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8621a APPLICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 862 aunolNG ADDRESS IWO LOT 12 190 bll� Ir. PLAN 1 owN NAME DeAnza Group, A California OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE CONTRACTORS NAME UTLETS-SWITCHES-RECEP 10.00/1.00 The Alden C(Mpany LIC.No 465640 LIGHTING FIXTURES 10.00/1.00 DR's AD ADDRESSRESS 411 Borel Ave,Bte. 410 PPLIANCES- RESIDENTIAL 4.00 PANELS 19.00 San Mattrin- HON DATE OF APPLICATION OARCHITECTPANELS ENGINEER Ic. NO OVER 200 AMP) 20.09 PLAN CHECK FEE P.C. NO. r1 SIGNS TRANS. 3.00 � ARCH. OR ENG. ADDRESS 2070 Business Cir. #220 Irvine. Ca. vP 92715 SPECIAL CIRCUIT 5.00 'v PERMIT VALIDATION ® TARY / JUL 2 91985 �! a ��s�� CI1J530AN A.TE•rn B D ELECT. PLG. MECH. El ❑ 1:1License EMP. METER OR POLE INS. 'F 20.00 ADDRESS 411 Borel te. 410 ADDRESS Ave,, San Mateo. Ca. 94402 MOTORS' SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONI' RACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busine and Professions Code, and my license is in full force and eff cl. Clyysss Lie Number TEMP. POLE 30.00 Date_]./35YRI Contractor , BUILDING PERMIT INFORMATION OWNER -Bl DficLARnT I hereby collo that I so exempt from the u Contrainessacor'e License Law for the following reason.(Sec.uires a•Businessand Professions Code: Any city or county which requiresa permit to construct, aticq MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION SIFT. ELEC. CONTR. LIC. NO. ELEC. TOTAL 't� improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to Ills a signed statement that he is licmised pursuant to the provisions of the Contractors License PER MIT TO Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant too civil penalty of not more than five hundred dollars(S500)J: STOR TVP CONSTR. ALTER -DRAIN & VENT -WATER (EA.) 5.00 ❑ 1, as owner or 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 tree. GROUP RES.UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of FIXTURES - PER TRAP 5.0950. GAS - EA. SYSTEM - I INC.4 OUTLETS 6.00 property who builds or improves thereon, and who does such work himself or through his own employees. provided that such improve- mentsarenotintended or offered for sale. If, however, the building FT. FL R AREA TOTA ACREAGE or improvement is sold within one year of completion 'the owner. builder will have the burden of proving that h e did not build or im- Prove for purpose ofsaic,l ❑ 1, as owner of the property, am exclusively contracting with - . GAS - EA. SYSTEM OVER 4 (EA.) 2.00 B ILDING USE RES IND CON PB Ocher ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 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 LAWN SPRINKLERS - 1 INC 5 V.8. 6.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts for such projects with a contraetods) licensed pursuant to the Contractor's License law. SEWER -SANITARY -STORM EA. 200/t/10.00 TRACT NO. PARCEL NO. ❑ 1air exempt under Sec.-, If&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date �ACC.DA WORKERS'COMPENSATION DECLARATION WATER SYSTEM 5.00 E ACG FILE NO. 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 (hereof (Sec. 3800, Lab.C.). Policy No. t y ❑ Ccrti 1 c Y 6.fui11T1ESrG'DIDp'an C1q Certified copy d w the city inspection division. Ap cant I i % J I I FIRE SPRINK Y ❑ N❑ ENERGY TZ4 v ❑ N❑ MISC. REFER TO ORD. CIiRTI PICATIi F 1 XIiMPT1ON FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. COMPENSWION INSURANCE [ This section need mot be completed if the permit is for one Y N [-]❑ 'Y N [:]❑ PLG. CONTR. LIC. NO. TLG OTAL hundred dollars (S 100) or les.) 1 certify that in the performance of the work for which this per- mit is issued, 1 shall not employ any person in any manner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING - become subject to the workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, alter making this Certificate of Ex. ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE ,,notion , you should hecnme subject to the Workeri Compensation provisions of the Labor Code, you must hollovah comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 100MCF.M.) 4.00 AIR HANDLING UNIT (OVER 10=C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I*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 UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address_B05C 18 ••iza- I certify that l have read this application and a(�theabove HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC 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 100,0008.T.U.) 6.00 hereby authorise representatives of this city to enter upon the abovrmentloned property I'or inspection purposes, BOILER -COMP (Over 100,000 BTU) BEE FEE SCH. MECHANICAL (We) agreegill, 'ode" fy and keep IT rr as the City of MISC. - REFER TO ORD. Cupertino aaties,'u P 6j gments,costs and expenses which may in any n a egad 't said Citin' consequnce of the granting of thi: .AX PERMIT ISSUANCE 10.00 t MECH. CONT. LIG NO. MECH. TA TOTAL TOTAL /- SignatureofApplicant/ ontmctor Dutc15 INSPECTOR COPY POST THIS CARD NEAR FRONT OF BUILDING 4 CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD vxmMJOBADDRESSA00NN T LOT# OWNER CONTRACTOR a. PERMIT ER PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSP CTION D INSPECTOR INSPECTION RECOR FOUNDATION Ie )M UFER PREGUNITE PERMIT IQiN lJUL + iss§ city of Cu C JZ'IQ,7 ISSUANCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICALT DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUI DI G ERMIT INFORMATION WOOD FLOOR 1. VALUATION SIFT. PLUMBING MECHANICAL ELECTRICAL QIFRAMING P AhI1T TO STORIES-* TYPE-CONSTR. INSULATION OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO. FT FLOOR AREA TOTAL'ACREAGE DIAPHRAGM 6 -(Ir$ l l —BUILOlNG USE RES IND CON PB Other El El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO, ROUGH PLUMBING L, GAS TEST TRACT NO. PARCEL NO MECHANICAL ELECTRICAL b . g.r FINALS DATE INSP. ACC DATE ACC FILE NO FRAMING SAN # ZONING ENG SITE NO. 1NSULATION PLUMBING GAS y -f, FIRE SPRINK Y N ENERGY T-24 Y [:j N MECHANICAL l COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE Y N[J A.L.U.C. Y I] NC] LATH --INTERIOR ELECTRICAL i LATH -EXTERIOR FIRE DEPT. SHEETROCK [ GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROV-XI SNIf FIREWALLS ELECTRIC PLAN CHECK FEEEE SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDIOCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. ARRANGE FOR INSPECTION BY PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. MICROFILM ELECTRIC PLUMBING MECHANICAL CONST. TAX TOTAL OFFICE COPY O Z Z P yCC - W d.. O D Z UO Li- V O IDaN F- G P QPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LD1 NG PROJECT I DENTI FICATION- APPLICATION & PERMIT - BUILDING - ELECTRICAL - -PLUMBING - MECHANICAL PERMIT NUMBER 8621 BiALDING ADDRE 'I O LOT 12 Y s DeAnza Group, A CaliforniaNAME Ltd. PartnershipPHONE 415/571-1 QTY. ELECTRIC PERMIT FEE 81 PLAN CHECK VALIDATION CONTRACTOR'S OUTLETS -NAME SWITCHES - RECEP 10.0011.00 LIGHTING FIXTURES 10.0011.00TheAldenCompanyLir-No. 465640 DATE OF APPLICATION rOADDRESS OR'S 411 Borel Ave,Ste. 410 San Mateo, Ca.94402HON415/571-14 PPLIANCES- RESIDENTIAL 4.00 1 PANELS 10.00 ARCHITECTPANELSOR ENGIOEValderon-Nakamura,c.w. C013712 OVER 200 AMP) 20,00 PLANCHECK FEE P.C.NO. SIGNS TRANS. 3.00 AENG, `2070 Business Ctr. #220ADDRESSDDRESS Irvine, Ca. ZIP 92715 SPECIALCIRCUIT '5,00 PERMIT VALIDATION RAV 1lR/• V JULn p291985 nn + U(iy Q Sbj;