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14119 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14119 INSPECTION DIVISION • JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 10435 N. TANTAU UNIT# LOT# PERMIT EXPIRES IF WORK OWNER TANDEM COMPUTERS CONTRACTOR RUDOLPH AND 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 z - PERMIT,VALIDATION PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED . UNDERGROUND /SLAB i ' f.. PLUMBING ELECTRICAL Off' I ,.ISSUANCE OATS i - BLDan .BCECT. PLG, NECK MECHANICAL Gid !E ❑ D' ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PRMIT INFORMANON , WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL PERMIT TO ELECTRICAL FRAMING $TORIES TYPE CONSTR. INSULATION OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED Sp.FL FLOOR RHEA TOTAL FCREALE ROOF DIAPHRAGM BUILOI -USE NES IND CON PB Orn,, APPLY,NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ El ❑ ❑ ASSESSORS PARCEL NO. ROUGH PLUMBING - - TRAC] NO. PARCEL NO, GAS TEST - MECHANICAL ACC.GATE ACG FILE NO. ELECTRICAL - FINALS DATE INSP. FRAMING SAN u zowrvc ENG.SITE No. INSULATION PLUMBING GAS FIRE SPRINK ENERGY T 24 MECHANICAL v rv� r ❑ NO COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A.L.u.C. LATH—INTERIOR ELECTRICAL LATH—EXTERIOR FIRE DEPT. to LUYE NY [] NF] SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC �� PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC • I- ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER Bat LOING APPLICATION & PERMIT ADDRESS 1` �-- I.lais y a /-I n'""F:ZU Ave-7`� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 14119 wNER'SPLAN CHECK VALIDATION NAME Er QTY- ELECTRIC PERMIT FEE Vera 46 PH s-ss�o CONTRACTORS IQ�WVy H UTLETS-SWITCHES-RECEP 10.00/1.00 4(�OI lee-�Ic.uo�l P-+ LIGHTING FIXTURES 10.00/1.00 CO ADDRESSNTRAS OR's {� APPLIANCES-RESIDENTIAL 4.00 /J I `1 PHONE PANELS 10,00 DATE OF APPLICATION AR OR NITEI,T PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGINEER ' sec.No. SIGNS TRANS. 3.00 ARCH.OR END. SPECIAL CIRCUIT S,OQ PERMIT VALIDATION ADDRESS ZIP EMP.METER OR POLE INS. 20.00 )4- APPLICANT p ,./ /tp a.Jo MOTORS SEE FEE SCH. ADDRESS I { ��I t W `-' r _ GU ert'1110 �� t SERVICECHANGE 20.00 D w00 LICENSED CONTRACTORS DECLARATION I�e Y• 0 � a U b I hereby affirm that 1 am licensed under provisions of Chapter 9 n(' ( ISS N E DAT Vi (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH, I;;2 z Professions CWC,and my liana is in full force and effect { ❑ ❑ ❑ 2 O�, - Date Class Co Number p y, 01 �aQ tut"' Q yi" Dale Contractor v)L-� w a OWN ER-B UI LDF-R DECLARATION BUILDING PERMIT In ¢ a o a o MISC.- REFER TO ORD INFORMATION X ; y I hereby affirm that I am exempt from the Contractor's License a Hoa0.. Law for the following mason.(Sec.7031.5,business and Professions PERMIT ISSUANCE 1VALUATION S/FT. 0.00 (�� Code:Any city or county which requires a Permit to Construct,Boer, Q0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. $LEC. G- O LL req WIGS the applicant for such Permit 10 file a signed Statement that - TOTAL PERMIT TO w he is licensed pursuant to the provisions of the Contractor's License La z i Laic(Chapter 9(commencing with Section 7000)of Division 3 ofthe TH fe a Business and Prossions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE Q r the basis for the alleged exemption.Any violation of Section 7031.5 STORIO6S s TYPE CONSTR. a by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($5001.): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law dos not apply to an owner of • properly who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments are not intended oroffered for Sale.IC however,the building GAS-EA.SYSTEM-11NC.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 buil)or im- RES IND CON PB Omer prove for purpose of Ndc.). INDUSTRIAL WASTE INTER. 30.00 �1�yJI,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licf,sed 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 don not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contmets for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 TRACT N0. PARCEL NO. the Contractor S License Law. O Ism exempt under Sec. .B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner_ H Dale WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKF-RS'C ATI N :CLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of convent to self-insure, ZONING ENG.SITE NO. ora certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.). Policy No. Company O O Certified copy is hereby famished. FIRE SPRINK ENERGY T 24 z Z D Certified copy is Filed with the city inspection division. MISC.- REFER TO ORD. ❑ N❑ V E] N[]O Applicant Y CCrn CERTIFICATEOF EXEMPT ION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.LU.C. LU > COMPENSATION INSURANCE PLG.CONTH. LIC.NO. PLG. v❑ N❑ '[1] N❑ d 0 'This section need not be completed if the permit is for one TOTAL Z) Z hundred dollars IS 100)or less.) V 0 1 certify that in the perfummnce of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued.I shall not employ any person in any manner so as to Ow become subject to the Worker Compensation Laws of California. BUILDING Date Applicant ALTER OR ADD TO MECH. 5.00 >_ N NOTICE TO APPLICANT: If,after making this Certificate of Ex- F Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.RM.) 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. HEATING UNIT (TO 100,0(X1 B.T.U.) 8.00 MICROFILM 3097,Civ.C.). Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC 3d Lender's Address 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILEA-CObP I3 H.P.or 100,000 B.T.U) 6.00 hereby authorize representative of this city to enter upon the BOILER-COMP (Own 100,0000TU)SEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to cavi, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX ma ho any way accrue against said'City in consequence of the gr ling oft i permit. MECH.CONT. LIC.NO. MECH. Ip �2 TOTAL TOTAL Si t of I'cant/ LLrac r Date OFFICE COPY