99090110 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO RUILDING-ELECTRICAL
BUILDING DIVISION APPIACATION/PEBINIT PLUMBING.MECHANICAL
BUILDING PROJECT'IDYITIRCATION
BUILDIN,,ADDRESS: SANITARY NO. APPLICATION SUBM L DATE
UJ +e Sawo..5 —k OCj /&/-
OWN'R'SNAMF;: PHONE CONTRACTOR'S NAMIi LIC NO'.
^II g7,r ()nT5�J^ A (3 '` I CONTROL
'RCHITECfIENGINEER: LIC NO: ADrISS: L� �'1 Q rrJ/0 /J ❑
w� /C
CONTACT: PHONE g' 3 �A/((a BUILDING PERMIT INFO
J4A•�f1 -k- Y ,(V Yqa_ so FQg0,97r, ❑ Conwltent It Paid by Applicant(Initial _6.- BLDG ELECT' PLUMB MECH
FFA„D r ^l ❑ �/ ❑ ❑
Lm Bar
LICENSED be TRACNR'S DECLARATION QTY ELECTRIC PERMIT FEE
1 therion 70(dof alit I amddhe d under nd Pref isa Chapcean(cnmTneTTcloT: JOB DESCRIPTION
'y�ylOc) wide Sretion]IXX11 or UivisimT3 ofthcdmineaaaM Pmfca�iam co�k.aN my liceroe is RESIDENTIAL:
F�� in full form and effect. PERMIT ISSUANCE
aFVz�j License Class Lk.♦ ❑SFDWL El KITCHEN REMODEL
N6a Data—Ccvumct« APPLIANCES-RESIDENTIAL []ADDITION ❑PLUMBING BE PIPE
ARCHITECTS DECLARATION PANELS ❑MULTI-UNIT ❑SIRUC URAI,
TJZ=Z IUTakruand myplaru Mall beused as puhlic reaxds
Oil TO 200 AMPS CHIMNEY
REP
H 4,F.,W Licensed Pmtm"real ❑INTERIOR ❑CHIMNEY REPAIR
20rica .MPS IMPROVEMENTSWIMMING
�C)W<
OWNER-BUILDER m C1ARATION ❑DFMOLUDON)DIS
C�Q 1 FrrebyaRmT Cher I am exempt from Be Contractor's License law for the OVER IOW AMPS ❑BATH REMODEIIFIEPAIR (]DEMOLITION
3 a V following n oson ISmliun]B?I3.Ousinas and I'rofaainnr Code:Any city or county SIGNS ELECTRICAL [I OTHER
u] LL which re,irn a Ilennit m abiant ally.iir,ve,detnnlisn, ep
or ray anary
y come
F"�0 prior.In I.,also rwluirn lle applicant f«each nea t to file arignd sTim,axim SPFCIALCIRCUITMISC. /// `
f�ta'y Ther bei,licensed pursuant to the prr,o'i«u of The Ccmvarear'a Lianae l�w(cm ter9 4
I�500 (commcncing wile Scctinn]gp)nfGvisTimJnfthc Busite.a oral Profnsi«u Coakl« TEMP.METER OR POOR INST. COMMERCIAL:
i a e C
That he is esemp dlerefmm and the boric f«Use a lcV eamption.Any Ittolmion of
[I NEW BLDG/ADDITION ❑DEMOLITION
Section 70313 by any applicant f«apermit subjccsa de applicant to a civil prealty of POWER DEVICES
FZT oti more than livchundrMdeftra tSSW].`o.0'�� ❑TENANT ❑FOODSERVICE
--Q ❑ Le.Dunn of Tne pmCeny or,pTy emplgm with u-ages ea their wle colnperuainn. SWIMMING PDOLELECTRIC IMPROVEMIiM'
Kt� will Jo the w«k,aN Be smatere u mor monsidd oroffcml f«sale(Sec.]0.W,BesimI [I OTHER
3 red 1'nrfeuimu Coj;!'he Clntrwbor'a License Law Joao orst apply to an owner W OUTLETS-SWITCHES-FlATURES
property who vlda«improve,bora on,rend who dm,,00 b wok himself-Tluoogh
his ow(T.,imiNoyee,pos'idni Thu wch inTpmvcmenTa are mot IntettlN a nRceI for NEW RESIDENTIAL ELECTR SQ FT.
