8610 APPLICAI`i FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
N: BUILDING PROJECT IDENTIFICATION PERMIT NUMBER
aUH_.lxm APPLICATION & PERMIT o
'. AGDRES, 7�Z� LOT 3
_ BUILDING - ELECTRICAL-PLUMBING-MECHANICAL
I_IA0611 ER y�x PLAN CHECK VALIDATION
NAME eAnza Group, A Californi IaTY. ELECTRIC PERMIT FEE
Ltd. Partnersbip PH❑NIS/S71-11,41
• NAMERAcroRs OUTLETS-SWITCHES-RECEP 10.00/1.00
The Alden Company LH:465 LIGHTING FIXTURES 10.00/1.00
CONTRACTOR"$
ADDRESS
411 Borel Ave, Ste. 410 _APPLIANCES.RESIDENTIAL 4.00
CONTRA
San Mateo Ca.94402 'HON415/571-1431 PANELS10.00 DATE OF APPLICATION
OR
OR
PANELS (OVER 200 AMP) y -20.00 PLAN CHECK FEE P.C.NO. t
ENGCaINE
deron-Nakamura Lm.6013712 SIGNS TRANS. 3.00
ADDRESS ENG. PEf{a11T Vfj`IDPTION
ARCH.08 2070 Business Ctr. 4220 SPECIAL CIRCUIT 5.ao P,(A�.[J
Irvine Ca. zip 92715 TEMP.METER OR POLE INS. 20.00 c� p p
APPLICANT'S
411 Borel Ave, Ste. 410 MOTORS SEE FEE SCH. [JUL 2 91985
ADDRESS
San Mateo Ca. 94402 SERVICE CHANGE 20.00
woo LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00
City of Cupertino
v w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE
y (commencing with Section 7000)of Division 3 of the Business and
n u BLDG. ELECT. PLG. MECH.
F m z Professions Code,and my license is in full fore a of ecu. ❑ ❑ ❑
O0 m o License Class_$_Lic Number
r N r j Date_fj`31 85 Contractor
a xBUILDING PERMIT
o a ° - OWNER-BUILUF.N DECLARA"I'10' INFORMATION
1 hereby a
h'xu 3 LL I- ffirm that 1 um exempt from the Contractor's License MISC.- REFER TO ORD
r LL 0< Law for the following reason.(Sec.7071.5.Business and Professions PERMIT ISSUANCE 10.00 VALUATION $/FT.
y0 Code:Any Clyne County which requires a permit to construct,alter.
¢ a p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. /
- 0 In requires the applicant for such permit to file a signed statement that TOTAL
u w m he is licensed pursuant to the provisions of tire Contractor's License PERMIT TO
Fzi Law(Chapter 9(commencing with Section 7000)of Division 3 oftha 1
a Business and Profasslons Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE L.�
SE I Oo the basis for the alleged exemption.Any violation of Section 7031.5 STORIESTYPE CONSTR.
aim by any applicant for u pC011lt subjects the applicant too Civil penalty
of not more than five hundred dollars 0500).). ALTER-DRAIN&VENT-WATER (EA.) 5.00 -
I ❑ I,us owner of the property,or my employees with wages us
their sole compensation,will do the work,and the structure is not BACK FLOW PROTECT. DEVICE 4.00 0 C.GROUP RE%W 4S.UNITS
intended nr'ofiereA for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractors License Law does not apply to an owner of
property who builds Ul'inmroves thCmmr,and who does such work FIXTURES-PERTRAP 5.00 SO.F FL RAREA TOTAL ACREAGE
O himself re through his own employees,provided that such improve-leahams are not through
on eicoud mploy'eesnlc.11'ded that suhc building GAS-EA.SVSTEM-11NC.40UTLETS 6.00 Ir
or improvement is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4 IEA.( 2.00 ILDwG uSE
builder will have the burden of proving that he did not build or int RES IND GN PB Omer
provuforpurposeofsalu.L ( INDUSTRIAL WASTE INTER. 30.00 q
❑ 1,as owner of the property,um exclusively conlracting with
licensed contractors to construct the project ISee 7044,Br,iness LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contmctors,Licensa Law does not apply
toan owner of property who builds or improves Iheruon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
confinets for such projects with a contracturts)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ I am exempt under Sec. ,B.AI'.C.for lois WATER HEATER W/VENT 6.00 _
reason
Owner Dare WATER SYSTEM 5.00 '
AC .DA ACC.FILE NO.
u'ORKERS'COMPENSA'rION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to selGinsure.
or a certificate of Workers'Compensation Insurance,or a cerlified 1 ZONING ENG,SITE NO.
copy thereof(Sec 3800,Lab.C.).
Policy No. �I n1 A-1den eo m any
❑ Certi¢ toys rn, lu Cd. -ter-"/ FIRE SPRINK ENERGYT 3<
O A4LCehrtilled copy//' c wit( tis he city inzpcetion division. MISC.- REFER TO ORD. Y � N� YE] NE]
2 N CERTIPICATS:OP Ii U6AIPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FL000 zoNE A.L.u.c.
L � COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG.
