15394 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
•
BUILP ING PROJECT I DENT[FICATI ON .PERMIT NUMBER
BUILDING APPLICATION & PERMIT C n
AD s�L � . . / 1,/, /./J, ✓ BUILDING - ELECTRICAL-PLUMBING-MECHANICAL J 94
o NEN' C Com/ PLAN CHECK VALIDATION
N
OTV. ELECTRIC PERMIT FEE
• CONT CTO 5 F
NA OUTLETS-SWITCHES-RECEP 10,00/1.00
LIGHTING FIXTURES 10.00/1.00
CONTRAC OR'S
ADDRE �J 1 �._ PPLIANCES-RESIDENTIAL 4.00
.� �� �,P PANELS 10.00
DATE OF APPLICATION
ACTOPCNIT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO.
ENG( [
uc,no, SIGNS TRANS. 3.00
ADOREDR SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP TEMP. METER OR POLE INS. 20.00
nooriGANkf MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00
D ¢ i
'02 LICENSL'U CONTRACTORS DECLARATION
a v w I hereby atliim that I min licensed under provisions of Chapter 9
< (commencing w Se' , 001 of Uivivion 3 of the Businesaamd ISSUANCE GATE
O'^ Prulessions Co /��-� B��(11',!ELECT. PLG. MECH.
1_ N z :u uc is in ft�- r/ / y(, I{as1ii77 ❑ ❑
z o m - License C use Lic.Nun /�C,»7
H r .A Uute / Contrano
a Y F ILDING PERMIT
¢ le w a OWNER-BUILDER UL'CLAItATION Up8
0 o TA INFORMATION
E
; LL y 1 hereby affirm Thal I um exempt from the Contractors License MISC.- REFER TO ORD
LL O ¢ Law for The following reason.(Sec.7071.5,Itusiness unJ I'rufcesioro VALUATION �. $/FT.
- PERMIT ISSUANCE 10.00 (J'-
¢ my Code:Any CIODa countywhicll ruquirnaprrnlinucnnslna9,u her, ELEC. C '_^ ^�
W¢ a improve,demolish,or repair any atruel arc,prim Tu its ivuuntt•,also ELEC.CONTR. LIC.NO. 1 ,L,� CO
iL o u requires The applicant lel such permit ler Lilo a signed slalen,uD that TOTAL /NJ v�
n w m he is lieelrsed Ponsoam l0 the provisions ut The Conlnmloi a License !PERMIT O
r z a Law(Chapter 9(commencingwin Section 70001of Division Sol'file
f 4 e Business and Profusions Code)or Chat hr is exempt thereto n Ault OTY. PLUMBING PERMIT FEE
¢ . m the basis lir Thealleged exemption.Any violation of Secliun7031.5 STORIES TYPE CONSTR.
by any applicant for a permit subjects The applicant to'A civil penally
of net nmrc tmn five ounbed dollar,(s5o01.1: ALTER-DRAIN&VENT-WATER IEA.) 5.00
❑ I,as owner of the properly,or myemployees with wages as BACKFLOW PROTECTDEVICE 4.00
their sole compensation,will du The work,and the al Ductal,is not . OCC.GROUP RES.UNITS
intended or offered for sale (S,,. 7044, Business and Profesaiom DRAINS-FLOOR, ROOF,AREA,COND. 5.00
Code:The Contractor's License Law don not apply In in owner of
property who builds or impn,ve,thereon,and who don such work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE
hinuellor Ihrouglh Ili,awn employees,provided(tat such impnwe-
nleill,Are not intended or oltehed lar sale.Il,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00
�. or in,pruvemenl is sold wilhln one year u1'completion, the owner-
buiNer will have the burden of proving that he did not build or hit- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE
prove for purpose ofsale.l' INDUSTRIAL WASTE INTER3000 RES IND CON PB Omer
❑ I,as owner of the property,am exclu,iv,ly convening wilt . .
El 1:1 11 1:1 13licensed eonvacrors to construct the project(Sec. 7044,Bhninese LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
And Prufc,sinns Code:9'he Contractor's License Low dors not apply
to an owner of property who builds or improve,thereon,And who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts 1'ursac I pniens with A conlructurO)licensed pa T.uhanT In
the Crmracmr' License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO.
