3151 " c1TY (WUPERT1110 INSPECTIOi' RECORD (c7�ce Copy)
3151 -10680 S. De Anza
• 1'I;PJ1I'I 110. SANITARY DIST. NO. LOT 110, ADDRESS
Concrete Steps Byer Properties
PROJECT OFINER ,TOB SITE P11014E NO.
PERMIT ISSUED Date ELECTRICAL
BuiIdi.nr 2-10-83 Date Insp.
Electrical Power Pole._ _
Plumbing Under ,round
Mrchnnical Rou ,h Wiring _
'temp. Gas/I',lcct. llal s
Solar Ceiling
Fire Sprinkler Fixtures Int/Ext _
Sign tlotors
Grounding
Misc. Temp. Power
Other
FINAL INSPECTIONS Not Approved
Date Insp.
r,r
Electric
PLUMBING
PlumbingBackflow Date Insp.
Mechanical Underground
Solar Underfloor
Pool Partial Rough
•
Grading Rough Complete
Planning Solar Rough
Fire De t. Water & Insulation _
Health De Main Drain
Other nr. ro R/of/S Drain _
Other Gas
Other
BUILDING Not Approved
Date Insp.
Pad Certification MECHANICAL
Foundation Date Insp.
Pre-Gunite Underfloor S.M.
Slab-Membrane
Bond Beam Ducts & Insulation Underfloor Girders Fire Dampers
Firepla_c:e
floor Steel Grease Duct & hood
Tiedowns One flour Shaft
Diaphrams -- —.—
Condensate Drain
Seismic Bracing Condensate
Anchorage
Halls-Panels Flues & Comb. Air
Frame Other
Lath A
Wallboards Int/Ext. Not pproved
Firewalls
• Other
Not Approved
DULLL)III
ELECTRICAL
PLUMBING
MECHANICAL
MISCELLANEOUS
i
it
i
c;
- ``
� k,
� z
f �,
s
Building Division l
PROJECT Cffn/Ck &-7-Lr .1'7-e Ar CONTROL H
ADDRESS /v 6 J_0 S. ��: �f�� /� L .l PERMIT N
OWNER Acs 2 F�c2 7i(et c PHONE SAN. #
ADDRESS BLDG. TYPE
REP. PHONE OCC. GROUP
ARCHITECT PHONE
ADDRESS
REP. PHONE
CONTRACTOR PHONE -7/0 G VAL.
ADDRESS STRUCT.PLAN CK
REP. PHONE BLDG.PLAN.CK
PLAN CHECK HOURS PERMIT FEE
CAP FEE
CONST. TAX
ENERGY FEE
TOTAL FEES
DATE REC. DATE RET.
BLDG. DEPT.
ENG. DEPT.
yr(o'
PLAN. DEPT. 7 ,(3 ,
STRUCT. ENG.
(CENTRAL FIRE DIST.
-HEALTH DEPT.
-SAN. DIST.
ENERGY
'HANDICAPPED
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT IDENTI TION ER MBER
BUILDING APPLICATION EMIT . __ _ 151
ADD
BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
O NER3 PLAN CHECK VALIDATION
NAME QTY. ELECTRIC PERMIT FEE
PHONE
CONTfl CTOR'S
C' pOUTLETS-SWITCHES-RECEP 5.00/1.00
Nw
�' a/Cqi"
m.No. LIGHTING FIXTURES 5.00/1.00
CONTRACTOR'S .S Lr PPLIANCES-RESIDENTIAL 4.00
A REsa
moo^ 1✓Q ear- /
vHONE PANELS 5.00 DATE OF APPLICATION
AARRCHITECT SIGNS 6.00 PLAN CHECK FEE P.C.NO.
ENGINEER
LIC.NO. SIGNS TRANS. 3.00
ARCH,ON ADDRESS ENG, 6PECIALCIRCUIT _ S.00 PERMIT VALIDATION
AZIP EMP.METER OR POLE INS. 15.00
ADDRESS
MOTORS SEE FEE SCH.
ADDRESS ,
SGs/a1 G• S '✓� SERVICE CHANGE 10.00 f ?f�*J
W'o o LICENSED CONTRACTORS DECLARATION
<u w I hereby affirm that f am licensed under provisions of Chapter'I 4ISSUANCE DATE
n (commenting with Sccti n 7000)of Divuion 3 of the Business and n e, M
r-� Professions Cod n ECH
license Iv in full force a B}IIBt `f 7LL-JI .
z o uR- Lienee Lic.Number
O H s-w Date Commctor
¢ a w u OWNER-BUILDER DELLA ION BUILDING'PERMIT
Nx;LL hereby affirm that I em exempt from the Contractor's License
MISC.- REFER TO ORD INFORMATION
w a VALUATION $/FT.
FuOJ Law forrhefollowingmason.(Sec: uires Business to
Professions PERMIT ISSUANCE 6.00
a, i Code:Any city or county which structure permit to construct.etre, / ^��
¢ ¢ 4 D improve,demolish,or.repair any structure,prior to its issuance,also ELEC.CONTR. LIC,NO. ELEC. ✓{
as C.u requires the applicant for such permit to file a signed slalemenl that TOTAL PERM T TO
w$w he is licensed pursuant to the provisions of the ).fDh i,KG License nr,�G n
HiQ Law less and Professions
(co moos Code)or Section is exempt
the of o and a'jayPJ
E 4 D Business and Professions Code)or that he is exempt a therefrom and QTY. PLUMBING PERMIT FEE
¢ r$ the basis for the alleged exemption.Any applicant
oIn.ction malty STORIES TYPE CONSTR.
