8606 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DENT[F I CATION PERMIT NUMBER
no{ails -10APPLICATION & PERMIT
t4'
LOT 7 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
GW 'S
NAME 8606
DeAnza Group, A a orni Ty ELECTRIC PERMIT FEE PLAN CHECK VALI DATION
Ltd. partnership PHONE 415 571- 48
MERACTORs
No , OUTLETS-SWITCHES-RECEP 10.00/1.00
The Alden Company LIC.No 465640 LIGHTING FIXTURES 10.00/1.00
ADDRESc7oRs 411 Sorel Ave,Ste. 410 PPLIANCES-RESIDENTIAL 4.00 '
CONTRA
San Mateo Ca.9440,2)NE 415/571'1 81 PANELS 10.00 DATE OF APPLICATION
ARCHITECT .PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
G
ENGINEER Calderon-NakamunaNO C01J3{712 SIGNS TRANS. 3.00
ARCH.OR ERG. 2070 Business Ctr. #220 SPECIALCIRCUIT 5,00 �•) PERMIT VALIDATION
Irvine Ca. ZIP 9271 EMP.METER OR POLE INS. 20.00 �g D
ADDRESS 411 Sorel Ave, Ste. 410 MOTORS SEE FEE SCH. /1l
APPLICA
San Mateo, Ca. 94402 SERVICE CHANGE 20.00 �JUL 2 91985
000
0 0 LICENSED CONTRACTORS DECLARATION TEMP. POLE 30.00
a u w I hereby affirm timt I am licensed Ruder provisions of Chapter 9 f ; r]IISSUANLE DATE'-._
v, a y (commencing with Section 7000)of Division 3 of the Business and .BLD ELECT.'-11, MECH.
r D z Professions Code,an my license is in full force an 4
Z i m o Licemse.Claz�785__Lic.Number ❑ ❑
F m F j Oatc Contractor
¢ IS a OWNER-BUII-DF:R DECLARATION BUILDING PERMIT
E. 0 d u INFORMATION
E.
g LL H 1 hereby affirm That I am exempt from the Contractor's License MISC.- REFER TO ORD
u_ Law Law for the following reason. 7031.5,Businessund PVdcssionS PERMIT ISSUANCE 10.00 VALUATION $/FT.
Code:Any city or county which requires a permit to construct,alter, / 2
ce ¢ <o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. ab•
wDLL requires the applicant for such permit to file a signed Statement that TOTAL PERMIT TO
m he is licensed pursuant to the provisions of the Conlractoi s License
r z ¢ Law(Chapter 9(commencing with Section 7000)of Division 3 of the
i O Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
¢ 1 m the basis for the alleged exemption.Any violation o($ection 7031.5 STORIES TYPE CONSTR.
by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than live hundred dollars
❑ I,as owner of the property.or my employees with wages us BACK F LOW PROTECT. DEV ICE 4.00 OCC.GROUP -AES.u ITS
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.The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 So.PT FLOOR AREA TOTAL ACREAGE
himself or through his own employees.Provided that such improve-
menu are not intended or offered for sale.If,however.the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM 4(EA.) 2.00
builder will have the burden of proving that hcdid no[build or im_ BUILDING USE
prove for purpose of sale.). INDUSTRIAL WASTE INTER30.00 RES IND CON PS Omer
.
❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑
licensed commctors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B- 6.00 ASSESSORS PARCEL N0. -
and Professions Code:The Contractor's License Law does 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 coutructons)licensed PUTSUZIM to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ I am exempt under Sec. ,tl.&P.C.fur Ibis WATER HEATER W/VENT 6.00
reason
Owner [)at, -71,9 1? 1
WATER SYSTEM 5.00 Acc.OAT9 ACC.FILE NO.
WORK F:RS'COMPISCSATION DECLARATION WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of...Sent to Self-irve,c,
crr a ccrlificale Of Workers'Compensation Insurance,or a certi Hed _ ZONING ENG.SITE NO.
opy thcmo f(Sxc. S q, ,:h C.1. •I -� -
rnheyNn.��(3 e_-A7,ien-Comps
O �T ��yy..tli0ed copy is her I ishct ' FIRE SPRINK ENERGY T 24
Z Z ❑ l�rtificd copy is I rl city inspcaion Aivieion.
� O Applicant MISC- REFER TO ORD. y ❑ N❑ Y ❑ N❑
N CERTIFICA'I'F OF EXIiA PTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C.
lL.> COMPENSATION INSURANCE PLG.CONTR, LIC.NO, PLG.
IThix section need not be completed if the permit is for one TOTAL YE] NNE] Y E] NE]
hundred doll...(S100) less.)
