8607APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUILDING PROJECT I DENTI FICATI ON
+
APPLICATION &PERMIT
BUILDING - ELECTRICAL -PLUMBING -MECHANICAL
PERMIT NUMBER
860
RD,LDIrvGA,A�
ADURE S I KV 'LOT G
O E 'S
NAME D"nza Group, A California
-
OTV- ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
Ltd. Partnership PHONE
CONTRACTORS
NAME
UTLETS-SWITCHES -RECEP 10.00/1.00
The Alden CoMpany LIC.No 465640
LIGHTING FIXTURES 10.00/1.00
ADDRESS TDv's 411 Borel Ave,Ste. 410
APPLIANCES - RESIDENTIAL 4.00
PANELS 10.00
Ran Mateo- Ca.94402RON415/571-1411
DATE OF APPLICATION
ORRCHITECT
ENGINEER
c. NO. 11
PANELS (OVER 200 AMP) 20.00
PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
ARCH ORERG 2070 Business Gtr. #220
ADDRESS
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
TEMP. METER OR POLE INS. 20.00
Irvine. Ca. zip 92715
Il C-P''ti`-^^`✓/
AS411 Borel Ave, Ste. 410
ADDREDDRESSS
MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
SAn Mateo. Ca. 94402
p
LICENSED CONTRACT ORS 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 Business and
I'm lesions Cod, and By license is in full force n f c .
License Cly,s $ LU. Number
ISSUANCE DATE
RL ELECT. PLG. MECH.
Late - ]�31/_g�Contrselm.
OWNER -BUILDER DECLn lin O
I hereby affirm that l am exempt from Dec Contractors License
CodLawe: Any Cityluwingrtywhi Seemireso perm7031.5, inessond Professions
Code: Any city Lir Torrey which requirese permit toconstant,.She"
BUILDING PERMIT
INFORMATION
MISC.- REFER TO ORD
PERMIT ISSUANCE 10.00
VALUATION
'
$/FT.
ELEQ CONTR. LIC. NO. ELEG.
TOTAL
tore, prem n its issuance. also
a],
improve, the fill repair any permit
he is tic the applicant far such permit to file a signed sctor's i thae
applicant
he is licensed pursuant the provisions of Dador a License
--
E IT TO
of 00 )of 3
(Cha and Codeog with Station is excuf Divider o of the
Business Proeo Professions
and Professions Codc) or that he is exempt therefrom and
ba
QTY. PLUMBING PERMIT FEE
ryA
the is
the basis for the alleged exemption. Any violation of Section 7031.5
mocivil penalty
by any applicant Hive hundred
of not more than five hundred dollars [$500).):
STORIM
YYpffCONSTR.
ALTER -DRAIN & VENT -WATER (EA.) 5.00
❑ 1, as owner of the property, or my employees with wages as
their vole compensation, will do the work, and the structure is not
A
BACK FLOW PROTECT. DEVICE 4.00
oeC. eROUP
I s
DRAINS -FLOOR, ROOF, AREA,COND. 5.00
intended or Offered for sale (Sr,. 7044, Business and Professions
Code: 'rhe Contractor's License Law does not apply to an owner of
property who builds or improves thereon, and who docs such work
himself or through his own employees, provided that such improve.
.cues are not intended or offered for sale. If. however. the budding
FIXTURES - PER TRAP 5.00
GAS - EA. SYSTEM - I INC.4 OUTLETS 6.00
SO. FT. FLOOR AREA
^�3ah
TOTAL ACREAGE
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that he did not build or im-
/1
- .
GAS EASYSTEM -OVER 4 (EA.) 2.00
BUILDING USE
prove for purpose cfsale.)..INDUSTRIAL
❑ I, as owner of the property, am exclusively contracling withEl
R IND CON PR Dinar
11 El El
WASTE INTER. 30.00
SPRINKLERS - 1 INC 5 V.B. 600
.
