8617 r APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
PERMIT NUMBER
BUILDING PROJECT IDENTIFICATION
-�- ADRESS APPLICATION & PERMIT 861
FDr Lo'N LOT 16 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL
ITPLAN CHECK VALIDATION
NAME DeAnza Group, A,Californis QTY. ELECTRIC PERMIT FEE
Ltd. partnershipPHONE 415/571-1 81
NAME c.oRs UTLETS-SWITCHES-RECEP 10.00/1.00
The Alden CompanV UC.NO. 465640 LIGHTING FIXTURES 10.00/1.00
CONTRACTORS 411 Sorel Ave,Ste. 410APPLIANCES-RESIDENTIAL 4.00
ADDH Ess
San Mateo Ca.94402HON415 571-14 1 PANELS 10.00 DATE OF APPLICATION
ORCHITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENGINE
aldaron-NakamllralO.NO. C013712 SIGNS TRANS. 3.00
ARCH.OR ENG. PERMIT VALIDATION
AODRESS
Irvine,2Cap 90 Business CIrz2TIRCUIT 5.00ER plv�
927171 EMP.5 METOR POLE INS. 20.00
'
APPLICANTS411 Sorel Ave, Ste. 410 MOTORS SEE FEE SCH.
ADDDREDRESSSrJUL 2 s
San Mateo Ca. 94402 SERVICE CHANGE 20.00 1985
0 0 o I.ICI'NSI'.D CONTRACTORS DECLARATION TEMP.POLE 30.00 p t
¢ o U I herebyaffirm that I am licensed under provisions of Chapter - / City of UA aer AT
P p !: ISSUANCE OAT
y (commencingwith Section 7000)of Division 3 of the Business and
a vAi - - BLDG ELECT. PLG. MECH.
D z Professions Code, nd my license is in full force" f t ❑ ❑ ❑
.z o m - License C�'sY���nc Lie Number
O w Date 973, on 7W
_
F N F
a a BUILDING PERMIT
¢ ¢ a OWNERBUILDIiR DIiC1.ARAT1
o o O MISC.- REFER TO ORD INFORMATION
w3 LL F I for hereby affirm that 1 am cxcmpl from the Contractor's License
u O J Law for the following reason.(Sec.7031.5,Business and Professions VALUATION SIFT.
H _ PERMIT ISSUANCE 10.00
Code:Any city or county which requires¢permit to construct,alter,
2 ¢Q 0O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO, ELEO /
0¢ requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO
a w m" he is licensed pursuant to the provisions of the Contractor's License
r z i Law(Chapter 9(commencingwith Section 7000tof Division 3 of the
¢ a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
¢ r o the basis for the alleged exemption.Any violation uftiection 7031.5 STORIES TYPE CONSTR.
u ;m by any applicant tura permit suhjccts the upplicam toacivil pcnWty ALTER-DRAIN&VENT-WATER (EA.) 5.00 a(/
of not mare than five hundred dollar,(5500).1:
❑ I;as owner of the property,or my cmployccs wi h wugesas BACK FLOW PROTECT. DEVICE 4.00
their sole conmti
,punon,will da the work,and the sl neeture Nmol OCC.GROUP RES.UNITS
intendec'm offered for sale (Sec. 7044, Business and Profession.¢ DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code: 'Circ Conlretor's License Law docs not apply to an owner of
property who bu11d.s or ImpNVCs thereon,ant]who tines such work FIXTURES-PER TRAP 5.00 SD.FT.FLOOR AREA TOT LACREAGE
himself re through his own cmployccs,provided that such ibuildm-
mentsarenolinghhis oraRmedfarsnle.ILed thatgthcbu0dvg GAS-EA.SYSTEM-1INC.4OUTLETS 6.00
or improvement is sold within one year of cumoplction, the owner. GAS EASYSTEM OVER 4(EA ( 200
builder will have the burden of proving that he did not build or int - . - . .
- BUILDING USE
prove far purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 E IND CON PIT Omer
❑ I,as owner of the property,ton exclusively can lmeting with ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Professions Code:The Contractors License Law docs 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 it contractors)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200f1f10.00 TRACT NO. PARCEL NO.
❑ 1ant exempt under Sec.-.BAP.C.for this WATER HEATER W/VENT 6.00
reason
Owner Tae WATER SYSTEM 5.00 ACC.DAT I ACC.FILE NO.