U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE
FEE SUMMARY
LL F mit is issued,I shall not employ any person in any manner sn asto
❑ become subject to the Workers'Compcnamion Laws of Californim.a
O a Dale Applicant ALTER OR ADD TO MECH. 5.00 BUILDING C71
>_ W NOTICE TO APPLICANT: If,after making this Certificate of Ex-
F Z emotion,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 His permit shall be dcenmd revoked. AIR HANDLING UNIT(TO I0=C.F,NL) 4.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IDDODOEM.) 6.00 SEISMIC FEE {
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work lox which this permit is issued(Sec. MICROFILM
3097,Civ.C.L Bank Of Amer iCe p.O. HEATING UNIT(TO 100,000 B.T.U.) 8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50
Lender's Address ELECTRIC
I certify that lface read this application and stme,ual Ile above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county PLUMBING
ordinances and stale laws relating to building construction, and BOILER-COMP(3 H.P.Or 100,000 B-T.U.) 6.00
hereby authorise representatives ins of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL
hereby authored preprese forinso ofth i purposes.
(We) agr t S ve, indomnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino a u. abililir judgments, costs and expenses which CONST.TAX
may in a ceras gains[ said City in consequence of the PERMIT ISSUANCE 10.00
grunting o t is l l r MECH.CONT. LIC.NO. MECH.
5/31/ TOTAL TOTAL ao�0
Signature of Appl cant/Contmcmr Dale
INSPECTOR COPY
r
f.
POST THIS CARD NEAR FRONT
j CITY OF CUPERTINOF
INSPECTION DIVISION
JOB INSPECTION
JOB ADDRESS
OWNER CONTRACTOR
OF BUILDING
RECORD
UNIT# LOT#
PERMIT NUMBER
8606
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
IS NOT STARTED WITHIN
780 DAYS OF PERMIT ISSU-
ANCE OR 780 DAYS FROM
LAST CALLED INSPECTION.
INSPECT ON DATE INSPECTOR INSPECTION RECORD
FOUNDATION Q1 ,
UFER i
PREG`UNITE fQr%5.
ruFL.
1.4 C,-4,t, c -
PERNPV I BION
JUL 2 g 1985
LCHY Of uliper.f,i0
ISSUANCE DATE
y+y.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLAB
PLUMBING _p I
s. ELECTRICAL
BL
r-yMECHANICALf
LAk
ELE T. PL MECH.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDUI DING ERMIT
INFORM TION
WOOD FLOOR VALUATION SIFT.
1 j ' f f •
PLUMBING
MECHANICAL
ELECTRICAL
lavr
PERMIT TO
j
STORIES TYPE CONSTR.
FRAMING
INSULATION
OCC GROUP RES. UNITS
PIACI: NO SUBFlOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
SO. FT.FLOOR AREA TOTAL ACREAGE
DI PIi `iS ii 5— - BUILDING USE
RES LINO CON PB Oihe,
X El El 1:1 1:1
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO.
ROUGH
PLUMBING
GAS TEST
TRACT NO. PARCEL NO.
MECHANICAL
ELECTRICAL le)-Iv, FINALS DATE INSP.
ACC. DATE ACC, FILE NO.
FRAMING gigIv-kr. SAN #
ZONING ENG.,SITENO.
INSULATION PLUMBING (f. p
GAS Z'*'S .S
FIRE SPRINK
Y N
ENERGY T-24
Y N
MECHAN AS S
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATIN
FLOOD ZONE
v N
A. L.U.C.
v NI]
LATH -INTERIOR ELECTRI
LATH -EXTERIOR FIRE DEPT.
SHEETROCK p -1$' GRADE FEE SUMMARY
SHEAR INTERIOR /0- 3 BUILDING
BUILDING
SHEAR EXTERIOR TEMPORARY APPROVALS
FIREWALLS ELECTRIC PLAN CHECK
F EE
GAS
SEISMIC FEE fNOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDJOCCUPANCY
OCCUPANCY OF BUILDINGIS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOF(. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
I- ONE WORKING DAY BEFORE REQUIRED INSPECTION.
0 PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z
SEE PERMIT FOR EXPIRATION DATE - 1
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
TOTAL
4(
OFFICE COPY
O
Z
O
tY 9Lu
dS.
Z) z
UO
LL U
O Lu
rn
Al
A PLICANT T0, FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY
VU1 LD1 NG PROJECT I DENTI FICATION
APPLICATION & PERMIT
BUILDING -ELECTRICAL- PLUMBING -MECHANICAL
PERMIT NUMBER
O ^ b bBUILDNGADDRESSLOT7
OWNER'SPLAN
NAME DeAnza Group, A a iforni
Ltd. Partnership FHONE 415/571-.47,
q,T ELECTRIC PERMIT FEE
CHECK VALIDATION
DATE OF APPLICATION
CTOR'S
NAME NAME
The Alden Company L,C.NO.
