29780 APPLIGANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO - - ' BUILDING-ELFCTRICAi, PERMIT NQ /�29/A ^O
BUILDING DIVISION APPLICATIONIPERMIT PLUMBING-MECHANICAL }V(
BUILDING PROJECT IDENTIFICATION
BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATE
lo5oI w . T�/NT�� �Avf, �j
OW 'SNAME_1DP:1' 1 (/D P/' ' �-D� p?pR CIDR:S NAFIL WC NO'.
�./VE/(=G C lAM N/C CONTROL N
•A 'LVINEE ' ' LICNO: ADDRESS: ❑
'C.� N Ti C
CONTACT: PHONE BUILDING PERMIT INFO
C/Z S 10 _2^I / j?OBJ ❑ Climiduent Fm Paid by Applicant(Initial) BLDG PLUMB MECH
r �i`UCCFNSED CONTRACTOR S DECLARATION
V L ❑ ❑ ❑
1 hereby aflion that I am nsed liceundptcr9lmnnoendn6 er provisions of Che QTY ELECTRIC PERMIT FEE
JOB DESCRIPTION
�aZ withSminn]Ig0)of lNvisimJnf the RusineN,analgOfarione ade,and mylicenw is RESIDENTIAL
O O PERMIT ISSUANCE
[ KITCHENtY u F Li full tone and effect, SFDWL ❑KITCHEN REMODEL' R Date Contract« .APPLIANCES-RENTI
SIDEAL - ❑ ❑
ADDITION PLUMBINGRE-PIPE
4ion ARCIII'IECI'SDIiCLARUION, ❑MULTI-UNIT ❑STRUCTURAL
Z p n Z 1 uMustaM my pWs dull he used u public rtcmds PANELS MODIFICATION
OZ—❑{pa7 UPTID'-�ASMPS C1 INTERIOR ❑CHIMNEY REPAIR
a�F + LltttLwnl Pmfcasionel - - 301-1000AMPS IMPROVEMENT
Y
.•-]1 than I.tlU1LUEf.un,DECLARATION OVER I"AMPS ❑BATH REMODEURFPAIR O DEMO ION
Q I hereby.Ruse dw 1 am evcvia fmm the Conuns,Cod Liana[y o co the
L O d V following reason.(Section-!011.5,B tirie.s wd Pnileuion.s Code:Any ity«county SIGNS f?LECIRICAI. El OT"a
3 LL F" which rryuirts a pennir rat cmwrvet,alter,innpmve.Jumalish,hr rtpoir any nrvctun; _
O prior W its ivsuarwe.also re0uirea the Wfiteant for such Permit to fik a signed.rmemeot SPECIALCIRCUIT/MISC
fa phi. that he is licensal Pan000n tan We re,,miki of the Contr:tda Lia.Law(Cluger9
W qC) (commencing with Section]"nofDlvisirw Sof We Basin and Prefic.itn,Cade)or TEMP,METER OR POLL INST. COMMERCIAL
a (� Woo he it;exempt themfmm and the bash for the alleged exemgion.Any AnIatim of ❑NEW BLDG/ADDITION ❑DEMOLITION
Savon7035 by any applicant for apennit subjects the appicau to a civil pemlty of POWER DEVICES ❑TENANT ❑FOOD SERVICE
>y .marc Won Eve M1uM¢d dollars(S500).
(]Las owtw+of thepm[�.xty,�xn�y cmpoyxs with wnynx estheirmlenanprnwtiun, SWIMMING POOL ELECTRIC IMPROVEMENT
will do thewort-and the structure is e«invaded arcdff ed for sWc(Si]Oli,Busincu ❑OTHER
W and Pmfcsaima Colic:Th,Co."license Law does set apply la an owns of OUTLETS-SWITCHES-FIXTURES
13 popary woo Wicis nr impmvcs derrm;and win d«s such work himwlf«through
his own employees,provided Wut such improvements ore not intended or u0'cred for NEW RESIDENTIAL ELECfRQ
sale ,
.If.hsa,,c th building or impemem ovis sold withinoneyearof compkdm.lie SQ.FT;FIDDOWAREA S/SQ.FT.
ow.fuilder w01 have lie burden of Wer hJid n«WiH«imquNe f«Iur- - a
proving
prsc mleJ, r ^C
rl I,uow«rNWe Sec.7 amexclusively Prvf.iiop with:kens 1convanon to TOTAL: �a 1Qw'v
tnruanrct We pojea(SS.]OYr.Buairt¢s aTd Pm(evims Cade:)TMnc Canvactor's U. - 1�� ll 1•a
censehwtkcsntnywM1s« ami QTY. PLUMBING PERMIT FEE
wMcmtvcw f«suchpoie,with neactoiuiaaowdunonnot hC.traJ (�
V V(CC\111
License Law. PERMIT ISSUANCE. CII Y Ur
❑1emcxcmp ender Sao .B&PCf«Wisreason
Owrtcr Date ALTER-DRAIN&VENT-WATER UA) VALUATION
WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE
I herehy cffuin under Penalty of t1nilly one of tha following declarations: _
❑ I have aTW will maintnina Cenif wof Cnnwnuo self-invert no,Worker's Coaryxn- DRAINS-FLOOR,ROOEAREA.COND.
