8620 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
• BU LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER
BUILDING109g APPLICATION & PERMIT w
ADDRESS LGT 13 U
ISI, /• BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
`/ OWNER'S PLAN CHECK VALIDATION
862
NAME DeAnze Group, A California QTY, ELECTRIC PERMIT FEE
T.rd- partnership ONE
NAMERAcroes OUTLETS-SWITCHES-RECEP 10.00/1.00
LIc.No. 465640 LIGHTING FIXTURES 10.00/1.00
ADORESSi4
5 411 Sorel Ave,Ste. 410 PPLIANCES-RESIDENTIAL 4.00 (�
San Mateo. HO PANELS 10,00 r DATE OF APPLICATION
ARCHITECT cTBDT PANELS (OVER 200 AMP) 20.00 A
OR
LAN CHECK FEE P.C.NO.
ENGINEER
a,deron-Nakamura IC.NO C013712SIGNS TRANS. 3.00
aRC� OR/ ADDRESS ENG. 2070 Business Ctr. #220 SPECIALCIRCUIT 5.00 _ LIDATION
6Ca. IP EMP.METER OR POLE INS. 20.00 'JUL O n
APPLICANT 411 Sorel Ave, Ste. 410 MOTORS SEE FEE SCH. 985
ADDRESS
qan MArtion Ca. 94402
SERVICE CHANGE 20.00
° ¢ TEMP.POLE 30.00 Gi{9 Of Cupertino
r
02 LICENSED CONTRACTORS DECLARATION ppu
< i w 1 hereby affirm that I-an licensed under provisions of Chapter 9 6 ISSUANCE DATE
(commencing with Section 7000)of Division 3 Of the Rulings and BL' G ELECT. PLG. MECH.
G m i Prol'cssions Code,and my license is in full force and eft^t ❑ ❑ ❑
Z o m - Liecnse Clas Lie.Number
mr w Date sin Contractor
a xn BUILDING PERMIT
¢ ¢ w < OWNER-BUILDER DECLARA'rl INFORMATION
F Or LL H I hereby affirm Ill I am exempt from the Contractor's License MISC.- n REFER TO ORD
u o¢ Law for the following reason.(Sec.-]031.5.Business and Professions VALUATION S/FT.
PERMIT ISSUANCE 10.00
rat Code:Any city or county which requires a permit to construct.alter,
a ¢ ¢ p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC.
° ¢ requires the applicant for such permit to file a signed statement that TOTAL
n w m w he is licensed pursuantdo the provisions of the Contractor's License PERMIT TO`r(v
rzQ
Law(Chapter 9(conineneing with Section 7000)of Division 3 ofthe s�
¢ ° :Iii"
and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
¢ H$ theBbasis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR,
a3 by any applicant lora permit Objects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred dollars(SS00).):
❑ I,as owner of(lie property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES. NITS
their sole compensation,will do the work.and the structure is not
intended or offered for sale (Sec. 7044. Business and ProfessionsDRAINS-FLOOR,ROOF,AREA,COND. 5.00 /
Code:The Contractors m License Law does not apply an owner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 so. .FLOOR AREA TOTAL ACREAGE
himself re through his own employees,provided that such improve-
ments are not finis sold w thin nofor
year
If,however,the own,
- GAS-EA.SYSTEM-1 INC.4OUTLETS 6.00
o,Impmaemmv is sold within one year of completion, the o r it GAS-EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden of proving that he did not build or it BUILDING USE
prove for purpose ciliate.). INDUSTRIAL WASTE INTER. 30.00 R INO CON PB Omer
O I,as owner of the property,am exclusively contracting with ❑ ❑ El 13
licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 1 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 contrxctodsl licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00
the Contractors License Law. TRACT NO, PARCEL NO.
ea❑son I am exempt under Sec.-,B&P.C.for this WATER HEATER W/VENT 6.00
r
O.,OCf Isme WATER SYSTEM 5.00 ACC.DAT ACC FILE No,
WORK FRS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00
I 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 thereof(Sec 3800,Lab C.).
Policy NO. u 1 n Hn-c+�� I i
O ❑ Cerci 1 turn r FIRE SPRINK ENERGY T2
z Z Dt Certified copy i t 'th he city inspection division.
F- O An cant MISC.- REFER TO ORD. Y N Y ❑ N�
fY W CERTIPICA'1 FOPE I:MPTION FROM WORK FRS' PERMIT ISSUANCE 10.00 FLOOD ZONE klL.U.C.
