8624 l
ll APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BU I LDING PROJECT I DENTIFICATI ON PERMIT NUMBER
BUILDING APPLICATION & PERMIT
s5 rJ� LOT 27
` �, PLAN 4 BUILDING 8624 6 4
- OWNERSPLAN CHECK VALIDATION
NAME DeAn2a Group, a California CITY, ELECTRIC PERMIT FEE
Ltd. Partnership ONE -
CONTRACTORS OUTLETS-SWITCHES-RECEP 10.00/1.00
The Alden Company LIC.No. 465640 LIGHTING FIXTURES 10.00/1.00
ADDRESS rDRs 411 Borel Ave,Ste.410 APPLIANCES-RESIDENTIAL 4.00
San Mateo Ca.94402 --415/571-1 81 PANELS 10.00 DATE OF APPLICATION
ARCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO,
ON
ENGINE
alderon-Nakamurnl=.NU. [013712 SIGNS TRANS. 3.00
ADR. ENG. 2070 Business Gtr. #220 SPECIAL CIRCUIT 5.00
T PERMIT VALIDATION
ADDRESS
55
Irvine Ca. z92715 TEMP,METER OR POLE INS. 20.00 pp��p�
APPLICANTS MOTORS SEE FEE SCH. Aly
ADDRESS
411 Sorel Ava Ste 410 SERVICE CHANGE 20.00 UL 2 9
woo San Mat 9.@ yCeNTR94f'HAS2DECLARATION TEMP.POLE 30.00 1985
¢ o u I hereby at on that I am licensed under provisions of Chapter 9 ISSUANCE DATE
or a N (clnunencing with Section 7000)of Division 3 of the Business and 'QVC `EpE(nT1I IO PLG. MECH.
H ED
0 z Professions Code:and my license is in full force t IAWY.jI' ❑
a ss - License Cls Lia Number,
r o Date Contractor Commclor
¢ m f . BUILDING PERMIT
¢ ono OWNER-BUILDER UECLARKFIO INFORMATION
wr 1 hereby affirm that I am exempt from the Contractor's License MIS[.- REFER TO ORD
3 u.w
Log Law for the following Reason.(Sec.7031.5,Business mid Professions VALUATION SIFT.
PERMIT ISSUANCE 10.00
Code:Any city or county which requires a permit to construct,alter.
'Q Q ¢ p improve,derrolis 1,or repair any structure,prior to its Issuance,also ELEC.CONTE. LIC.NO. ELEC.
O ¢ requires the applicant 1'0,such permit to file a signed statement that TOTALT
pEq 1T0
u w m he is li,.Rcd pursuant to the provisions of the Contract.,',License
F Z s- Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe '
40 Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
¢ r e the basis for the alleged exemption.Any violation of$ection 7031.5 STORIES TYPE CONSTR.
aim by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00
of not ore than five hundred dollars(S500).):
❑ 1m,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 CC.GR UP S.u S
their sole compensation,will do the work,and the structure is not
intended or offered for Sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:'Fire Contractor's License Law dues not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOAL ACREAGE
• himself or through his own employees.provided that such improve-
meals are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of conipletion, the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00
builder will have the burden of proving that he did not build or im-
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 FkEXIND CON PB Other
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑
liconsed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 t ASSESSORSPARC EL NO.
and professions Code The Contractor's License Law dues 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 coutractorl 0 licensed pursuant to SEWER-SAN ITARY-STORM EA.200f1/10.00
the COplra CLOT s License Line. TRACT NO. PARCEL NO.
O I am exempt under Sec,-,B&P.C,for this WATER HEATER W/VENT 6.00 /
reason
Owner Dam WATER SYSTEM 5.00 Ac .DATE ACC FILE NO.
WORK ERS'COMPENSA'I'ION DECLARATION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a certificate ofconsent to self-insure, ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a,edified
copy there![fk� ul K).
'Policy No._YLy idbSh A Iden omTpan
Q Cert Eed copy is he b G nish ' ) FIRE SPRINK ENERGY T 24
Z Z Certified copy is II Is e city inspection division. MIS[- REFER TO ORD.
O Applicant Y ❑ N❑ Y ❑ N❑
~ va PERMIT ISSUANCE 10.00
LU - CERTI PICATEOF AT IPF O 'BOAC WORKERS' FLOOD ZOrvE A.L.U.C.
W � COh1I'fv\SATION INSURANCE PLG.CONTE. LIC.NO. PLG.
CL 0 This section need not he completed if the permit is for one TOTAL v❑ N❑ Y ❑ N❑
hundred dollars(5100)odes,.)