:ale if.Mwrv,Oc huilding or impTovcmea ie sold widdn—yevof completion.IM SQ.FT FLOOR AREA 5/SQ.FT
owneet,rikor will have the harden of Loosing that he did n(A huild rn inNmve for pur-
p ac of sakJ.
I,ns owner of thepmpeny.eselhat axTW` TOTAL Fin
nn.mal the projml NL,,70sP Buy ,u,,uN Nor'—ion,CNet)The Contmutur'a V-
CTrrLaw does not apply to an c.Ter of Printwho cold,or imlroves meson.bard QTY, PLUMBING PERMIT FEE
wbo comnnsfbr wch WOJRta with a c«macoa ts)licensed pun,. .to Ile Coaetmetura
Lia..A.�law. PERMIT ISSUANCE
❑ lam eaeminuMcr See ,B,@PC f«Thie«nwm
tTvncr
ALTER-DRAIN R VENT-WATER(EA) VALUATION
Uac
ftJWORKITRoa COMPENSATION'DECLAIUTION BACK ROW PROTECT.DEVICE
1 hereby a1Tmm under Penalty of Perjury me of the following daclamTiana'.
l havcuTdwill maintain a Cirri re ofCwemm In self-inewm for Worker's Comps. DR\INS-FLUOR.ROOK AREA.COND.
swim,as pmvldN'for M1y Suef,00 37(X)of the Lather Code,for Be pefoamaocc of us, STORIES TYPE.CONSTRUCTION
work f«which This'mria is iwued, EI%rURIS-PER TRAP
❑I has,and will maintain Workers Comyensuinn Immarce,as mryurd by Seetion
3Myot ThelandsCode,fm thepe-aanri ofthe w«1f«which GAS-G.SYti TEM-OVER
GROUP APN
My Work beWd dPoork
Commit, 1/— mmcPdicy Na: Z�
CERA IICATE UP EX ES1Pr1CN FROM KERkF' ? O
COMPENSATION INSURAN ` J GREASIJNDUSTRLWASTE1NT1iRCEPIDR
Mis aenlim rcN n,e bemmpklN if the permit is for one M1urdml Jollma f51(Xp BUILDING DI ION FRCS
or War,) OR[? STRAP
PIANCHECK 12E
(certify that int he effertiarocany
of to be cera wujetTo the Woser,Condone-ill SEWER-SANITARY-STORM EA. F1'.
Tw employ any Person in any manner uo as Tn nemne aubjecT to The W«trTi Condone ENERGY FEE
O Z scion law,of Califomle.Dare WATER HEATER WT/E,LI:CTN
Z O Applicant NI:NGRADING FEE
NOTICh ecoore TO sandPo the Wcr:Ir,after Conmakingn Cisinmof of liaiNsr Cn,you.yta ould
most WATER SYS'I'ENMEATING
hecumc whjcrT y the Workers CmTpemuim Permit
ioaa of the Iib«Cade,rmT TrTuu SOILS I1E
fonhwimunnply wlm.mh pnrviainne«Nis PCTmitshullIs,decmel mvo4N. WATER SERVICE
7 z CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PUMP. SQ 17. PAID
UO Ihorubhi,h,hi Thdtnem iaurd!(Sca.Yo ,Cis.agercylnmhe.perfmmr•�c of Date Rceipt
rL — thew«kr«wnirn Tse.peseta i..iuucJ�srr.Rro].civ.c.)
O U Lrdai Name TOTAL
L) IcTnkr'a AJJTcas TOTAL:
yI rectify Thal I have read Thi.appl'Tohn ural uue Lha the ab�ve inf«nurion is BUILDING FEE
rn cartm.l agmemmmpy wise an city amd county«dinemma enJ xwm Pew rdadng T^ QTY. MECHANICAL PERMIT FEE
UZ Wikhe,,mr.i.o.old hereby audwrire Tepreives eraof Biscay to enter upon Be SEISMIC ME 11 uv
uMavc-muntimcd pmpeny nw iaspSrimn Carlow.
