8632 APPLICANTJO FILL IN INFORMATION WITHIN RED.LINES - USE BALLPOINT PEN ONLY
-" BUILDING PROJECT IDENTIFICATION FICATION PERMIT NUMBER
aDILDING 8632
AouRess APPLICATION & PERMIT
LOT 24
t �•1--'! / (y BUILDINGELECTRICAL-
DW PLAN CHECK VALIDATION
NBME DeAnza Group,' a California QTY_ ELECTRIC PERMIT FEE
• PHONE
415/571
NAME D Wq_- UTLETS-SWITCHES-RECEP 10.00/1.00
LIC.ND, LIGHTING FIXTURES 10.00/1.00
r, c en APPLIANCES-RESIDENTIAL 4.00
ADDRESS 411 Borel Ave,SCe.410
PHONE PANELS 10.00 DATE OF APPLICATION
oR RMC PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P.C.NO.
ENGINEER
Ic.ND. SIGNS TRANS. 3.00 n
ADDR.D PERMIT VAt ON
ADDRESS SPECIAL CIRCUIT 5.00 try(.
2070 Business CCr. 4220
zla EMP.METER OR POLE INS. 20.00 /� o
ADOREas lel+ MOTORS SEE FEE SCH. ' t 2
SERVICE CHANGE 20.00 91985
QTOLD G8• 964'f TMD CONTRACTORS DECLARATION s TEMP.POLE 30.00 City of CU
¢ v O I hereby affirm that I am licensed under provisions of Chapter 9 y p//1���{{
2 w ISSUANCE DA?M/7
m ¢w (commenemg with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
D z Professions Code,and my license is in f.11,fome a eff t.
z o - License Class_�� Lic.Number
4 se Date a /e�Yor Contractor
Q y E �T
¢ tc w ¢ OW'NER-BUILDBR DIiCL NRA )• BUILDING PERMIT
o T" INFORMATION
E:
g LL y 1 hereby affirm that I am exempt from the Co ctor's License MISC.- REFER TO ORD
O ¢ Law for the following reason(Sec.7031.5,Business unJ Professions VALUATION $/FT.
PERMIT ISSUANCE 10.00
Code:Any city or county which req Lines a permit to construct,alter,
IS a, a0 improve,demolish,or repair any structure,prior t0 its issuance,also ELEC.CONTR. LIC,NO. ELEC.
n O¢ requires the applicant for such permit to file a signed statement that
o TOTAL
u w es s- he is licensed pursuant to the provisions of the Contractor's License '/ R T TO
r z a
Law(Chapter 9(commencing with Section 7000)of Division 3 of the
x O Business and Professions Code).or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
re r m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
by any applicant for a permit subjects the applicant o a civil penalty' ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars($500).):
❑ 1,as owner of the property,or nsy employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCG GROUP s. NIT
452
their sale compensation,will on the work,and Om s'
tructure is not
intended or offered for sale (Sec 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 /
Code The Contractor's License Law does not apply to an owner of
property who builds cr improves thero"n,Itml Who does such Work FIXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTALACE ACREAGE
•
himself
rethrough his own emredfors, .[1,hothatsuchimprove-
mentsded or within
od Gyeasale.lhowever,the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00
or improvement is sold within one year of clic did ion, the owner- GAS-EA:SYSTEM-OVER 4 IEA.) 2.00
Pry builder will have the burden of proving that he did oat build.r ilm IL INN USE
Prove 1,is
nee of the
INDUSTRIAL WASTE INTER. 30.00 RES I❑ ❑N ❑ D❑
❑ 1,as owner of the PropeHY.am cxclusive)Y convent ing with
licensed contractors to construct the proicct (Sec.7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:'Fhe Contract.,',License Law docs not apply
to an owner of property who huilds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such projects with a contracton(s)licensed Pursuant t.
Om Contractor's License Law, - SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCELNO. -
❑ I am exempt antler Sec. B,&P.C.fur this WATER HEATER W/VENT 6.00 /]
on /
Owner Date WATER SYSTEM 5.00 IAW.DT ACC�F ILE NO.
WORKERS'COMPEN'SATION DECLARATION WATER TREATING EQUIP. 5.00 '
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.).
Poli<Y No, r I " , .
O ❑ Certilie µrdan CoWparr RE SPRINK ENERGYTH4
Z Z L� CerldieJ s tl ith the city inspection division.
FO APpLut MISC- REFER TO ORD. YE] NE] YE] N[J
ft, rn CERTIFICATI OP EXEMPHON FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.c.
L COMPENSATION INSURANCE PLG.CONTE. LIG NO. PLG.
0 (This section need not be completed if the permit is for one TOTAL v N� v ❑ N�
Z hundred dollars IS 100)or less.)