Z (This section need not be completed if the permit is for one TOTAL
hundred dollars IS 100)or less.)
L) O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
L l- mit is issued,I shall not employ any person in any manner,so as to
U become subject to the Workers'Compensation Laws of California.
W Datc Applicant BUILDING /
} N NOTICE TO APPLICANT: If,after making this Certificate of lis- ALTER OR ADD TO MECH. 5.00
2 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 10PWC.EM.) 6.00 SEISMIC FEE
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. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name��^�1• ^f Amerio- D /1
Undeh Address -tD_�a_ HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I certify that I hove read thiseppSication H stg�Af bllw above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to conhply with aIITT''ilY um muntY PLUMBING
ordinances and state laws relating to building construction, I3 and BOILER-COMP H.P.or 100,000 B.T.U.) 6.00
Oe rcby authorise representatives of this city to enter upon file BOILER-COMP (Over 10ODOOBTU)SEE FEESCH. MECHANICAL
,hove-mentioned property for inspection purposes.
(we) n h SevL, indenmify and keep haemes,file City of MISC.- REFER TO ORD.
Cupetlin ih t liabilities,Judgments, costs and expanses which CONST.TAX
may in h y y accnl against said City in conseduence of the PERMIT ISSUANCE 10.00
Branthng % Crl ul. '1 51,41 IRS MECH.CONT. LIC.NO. MECH.
TOTAL TOTAL -
SignaturcofAp licant/Contractor Dulc
INSPECTOR COPY
POST THIS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO
INSPECTION DIVISION
JOB INSPECTION RECORD
JOB ADDRESS 02ZTJ r/_SX 4f AIV, UNIT# LOT#
OWNER ky2 rdio • CONTRACTORkag pi Co.
INSPECTION DATE INSPECTOR INSPECTION RECOR
FOUNDATION 8 6r 5 ywxA
UFER
PREGUNITE
POUR NO CONCRETE UNTIL ABOVE HAS BEEM SIGNED
UNDERGROUND/SLAB
PLUMBING,
ELECTRICAL
MECHANICAL
DO NOT POUR FLOOR UNTIL ABDVE HAS BEEN SIGNED
WOOD FLOOR
PLUMBING
MECHANICAL
ELECTRICAL
FRAMING
INSULATION l
PLACE ND SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF,
DIAPHRAGM D~3I
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
ROUGH
PLUMBING
GAS TEST
MECHANICAL
ti; MIT NUMBER
f BUI DING PERMIT(
I FORMATION
VAC ATION SIFT.
ERMIT TO +
TORI 5 TYPE CONSTR-
S I IiY,
s':
OCC. GROUP RES. UNITS
1
SO. FT FLOOR AREA TOTAL ACREAGE
BUILDING USE
E IND CON PB Other
ASSESSORS PARCEL NO
7i /"i
ACC DA
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
LAST CAr{D_31EVSPECTI ON.
FINALS DATE INSP.
D
FRAMING
PERMIT VA1ILII DATION
lJ UL 2 9 1985
y Of 06portH«i
ISSUANCE DATE
ZONING ENG. SITE NO.
f BUI DING PERMIT(
I FORMATION
VAC ATION SIFT.
ERMIT TO +
TORI 5 TYPE CONSTR-
S I IiY,
s':
OCC. GROUP RES. UNITS
1
SO. FT FLOOR AREA TOTAL ACREAGE
BUILDING USE
E IND CON PB Other
ASSESSORS PARCEL NO
7i /"i
ACC DA
I
ELECTRICAL FINALS DATE INSP.
FRAMING SAN #
ZONING ENG. SITE NO.
INSULATION r 3 PLUMBING 3
r GAS
FIRE SPR INK
Y NE]
ENERGY T 74
Y NE]
MECHANICAL
COVER ND WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD ZONE
Y F] N[:]
A.L U.C.
Y "
LATH -INTERIOR ELECTRICAL f
LATH -EXTERIOR FIRE DEPT.
SHEETROCK -Z b GRADE FEE SUMMARY
SHEAR INTERIOR BUILDING
BUILDING
F
SHEAR EXTERIOR L0-3{—gc' TEMPORARY APPROVALS'