action,u pmvidaSection
l for by 1]00 of the Labor Code,for We p of«marce of the STORIES TYPE CONSTRUCTION
work fa which this Permit is iuual. FIXTURES-PER TRAP
1 hove and will mainmin W«kcre Cmn varration IrtNura«c,ns oa aired by,S rfloo
1700ofN [.a!Wr Cu. ,for the Pern.,of th work for which this permit is issued. GAS-Els.SYSTEM-I INC.J OUTLETS OCC.GROUP APN
fly W«kela CmWertaaGoo I.c cortkr end Polity rnmM are
/Cama: Paltry No.: GAS-FA.SYSTEM OVER i(EA)
CER TI IICATE OF UEM19ION FROM WORKERS'
COMPENSATION INSURANCE GREASMNDUSTRL WA.SIE INTERCEPTOR
(Thi,amin�«zd not bec«npkted ifth pcnnit is forme hueA idullhas(SIM) - BUILDING DIVISION FEES
«!chit.) GREASE TRAP PLANCI IECK PEE
I unify Nat in(be pMnmwnce.fthc work for which Wis pe non is issoed,l iholl SEWER-SANITARY-STORM EA.NO FT.
set employ any Person in any mn anw u to bccurnc subject to de W«km'Coo x a, ENERGY FEE \
O Z 'main.Isws of Celifomia Dane WATER HEATER WNENT BLECTR
Z O APpicant GRADING FEeV
uJ Wai C NOTICE TO APPLICANT:If,o0a making this Certificate of Exempim,you NtuH WATER SYSTENVI REATiNG
mc subject to tic
SOILS FEE
bai /�
mopemaaim prov;skwn U the Lab«Code,you must
aN OmhwiW comply with wen pmvisimN«Wis PcrositaMllhdccrTed rtvukcJ. WATERSERVIce
A
1 CONSTRUCTION LFNDINGAGENCY NEW NFSIDFNf1ALPLMB. SQ,FT. PAID 07
UO Iherthy off Wan Were iaeconswerion krding agr«Yfor do pufnmtence of DHe R.,l
D. F-' the work for which this pemit muted!(Se,.1097.Civ.C.) , •
IxndeT',Name- )
O W Landers Addnus TOTAL '
Ly, 1 terrify than 1 hive read this application and nate that do above infonnanlon ix BUILDING FEE
L. , t'narcc,1 agree fa comply wim all city and manly ordina«a anti swan law,relating w QTY. MECHANICAL PERMIT FEE
U Z Ivildin¢mrnwrtion,wed lereby vaWe^,e repeemeuvaofmi,air.,to craerupm We SEISMIC FEE
" ,hove-rrcuivned pmpeny for inspection uTo,sa.
(We)spree to save,indemnify aha keep haonle.0 th City of Cti,oino against PBILMIT ISSUANCE ELECTRIC M17
HibilitimpAgTrcnO,costs and expos which nay in any way ucrnm against said City ACIER OR ADD TO MECH. PLUMBING FEE
in consequence active fronting ofthis permit.
APPLI ANT UNDERST S AND IL COMPLY WITH ALL NON-POINT' AIR HANDLING UNIT(TO 10,"CFMI
.SOUR UTATIONS q MECHANICALII?E
1� AIR HANDLING UNIT(OVER 10,000 CF11) CON.STRUCIONTAX
Signature oftTxuc Date EXHAUST HOOD(WMUC)
HAlAR ERIALS DISCLOSURE HOUSING MITIGATION FEE
Will the,applbeantm futwe Wilding accu,nit wort or haNk hanadtu,mucriw HEATING UNIT(TO I W."BTU)
u defmed M the Copation Municipal Code•Choprer 9.1;and the Health and Safety
CadliLSStmcij,n.255]1(.14 HEATING UNIT(OVER I N),(W BTU)
5�+`C NoPAID
� VE\'TILAl10N FAN(SINGE!:RFSID) Ihtc Rarip♦
Will tle applicant or future building occupant me equipment or rkvices which HOILaR-COMP(BHP OR 100,000 BTU)
mit hvarduN uair ttmauninatns as dcftcd by We Bay Arca Air Quality Management
Diurin+ RORER-COMP(OVER 101"BTU)
❑Ya r\Jo r
I bout rd th hazardous mvenals re9ubemenota ...CnaPer 6.93 M the,Cali- AIR CONDITIONER ISSUANCE DATE
frmia Health&Safety Code,Satitrs?5503,]55]1 and 25511.I w mead that if Ne NM
EWRFSIDEiALMECIL SQ,PC
building anttwicml caterrun dutitismyTagnrion
uihiliry toythc«tvpam _
of da, 11 11 not poor to is uoawe of a Cen't"ge of Otter
Owrcr«atnbdz t me TOTAL: ISSUED BY:
OFFICE
10300 Torre Avenue
Cupertino, CA 95014
Caper ui -lo Building Division
(408)777-3228
(408)777-3333 (fax)
January 22, 1996
Tandem Computers
10501 N. Tantau Avenue
Cupertino, California 95014
SUBJECT Permit: 929780,
Dear Owner:
We have been cleaning out our files in the Building Department, and contacting those
people with permits which have remained "open".
According to our inspection records, the subject permit has never been finaled. Many
times an inspector will sign the permit in the field, but neglect to report all of the
information to the clerical staff for input into the computer. If your records show the
subject permit as frialed, would you please contact us so we may complete our records?
If the permit is not signed off your permit can be reactivated and an inspection could be
scheduled for final closure of the permit
If we do not hear from you within ten (10) working days, we will dispose of the file and
remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CUPERTINO
Christy Akatiff, Administrative Clerk
0