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
licensed contractors to construct the project (Sec. 7044, BusinessLAWN
and Professions Code: The Contractor's License Law docs not apply
to an owner or properly who builds or improves thereon, and who
ASSESSORS PARDEL NO.
contracts for such projects with a conlraetoAs) licensed pursuant to
the Contractor's License Law.
❑ lam exempt under Sec. ,B.&P,C. for this
lea, in
SEWER -SANITARY -STORM EA. 200ft/10.00
TRACT NO.
-761
PARCEL NO.
WATER HEATER W/VENT 6.00
Owner Date
WATER SYSTEM 5.00
ACC. DA
ACC. FILE NO.
WATER TREATING EQUIP. 5.00
WORK ERS'COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self-In,Tr,.
ZONING
ENG. SITE NO.
or a certificate of Workers' Compensation Insurance, or a certified
copy thereof (Sec. 3800, Lab.C.L
Policy No.-p/+9� n1 y .�Q�-�a
❑ Certif-led tf li�ayfurni !F ^�
O ertified copy s f ' l /the Lily inspection division.
App ant_ !F
y
FIRE SPRINK
Y0 N
ENERGY T 24
Y❑ NE]
MISC.- REFER TO ORD.
PERMIT ISSUANCE 10.00
CFR'fIPICA'I: )' :XL'MPTION 17RONI WORKF. RS'
COMPENSATION INSURANCE
IThis section need not be completed if the permit is for One
hundred dollars IS 100) m less,)
FLOOD ZONE
Y [:] IN
A,L.U.C.
Y E] N �
PLG. CONTR. LIC. NO,
TOPLG.
TAL
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
QTY. MECHANICAL PERMIT FEE
FEE SUMMARY
become subject to tire Workers' Compensuli.. Laws of California.
ALTER OR ADD TO MECH., 5.00
Date Applicant
BUILDING
O�
NOTICE TO APPLICANT: If, after making this Certificate of F.x-
APPLIANCE 5.00
PLAN CHECK
FEE
enlPlum, you should become subject to the Workers'Compensation
provisions of the Labor Code, you nest forthwith comply with
such pravlSIOnscr this Permit shalt be deemed revoked
AIR HANDLING UNIT (TO 10MC.F.M.) 4.00 '
AIR HANDLING UNIT (OVER 10MC.F.M.)6.00
SEISMIC FEE
/Dae
CONSTRUCT ION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec.
3097, Civ.CJ.
EXHAUST HOOD (WITH DUCT) 5.00
MICROFILM
w
H EATING UN IT (TO 100,000 B.T.U.) 8.00
Lender's Nome TIAnk Elf America, P.O.
Lender; Addresso.... 1A
HEATI NG UN IT (OVER 100,000 B.T.U.) 9.50
ELECTRIC
a
I codify that l hxvereadihisapplicatinn andse'Ail hft eabove
VENTILATION FAN (SINGLE) 4.00
intilnrution is correct. I agree to comply with all city and county
ordinances and state laws relating to building construction, and
PLUMBING
BOILER-COMP13 H.P. or 100,000 B.T.U.) 6.00
hereby authorise representatives city to enter upon the
above-mentioned property for inspection purposes.
BOI LER-COMP (Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
'
(We) agree 10 av •, indemnify and keep harmless the City of
Cupertino age' st i lilities, judgments, costs and expenses which
may in any o Tue ag st said City' in consequence of the
grunting oft', n
MISC. - REFER TO ORD.
PERMIT ISSUANCE 10.00
CONST. TAX
(fA
MECH. CONT. LAC. NO.
MECH.
31 S
TOTAL
TOTAL
Q 0
O Q'�
Signature of pplicant/Conti or Date
INSPECTOR COPY
0
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NT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY
OFFICE COPY
PERMITNUMBER
11 LDI NG PROJECT IDENTIFICATION
APPLICATION &PERMIT
ELECTRICAL- PLUMBING -MECHANICAL8607
UILDIn
LOT
64JILDING
OWNER's
NAME DeAnza Group, A Calif.