465640
OUTLETS- SWITCHES - RECEP 10.0011.00
LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S 411 Borelve to . 410
ADDRESS
San Mateo, Ca.9440Z1E415/571-1
APPLIANCES - RESIDENTIAL 4.00
PANELS 10:00
ARCHITECT
OR
ENGINEERC alderon-Nakamult'.NO
C013712
PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
AARCH.
ORDDRESS ENGBusiness Gtr.
Irvine, Ca.
ZIP
927
SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
2 19R
TEMP. METER OR POLE INS. 20.00
APPLICANT'S 411 BorelAve',te. 410
ADDRESS
San Mateo, Ca. 94402
MOTORS SEE FEE SCH,
SERVICE CHANGE 20.00
LICENSED CONTRACTORS DECLARATION TEMP. POLE 30.00
1 hereby affirm that I am licensed under provisions of Chapter 9
commencing with Section 7000) or Division 3 of the Business nd
Professions Code, an my license Is in full force a (k0
License Cla_ Lie. Number
rISSU N E DATE
BLD EL ¢TL i7e n MECH.
Date Contractor
8UIL PERMITvi
OWNER -BUILDER DECLARATION
hereby affirm that 1 am exempt from the Contractor's License
Law for the following reason. (See. 7031.5, BusinessarldProfessions
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) OfDivision 3 of the
Business and Professions Code) or that he is exempt therefrom and
ORMINFORMATION
MISC, - REFER TO ORD
VALUATION $/FT.
PERMIT ISSUANCE 10.00
ELEC. CONTR. LIC. NO.
ELEC. TOTAL
QTY. PLUMBING PERMIT FEE
PERMIT TO
STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation Of Section 7031.5
by any applicant for a permit subjects the applicant to a civil penalty
of'not more than five hundred dollars (5500).): ALTER -DRAIN &VENT -WATER LEA.} 5.00
1, as owner of the property, or my employees with wages asggCK
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
himself or through his own employees, provided that such improve-
meats are not intended or offered for sale. If, however, the building
FLOW PROTECT. DEVICE 4.00
DRAINS -FLOOR, ROOF, AREA, COND. 5.00
OCC. ROUP RES. -
FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE
GAS - EA. SYSTEM -1 INCA OUTLETS 6.00
or improvement is sold within one year of completion, the owner
builder will have the burden of proving [hat he did not build or im-
prove 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 EA. SYSTEM OVER 4 (EA.) 2.00 BUILDING USE
R IND CON PB other
El El El 1:1
ASSESSORS PARCEL No.
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 with a contractor(s) licensed pursuant to
the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ftl10.00 TRACT NO. PARCEL NO.
am exempt under Sec, B.&P.C. for this
reason
r
WATER HEATER W/VENT 6.00
Owner Date WATER SYSTEM 5.00 ACC.DATIR ACC. FILE NO.
WATER TREATING EQUIP. 5.00WORKERS'COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent to self-in'suro.
or a certificate of Compensation Insurance, or a certified ZONING ENG. SITE NO.
aWorkers'
copy thereof qTt ) T e Alden CompaPolicyNo. r C9i
FIRE SPRINK
Y N
ENERGY T-24
Y N
ertihed copy is he y u niche
ertified copy is a city 'inspection division.
Applicant MISC. - REFER 70 ORD.
CERTIFICATE OF EXE ION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A,L.U.C.
PLG. CONTR. LIC. NO.
TOALT
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.)
certify that in the performance of the work for which this per-
mit is issued, i.shall not emptoy any person in'any manner so as to
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 Worker' Compensation APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
FEEAIRHANDLINGUNIT (TO 10)X0QF,M.) 4.00
AIR HANDLING UNIT (OVER 10POOC.F.M.) 6.00 SEISMIC FEE
hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec.
3097,Civ.C.). Bank of America, P.O.
EXHAUST HOOD (WITH DUCT) 5.00
MICROFILM
HEATING UNIT (TO100,0008.T.U.) 8:00
H EATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRICLLender's Address
ender's Name
s 9
I certify that I have read this application and state that the above
information is correct. [ agree to comply with all city and county
ordinances and state laws relating to building construction, and
V ENTI LATION FAN (SINGLE) 4.00
PLUMBING
BOILER-COhl i3 H.P. or 100,0008.T.U.) 6.00
BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICALherebyauthorizerepresentativesofthiscitytoenteruponthe
above-mentioned property for inspect ion purposes.
MISC. - REFER TO ORD. We) agr [ ve, indemnify and keep harmless the City of
Cupertino g abilitie ,judgments, Costs and expenses which
may in a accrue ainst said City in consequence of the
granting o i
5/31/8
CONST. TAX
PERMIT ISSUANCE 10.00
MECH, CONT. LIC. NO. MECH.
TOTAL
TOTAL
r. 'f , Signature oFAppl ant/Contractor Bate'
OFFICE COPY