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0001009741 108q I APPLICANTTO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY U CITY OF CUPERTINO BUILDING - ELECTRICAL .R BUILDING DIVISION APPLICATIOWPERMIT PLUMBING -MECHANICAL. - BUILDING PROJECT LDENTDTCATION BUILDING ADDvRRESS: SANITARY NO. A/PPIJCATION SUBMITTAL DA FTI ON -IE , r^ OWI. PHONE CONTRACTORS NAME LIC NO: SOSij%�" C� NIC CONTROL HITEGTIIINGINEAR: LIC NO. ADDRESS: I I(idYM� ❑ ,x CONTACT: PHONE: Yh\G�a'k4�� rCVCt LkoG-Z\ ^ ❑ Cuttwllanl Fees Paid by Applicant (Initial) BUILDING PERMIT INFO ' BLDG/ ELECT PLUMB MECH L ❑ ❑ ❑ LICES' ON'I'RACFOR'S OFCLARAUON .ed orae! mvisioes of Chester 9 (e.irg I hereby affirm I am Ecrnp QTY -ELECTRIC PERMIT - FEE JOB DFSCRIPTION PERMIT ISSUANCE wild Seetton7")of Division 3 oftbe Busircsa wd Hnfeiaiau Cade. ded my lialue is in full fm,e and West, RESIDENTIAL' ❑SF TYWL ❑ KITCHEN REMODEL APPLIANCES - RFSIDFMIAL IJcense Clacx Lis.N Dell Coutrecna ❑ADDITION ❑PLUMBING RE -PIPE ❑MULTI-UNUT El STRUCTURAL MODIFICATION ARCIIITECTS DECLARATION I vakrvrwd my plans dtull he resN m public taurds PANIi1S UPTO200AMPS El INTERIOR ❑CHIMNEY REPAIR IMPROVEMENT L]SWIMMING POOLS ❑ BATH REMODEIIREPAIR ❑DEMOLITION ❑OTHER Licensed Plvfesstmul OWNER -BUILDER DECLARATION 1 hereby WRmm Oat 1 nm cxcmp fmm the Cmtnnsr's Licenm law for Ile t'ollowing msmn. (Seeinn 7031.5. Business and Fromeslons Crste. Any city or county 201-10B0AMPS OVER LIMO AMPS SIGNS FI.ECTRICAL which teyuid. u permit to constNct, stiff, inymoc, demolish, or mrsor any swctum SPECIAL CIRCUMMISC. 'nor to its mrtatce.also "ones lte applirem arsuchpmdnm tihca.d8ned aWemrnt thatla, e, liceroW Im .,.m Ins the povisiumsofthe Cumdateas Licclne Law (Cheger9 (mmmencin{with Sction]WO)nf Di.i,mn 3 m(tbe Beeen saad Profeuicso CesdOor TEMP. METER OR POLE INS]'. COMMERCIAL Our he is cxcmp tlembom end Or, basis for the elkged escmption Any viaatimn of ❑ NEW BLED ADDFTION ❑ DEMOLITION Snehmn]031.5 by troy .,he., liuulzmtd seljcav the xpplicerno a civil petwhy of not mom Trot five hundred dollars (S500). ❑ L tes owner of wthe pWcrty. m my emploremployeeswith wages es their sate comPensamer. f mure is nu ine,rdN or Ml nts! for sale (Sec.]1111, Business will do de ort, aurte sau fund Professions Cot: Tie Contmctcis Le,eme law does not apply to an water of POWER DEVICES MZF.sIANT [I FWD SERVICE IMPROVEMENT [I OTHER 7-2 in do Aq SWIMM ING POOL ELEC1'R IC OUII.EfS- SNITCHES - FIXTURES property who baric s m improves Iham n. and who docs such work himself or through ha mon employees, emvitd That sash impovenems ate not intended m off red for .ole If.hwevm. the hudding ler lntpmvcnomis cold within eneyeasnf,00rdmttm, Or NEW REST) FAL ELECIR SQ FT. SQ. FT. FLOOR AREA, $ISQ. Fl'. tworer-hrilrer will have the huNen of proving dw he did not build v ilnpnve fa sur. pose of nate.). ❑ 1, re war oij 0e pmpny, caclusi" ns with on m TOTAL :inmeC rtes P -fess mmtrvet the pmjat ISa. ](W. Bmiress ad Prufnxires Code:) The Conuecla's Li- . B rnseUse cos nor applyto adeaO, of prupeny who bud& or irepmves lsmore. and QTY PLUMBING PERMIT FEE whoeorlm,r' Rws.Ch Frmjtll withn somm"c")lttnKd plrtFYMtm me Ctmeastot" PERMIT ISSUANCE Lic. Use ❑ 1 am esemp under Sec. . B h P C tar this ruuo Oveer Dare ALTER - DRAIN A: VENT- WATER (EA) VALUATION WORKER'S COMPENSATION DECLARATION BACK FLOW PRfTIECT. DEVICE 1 hereby affirm mdcr pneh, of perjury one M the, Nd wing declarations: I have mW will nNinlain;iCmiticumofCnn.vmuumll-insu¢for Wurkcr's Cnmpm ouster, m I m vided for by Section 3700 oftbe Lath, Code, for Ne Ndon ance of the DRAINS- 11.