20910 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
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Building Pro M Identiflaticn PERMIT NO.
bdGiing -30 .P 20910
16 amtphomn.
e0 CITY OF e'UPERTINO-BUILDING DIVISION
APPLICATION / PERMIT [[
Architect r.
Lie-No,Nn uM-DINGELFS:'IHICALML lNG-MECHANKAL CAITGORY CONTROL
QTY ELECTRICPERMIT FEE BUILDING PERMIT INFO
Acidr PERMITISSUANCE ❑ ❑ ❑
LICENSED CONTRACTOR'S DECLARATION
I hereby aHlrmthat l am licensed under pnovbivnsof Chapter9(acnmee APPLIANCFSRESIDENITAL JOB DESCRaN
Ingwlth Samm7000)of DiviaM3 ofthe Buelwean pwfemlmuCode,and my
p
hoe
ff�
Dater Ls In lu ontrouor PANELS `��
Limn. is/ >y
Dale Comraaor
ARCHITECTS DECLARATION -
OntU Z ]understand my pbroehall be used u publieneords. OVERIODOAMPS SQ.FT.FLOOR AREA $/SQ.FT.
w O Glco�d Profemlorul SIGNSELECTRICAL
�j
Q OWNER-BUILDER DECLARATION SPECIALCIRCU1T/M19C
Ihercby aWrmtlutlam exemptlmmthe CoNa
raorb Lkenx law(or the
pp following mson.(Seaei
(Section 70315,Bunea.and Peofeabru Code.My dryer
6 7 F- TEMP.METQt OR POLE INST.
� muntywhkh requbnapemdto coM1lbYa,ilter,lmprove,demnWh,errepar
gggqg anystml mpr wiro b we,aleorequbntheappBantfmsuchpermitto POWER DEVICES
a F 6 file a elgtu i foremen that he h llreneed p..t to the provtsbn of the
�Or;1. Conteadori Lkene Law(Chapter 9(mmoendng with Se icm 7000)of Divi- yyyp,{MdNC pDa.pl.Ectly VALUATION
H OJ Wun3of the Bufnmand Profmlom Code)orthat he b emmpt tFerefromard
6 i the b.eb for the alleged exemption. My vI,4ek n of Section MIS by any
mctOVDSISSWITC}IFS
applicant fora pedt aubjes the applicant to a dvll pevXy of not more than
five hundred ddlara CLW. NEW RESIDENTIAL
MI,as owner of the property,or my employm with wage n their wLe STOR 6 TYPE CONSTRUCTION
o
competwtlon,wlhdothe work,wdthe smietureb wt bdeided m offered for
S O sale(Sec 70N,Busmen ant Prafmbns Code:The Contractor's Limn Law
$$ dm nM.pply to an owner of property who build.or Improves thereon,and OCGGROUP RES AMTS
who doeswchworkhbruelferthro ugh M.ownempI yces,provided that.eh
Improvements are not Intended offered fmsale.If,however,thebullding or TOTAL
Improvement bwd whhldmreyearafcarrpletbRlhe mwnerbuuilderwW love
trycpnrden of proving that he did not bulla or improve for purpose of sale.). QTY, P ING PE 1 FEE
LI S as owner of the property,am excluavely contracting with ho rued FLOOD ZONE APN
mntraaora to conerua the project(See 7014,Busmen and Professions Cade: I'FRATI'T E
The Contractor'.Llaru,Law don not apply to an ownrr of property who
build. or Improves thereon,and who mMram for such ptofem with• AL _D 4 7FR(EN
acta(.)Banxd punsuwtwthe Contras .Lfee.law. BAIX FLOW PRO E FEE SUMMARY
U I am exempt under Sm B 4 P C for thio rcwn
a
Ownu Dae DRAINS FLOOR F,AREA,COND. SANITARY Y_ N_
S WORKMAN COMPENSATION DECLARATION•
❑I he
affirm that I have a mtlfiate of e..t tm self-lesure,or FSS `.RdOOI-TAX Y N
RECEIPr0
certalcate of Wofleri Compemation lruurana or a artBied copy thereof t5ee GAS .FA -1 ING40 PARK FEE V N
38(q,Lab CJ RECEIPT e
Paley# GAS EA. -OVER 4(EA)
y BUILDING DIVISION FEES
VrI
Wea copy 6hereby fvminhea. GREASE/INDUSIRL WAS] ErTOR PLANCHECK FEE
rllnea ropy b Wed Wim the city supe aloes aldsimr.
