The URL can be used to link to this page

13233 i POST THIS CARD NEAR FRONT OF BUILDING . - CITY OF CUPERTINO PERF,IT NUMBER INSPECTION DIVISION JOB INSPECTION RECORD - PERMIT EXPIRATION ' JOBADDRESS 10435 N TANTUA B. # 3 , 4 .r UNIT# LOT# - PERMIT EXPIRES IF WORK OWNER TANDEM COMPUTER CONTRACTOR RUDOLPH & SLETTEN IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION �. ANCE OR 180 DAYS FROM ` LAST CALLED INSPECTION. LIFER - PERMIT VALIDATION PREGUNITE ,C� rte. (J a POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED n-a9 �� Vga JySP+NSHAnd / UNDERGROUND /SLAB / �/��(^�,�'G T PLUMBING R0 vaj#ov F1ad (;4F?aS A AOA ' "— ELECTRICAL ISSUANCE 04TE MECHANICAL �1 FLEcr.. PLG. MECR. ."irk ^' P:u.�GI❑ � ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION 1 WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL PERMIT To ELECTRICAL FRAMING STORIES TYPE CONSTR. INSULATION OCC.GROUP RES.UNRS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.FT FLOOR AREA TOTAL ACREAGE ROOF DIAPHRAGM BUILDING USE HES IND' CON PB Olne, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED - - ❑ E ❑ ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING TRACT NO, PARCEL NO. GAS TEST ' MECHANICAL ACC.GATE ACC.FILENO ELECTRICAL FINALS DATE INSP. FRAMING - SAN # mnwG ENG.SITE No, INSULATION PLUMBING GAS FIRE SPRINK ENERGY T 20 MECHANICAL ❑ N[:] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOODZONE A.L.UC. LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEP v� N� v "n❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING ' SHEAR EXTERIOR TEMPORARY A PROVALS BUILDING ' �!. „ FIREWALLS - ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JCICCUPANCY ISEISMIC FEE (,�'U .. OCCUPANCYOF'BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING.252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. i OFFICE COPY - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER LDIN0 APPLICATION & PERMIT 13233 ADDRESSq' 3 / j BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OwINER'9 -I LJ PLAN CHECK VALIDATION AME) _7Z J5�31 CITY. ELECTRIC PERMIT FEE !. CONTRACTOR'Sres Z� /� UTLETS-SWITCHES-RECEP 10.00/1.00 / NA ' / sec.NO. I OIfl 1q LIGHTING FIXTURES 10.00/1.00 r/ c TRACTORS ,It PPLIANCES-RESIDENTIAL 4.00 AODREss /(t 'f' �.a , gO(u T' PHONE . 7,49/ PANELS 10.00 " 'DATE OF APPLICATION RCHITECT - PANELS (OVER 2OO AMP) 20.00 -PLAN CHECKFEE P.PANELS NO. OR eneiNEeR�` wu-iC Ian SIGNS TRANS. 3.00 ' �.fcic.41 r.. ARCR.OR ENO. . 5.00 PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT EMP.METER OR POLE INS. 20.00 APPLICANTS is MOTORS SEE FEE SCH. ADDRESSIUU3� /J: U4 SERVICE CHANGE 20.00 /0 wo o LICENSED CONTRACTORS DECLARATION / t7 ¢ v u 1 hereby affirm that I am licensed under provisions of Chapter 9 - ISSUANCE DATE a z"' (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. wa, Profession Coi1c, d n y license is in full l'u al yb fee ❑ ❑ ❑ Z o u.- License la 1 Lic,Numbe Q Date' Contractor a y F BUILDING PERMIf ¢ ¢ w OWNER-BUILDER DECLARATION INFORMATION wLL I hereby'affirm that I ani exempt from the Contractor's License MISC-- REFER TO ORD LLog Law for the following rcawn.(Sec.7031.5,BusinessanJ Profcvions pERMITISSUANCE 10.00 VAWATION S/FT. � - Code:Any city or county whichmqui¢sa permit tocoluttucL alter, a&-, Q Q Q p Improve,demolish,Or repair any structure,prior to Its issuance ako ELEC.CONTR. LIC.NO. ELEC. O it requires the applicant for such pemlit to File a signed statement that TOTAL PERMIT TO n w w he is licensed pursuant to the provisions of the Contractors License 2 F z > Law(Chapter 9(commencing with Section 7000)of Division 3 of the �"01),E-C..--. a Business and Pt therefrom and DTV. PL professions Code)or that he is exempt PERMIT FEE E I O STORIES TYPE CONSTR. ¢ r the basis for the alleged exemption.Any violationof Stiction 7071.5 A , by any applicant for a permit subjects the applicant toe civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(55000.): ❑ 1,as owner of the properly,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 C GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for It(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code The Contractor's License Low docs not apply to an owner of property who builds or ilnprovea thereon,and who docs such work FIXTURES-PER TRAP 5.00 _;E FT FLOOR AREA TOTAL ACREAGE himself or through de own employees,provided that such improve- ments arC not intended or offered for lc.If,ed that such he improve. GAS or SYSTEM-I INC.4 OUTLETS 6.00 or improvement Is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CON PB Our., prove for purpose nfoile.). INDUSTRIALWASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑ C I,as owner of the property,am Exclusively contracting with licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not apply In an..net of property who build,or improves thereon.send who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 conlmcts for such projects with a contraclons)licensed pursuant In the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ l am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC FILE NO. wORKIiRs'COMPIiNsn1'ION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a cerrificate of consent to self-insure ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3810,Lab.C.). Policy No. Company- -� Q ❑ Cetlif copy is hereby famished. FIRE SPRINK ENERGY T 24 Z 2 ❑ Cert a op Ili 1 cit inspection division. O Applicant c � �� MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ H PERMIT'ISSUANCE 10.00 PLo _NE A,L.U.C. LU CIiRTI FICATEPE EXEMPTION PROM WORKERS' UJ >_ used not be completed INSURANCE. PLG.CONTR. LIC.No. Pili. Y❑ N❑ Y❑ N❑ EL O hundred remain need not M completed i(the permit is(or arm TOTAL Q Z hundcrtily that IS 1the nrform CJ O I certify Thal h the t employ an of the work for which this per- CITY MECHANICAL PERMIT FEE FEE SUMMARY � F mit is issued,I shell not emDby any person in any manner so as to O w become subject to the Workers'Compensation Laws ofCaliforria. BUILDING �e Date Applicant ALTER OR ADD TO MECH. 5.00 } tail NOTICE'f0 APPLICANT: If,after making this Certificate of Ex- F ? emption,you should become subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Codc, you mull forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO IOPMC.F.NL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNff(OVER 10=C.F.M.) 6.00 SEISMIC FEE � 010 1 hereby affirm that there u a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit n issued(Sec. MICROFILM 3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 information u correct. I agree to comply with all city and county BOILER-COMP(3 H.P.or 1(X7,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection.purposes. <) agree 10 Five, indemnify and keep hamdess the City of MISC.- REFER TO ORD. C too against RabI Itics,.'udgmcnts, costs vad expenxs w ich PERMIT ISSUANCE 10.00 CONST.TAX y any way eccm Pg st sa y in aonsequc cu o the an of this permit. MECH.CONT. LIG NO. MECH. /r TOTAL TOTAL .21 Si a[ureof Applicant/ ontractor Date I/ OFFICE COPY . r