W > - COhIPIi NSA 1' INSURANCE PLG.CONTR. LIC.NO. PLG.
Z (This section need not be compacted if the Permit is for one TOTAL v N� V N�
hundred dollars IS 100)or less.)
U O 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued, I shall not employ any person in any manner So as to
U
mabecome subject to the Workers'Compensation Laws of California. rn
y• Date Applirnt - BUILDING
} 0' NO'T'ICE TO APPLICANT: If,after making this Certificate of E.- ALTER OR ADD TO MECH. 5.00
Z_ eruption,you should become subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK
U
provisions
sisof the
it...
Code, You must forthwith comply with FEE
p permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
CONSTRUC'r1ON LENDING AGENCY AIR HANDLING UNITIOVER 10p00C.F.M.) 6.00 SEISMIC FEE
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. MICROFILM
3097,Civ.(.). HEATING UNIT TO 100,000 B.T.U.) 8.00
Lender's Name Rank of Amnrlra, Q.0.
Lender's Address a... 0 �Sg HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC
I certify that I have read this application an,!WlUthe above VENTILATION FAN (SINGLE) 4.00
information n correct. agree tand comply with all city acounty
r ordinances and slide laws relating to building construction,ndon, and BOILER-COMP I3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING
u hereby authorite representatives of this city to cote, upon the
above-mentioned property for inspection purposes BOILER-COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino agars I' bilitics,Judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX
may in any erue ag Toil said City in On
of the
granting of th i MECH.CONT. LIC.NO. MECH.
513118 TOTAL TOTAL /
SignaNre of Appllca ret/Contruc or Date
INSPECTOR COPY
POST THIS CARD NEAR FRONT OF BUILDING,
CITY OF CUPERTINO
INSPECTION DIVISION
JOB INSPECTION RECORD
JOB ADDRESS IM / r M
vfi/
i UN1
OWNER CONfJATRACTOR
PERMNOk76ERIT
Q8620
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU-„
OR 180 DAYS FROM'
LASTCALLEDINSPECTION.
r
INSPECTIOND INSPECTOR INSPEC ION RECOR
FOUNDATION g 0/-,
ANCE
UFER i
PREGUNITE
PERV_I_l VALIDATION
lJti i 9 985
r
IOf
cNVfiSSUA
BEEN SIGNEDPOURNOCONCRETEUNDERGROUNDVSLAB
PLUMBING y
ELECTRICAL
MECHANICAL
BL , ELECT. PLG, I MBCH,
110 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 13
NFOR TION
LDIN .PERMIT
A
WOOD FLOOR VALUATION
r
91FT.
PLUMBING
MECHANICALPERMIT
ELECTRICAL
a l
TO
FRAMING
INSULATION
57DRI E5 T P COhSTR.
OCC. GROUP RES. UNITS '
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
SO. FT. FLOOR AREA TOTAL ACREAGE
DIAPHRAGM (D i `{ BUILDING BUILDING OSE
R IND CON Ps Other
r
El
ASSESSORS PARCEL NO. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
ROUGH
PLUMBING r,
GAS TEST
MECHANICAL II
TRACT NO.' PARCEL NO.
ELECTRICAL 64— FINALS DATE INSP.
ACC.OATE ACC. FILE NO,
FRAMING SAN #
ZONING ENG. SITE NO.
INSULATION _ _ PLUMBING
GAS
FIRE SPRINK
Y NE]
ENERGYT-24
Y E] NE]
COVER
MECHANICAL
NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD20NE'
Y[:] N
A.L.U.C. A.L
N YI__I
LATH -INTERIOR ELECTRICAL _ J
LATH --EXTERIOR FIRE DEPT.
SHEETROCK GRADE f / FEE SUMMARY
SHEAR INTERIOR _ BUILDING
BUILDING z 7
SHEAR EXTERIOR TEMPORARY APPROVALS
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS I
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDOCCUPANCY
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR-
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
z
PLEASE GIVE JOB ADDRESS WHEN PHONING.
