgwith Section 70001o1Division Sof the - ¢ o Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT FEE ¢ H m the basis for the alleged exemption.Any violation of Section 7031,5 STORIES .TYPE CONSTR. n ; _ by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(5500).): ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEV ICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale(Sec. 7044. Business and Professions Code: ROOF,AREA,GOND. 5.00 ` "(� Code:The Contractor's License Law does not apply to an owner of r , property who builds Or Improves thereon,and who does such work FIXTURES-PER TRAP 5.00 S0�.FT/.­­FLOOR 'TOTAL ACREAGE • himself re throne his own employees,provided that such improve- hients mself a not through or employees,ffered for provided that s.the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or improvement is sold within one year of completion, - . - . .00 the owner- GAS EASYSTEM OVER 4 IEA) 2 builder will have the burden of proving that he did not build or im- BUILDING USE prove for purpose of I INDUSTRIAL WASTE INTER. 30.00 Res IND CON PB Omer ❑ I,as owner Of the property,am exclusively contracting with ❑ 0 ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. V and Professions Code:The Contractor's License Law does not apply to nn owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contructous)licensed pursatmt to I the Coutractur's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. reason am exempt under Scc. .B.&P.C.ti+r this WATER HEATER W/VENT 6.00 i Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSA'f ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby atfirm that I have a certificate of consent to selGinsure, ZONING ENG.SITE NO. or a certificate of Workers'Compensatioi Insurance,or a certified - Copy thereof(Sit,.3800, I-fib.C.). I� policy No(-DAO f Y y p O ❑ Ccrtit e den$CmpBn)' RE SPRINK ENERGY T 24 qtCerbDeB e. ed LLh the cit inspection division. O AIT ant_� MISC.- REFER TO ORD. y NEJ r ❑ N[] N CERT'IFICATF.OF EXEMPTION'FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOOZONE A.L.U.C. Ui > COhIPI-NSATION INSURANCE .' PLG.CONTR. LIC.NO. PLG. 0- Z( This section need Isn't [:]be completed if the permit is for one TOTAL y N❑. V El NE] hundred dollars IS 100)or less.) U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY (,L I- mit is issued, I shall not employ any person in:ury manner xo as to 0U became subject to the Workers Cornpcnsatroo Laws of California. Date Applicant BUILDING }Mail NOTICE TO APPLICANT: If,after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 F ? emption,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) - 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.F.M.) 6.00 SEISMIC FEE I I hereby affirm that there is a construction leading agency for EXHAUST HOOD(WITH DUCT) 5.00 De performance of the work for which this permit is i,,u Irl(Sec MICROFILM 3097.Civ.C.y ' HEATING UNIT(TO 100,000 B.T.U.) 8.06 Lender's Name BBnk, of AmpriE. DAA Lender's Address Box- 1$0iH EATI NG UNIT I OVER 100,000 B.T.U.)9.50 ELECTRIC -Pa�0-Ato-Ca- I certify that l have I agave t cam lou and st¢1(1tg�ge above VENTILATION FAN (SINGLE) 4.00 information is state. I agree to comply with al Ity ads county PLUMBING ordinances and state lows relating to building Consiruchnn, unJ BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. gOILEfl-COMP (Over 100,000 BTU(SEE FEE SCH. MECHANICAL (We) agree to save, indcmnIfy and keep harmless the City of MISC.- REFER TO ORD. CONST.TAX Cupertino age ast abilities, inJgments, costs and expenses which may in any ay ra rue ag inst said City' in consequence of the PERMIT ISSUANCE 10.00 granting of 11 Ice L MECH.CONT. LIC.NO. MECH. %IIITOTAL /^ 5_ TOTAL Signature of ppl c a[/Cont of jDate INSPECTOR COPY - MECHANICAL 4,_ G ld.Ge- . ACC. GATE ACC. FILE NO. ELECTRICAL PINALS DATE INSP. f FRAMING SAN # ZONING ENG. SITE NO. INSULATION % 3- Qr PLUMBING - i POST THIS CARD NEAR FRONT OF BUILDING N T y CITY OF CUPERTINO94 PERMIT NUMBER ; INSPECTION DIVISION ENERGY T.24 NEI JOB INSPECTION RECORD dee K o PERMIT EXPIRATION COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED JOB ADDR SS UN 7# LOT# J OWNER CONTRACTOR V/I/ PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN A. L.U.C. Y N 180 DAYS OF PERMIT ISSU- INSPECTION D E INSPECTOR INSPECTION RECORD FIRE DEPT. ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. FOUNDATION ( S` 1p_ / f f 1iWC UFER (3 SHEAR INTERIOR - PREGUNITE BUILDING PERMIxr,IBf oN SHEAR EXTERIOR TEMPORARY APPROVALS JUL 2 1985 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED PLAN CHECK FEE v0 UNDERGROUND ISL B PLUMBING NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED ELECTRICAL OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR- MICROFILM I ISSu NCE DATE MECHANICAL ELE I . CH MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED OFFICE COPY N BUILDING PERMIT INFORMATION WOOD FLOOR v ELATION -S/FT. j PLUMBING MECHANICAL J ELECTRICAL RMIT TO I STORIES TYPE CONSTR- FRAMI NG INSULATION OCC. GROUP RES. UnJ,ITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO FT.,FLO0AAREA l TOTAL ACREAGE DIAPHRAGM BUILDING USE RES IND 'CON PS Oiher Q APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO. ROUGH PLUMBING GAS TEST TR ;T T NOi PARCEL NO. MECHANICAL 4,_ G ld.Ge- . ACC. GATE ACC. FILE NO. ELECTRICAL PINALS DATE INSP. f FRAMING SAN # ZONING ENG. SITE NO. INSULATION % 3- Qr PLUMBING - i 2 GAS FIRE SPRINK 1 NE]Y ENERGY T.24 NEI MECHANICAL _y(L- COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE Y ElN A. L.U.C. Y N LATH -INTERIOR ELECTRICAL 6 LATH -EXTERIOR FIRE DEPT. SHEETROCK GRADE FEESUMMARY SHEAR INTERIOR - BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDOCCUPANCY OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR- MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, oONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL l f,7 s OFFICE COPY 2 O ZZ F— w W _ IL DZ UO_ LL l OW y U LICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY DENTI FICATION PERMIT NUMBER APPLICATION &PERMIT BUILDING — ELECTRICAL— PLUMBING — MECHANICAL 8611LOT1 PLAN 4 OWN R'SPLAN NAME DeAnza Group, A Californi Ltd. Partnership PHOI415/571-14 CHECK VALIDATION QTY. ELECTRIC PERMIT FEE 1 OUTLETS-SWITCHES-RECEP 10.0011.00 c7DRs NAME NAME The Alden Company LIM5640 LIGHTING FIXTURES 10,0011.00 PPLIANCES- RESIDENTIAL 4.00 1 PANELS 10.00 DATE OF APPLICATION raNTRACTCR•s 411 Borel te. 410 ADDRESS Ave,1 San Mateo,Ca.94402 PHDI,415/571-14 ARCHITECT OR EN IEC,13712 aR deron-Nakamura LIc. PANELS(OVER200AMP) 20,00 PLAN CHECK FEE P,C.NO. SIGNS TRANS. 3,00 ARCH, ORENG. 2070 Business Ctr. 220ADDRESSDDRESS SPECIAL CIRCUIT 5.00 PER T TION TEMP. METER OR POLE INS. 20.00Irvine, Ca. ZIP92715 qJUL2 9 1965APPLICANTS411BorelAve, Ste. 410DDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00SanMateo, Ca. 94402 City of CupertinoLICENSEDCONTRACTORSDECLARATIONTEMP. POLE 30.00 1 hereby affirm III at I am licensed under provisions of Chapter 9 commencing with Section 7000) of Division 3 of Ill Business and Professions Code, arty my license is in full for t. License D Lic. Number ISSUANCE DATE BL G. ELECT. PLG. MECH. Date. 5 1 5 Contractor2 BUILDING PERMIT INFORMATIONOWNER -BUILDER DECLARATIO I hereby affirm that [ am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any s[ruclurc, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that lie is exempt therefrom and MISC. — REFER TO ORD pERM1T ISSUANCE 10.00 VALUATION DO SIFT. ELEC. CONTR. LIC, NO. ELEC TOTA.L P RMIT TO OTY, PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ALTER -DRAIN & VENT -WATER {EA.) 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 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work provided that such improve- himself or through his own offeredmensarenotintendedoroffered for sale. If, however, the buildingfor BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS lDRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP 5.00 SD. FT. FLOOR AREA p T07ALACREAGE GAS - EA. SYSTEM -1 I NC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im- prove for purpose of sale.), 11I, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE RE 1ND CON PB Other INDUSTRIAL WASTE INTER, 30.00 licesed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon. and who LAWN SPRINKLERS - 1 INC 5 V.B. 6,0o ASSESSORS PARCEL, NO. L LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. laammexempt under Sec. ,B.&P.C.for this reason SEWER -SANITARY -STORM EA. 200h110,00 TRACT NO 7l/f/q4y PARCEL NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC, FILE NO. WATER TREATING EQUIP. 5.00WORKERS'COMPENSATIONDECLARATION 1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thereof (Sec. 3800, Lab.C.). Policy No. ny hP Aldan f'n3r F[RESPAINK Y N ENERGYT24 Y N r hed. Cor tified copy by rnis pyf Certified co f ith the city inspection division. Applicant MISC. REFER TO ORD. CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U,C. PLG. CONTR. LIC. NO.PLG. TOTAL COMPENSATION INSURANCE This section need not be completed if the permit is for one Y N Y N QTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars (S 100) or less.) 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 become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECKemption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. FEEAIRHANDLINGUNIT (TO 10,000C.F.M) 4,00 AIR HANDLING UNIT(OVER 10MC.F M.) 6.00 SEISMIC FEE ICONSTRUCTIONLENDINGAGENCY 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. 3097,Civ.C.). Lender's Name Bank of America, P. 0• Lender's Address Box 2-80,P 1 r1 r n Icertify that Ihave read this application and stR433J91%eabove MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OV ER100,000B.T.U.)9,50 ELECTRIC VENTILATION FAN (SINGLE) 4,00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUM ING t. BOILER -COMA 13 H.P. or 100,000 B.T.U.) 6.00 BOI LER-COMP (Over 100,000 BTU) SEE FEE SCH, MECHANI CALherebyauthorizerepresentativesofthiscitytoenteruponthe above-mentioned property for inspection purposes. MISC. - REFER TO ORD. We) agree to v , indemnify and keep harmless the City of Cupertino ago' Stis Pities, ' dgments, costs and expenses which may in any ay c e ag, st said City in consequence of the gran [Ing of If s t 5/31/85 CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL Signature ofAppllca t/Contracor Date OFFICE COPY