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDJOCCUPANCY
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
0 PLEASE GIVE JOB ADDRESS WHEN PHONING.
SEE PERMIT FOR EXPIRATION DATE -
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX f
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
TOTAL
OFFICE COPY
I
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APPLICATION PER IT
BUILDING --ELECTRICAL- PLUMBING - MECHANICAL
PERMIT NUMBER
8610 / OI
OWNER'S
NAME DeAnza Group, A Californi
Ltd. Partnership PHOIA15/571-14
TY ELECTRIC PERMIT FEE
1
PLAN CHECK VALIDATION
CONTRNAME ACTOR'S OUTLETS-SWITCHES-RECEP 10.0011.00
The Alden Company L.,05640
DATE OF APPLICATION
LIGHTING FIXTURES 10.0011.00
CONTRACTOR'S
ADDRESS
411 BOrel Ave, Ste. 410
San Mateo, Ca. 94402 PHON415/571-14
APPLIANCES - RESIDENTIAL 4.00
l PANELS 10.00
ARCHITECTPANELS(OVER200AMP) OR
EN'ChTd eron-Nakamura L11.013712
20,00 PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
ARCHENG. 2070 Business Ctr. #220AOORESSESS SPECIALCIRCUIT 5.00 P1:R 1PATION
ITEMP. METER OR POLE INS. 20.00Irvine, Ca. 21P 92715 JUL 2 9 1985
ADORESSTS
411 Borel Ave,. Ste. 410 MOTORS 'SEE FEE SCH.
SERVICE CHANGE 20.00SanMateo, Ca. 94402 City Of CUpertina
LICENSED CONTRACTORS DECLARATION TEMP. POLE 30,00
1 hereby affirm that I am licensed under provisions of Chapter 9
commencing with Section 7000) of Divisian'3 of the Business and
Professions.Code, andmy license is in full for q ect.
License Class ttSS Lie. Nilmher U
Date 5 85 Contractor
ISSUANCE DATE
BLDG.
It3,]WULI
ELECT. PLG. MECH.
El
BUILDING PERMIT
INFORMATIONOWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Can tractor'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 structure, 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 Contractors License
Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
MISC. - REFER TO ORD
PERMIT ISSUANCE 10.00
VALUATION
12/j Q
SIFT.
ELEC. CONTR. LIC. NO. ELEC.
TOTAL PERMIT TO
QTY. PLUMBING PERMIT FEE
the basis for the alleged exemption. Any violation of Section 7031.5 STORIES TYPE CONSTR. ,
by anyotmo
applicant for
iv hundr d'
dollcls
the (
S500plicanttoacivilpena[
ty
of not more: than five hundred dollars (5500).):
1`+
ALTER -DRAIN & VENT -WATER (EA.) 5.00
I, 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. 5.00intendedorofferedforsale (See. 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
himself or through his awn employees, provided that such improve-
ments are not intended or offered for sale. if, however, the building
FIXTURES - PER TRAP 5.00 SQ. FT. FLOOR AREA
7rJ
TOTALACREAGE
GAS- EA. SYSTEM -1 1NC.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.).
0 1, as owner of the property, am exclusively contracting with
GAS - EA. SYSTEM -OVER 4 CEA.} 2.00 BUILDING USE
RP IND CON PB other
INDUSTRIAL WASTE INTER. 30.00
LAWN SPRINKLERS- 1 INC 5 V.B. 6.00licensedcontractors,to construct the project (Sec..7044, Business
and Professions Cade>, The Contractor's License Law does not apply
to an owner of property who builds or improves thereon, and who
ASSESSORS PARCEL NO.
LAWN SPRINKLERS -OVER 5 (EA.) 1.00
contracts for such projects with a contractor(s) licensed pursuant to
the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO.
I am exempt under Sec. B.&P.C. for this
reason
WATER HEATER W/VENT 6.00
Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO.
WATER TREATING EOUIP. 5.00WORKERS'COMPENSATION DECLARATION
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. 3 00, Lab.C.).
Policy No.ti n en Company
FIRE SPRINK
Y [-] N
ENERGY T-24
Y [:] NQ
0 Certified copy is r furni ed.
EC Certified copy a ttl the city inspection division.
Appfrcant Ml REFER TO ORD.
CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE AA-U.C.
PLG, CONTR. LIC. NO. PLG,
TOTAL
COMPENSATION INSURANCE
This section need not be completed if the permit is for one
Y N E] Y N
hundred dollars (S 100) or less.)
I certify that in the performance of the work for which this per -FEE
mit is issued, 1 shall not employ any person in any manner so as to MECHANICAL PERMIT FEE YFEESUMMARY
BUILDING
become subject to the Workers' Compensation Laws of California.
Date Applicant ALTER OR ADD TO MECH. 5.00
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
emption, you should become subject to the Workers' Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Cade, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
FEEAIRHANDLINGUNIT (TO 10PWQF. M.) 4.00
AIR HANDLING UNIT (OVER 10=1 .F.M.) 6.00 SEISMIC FEECONSTRUCTIONLENDINGAGENCY
1 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 Amerig'a, P. Q.
Lender's Address Box 180 ^ 61
I certify that I have read this application and s"kthe above
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
HEATING UNIT (OVER 100,000 B.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
PLUMBING
BOILER-COMP(3 H,P,Or100,000B.T.U.) 6.00
BOl LER COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICALherebyauthariierepresentativesofthiscitytoenteruponthe
above-mentioned property for inspection purposes.
MISC. - REFER TO ORD. We) save, indemnify and keep harmless the City of
Cupertin liabili ' s, judgments, casts and expenses which
may in y accrtt against said City in consequence of the
grantin i
5/31/85
CONST. TAX
PERMIT ISSUANCE 10.00
MECH. CONT. LIC. NO. MECH.
TOTAL
TOTAL
Signature of Applicant/Contractor Date
OFFICE COPY