SEE PERMIT FOR EXPIRATION DATE -
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
ol
MICROFILM
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
TOTAL
OFFICE COPY
POST THIS CARD NEAR FRONT OF BUILDING,
CITY OF CUPERTINO
INSPECTION DIVISION
JOB INSPECTION RECORD
JOB ADDRESS IM / r M
vfi/
i UN1
OWNER CONfJATRACTOR
PERMNOk76ERIT
Q8620
PERMIT EXPIRATION
PERMIT EXPIRES IF WORK
IS NOT STARTED WITHIN
180 DAYS OF PERMIT ISSU-„
OR 180 DAYS FROM'
LASTCALLEDINSPECTION.
r
INSPECTIOND INSPECTOR INSPEC ION RECOR
FOUNDATION g 0/-,
ANCE
UFER i
PREGUNITE
PERV_I_l VALIDATION
lJti i 9 985
r
IOf
cNVfiSSUA
BEEN SIGNEDPOURNOCONCRETEUNDERGROUNDVSLAB
PLUMBING y
ELECTRICAL
MECHANICAL
BL , ELECT. PLG, I MBCH,
110 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 13
NFOR TION
LDIN .PERMIT
A
WOOD FLOOR VALUATION
r
91FT.
PLUMBING
MECHANICALPERMIT
ELECTRICAL
a l
TO
FRAMING
INSULATION
57DRI E5 T P COhSTR.
OCC. GROUP RES. UNITS '
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF
SO. FT. FLOOR AREA TOTAL ACREAGE
DIAPHRAGM (D i `{ BUILDING BUILDING OSE
R IND CON Ps Other
r
El
ASSESSORS PARCEL NO. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED
ROUGH
PLUMBING r,
GAS TEST
MECHANICAL II
TRACT NO.' PARCEL NO.
ELECTRICAL 64— FINALS DATE INSP.
ACC.OATE ACC. FILE NO,
FRAMING SAN #
ZONING ENG. SITE NO.
INSULATION _ _ PLUMBING
GAS
FIRE SPRINK
Y NE]
ENERGYT-24
Y E] NE]
COVER
MECHANICAL
NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
FLOOD20NE'
Y[:] N
A.L.U.C. A.L
N YI__I
LATH -INTERIOR ELECTRICAL _ J
LATH --EXTERIOR FIRE DEPT.
SHEETROCK GRADE f / FEE SUMMARY
SHEAR INTERIOR _ BUILDING
BUILDING z 7
SHEAR EXTERIOR TEMPORARY APPROVALS
FIREWALLS ELECTRIC PLAN CHECK
FEE
GAS I
SEISMIC FEENOTAPEORPLASTERUNTILABOVEHASBEENSIGNEDOCCUPANCY
OCCUPANCY OF BUILDING ISNOT PERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR-
ARRANGE FOR INSPECTION BY PHONING 252-4505,
ONE WORKING DAY BEFORE REQUIRED INSPECTION.
z
PLEASE GIVE JOB ADDRESS WHEN PHONING.
SEE PERMIT FOR EXPIRATION DATE -
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION.
ol
MICROFILM
ELECTRIC
PLUMBING
MECHANICAL
CONST. TAX
TOTAL
OFFICE COPY
or PPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
O
Z
I-
tX
LU
CL
U
Lf_
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f—
b
BUILDING PROJECT 1 DENTI FICATION
APPLICATION &PERMIT
BUILQING —ELECTRICAL— PLUMBING —MECHANICAL
PERMIT NUMBER
O
ILDINV, jiDORE55A , '1 LOT 1 3
1 V V .7Og/
vr
OWNER'S
NAME DeAnza Group, A California
Ltd. Partnership PHDNE415/571-1
QTY. ELECTRIC PERMIT FEE
81
PLAN CHECK VALIDATION
CONTRACTOR'S
NAME OUTLETS -SWITCHES - RECEP 10.0011.00
LIGHTING FIXTURES 10.00/1.00TheAldenCompanyLIo.No. 465640
DATE OF APPLICATION
CONTRACTOR'S 411 Borel Ave Ste. 410
ADDRESS
Sari Mateo, Ca. 94402PHOK415/571•-14
APPLIANCES - RESIDENTIAL 4.00
1 PANELS 10.00
ARCHITECT
OR
eNGINEC alderon—Nakamura,D.NO. C013712
PANELS (OVER 200 AMP) 20,00
PLAN CHECK FEE . P.C. NO.