U O I certify that in Ore performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I slmll not employ any person in any manner so as m
O become subject to the Workers Compensation Laws of California. `
U n Dam Applicant ALTER OR ADD TO MECH. 5.00 BUILDING d Q
} h NOTICF TO APPLICANT': If,after making this Certificate of IEx-
F Z emption,you should become subject to Ore 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
CONSTRUCTIONLILADING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
1 Imrchy affirm that there is a construct inn lending agency forEXHAUST HOOD (WITH DUCT) 5.00
the p,it'o.roun,c of'tire work for which this permit is issued(Sec. MICROFILM
3097,Cie.C.). HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Name BBIIk_Q ?riea.P.
Lender's Acidic . +��rr.�kA• HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I certify flu(I have read this application and stat,that the above VENTILATION FAN (SINGLE) 4.00
r information is correct. I agree to comply with all city and county BOILER- H.P.or 100,0008.T.U.1 6.00 PLUMBING
s ordinances and nate laws relating Io building construction, and
hereby authorise representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above mentioned property for inspection purposes.
(We) agree m save. i le oily and keep harmless the Cit)'of MIS[.- REFER TO ORD.
Cupertino against liab lit s, dgrne s, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any way a u g' nst sal City in consequence of Ilw
granting of this pen\. MECH.CONT. LIC.NO. MECH.
5/31/85 TOTAL TOTAL _
Signature of Applicant/Contactor Date
INSPECTOR COPY
POST THIS CARD NEAR FRONT OF BUILDING
i
I
CITY O F 'CU PE RTi N Q
INSPECTION DIVISION
JOB INSPECTION ECORD
JOB ADDRESS "/ U T#
OWNER CONTRACTOR
PERMIT NUMBER
Q 624
PERMIT EXPIRATION
PERMIT EXPIRES_ IF WORK
IS NOT STARTED WITHIN
180 DAYS OF PERMIT MU,
ANCE OR 180 DAYS FROM
INSPECTION.
INSPECTIONATE SPECTOR INSPECTION. RECORD
FOUNDATION ,.t
A/LASTCALLED
UFER
PREGUN ITE
PERMIT VALIDATION
PAID !•
JUL'2 9 1985
ff
A PAP9900r'! f]rss`{lELECT.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/,SAB
PLUMBING
ELECTRICAL
MECHANICAL
B40
INA
vk
146"
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED f BUI DING P RMIT
INFORMATION
WOOD FLOOR
VALUATION $/FT.
i
T 10
D/ /
PLUMBING
MECHANICAL
ELECTRICAL
FRAMING
INSULATION
STORIES STORIES TYPE CONSTR.
OCC.G/ROUP RES. UNYTS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
50, FT FLOOR AREA TOTAL ACREAGE
DIAPHRAGM
BUILDING Uf4E
i'IND CON PB Olhe,
1:1 El, El
ASSESSORS'PARCEL NO, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
ROUGH
PLUMBING f
GAS TEST X fr J
TRACT NO. PARCEL NO.
MECHANICAL
ELECTRICAL — , MALS ATE INSP.
ACC. DATE ACC FILE NO,
FRAMING SAN #
ZONING ENG, SITE NO,
INSULATION IPLUMBING
GA5 //
FIRE SPRINK
Y N
ENERGY T•74
Y N
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD ZONE
Y . N
A.L. U.L.
Y N[:]
LATH—INTERIOR ELECTRICAL r0/ 6 v
LATH—EXTERIOR FIRE DEPT.
SHEETROCK GRADE .. f FEE SUMMARY
SHEAR INTERIOR BUILDING
BUILDING
SHEAR EXTERIOR d—2%—fir] TEMPORARY APPROVAL
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDOCCUPANCY
A.
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR.
LU
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLEASE GIVE JOB ADDRESS WHEN PHONING.
z
SEE PERMIT FOR EXPIRATION DATE -
MICROFILM
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE0
CALLING FOR FINAL INSPECTION.
TOTAL
fy`
OFFICE COPY 11,___
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APPLi;CANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUIGING PROJECT IDENTIFICATION
APPLICATION & PERMIT
BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
PERMIT NUMBER
8624
BUILDING .
LAN 4
AD
eMh
OvOrNAMERS DeAnza Group, a California
Ltd. Partnership PHONE 415/571-1
q
81r
ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
CONTRACTOR'S
NAMENAME OUTLETS-SWITCHES-RECEP 10.0011.00
The Alden Company LIC.No. 465640
DATE OF APPLICATION
LIGHTING FIXTURES 10.0011.00
CONTRACTOR'S 411 Borel Ave,Ste. 10
ADDRESS
San Mateo, Ca.94402 AHON,415/571-1
PPLIANCES-RESIDENTIAL 4.00
PANELS 10.00
ARCHITECTPANELSOR
ENGINEUalderon-Nakamur C01371ztic. No.