Ltd. Partnership PRONL 415,/1
ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
DATE OF APPLICATION
CONTRACTOR'S
NAME -
The Alden Company LIa.NO. 465640
UTLETS-SWITCHES -RECEP 10.0011.00
LIGHTING FIXTURES 10.0011.00
CONTRACTOR'S
ADDRESS 411 Borel Ave, Ste. 410
San Mateo, Ca.944021ONA15/571-1481
APPLIANCES -RESIDENTIAL 4.00
PANELS 10.00
ARCHITECT
OR
ENGINEValderon-Nakamur@,e,NO, C013712
PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO.
SIGNS TRANS. 3.00
ARCHEORENG
2070 Business Ctr. #220
Irvine, Ca. Z,,
92715
SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
Q p UD -
c
Sly
TEMP. METER OR POLE INS. 20.00
nooLiessTS 411 Borel Ave, Ste. 10
San Mateo, Ca. 94402
MOTORS SEE FEE SCH,
SERVICE CHANGE 20.003%
i
J
LICENSED CONTRACTORS DECLARATIONTEMP.
I hereby affirm that I am licensed underrovisions of Chapter 9//N tpjjQP
POLE 30,00
commencing with Section 7000) of Division 3 of the Business and
Professions Code, d my license is in full force P,L
License Clg)ssr3 i> Lic. Number
Date Contractor
L ELECT. PLG. MECH.
BUILDING PERMIT
INFORMATIONOWNER -BUILDER DECLARA 10
I hereby affirm that l am exempt from the Contractor's License
Law for the following reason. (Sec. 7031.5, Business and Professions
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) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
MISC. - REFER TO ORD
VALUATION 51t=T.
PERMIT ISSUANCE 10.00
ELEC, CONTR. LIC. NO, ELEC.
TOTAL PERMITTO
J
lam' OTY. PLUMBING PERMIT FEE
the basis for the alleged exemption. Any violation of Section 7031.5 STORIES TYPE CONSTR.
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(EA,) 5.OD
1, as owner of the property, or my employees with wages as
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-
mentsarenotintendedoroffcredforsale.If, however, the building
BACKFLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS
DRAINS -FLOOR, ROOF, AREA, COND. 5.00
F IXTUR ES - PER TRAP 5.00 so. FT. FLOOR AREA 7 TOTAL ACREAGE
GAS-EA.SYSTEM-11NC.40UTLETS 6.00
or improvement is sold within one year of completion, the owner
builder will have the burden of proving that he did not build or im-
Prove for purpose of sale.).
1711, 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
q IND CDN PB Other
INDUSTRIALWASTE INTER. 30,00
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
contracts for such projects with a contractors) licensed pursuant to
the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft110.00 TRACTNO. PARCEL NO,
0 1 am exempt under Sec. B.&P.C. for this
reason
WATER HEATER W1V ENT 6.00
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC. FILE NO,
WATER TREATING EQUIP, 5.00WORKERS'COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to sclf-insure.
or a certificate or Workers' Compensation Insurance, or a certified
copy thereof (Sec. 3800 Lab.0.).
Policy No.i f y
Certified copy is'h furni d..
XICertified copy s fi 1 he city inspection division.
Applicant
ZONING ENG. SITE NO.
S&^/ (o JZ
FiRESPRINK
Y N
ENERGYT•24
Y N MISC. - REFER TO ORD.
CERTIFICATE OF XEMPTION FROM WORKERS' PERMIT ISSUANCE 14.00 FLOOp ZONE A.L. D.C.
PLG. CONTR. LIC, NO. PLG,
TOTAL I
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, 1 shall not employ any person in any manner so as to
BUILDING
00becamesubjecttotheWorkers' Campensation Laws or California.