SIGNS TRANS. 3.00
ARCH. OR ENG. 2070 Business Ctr. #220
ADDRESS
Irvine, Ca. Zn.92715
SPECIAL CIRCUIT 5,00 PERMtT VALIDATIOu
r ( PUL 2 1985
city of Crtpertinn
EMP. METER OR POLE INS. 20.00
APPLICANT'S 411 Borel Ave, Ste. 410
San Mateo, Ca. 94402
MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
LICENSED CONTRACTORS DECLARATION TEMP. POLE 30,00
1 hereby affirm that 1 am licensed under provisions of Chapter 9
commencing with Section 7000) of Division 3 of the Busincf
and
Professions Code, d my license is in full fotce,a yf
License C s Lic. Number 4 O
Date Contractor
ISSUANCE DATE
B ELECT, PLG. MECH.
BUILDING PERMIT
OWNER -BUILDER DECLARATION
1 hereby affirm that [ 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 10 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
INFORMATION
MISC. — REFER'TO ORD
VALUATION
f D
SIFT,
PERMIT ISSUANCE 10.00
ELEC. CONTR. LIC. NO, , ELEC.
TOTAL PERMIT TO
A1L'1_1
OTY. PLUMBING PERMIT FEE
STORIES TYPE CONSTR, the basis for the alleged exemption. Any violation of Section 703 LS
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.) 5.00
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
BACK FLOW PROTECT, DEVICE 4.00 OCC. GROUP RES. UNITS,'
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
his own employees, provided that such improve- himself
re
of
intendedmenuarenotintended or offered for sale. [f, however, the building
FIXTURES - PER TRAP 5.00 Sal FT. FLOOR AREA TOTAL ACREAGE
GAS - EA, SYSTEM -1 I NC.4 OUTLETS 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.).INDUSTRIAL
1, as owner of the property, am exclusively contracting with
GAS - EA. SYSTEM - OVER 4 IEA.) 2.00 BUILDING USE
IND CON PB Other
WASTE INTER, 30.00
icensed 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
ASSESSORS PARCEL NO. LAWN SPRINKLERS - 1 INC 5 V,B. 6.00
LAWN SPR IN KLERS - OVER 5 (EA.) 1.00
contracts for such projects with a contractors) licensed pursuant to
the Contractor's License Law.
1 am exempt under Sec. B.&P.C. for this
SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO, PARCEL NO.
WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5,00 ACC. DATi ACC. FILE NO.
WORKERS' COMPENSATION DECLARATION WATER TREATING EQUIP. 5,00
1 hereby affirm that 1 have a certificate of consent to self -insure,
or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG, SITE NO.
copy thereof fSec. 3800, Lab.C,),
Policy No. n
FIRE SPRINK
Y N
ENERGY T-24
Y N
te[ti le Copy IS furnts
I( Certified copy e s he city inspection division.
Applicant la MISC. REFER TO ORD.
CERTIFICATEOF 15FROM WORKERS'
PERMIT ISSUANCE 10.00 FLOODZONE 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(S100) or less.)
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
become subject to the Workers' Compensation Laws of California.
Date Applicant
NOTICE TO APPLICANT; If, after making this Certificate of Ex-
nnBUILDINGvALTERORADDTOMECH. 5,00
APPLIANCE 5,00 PLAN CHECKemption, 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.
CONSTRUGT1oNLENDING AGENCY
FEEAIRHANDLINGUNIT (TO 10A00C.F.M.) 4,00
AIR HANDLING UNIT (OVER101D00C,F.M.) 6.00 SEISMIC FEE /
hereby affirm that there is a construction lending agency for I EXHAUST HOOD (WITH DUCT) 5.00
the performance of the work for which this permit is issued (Sec.
3097,Civ.C.). Bank bf America, P.O. Lenders Name
Lender's Address
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 [ at 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. Or 100,000 B.T.U.) 6.00
BOILER -COMP (Over 100,000 BTU) SEE FEE SCH: MECHANICALherebyauthorizerepresentalivesofthiscitytoenteruponthe
above-mentioned property for inspection purposes.
MISC. - REFER TO ORD.
CONST. TAX
We) agree to e, ind nify and keep harmless the City of
Cupertino aga' s 1 bilities, judgments, costs and expenses which
may in any a true ag "nA said City in consequence of the
granting of th i
5131185
PERMIT ISSUANCE 10.00
MECH. CONT, LIC, NO. MECH.
TOTAL
TOTAL
Signature ofApplica t/Contractor Date
OFFICE COPY