8625POST THIS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO
INSPECTION DIVISION
JOB INSPECTION RECORD
JR j
IPERMIT
JOB ADDRESS i 'KZ 5A44- 4 UNIT# LOT#
OWNER CCONTRACTOR
PER651T NUMBER
C,r,
ti
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 _ 6
li UFER
PREGUNITE
l _
PERMIT VALIDATION
i .
ISSUAN E DATE -
G- -r
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLAB
PLUMBING
ELECTRICAL
MECHANICAL
BLDG: ELE r. PL c ,
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUIL ING P R MIT
INFORMATION
WOOD FLOOR VALUATION $/FT.
PLUMBING
MECHANICAL
ELECTRICAL
v/aV d
PERMIT TO
FRAMING -
INSULATION
STORIES TYPECONSTR.
I
OCC. GROUP RES'.UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
90, FT FL06R AREA TOTALACREAGE
DIAPHRAGM
BUILDING USE
RES IND CON PB Oehv
El El El El 0
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO.
ROUGH
1•/ / - PLUMBING
GAS TEST --%y—
MECHANICAL 26urle
TRACT NO. PARCEL NO
ACC. DATE ACC. FILE NO,
ELECTRICAL
r FINALS DATE INSP.
FRAMING SAN # 7/S ZONING ENG, SITE NO.
INSULATION PLUMBING :L-y—yz
GAS V _
FIRE SPR INK
Y - IN f—]
ENERGY T-24
Y xMECHANICALa / f _ (p
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD ZONE
Y EI NE]
A.L.U.C.
v 0 NO
LATH—INTERIOR ELECTRICAL
LATH—EXTERIOR FIRE DEPT.
SHEETROCK p GRADE J FEE SUMMARY
SHEAR INTERIOR L BUILDING '— `6
BUILDING
SHEAR EXTERIOR /U—a, TEMPORARY APPROVALS.
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDJOCCUPANCY
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
H ONE WORKING DAY BEFORE REQUIRED INSPECTION.
z PLEASE GIVE JOB ADDRESS WHEN PHONING.
SEE PERMIT FOR EXPIRATION DATE --
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
TOTAL
OFFICE COPY r
F k APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
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A
BUILDING PROJECT IDENTIFICATION
APPLICATION & PERMIT
BUlLD1NG - ELECTRICAL- PLUMBING - MECHANICAL
PERMIT NUMBER
8625
BUILDWLOT 28AD
LOT
V 11 A(!Ilk 1.2 3A 3
NAME DeAnza Group, a California -
Ltd. PartnershipPHONE 415/571-1
QTY. ELECTRIC PERMIT FEE
81
PLAN CHECK VALIDATION
croRs
NAME NAME OUTLETS -SWITCHES- RECEP 10.00/1.00
LIGHTING. FIXTURES 10.0011.00TheAldenCompanyL,C.No. 465640
rONTRACADDRESS Tags 411 Borel Ave,Ste.410 PPLIANCES-RESIDENTIAL 4.00
p PANELS 10.00SanMateoCa. 94402 PHONE 45/571' 1481 DATE OF APPLICATION
ARCHITECT
OORENGINE
alderon-Nakamuraic.No. C013712
PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
ARCH. OR ENG.
2BusinessCtrzl®2l15AIrvine
CIRCUITIER
PERMIT VALIDATION
TSPECIAL
OR POLE INS. 2000
CaRESS .
APPLICANT'S
AO DR ESS MOTORS SEE FEE SCH.
SERVICE CHANGE 20,00411BorelAve,Ste,410 f1]
OSanMgtft@96*,-TR A40 -DECLARATION TEMP. POLE 30.00
I hereby affirm that I am licensed under provisions of Chapter 9.
commencing with Section 7000) of Division 3 of the Busine s and
Pro fessionsCode, a my license is in full forcea f t4ClasFLic. Number
ISSUANCE SATE
It j r,BL7
ELECT:
I; 1
PLG. MECH.