❑ I and rx mph under Sec. ,B.&I'.(•,torlhis
reA,.n WATER HEATER W/VENT 6.00
l
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO.
W'ORKERS'COMPENSA'TION DECLARAI ION WATER TREATING EQUIP. 5.00
I hereby affirm (hal I half,A cenit"at,Wo) 'nl n -Tam•, ZONINGor a xrliRRY1
ri CohnnehUM Tan r µnif is ENG.SITE NO.
copy There.
1'sliry NoIY❑ (-m ` L f
[We(Ld / FIRE SPRINK ENERGY T-Y<
Z Z e �P
Fp
1A,,hcAA_,,
ol _ __y MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑
y CHR'Il IC'A'I'E UI'IiSP�\I PILON PROA✓\I/'ilk KliRS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.u.C.
CL 0 (ILIs .noun il"I nolo b'lco u,1'I'•d it INSURANCE
permit i. lin ane PLG.CONTIi. LIC.NO. TOTAL Y❑ N❑ Y❑ pry❑
ao
:-) Z hundred dollurs(51001 err lra.l
LL _O I eeNtY 1141 -m ala pulunnun,e of the work for whiclh fihi]pct OT,. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit i,iaauc ,hall nes employ vp'prison in any u I I au:u w
O W beconm s y lO the WnrkrN Con.pensaTirn Laws s1 CaliforniA.
Q. Dale - Applicant ALTER OR ADD TO MECH. 5.00 BUILDING w
} to NOTICP U AI'PLIG\N I': II,suer ria Ling this ccnificaln of loo-
F Z empti n,you slmulo becmne subject Co the Workers*Compcn,xlloo APPLIANCE 5.00 FEE PLAN CHECK q p C,
C..1 pact visions
is of the th Labor Code, you nool Isrthwilh COhnp1Y with
t pernit shat[be deemed revoked, AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00
CONSTRUCTION LENDING,AGENCY AIR HANDLING UNIT(OVER IO,000GEM.) 6.00 SEISMIC FEE .SZ)
1 hereby affirm Chat 11 'n, u a camvuctian lending ugenoy for EXHAUST HOOD (WITH DUCT) 5.00
The peNbnmante of 1 work for whish This permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,0Add00 B.T.U.) 8.00
Lender's r , .
HEATING UNIT(OV ER 100000 B.T.U.)950
Lcnder'a Atldre ELECTRIC .5L C'Lo
I certify Chat l have read this application and slate lhw The above VENTILATION FAN (SINGLE) 4.00
. Ordinances I% correct. agreeti10 comply with all city and enemy BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING
information
and stale laws re ling u, building construction,anion, and
hereby ,rionea roperty for ins of on city to ewer upon the 801 LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
ubove•nnntianeJ properly Int inspection purposes.
!Wel Agree to arae, in.l,runit)' and keep hannlras Ihr ('ily m MISC.- REFER TO ORD.
uperl'n' a• ioll Mobilities,judgment eras and exl,enses which CONST.TAX
may any wa A,,rue a• hst I1_'ip' in unus•quunn. of III,• PERMIT ISSUANCE 10,00
•n
It 0 1 eI Hk//� ��y��//7 MCCli,CONT. LIC.NO. MECII, p
TOTAL TOTAL
S t neol'AP iranTlCuinlnn Dalt -�
OFFICE COPY
POST THIS CARD NEAR FROINT OF BUILDING
PERMIT NUMRLR
t = . CITY OF, CUPERTINO 15394
INSPECTION DIVISION
JOB INSPECTION RECORD- '
PERMIT EXPIRATION
10400 Ridgeview. Court
JOB ADDRESS UNIT# _LOT# PERMIT EXPIRES IF WORK
OWNER 'Tandem Com uters CONTRACTOR IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT'ISSU
FOUNDATION. . -- ANCE OR 180 DAYS FROM
NOTE: LASTCALLED INSPECTION. '
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB , r
PLUMBING.
`. ELECTRICAL - A? ISSUANCE UATIt'
MECHANICAL - _ ELECT I PLG. MECR.'
DO NOT POUR FLOOR UNTIL ABOVE HAS-BEEN SIGNED BUILDING PERMIT
INFORMATION
WOOD FLOOR' VALUATION .. s/Pr.