CERTIFICATE OF EXEMPTION FROM WORKERS GREASE TRAP PAID
COMPENSATION INSURANCE SEWER-SANITARY STORM EA.20Q7 Date
RCoei t#
(ThMon io aerued not b,completed If the permit bfor one hundred deal.
($100)or lea.) WATER HEATER W/VEM/E].FLTR ENERGYFEE Y_ N_
I certify that In the peaomence of the work for which this permit bw
Ied,
I shill rad employ any penum lo any manner w as to become subje t to the WATER SYSTEM/TREATING
Worker Compensation Law.of California.Dae PAID
0 Z Applicant NEW RESIDEMIAL PLMB. SQFr. Date Recei t#
Z O NOTICE TO APPLICANT:H,after making this Certlflcate of Exemption,you
should become wbjed to the Workeni Compensation provlswne of the Labor TOTAL:
N Cade,you must forthwith comply with such provision or this permit shall Est
LU j deemed revoked. -BUILDING
CONSTRUCTION LENDING AGENCY SEISMIC FEE
0. G Ihereby.mrm that there b a corurunon lending agenwy for the perform, TOTAL ELECTRIC FEE
Z era of the work whkh this permit h bwed(Sec.309J,CW.C.)
(� O larder,Name PLUMBING FEE
LL ~ Lerder.Addrea QTY. MECHANICAL PERMIT FEE MECHANICAL FEE �O
O I adlfytha 1 have read thio applieand
sdor eve that theabose Information
O LU bcomea.I.greetocomplywlth all cily.ed ntynrdleanmMR
andootelaws PERISSUANCE Z_07 FEES PAID
r N rt1aH to buoding mroltualon,and here utharize rtmn
pcnmHvof this
cit t ntcru the abw rationed for ALTFRORADDTOMECH.
~ Z y . t a.rr .n a P e,,,mlen t w Ica Date Recti t#
V ago
bill
,judg .order whkh mayU yway ALR HANDLING UNIT(T010,000 CFM) SUBTOTAL•
.ga idC In ens dg of Chia MR HANDLING UNIT(OVEN 10,000 CFM) CONSTRUCTION TAX
Sig sof Apph ort t D(HAUSTHOOD(W/DUC) CONSTRUCTION TAX PAID:
HATAR S MATERIALSDISCLOSURE
W I theappBantorfutu hulldingomapant.tm,mhardleharardous HEATING UNIT(TO 100,ODO BTU) Date Recel t#
muterbl a,defined by the Cupertino Municipal Code,Chapter 9.17,and the
Health and SafetyCod HEATING (OVER IW,000 BTU)ion 25532(a)7 TOTAL:
F�1 yea No
Thai the apphcant m buildleg occupant use equlpmrm or devl VENTILATION FAN(SINGLE RESTD) ISSUANCE DATE
which emit hazardous air conuMauna act drifted by the B.y Area Air PAM
�1111\
• Qua Wy Management garltl7 BOILEA{OMP PFU'OR 10(1,IXq BTU) �I1LJ
Yn No
have read the hon moot rtqulrtrrcnb under Chapter 6.95 of BOILER-COMP(OVER 100,0008111) (� AUGU p
He Ilfornb Health 4 Sa! Code,Sea n 2SS05,15S33 wd 25534.1 G N P
urdI tllthe gdaes not meetly,have a tenant,that It is my NEW RESIDENTIAL MECFi. SQFr.
ro rvslbdty rad the pant at regaluments kh mus be m j
p ofaA APO
f rrcy.
Uv red gent to P4 V TOTAL �� ISSUEDBY..
OFFICE COPY VVV
ROBERT LnvDSKOG, P.E. BUS: (408) 252-0190
Consulting Engineer FAX: (408) 252-9982
• 20910
October 02, 1990
Planning Department
City of Cupertino
Cupertino, CA. 95014
Dear Planning Dept.
On October 2, 1990, I inspected the Alliance Evironmental
Chamber in the Reliability Laboratory at Tandem Computers at 10300
North Tantau Avenue in Cupertino. I witnessed the operation of the
chamber and inspected the components and associated piping. I
verified the equipment and its components were installed as per
the Alliance Industries Drawing for this system.
Mr. David Yeo, of Alliance, informed me the refrigeration
unit and piping has been pressure tested to 150 psi and checked for
leaks. I inspected the refrigerant piping system and cooling tower
water connections installed on the roof and in the laboratory, and
I saw no evidence of any leaks or malfunctioning components.
•
Respectfully Submitted,
QRpHSSIpy
LiN 9�F
Robert Lindskog
Registered Engineer CE 24858
No. 248 "
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Expelm
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�l9lFOF CAl\E��a\P
18415 Chelmsford Drive • Cupertino, California 95014