n ; by any applicant fora permit subjects the applicant to o civil penally
of mol .as owanfNe hundred dollars(55emp ALTER-DRAIN&VENT-WATER-(EA.) 4.DD
❑ h comper,ofnsat theon,property,or my employes with wages as BACK FLOW PROTECT.DEVICE 2.00 DCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered for sole(Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 4.00
Code:The Contractor's License Law does not apply to an owner of
propertywho builds or Improves thereon,and who docs such work FIXTURES-PER TRAP 4.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself a through de own trend Im Te.1f,h.wcv such improve-
orImprments rementisart noldoroffeoneyeaulelcompleveq the the oiling GAS-EA.SVSTEM-11NC.40UTLETS 4.00
or improvement is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4(EA.)
builder will have the burden of proving that he did not the
or im- 1.00 BUILDING USE
prove for purpose owner of sthep RES INDUSTRIALWASTE INTER. 20.00 11 w❑ ❑N ❑ Other
❑ I,as owner of.the proputy,am exclusively contract ing with
licensed contractors to construct the Project Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO.
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 cantracums)lictnsed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200108.00 TRACT NO, PARCEL NO.
i
nt am exempt under Suc. ,e&P.C.for this
stWATER HEATER W/VENT 4.00
Date Owner WATER SYSTEM 4.00 ACG.DATE ALC.FILE NO.
WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 4.00
1 hereby affirm that I have a certificate ofconsent to self-insure,
or a cerlificate of Workers Com nation Insurance•or a certified ZONING ENG.SITE NO.
copy themof(Sce.3900.Lab.C.).
Policy No: Company
Q ❑ CuM-OMPENSATION
�yfuini eJ. ,J/J FIRE SPflINK ENERGY T44
Z Z ❑ Cus, rwv��,t the cil� '(ns c r� wisdom.'
O ApplicanLVL MISC.- REFER TO ORD. v N❑ v rv�
PERMIT ISSUANCE FLODOZONE A.L.U.C.
W rn Cl PTINS FROM WORKERS' 6:00W � INSURANCE PLG.CONTR. LIC.N0. vLG.
d a (This section need not be completed if the permit is for one TOTAL Y N� Y N[30
'Z hundred dollam($100)or less.)
U O I certify that m the performance of the..,it for which this per. QTY MECHANICAL PERMIT FEE FEE SUMMARY
LL U mit is issued,1 shall not employ anypersonin any manner So as to
O m become subject to the Workers Comperaw irm Laws of Cnlifor.in.
a Dale Applicant BUILDING �-D
} Z NOTICE TO APPLICANT! If,after making this Certificate of fix- ALTER OR ADD TO MECH. 4.00 -2
-_�
F _ emption,you.ahould become subject to the Workers'Cornpeniatian APPLIANCE 4.00 PLAN CHECK ]] 3 3
provisions of the Labor Code. you must forthwith comply wilh FEE �J
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10 F. 3.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNITiOVER 10,000QFM.15.00 SEISMIC FEE .S'�
I hereby affirm that there is u construction lending agency for EXHAUST HOOD(WITH DUCT) 2.00
the performance of the work for which this permit is issued(See. MICROFILM
3097,Civ.C.). MISSUANCE
UNIT(TO 100,000 B.T.U.) 4.00
Lender's Name
Lender's'Address UN IT ER 100,000 B.T.U.)7.50 ELECTRIC
I certify that I have read this application and State That the aboveFAN (SINGLE) 3.00
ordinahnf.rmnces
n correct. I agree tog to b with all city and countyPLUMBING
hereby
ices and stale Taws relating to building.construction. and BOILER-COW 3 H.P.Or 100,000 B.T.U) 4.00
hereby authorise representatives for
of This city to enter upon the
above-mentioned Property for inspection purpuscs_ COMP (Over 100,000 BTUI SEE FEE BCH. MECHANICAL
(We) agree to vve. indemnify and keep harmers the City ofREFER TO ORD. -
Cupertino against liabilities,judgments, costs and expenses whichCONST.TAX
In in any wa &2wYnImoor
t Said City in consequence of theSSUANCE 3.00
g I ('I q CNT. LIC.NO. MECH,
f7K TOTAL TOTAL 3� L3
S' umofDate ��
OFFICE COPY
CITY C&PERTINO BUILDING PERMIT APPAON
Review by Public Works Department
PROJECT NAME Concrete Steps FILE'NO./SEQUENCE NO.
STREET ADDRESS 10690 S. De Anza Blvd. TRACT NO.
ASSESSOR'S PARCEL # PARCEL NO.
DEVELOPER Byer Properties TELEPHONE $ Blach Const.
»7-jinn
The following checked items are required by the Public Works Department : Contact
at (408) 252-4505, extension 232.
Date
Owner's 2nd City
Required Checkoff Review Released
A. ENGINEERING DOCUMENTS
1. *Agreements (see "Remarks")
2. *Bonds
3. *Quitclaim
4. Dedication
5. Easement
6. Fees
a. Storm
i
b. Grading Plan------------------- ---
��-----• •----------- --------- I-
d.
c. Grading Permit---------------- ---------- ---- - ----- --------- --------Retaining Wall_________•______
----------------------- -------- -----------
e. Other (see "Remarks")_________
f. Geological----------------- --------- ----------- --------
B. SUBDIVISION MAP REQUIREMENTS
1. Tract
2. Parcel
C. STREET IMPROVEMENTS
D. CENTRAL .FIRE DEPT. CLEARANCE
E. GEOLOGICAL REQUIRED
F. SOILS REPORT
G. SOILS LETTER
Remarks
Building Permits may4�e issued as of this date:
*City forms
White - Building - Final Approval
Canary - Public Works - Final Engine ring Staff
Pink - Building - First Check
Goldenrod - Developer - First Check