Date Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Ex- I ALTER OR ADD TO MECH. 5.00
APPLIANCE 5.00 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 he deemed revoked. AIR HANDLING UNIT (TO 10JX10 C.F.M.) 4.00
AIR HANDLING UNIT (OVER 10=C.F.M.) 6.00 SEISMIC FEECONSTRUCTIONLENDINGAGENCY
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.). Bank Of America, P.O.
Lender's Name
Lender's Address
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) B4O0
HEATING UNIT(OV ER100,000B,T.U,)9.50 ELECTRIC
I certify that 1 have read this application and state.that the above
information is correct, 1 agree to comply with all city and county
ordinances and state laws relating to building construction, and
VENTILATION FAN (SINGLE) 4.00
PLUMBING
BOILER-COMP(3 H.P. or 100,000B,T.U.) 6.00
801 LER-COMP IOver 700,000 BTUI SEE FEE St 3f. MECHANICALherebyauthorizerepresentativesofthiscitytoenteruponthe
above-mentioned property for inspection purposes,
MISC. - REFER TO ORD.
CONST. TAX
Wc) agree to av indemnify and keep harmless the City of
Cupertino ag ' s lilies, 'udgments, costs and expenses which
may in any a e ag st said City in consequence of the
granting of s e
5/31/8
PERMIT ISSUANCE 10.00
MECH. CONT. LIC. NO. MECH.
TOTAL
TOTAL 0
SignatureafApplicanE/COniracor Date
OFFICE COPY
POST THIS CARD NEAR FRONT
CITY OF CUPERTINOF
INSPECTION DIVISION
JOB INSPECTION
JOB ADDRESS /
OWNER 45 CONTRACTOR
OF BUILDING
RECORD
UNIT# LOT#
PERMIT NUMBER
0 17
s
PERMIT EXPIRATION
0ERl r -:'r' XPIRFS IF WORK
IS NOT STARTED WITHIN
DAYS OF PERMIT ISSU-
ANCE OR 180 DAYS FROM
LASTCALLED INSPECTION.
INSPECTIO RTE INSPECTOR I S CT[ON RECORD180
FOUNDATION 4Sl
UFER -
c j0-$'T
PR EGUNITE 1
1c -
PERMIT VALIDATION
ISSUANCE DATE
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND/SLAB
PLUMBING
ELECTRICAL
MECHANICAL
SLD _ E T PL M
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDiN ERMI
INFORMATION
WOOD FLOOR VALUATION $/FT.
PLUMBING
MECHANICAL
ELECTRICAL
9 MI7 TD
kIL"
STORIES TYPE CONSTR.
FRAMING
INSULATION
OCC. GROUP
r
RES.UNITS, '
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
S0. FT. FLOOR AREA TOTAL ACREAGE
DIAPHRAGM
BUILDING USE
RES IND CON PB Ocher
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
ASSESSORS PARCEL NO.
ROUGH
PLUMBING t
GAS TEST
TRACT NO. PARCEL N0.
MECHANICAL a_ _
ELECTRICAL FINALSJ DATE INSP.
ACC. DATE ACC. FILE NO.
FRAMING SAN # f
IN ULATION d_ _ !j PLUMBING
ZONING
I'—
ENG. SITE NO.
c G
FIRE SFRINK
Y N
ENERGY T-24
Y N
p, ANICA / .2 p 7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED NG —r;' j
FLOOD ZONE
Y N
A.L.U.C.
Y 1] N
LATH—INTERIOR RI L yERRLATH—EXTERIOR T.
SHEETROCK p. E FEE SUMMARY
SHEAR INTERIOR ,a Z BUILDING IL
BUILDING
1SHEAREXTERIORTEMPORARYAPPROVALS
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDJOCCUPANCY
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505,
0
w
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
PLEASE GIVE JOB ADDRESS WHEN PHONING.
z
SEE PERMIT FOR EXPIRATION DATE —
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
TOTAL
OFFICE COPY