License
Date J Contractor
0 ¢'BUl k11 IG PERMIT
FORMRTIONOWNER -BUILDER DECLARA IOC
I hereby affirm that 1 am exempt from the Contractor's License
Law for Ac1ollowingreason. (Scc.7031.5,Business and ProfessionspERMITlSSUANOE
Code: Any city or eaunty 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
misc. --REFER TO ORD
70.00
ALUATIO FT.
ELEC. CONTR. LIC; NO. ELEC.
TOTAL PP ERMIT TO
QTY. PLUMBING PERMIT FEE
STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5
by any applicant for apermi[subjects the applicant to a civil penally
of not more than five hundred dollars (5500).); ALTER DRAIN &VENT -WATER (EA.) 5.00
I, as owner of the property, or my employees with wagcs as
their sole compensation, will do the work, and the structure is not
BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS
DRAINS -FLOOR, ROOF, AREA, COND. 5.00intendedorofferedforsale (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 cmployees,provided that such improve-
mcnts are not intended or offered for sale. If, however, the building
FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTALACREAGE
GAS EA.SY57EM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion, the owner-
builder will havc the burden of proving that he did not build or im-
proveforpurposeofsale.).
1, as owner of the property, am exclusively contracting with
GAS EA. SYSTEM OVER 4 (EA,) 2.00 BUILDING USE
IND CDN PB Other
INDUSTRIAL WASTE INTER. 30,00
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00licensedcontractorstoconstructtheproject (Sec. 7044, Busincss
and Professions Code: The Contractor's License Law does not apply
to an owner of property who builds or improves thereon, and who
ASSESSORS PARCEL NO.
LAWN SPR IN KLERS - OVER 5 (EA.) 1.00
contracts for such projects with a c_ontmctor(s) licensed pursuant to
the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO.
I am exempt under Sec. B.&P.C. for this
reason
ACC. DATV ACC, FILE NO.
WATER HEATER W/VENT 6.00
Owner Date WATER SYSTEM 5.00
WATER TREATING. EQUIP. 5.00WORKERS'COMPENSATiON DECLARATION
1 hereby affirm that l have a certificate of consent to self -insure,
or a certificate of Workers' Compensation Insurance, or a certified
copy thereof (e . g$Q bt_r
ZONING ENG, SITE NO.
l S--;Br-
Policy No. en
FIRE SMINK
Y N
ENERGY T-24
Y N
ECertified copy is here r i ed.
Cerlified copy is G i c' inspection division.
Applicant misc. - REFER TO ORD.
CERTIFICATE OF EXEM ION 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-
mit is issued, I shall not employ any person in any manner so as to
becomesubjecttotheWorkers'Compensation Laws of California.
Date Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
BUILDING rALTERORADDTOMECH500
APPLIANCE 6.00 PLAN CHECK
FEE
emption, 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. AIR HANDLING UNIT (TO 10PMC.F.M.) 4.00
AIR HANDLING UNIT(OVER 1=C.F.M.) 6.00
cs
SEISMIC FEE UCONSTRUCTIONLENDINGAGENCY
hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00
the performance of rhe work for which this permit is issued (Sec.
3097, Civ .C.).
Lendcr'sNa ankgI&
s
m
Lender'sAddreac ok
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
HEATING UNIT (OVER 100,000 B.T.U.)9,50 ELECTRIC
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. of 100,000 B.T.U.) 6.00
BQI LER-COMP (Over 700,000 BTU) SEE FEE SCH. MECHANICALherebyauthorizerepresentativesof (his city to enter upon the
above-mentioned property forinspeelion purposes.
MISC. REFER TO ORD.
CONST. TAX a
We) agree to s e in emnify and keep harmless the. City of
Cupertino against b tie , judg Bots, costs and expenses which
may in any way c t id City in consequence of the
granting of this pe i
5/31/85
PERMIT ISSUANCE 10.00
MECH. CONT. LIC. NO. MECH.
TOTAL
TOTAL paSignaturDate
OFFICE COPY