U O 1 certify that in the performance of The work for which this per. QTY. MECHANICAL PERMIT FEE FEE SUMMARY
UL 1- mit is issued,I shall not employ any person in any manner so as to
become subject to the Workers'Compensation Laws of California.
U a Date Applicant ALTER OR ADD TO MECH. 500 BUILDING
} to NOTICE TO APPLICANT: If,after making this Certificate of fix .
♦- Z emption,you should become subject In the Workers'Compensali.n APPLIANCE 5.00 PLAN CHECK
provisions.of_the Labor Code, you must forthwith comply with U FEE such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.NL) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10)M0GF.M.) 6.00 SEISMIC FEE �-
I hereby affirm [hut 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.CJ, HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name
&!M �- HEATING UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC
Addr
Lender's Andyess f1,..V::- ,�Q�
I certify that I have read this application and staetY$tbove VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
ordinances and state laws reaming to building construction, and BOILER-COMM H.P.or 100,000 B.T.U.) 6.00
hereby entioined representatives Inspection
this city to cmc, upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
herebyn ruliorii propertyI.,vesp of this
purposes.
` (We) agree to ,av indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino agT is li tilities judgmm�t,, costs and cxpenxcs which CONST.TAX
may in any o a true a Lfivo said City in er'crlucn.. of the PERMIT ISSUANCE 10.00
FT. oft ', n [`, MECH,CONT. LIG NO. ME 10.00
fy�,•wF °TA` TOTAL
Signature of Ai,)ic nt/CmHr mor Laic
P
INSPECTOR COPY
r POST THIS CARD NEAR FRONT OF BUILDING +
rf-r CITY OF CUPERTINO '
INSPECTION DIVISION
JOB INSPECTION RECORD
J % d
JOB ADDRESS • e6l Ceree+1R UNIT## LOT#
OWNER ,* CONTRACTORLde-n Co.
PFRINIT NUMBER
QQ8632
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
LAST CALLED INSPECTION.
INSPECTION DATE INSPECTOR INSPECTION RECORD
FOUNDATION = y f_`r
UFER
PR EGUN ITE
PE J_VALIDATION
gg
ieJ<d%
JUL 2 91985
City of Cupertino
ISSUANCE DATE
POUR NO NCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLAB
PLUMBING 3a -
ELECTRICAL
MECHANICAL
BLDG: E CT, PLG. MECH.
A [A
DO NOT POUR FLOUR UNTIL ABOVE HAS BEEN SIGNED Bu LDING ERMIT
1 FORMATION
WOOD FLOOR,
VALUATION S/FT.
PLUMBING
MECHANICAL
ELECTRICAL
r PERMIT TO
fFRAMING
INSULATION
STORIES' T FONSTR.
OCC. GROUP REFiUNITS"
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF -
SOL FT. FLOOR AREA TOTAL ' ACREAGE
DIAPHRAGM Q "( i t
BUILDING USE
A .S', IND' CON PB Other
El El El Q
ASSESSORS PARCEL NO,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
ROUGH
PLUMBING
GAS TEST
TRACT NO.
i ,
PARCEL NO.
MECHANICAL% }f'
ELECTRICAL (ti FINALS DATE INSP.
ACC: DATE ACC. FILE NO.
FRAMING SAN #
ZONING ENG. SITE NO.
INSULATION _ PLUMBING ,2-``--
y/
Qp(
7OGAS
f- /V "-
FIRESPRINK
Y N
ENERGY T-74
Y N
MECHANICAL L 21 -sl
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD ZONE
Y N
A.L.L.0 C.
Y N
LATH—INTERIOR ELECTRICAL a -0m
LATH—EXTERIOR FIRE DEPT.
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR Z BUILDING _ -x --
BUILDING
SHEAR EXTERIOR TEMPORAW APPROVALS
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDOCCUPANCY
OCCUPANCYOFBUILDING ISNOT PERMITTED UNTIL BUILDINGFINALISSIGNEDBYBUILDINGINSPECTOR.
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
O PLEASE GIVE JOB ADDRESS WHEN PHONING.
z
SEE PERMIT FOR EXPIRATION DATE —
MICROFILMLU
r
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL. INSPECTION.
TOTAL
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY
O
Z z
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ao
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Om
y
I•- Z
LAI
BUILDING PROJECT IDENTIFICATION
APPLICATION &PERMIT
PERMITNUMBER
Bull, C, ss J LOTOD
BUILDING - ELECTRICAL- PLUMBING - MECHANICAL 8632
S
NAME DeAnza, Group,. a California QTY. ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
Ltd. Partnership PHONE 415 5 1-1
CONTRACTORS
NAME UTLETS-SWITCHES -RECEP 10.0011.00
LIGHTING FIXTURES 10.0011.00TheAldenCompanyLIC. NO. 465640
CONTRACTOR'S
ADDRESS 411 BOrel Ave,Ste.410 APPLIANCES - RESIDENTIAL 4.00
PANELS 10.00SanMateoCa. 94402 PHONE 415/571-148l DATE OF APPLICATION
ARCHITECTPANELS
aRENGI NE CHalderon-Nakamuralc.NO. C013712
OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. N0.