OVER 200 AMP) 20,00
PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
ADDRESS ENG. 207 Business Ctr. 220
Irvine, Ca. 212715
SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
Pru
JUL 291985
EMP. METER OR POLE INS. 20.00
APPLICANT'S
ADDRESS
411 Borel Ave,Ste.410
MOTORS ,SEE FEE SCH.
SERVICE CHANGE 20,00
San 'LkEl RDC&ffR Q?DECLARATION TEMP. POLE 30.00
l hereby affirm that I am licensed under provisions of Chapter 9
commencing with Section 7000) of Division 3 [ l Business and
Professions Code, a my license is in full force t4
License Clasj Lic. Number
IS&U C E
B EAitfl?
El
rPL+G. MECH.
Date Contractor
BUILDING PERMIT
INFORMATIONOWNER -BUILDER DECLARATIO
I hereby affirm that 1 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 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 Contractor's License
Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5
MISC. - REFER TO OR D
VALUATION S/FT.
PERMIT ISSUANCE 10.00
ELEC. CONTR, LIC. NO. ELEC.
TOTAL PERMIT TO
I'l / % VCITY.PLUMBING PERMIT FEE
STORIES TYPE CO TR.
by any applicant for a permit subjects the applicant toacivii penalty
of riot more than five hundred dollars (5500).): ALTER -DRAIN & VENT -WATER (EA.) 5,00 6i, 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 docs such work
himself or through his own employees, provided that such
mimprove-
mes are not intended or offered for sale. ]f, however, the building
BACK F LOW PROTECT. DEV ICE 4.00 OCCyfa UP R 5. UNI75
DRAINS -FLOOR, ROOF, AREA,COND. 5,00
FIXTURES -'PER TRAP 5.00 SQ FT. FLOOR AREA TOTAL ACREAGE
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 or sale.),
131, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 70, Business
and Professions Code: The Contractor's License Law does not apply
to an owner of property who builds or improves thereon, and who
GAS EA. SYSTEM -OVER 4 {EA.) 2.00 ILpwG USE
IND CON PB Other
El El 1144ASSESSORSPARCELNO,
INDUSTRIAL WASTE INTER. 30.00
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
contracts for such projects wish a contractor(s) licensed pursuant to
the Contractor's License Law. SEWER -SANITARY -STORM EA. 20Dft110.00 TRACT NO. PARCEL NO.
am exempt under Sec. B.&P.C.for this
reason
WATER HEATERW/VENT 6.00
Owner Date WATER SYSTEMX5.00 ACC. DATE/ ACC. FILE NO,
WORKERS' COMPENSATION DECLARATION WATER TREATING EQUIP, . 5,00
I hereby affirm that I have a certificate of consent to self -insure.
or a certificate of Workers' Compensation Insurance, or a certified 11,411 1e3 - ZONING ENG. SITE NO,
copy thereofi5U919g,, --)PTIIV Alden ComparePolicyNO.- o.
FIRE SPRINK
Y N
ENERGY T•24
Y N[
Certified copy is h b f nishCertified
8_ Certified copy is t d city inspection division.
Applicant Applicant MIS REFER TO ORD.
OF EXE il'IION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
PLG. CONTR, LIC, NO. PLG.
TOTAL
COMPENSATION INSURANCE
This seclidn need not he completed if the permit is for one
Y N Y N
QTY- MECHANICAL PERMIT FEE FEE SUMMARY
hundred dollars (SI00) or lass.) ,
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
become subject to the Workers' Compensation Laws of California.
Date ApplicantALTER
NOTICE TO APPLICANT: If, after making this Certificate of Ex
BUILDING
OR qpp TO MECH. 500
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,
CONSTRUCTION LENDING AGENCY
FEEAIRHANDLINGUNIT (TO 10p00CF,M.) 4.00
AIR HANDLING UNIT (OVER 10=C.F.M.) 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.
3097, Civ,C.), B a
Lender's Name $
ag3n{k g e l g
Lender's Address 94
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8,00
HEATING ELECTRIC
1 certify that I have read this application and state that the above
information is correct. I agree to comply with ail city and county
ordinances and state laws relating to building construction, and
VENTILATION FAN (SINGLE) 4.00
PLUMBING
BOILER -COMP (3 H.P,pr 100,000 B.T,U.) 6.00
BOILER -COMP lover 100,000BTU)SEE FEESCH. MECHANICALherebyauthorizerepresentativesofthiscitytoenteruponthe
inspection purposes. above-mentioned property fo['
L.,
lye) agree to sav ' etify a d keep barmless the City of
Cupertino against li t s,dgme ts, costs and expenses which
may in any way a ru gst sai City in consequence of the
granting of this per 't
5/31/85
MISC. - REFER TO'ORD.
CONST. TAX
PERMIT ISSUANCE 10.00
MECH. CONT. LIC. NO. MECH.
TOTAL
TOTAL V
Signature of Appficant/Cc ctor Date
OFFICE COPY