PLUMBING - ;,�•ry-�y 'd 7
3 /C..(../) ter'
MECHANICAL ' �:.�
ELECTRICAL veRMn TO
FRAMING•' •
. INSULATION STORIES TYPE CONSTR, .
'OCC.GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF NOTE:NO.FINAL INSP.SHALL BE MADE BEFORE sa.IT,FLoon ARFA TOTAL ncRLACL
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING USE
ROOF SHEATHING �> Res 'IND CON PR Om.,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 1-1 ❑ ❑ ❑
'ROUGH SAN.N ASSESSORS PARCEL NO
PLUMBING - ELECT.ENERGY
TUBS B SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO
MECHANICAL - MECR ENERGY -
' ELECTRICAL BUILDING ENERGY ACC.DATE .. ACC car.NO.
FRAMING - - ELECT.FINAL TEST
ZONING ENG.SITE N0.
INSULATION � PLUMBING
GAS TEST GAS ••
FIRE SPR INK ENERGT'LjC
MECHANICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ NE] Y ❑ N[ '
a E
' • EXTERIOR SHEAR ,- - - ELECTRICAL RELEASE /p'V, 8000 LONA L U C.
INTERIOR SHEAR FIRE DEPT. Y❑ NoY ❑ N❑
SHEETROCK - GRADE FEE SUMMARY
EXTERIOR LATH BUILDING / v _ k_
INTERIOR'LATH - TEM RARYAPPROVA BUILDING
SCRATCH COAT `' ELECTRIC PLAN CHECK
GAS
'FEE ° L
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM
LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
O~� E GIVE
WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
Z PLEASE JOB ADDRESS WHEN PHONING,
SEE PERMIT FOR.EXPIRATION DATE — MECHANICAL
IMPORTANT! CONST.TAX,
PLEASE READ REVERSE SIDE BEFORE 7�f
CALLING FOR FINAL INSPECTION. ' TOTAL-,
OFFICE COPY
ADDITIONAL PERMIT FEES
BUILDING PROJECT IDENTIFICATION VALUATION
pmLENNSG
Hoop u
.A.E
NPM
FEE SUMMARY
PHONE
CONTRA ORS
BUILDING
¢.NO\ jT�V PLAN CHECK
woDR
A..R
FEE
PHONE SEISMIC FEE
OTY. ELECTRIC PERMIT FEE
UTLETS-SWITCHES-RECEP I IELECTRIC
LIGHTING FIXTURES p
PPLIANCES-RESIDENTIAL PLUMBING 3��_
PANELS MECHANICAL
SIGNS
SIGNS TRANS. TOTAL
SPECIALCIRCUIT
EMP.METER OR POLE INS- PERMIT VALIDATION
MOTORS SEE FEE SCH.
0�
O SERVICE CHANGE
I z Z
F 0 TOTAL
LU -
W ? OTY. PLUMBING PERMIT FEEcE DATE
a 0 BLDG ELECT.. ELECT. PLG. MECH.
=) Z ALTER-DRAIN&VENT-WATER(EA.) ❑ ❑ ❑
U O BACKFLOW PROTECT.DEVICE
0 u DRAWS-FLOOR,ROOF,AR EA.CO
} m FIXTURES-PER TRAP Iw
F— Z GAS-EA.SYSTEM-1 INC.4 OUT Q
() GAS-EA.SYSTEM-OVER 41E
INDUSTRIAL WASTE INTER. -
LAWN SPRINKLERS-1 INC 5 V.8.
LAWN SPRINKLERS-OVER 5(EA.)
SEWER-SANITARY-STORM EA.pOft/
WATER HEATER W/VENT-
WATER SYSTEM
WATER TREATING EQUIP.
OTY. MECHANICAL PERMIT FEE
ALTER OR ADD TO MECH.
APPLIANCE
AIR HANDLING UNIT(TO 10=r.F.M)
AIR HANDLING UNIT(OVER 10pODC.FNL)
EXHAUST HOOD(WITH DUCT)
HEATING UNIT(TO 100,000 B.T.U.)
HEATING UNIT(OVER 100,000 B.T.U.)
VENTILATION FAN(SINGLE)
BOILER-COMP 13 H.P.or 1 D0,000 B.T.U.1
BOI LER-COMP IO-r 100.00D EITUI SEE FEE SCH.
TOTAL