SIGNS TRANS. 3.00
ARCH. OR ENG.
2070 Business Citr. #220ADDRESSV /
Irvine Ca. 92715 ZIP
SPECIAL CIRCUIT 5,OD PERMIT VALIDATION
n aPAMO
2 9
EMP. METER OR POLE INS. 20.00
APPLICANT'S
IADDRESS4 , MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00411BorelAveSte.410 San Mateo JUL 1985
IN .dA91Mer 1aG
Ca- Q&*{52DCONTRACTORS DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9ISS
TEMP. POLE 30.00
commencing with Section 7000) of Division 3 of the usiness and
Professions Code, and my license is in full force a Wil
License Class Lic. Number
B G. I ELECT. PLG.
I
MECH.
Date .77 Contractor
BUILDING PERMIT
OWNER -BUILDER DECLARA I
I hereby affirm that I am exempt from the Contractor's License
Law far the following reason. (See. 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
INFORMATION
MISC. - REFER TO ORD
VALUATION SIFT.
PERMIT ISSUANCE 10.00
ELEC. CONTR. LIC. NO. ELEC.
TOTAL ERMIT 70
QTY. PLUMBING PERMIT FEE
Law (Chapter 9 (commencingwith Section 7000) of Division 3 ofthe
Business and Professions Code) or that he is exempt therefrom and
the basis for the alleged exemption. Any violation al'Section 7031.5
rlJ
t/
STORIES
by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred d ollars (S5 00).): awgLTERDRAIN &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
BACK F LOW PROTECT. DEV ICE 4.00 OQUP RES UNITS
DRAINS -FLOOR, ROOF, AREACOND. 5.00intendedorofferedforsale (See. 7044, Business and Professions
Code: The Contractor's License Law does not apply to an owner of
properly who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improve-
meets are not intended or offered for sale. If, however, the building
II
IFIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE
GAS - EA. SYSTEM - 1 INC.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 fm-
for purpose of sale.).
1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (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
GAS EASYSTEM -OVER 4 {EA.) 2.00 BUILDING USE
RE IND CON P$ Other
ASSESSORS PARCEL NO.
INDUSTRIAL WASTE INTER. 30.00
LAWN SPRINKLERS -I INC 5 V.B. 6.00
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
contracts for such projects with a cantractor(s) licensed pursuant to
the Contractor's License Law. 200ft110SEWERSANITARY, .00STORMEA TRACT rem. P/ ARCEL NO.
I am exempt under Sec. B.&P.C. for this WATER HEATER WIVENT 6.00
reason
Owner Date WATER SYSTEM 5.00 Acc.O ! ACC - FILE NO.
WATER TREATING EQUIP. 5.00WORKERS'COMPENSATION DECLARATION
1 hereby affirm that 1 have a certificate ofconsent to self -insure,
or a certificate of Workers' Compensation Insurance, or a certified
ZONING ENG. SITE NO.
44copythereof (Sec. 3800, Lab.C.).
Policy No. pT7 _'1'hc Alrinn f'mm n
FIRE SPRINK
Y N
ENERGY T-24
Y N
q_
CK2
ertiE<ed is ereb furnished.
Certified s I with the city inspection division. tai
3
Applicant MISC. - REFER TO ORD.
CERTIFICATE 1: 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-
mil is issued, 1 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: 1Q 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.
CONSTRUCTION LENDING AGENCY
FEEAIRHANDLINGUNIT (TO 10PM C.F.M.) 4.00
AIR HANDLING UNIT(OVER10p000.F.M.) 6.00 SEISMIC FEE 6)
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.).
MICROFILM
HEATING UN IT (70 100,000 B.T.U.) 8.00
H EATING UNIT (OV ER 100,000 B.T.U.) 9.50 ELECTRIC
Lender's Name
Lender'sAddrecc OX a O
TJa
I certify that I have read this application and state that the above 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. or 100,000 B.T.U.) 6.00
BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICALherebyauthorizerepresentativesofthiscitytoenteruponthe
above-mentioned property for inspection purposes.
MISC. - REFER TO ORD.
CONST. TAX
ind coaly and keep harmless the City ofwe)
aVsHCupertinoitieudgments, casts and expenses which
may in ae a ainsl said City in consequence of the
granting o
5/31/85
PERMIT ISSUANCE 10.OD
MECH. CONT. LIC. NO. MECH.
TOTAL
TOTAL
Sigictor Date
OFFICE COPY