(We)agree To cave,indemnify and keep Iwrat the City of Cu ice inn against PERMIT ISSUANCE ELECTRIC
Iiabillties,jN�mema,a war anal exp:m<a which may in any way acme against said City
in umayuence of The granting of this permit. ALTER OR ADD TO SUCH. PLUb1 BING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WI'ALL NQ�PpIN� AIR HANDLING UNIT(TO 10,000CFM)
SOUR9ER l TIONS. / (�^ /,L MECHANICALIF.E
AIR HANDLING UNIT(OVER IG.M)CFM CONSTRUCTION I"
igturur orpplic CmRI—X)- Data EXHAUST HOOD(WIDUCq I LOUSING MITIGATION FEE
I lAHx)US MATERIALS DISCLOSURE
Will the aTplicam or Nature building occupant.roe or M1:ualk hveNaus ommema HEATING UNIT(TO H10.000 BTU)
es deired hY The Cul'cnino Municipal Code.Omper 9.12 aril The Head h and Solely
Cade.Section 25532(01 HEATING UNIT(OVER 100.000 BTU)
[:1 ye,, 0 N
VI-MIIATION PAN fSWCLIi RESIDI PAID .
Uill d applicant or future budding recupam one tri snrm or ce ice,which Date R ip
it hvnrdua,air emorro ands as defused by The Bey Arta Ah Quality Mwagement BOILER-COMP(3HP OR 100,000 RTU)
T I;
Tstricf!
0)e, -1 No BOILER-COMP(OVER 100(p0 BTU)
I hmc rend the hunnbus ourb,twls o aireTrcnt,uTWer CTalrn 695 d IN,Cali- AIR CONDITIONER ISSUANCE DATI7
fmkfi Health&Safely d ba,
a,Sectinn.v 255(15.353}nN 255?J5 1 oa�if I� NEW RESIDENTIAL MECH. SQ.FT.
ofUs,8doe oda By navm TrnmnLthatiTismY dMlit to e pant
ol'Ne,req ' m ¢M1 nuu nelpnurm
m vuthorisd seg (lac TOTAL:
1"S'ED BY:
OFFICE
• CITY OF CUPERTINO
• 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: karenb
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:31G20077.00
DATE ISSUED...... . : 09/1G/1999
RECEIPT a. ........ : 10105
REFERENCE ID # ... : 99090110
SITE ADDRESS . . ...: 19333 VALLCO PY
SUBDIVISION .. . . . . .
CITY ......... ... . : CUPERTINO
IMPACT AREA ...... .
OWNER . . . . . .. .. ... : TANDEM COMPUTERS INC ✓
ADDRESS . . . . .. .... :
CITY/STATE/ZIP ... : CUPERTINO CA, CA 95014-3548 1
RECEIVED FROM .... : TIM
CONTRACTOR . . ..... : LIC #
COMPANY .. . . . ..... :
ADDRESS ...... . ...:
CITY/STATE/ZIP . . ..
TELEPHONE ...... . .:
FEE IO UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEN BAL
---------- ---------- --- ____ ---------- --_-------
BTEMP FLAT RATE 1.00 57.50 0.00 57.50 0.00
EPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
PERMIT : 93.02 0.00 93.02 0.00
METHOD OF PAYMENT AMOUNT NUMBER
-- ------------ ------------------
CHECK 93.02 9799
------------
TOTAL RECEIPT 93.02
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
103 UFER 304 ROUGH ELECTRICAL
I
I
INVOICE, INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
• CITY OF CUPERTINO
BUILDING PERMIT INVOICE OPERATOR: karenb
Sec: TvP: Rng: Sub: Blk: Loe:316200]].00
INVOICE DATE..... . : 09/16/1999 _
REFERENCE ID b .. . : 99090110
SITE ADDRESS ..... : 19333 VALLCO PY
SUBDIVISION ... . .. .
CITY ......... .. . .. CUPERTINO
IMPACT AREA .... . . .
OWNER . . . . . . . . . . ..: TANDEM COMPUTERS INC
ADDRESS ........ . . :
CITY/STATE/ZIP .. . : CUPERTINO CA, CA 95019-3598
CONTRACTOR ..... . . : LIC #
COMPANY ...... .. . . :
ADDRESS . . . ....... :
CITY/STATE/ZIP ... .
TELEPHONE ... . . ...:
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
_____ I
ETEMP P 59.50 0.00 59.50
EPERMITFEE P 35.52 0.00 35.52
93.02 0.00 93.02 {/r
VOICE-ID ----------------------------
-- DESCRIPTION----_-_-- VOICE ID --- ------PTION /
�------� --304--- AL-----------.
DFER 309 ROUGH ELECTRICAL '
l