WORKERS'COMPEN'SATION DECLARAT ION WATER TREATING EQUIP. 5.00
I hereby affirm that I have a Certificate ofconsent to self-insure. ZONING ENG.SITE N0.
ora certificate of Workeri Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab C.).
Policy No. qty Aiden -,
t U ❑ Cetli s IY d Yl'urn ' ompan ' FIRE BPRINK ENERGY T-24'
Z ZO \pf$cCatified cop li will the city inspcaian division. MISC.- REFER TO ORD. v ry v N
lT ❑ ❑ ❑ _ ❑.
)- to PERMIT ISSUANCE 10.00
LU - COkTIPIG :O iATI. FROM WORKERS, _ FLOOD ZONE' A.L.u.G.
W CO M PIi. S,\TION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL Z C](This sediom need not be completed if the permit is for one TOTAL Y NE] v EJ NE]
hundred d(ASTS(S 100)or less.)
U O 1 certify that in lire performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
lL 1- mit is issued,1 shall not employ any person in any mummer sa as to
O L) become subject to the Workers'Compensation Laws of California.
a Dee Applicant ALTER OR ADD TO MECH. 5.00 BUILDING
} to NOTICE TO APPLICANT: If,after making this Certificate of L.-
F. 2 emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with FEE
U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE
I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00
31097 rfmnmuce of ate work for which this permit is issued ISec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
Lender's Name Bank of Amariea, P.O.
Lender's Address___$gg],8 HEATING UNIT(OVER 100,000B.T.U.)9.50 ELECTRIC
I certify that l huva rcod thisapplicali,!td 151 t ,rthC above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
ordinances and state lows relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00
hereby authorize representatives of this city to enter upon the
above-nentioned properly for inspection purposes. BOILER-COMP (Over 100,000 BTW SEE FEE SCH. MECHANICAL
(We) agree to save, I,Jeounfly and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against lolloini s,judge eels, costs and expenses which CONST.TAX
may in any way c e Igainst aid City in consegncnce of the PERMIT ISSUANCE 10.00
granting of ths,er i MECH.CONT. LIG NO. MECH.
5 31 85 TOTAL TOTAL
Signature of AT licJAWo tractor`Dac
INSPECTOR COPY-
. I
w
K -
POST THIS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO - -
INSPECTION DIVISION
JOB INSPECTION RECORD
JOB ADDRE55IF
ol
UNIT LOT#
OWNER CONTRACTOR jpxIS
RMITNDMB ER
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU-
DANCE OR 180 DAYS FROM
LASTCALLED INSPECTION.
INS CTI ON TE INSPECTOR INSPEC ION RECORD
FOUNDATION W 16fi S `
LIFER S$
PREGUNITE
PERMIT N
JUL 2 g 1985
city of cuperti,-Ia
ISSUANCE DATE
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND I B
PLUMBING 5
ELECTRICAL
MECHANICAL
BL G PELECT,PLG. MECH.
rld
DO NOTPOUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BMIT
N
WOOD FLOOR
VAL ATION
v -y
SIFT.
PLUMBING
MECHANICAL
ELECTRICAL
WHIT ro
FRAMING
INSULATION
STORIES'" TYPE'CONSTR
OCC GROUP RES. UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED`-
ROOF
SGjFT FLOOR AREA
1
TOTAL ACR PAGE
DIAPHRAGM;
BUILDING USE
RES INO CON PB, Other
ElJQfoo1:1
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
RdUGH
ASSESSORS PARCEL NO.
PLUMBING / y
GAS TEST
MECHANICAL
TRACT NO
fr 11
PARCEL NO
ELECTRICALFINALS DATE INSP.
ACC: DATE ,` ACC. FILE NO,
FRAMING ] SAN
ZONING ENG. SITE NO,
INSULATION PL MB NG7 .
G S
FIRE SPAINK
Y N
ENERGY T-24
Y 0 NEJ
M CH CAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
LATH -INTERIOR ELECTRICAL
FLOOD ZONE
Y N[:]
A.Lu.c.
Y o ' N
LATH -EXTERIOR FIRE DEPT.
SHEETROCK GRADE FEE SUMMARY
SHEAR INTERIOR BUILDING
BUILDING
SHEAR EXTERIOR (J r( .. TEMPORARY APPROVAL
FIREWALLS v ELECTRIC PLAN CHECK
FEEEE
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDOCCUPANCY
OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BYSUILDING INSPECTOR. MICROFILM
Lu
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
IfIMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
TOTAL
1 17
OFFICE COPY