(AAC RO(IE. AREA, COND. STORIES TYPECONSTRUMION work for which the, Permit is issued. RKTIIRES - PER TRAP ❑ I have and will msumm. Worker's Compmsetimn [.a.. as aquved by Seen. 37M sef the Lehr Cote. fettle prf.e of the wok for which thin permit is issued, My Worker's Compensation l muance carrier and PAicy numbff are: Cartier: Pot icy No.: CERTIFICATE OI' 17XEM TION FROM WORKERS COMPENSATION INSURANCEja OCC.GROUP APN 9 IG U / ,p Q 2 tl GAS- PA, SYSTEM- I INC. 4 OUTLETS GAS - EA. SYSTEM -OVER 4 (EA) GREASE/INDUSTRL WASTE INTERCEP-1UR BUILDING DIVISION FEES (Thusection mle�rrR be compklN if the pttmil is Toon hutdrllars (SI(p) u les") GREASETRAP PfANCHECK FFJ; - IccnifyOnainthe,Peformvoe oflhe went r« which shin pmusedT Isfrall not employ fury prr.tm in any Inanv+wt v le M1nvmle subjat to the Wri Gnmpn SEWER - SANITARY - S' FORM EA. 2(X) FT. ENERGY FIX WAI'lIR 11IATER WNENI'IEL[CTR GRADING RIE .roto laws of CaliOrnia. I3elc A,I,s.t NOTICE TO APPLICANT': If, draft basking this Cendicatc a Exempyou should become subjm to the Woha's Comrmpercution povivaa stile falr,Code. You mon NATER SYSTEMO`REAI'ING SOILS FEE forthwith comply with such povisioos or this Permit sladl he deemed ed. WATER SERVICE _ CONSTRUCT ION LP.N DI NO AGENCYDF Ihereby dr. than therek a cmmlrucliun lending agenev fix Rtformence lee out for which this Permit k Tasted ISee, YN7, Civ. C ) 1-cedeh Name P I�^ Rcai tN 1 y \ P 1 SQ. EL UI TOTAL UUU B IN I<mrfx Acidness11ft I eerifY Nat I lave read thix aMitcation and use that the aboamerta rl, 1 Naas m,attply wilt ell city and,00r y eedmenwn fund einn relatm, to betildm,,omome,nor, and hemhyaulbmrne rePemnmlivo of tbischyermp,n�S 9' AN NMaw ICII?Ealcove-mentioned Ic FEE p,geny fu imPtcsion purposes. (We) agmem . a'e. indemnify aM kap hamllevs the City of ino epi PL 1RRSGFEE Habilis, juAl wire, cons vM expemex which may in any way accrueml said Cil rnmeesenecuf the gnemibgmf tis permit. MORin MECHANICAL FEE APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALON-POI SOURCE REGULATIONS. ) ( 0 CF ) CONSTRUCTION TAX R HANDLING l Signmem d AgplicfunJCoosmnor DncFf HAPARIIOUS MATERIALS DISCLOSURE at MIT USI'H T) HOUSING MITIGATION FEE Nillthert,lierm, or ruler, building occupam a tom or handle htrroNwo maleridHEATING UNIT(lUl NIUH ) as def d by the Cupnio Mun'eipal Cods, Cfeptcr 9. I2, awl the Ilcalm and !o'Cak, Satitm 25534(x)" ING UNIT (OVE Idslr T ) ❑Yes ❑Nn VFNfI )N FA (SINGE I PAID -- Date RettiplN a use esmIrmartt or Will fle, tipplit,set or future building TOTAL: .1" Mfumgw s hamrtu for oemam mad, tRrmM by the Pay Arte Q.1"' D,,tew'] ❑Yes [:1 Nn BOILER- COMP (OV ER 100.00() BTU) 2D O so AIR CONDITIONER I have read tie haysdmms ramealx meat ntxs under Chapff 695 M the CWT- ISSUANCE DATE NEW RESIDENTAL MECH. SQ. PT. fsanin Health R Safety Cot, Saliva±5505.25533 and 25531. i udataul Wt if the baildimmg dao rat cvttentlY laveetrnent. thm it is my mnpucibilitY to totify the oavpw a> — '2 of the, reyuircmmu whdh road he ran prior to ixaorcu of a CcniOcutc of Occulearey, r ISSUED BY: TOTAL'. Owees er alrOtmo d agcm Dmc OFFICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE (� CITY OF CUPERTINO • BUILDING PERMIT INVOICE OPERATOR: karenb Sec: Twp: Rvg: Sub: Blk: Loe:31609028.00 INVOICE DATE......: 01/20/2000 REFERENCE ID 4 ...: 00010097 SITE ADDRESS .....: 10710 TANTAU AV SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER .... ........ : TANDEM COMPUTERS INC - ADDRESS ........... CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-3548 is CONTRACTOR .......: RUSSELL, DAVID J LIC N 5655 COMPANY ..........: SOUTHBAY CONSTRUCTION ADDRESS ..........: 511 DIVISION STREET CITY/STATE/ZIP ...: CAMPBELL, CA 95008 TELEPHONE ........: (408)379-0400 FEE DESCRIPTION CHK TOTAL FEE PAID -TO -DATE BALANCE DUE _ --- --------- BTEMPPERM P 200.00 ------------ ----------- 0.00 200.00 --------- 200.00 ------------ ----------- 0.00 200.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ........ 1 ............................ FOUNDATION ........ 102 ..............o.......�..... PIERS UFER 104 REBAR ANCHOR BOLTS 106 SEWER 4 WATER 202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL 204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB S OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL 501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY 503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY 505 FINAL ELECTRICAL 506 GAS TEST , 507 FINAL PLUMBING 508 FINAL MECHANICAL 509 FINAL GRADE 510 FINAL PLANNING 514 FINAL PUBLIC WORKS is r 1 LJ 11 • Ory. it Applicable Fee /0 . Fee Description Fee Group �BPERMFEE BLDG PERMIT FEES (BUILDING I 15CONSTAX 1CONSTRUCTION TAX 1BUILDING JBENERGY JENERGY JBUILOING SENERGYAOD JENERGY ADD MULTI (BUILDING 1BOVERTIME INSPECTION OVERTIME IBUILOING BTEMPPERM ITEMPORARY BLOG PERMIT IBUILDING BMITIGAT HOUSING MITIGATION FEE BUILDING BPLANCHK PLAN CHECK FEE BUILDING BPLANCKADD PLAN CHECK ADO MULTI BUILDING BPLANCKREP PLAN CHECK REPEAT FEE BUILDING BREINSPECT REINSPECTION FEE BUILDING BSCBLVD SCS SPECIFIC PLAN BUILDING BSEISMICOM SEISMIC COMMERCIAL BUILDING BSEISMICRE SEISMIC FEE RES BUILDING ESPECIAL SPECIAL INSPECTION BUILDING BSWIM SWIMMING POOL BUILDING ZADDCHG ADDRESS CHANGE NG BUILDING JELEC PERMIT ISSUANCE ELECTRICAL BELEC1000 ELEC 600V —1000A ELECTRICAL BELEC1001 ELEC 600V >1000A ELECTRICAL BEI FC200 ELECT SVCS 600V �200A ELECTRICAL BNEWMULTI MULTIFAMILY RES ELECTRICAL BREMBUSWAY REMODEL BUSWAYS ELECTRICAL BREMFIXT LIGHTING FIXTURES ELECTRICAL BREMMISC MISC APPARATUS ELECTRICAL BREMNRAPP IREM NON -RES APPLIANCE i ELECTRICAL IBREMPOLE 1POLEIPLATFORM IXTURE JELECTRICAL BREMPOWER IPOWER DEVICEIAPPARATUS JELECTRICAL BREMRECEPT JRCPTL, SWITCH &OUTLETS JELECTRICAL BREMRESAPP REM DEL RES APPLIANCE JELECTRICAL BREMSIGNAD RMOL SIGNS ADD BRANCH ELECTRICAL BREMSIGNS REMODEL SIGNS. MARQUEE ELECTRICAL BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL BSF&2FAM SINGLE & 2 FAMILY ELECTRICAL BTEMP TEMPORARY POWER ELECTRICAL BTEMPSVCS TEMP DIST SVCS ELECTRICAL MPERMITFEE MECH PERMIT ISSUANCE MECHANICAL BAPPLOTHER OTHER APPUANCES IMECHANICAL BBOILERI BOILER o 100,000 BTU IMECRANCAL BBOILER2 BOILER >100KTO500KBTU IMECHANICAL BBOILER3 BOILER >500K TO 1M BTU MECHANICAL BBOILER4 BOI R>1M TO 1.75M BTU MECHANICAL BROILERS BOILER> 1.75M BTU MECHANICAL BREMAPPU APPLIANCE INSTALL MECHANICAL BROTH-07—HEATER INSTALLATION ME HANICAL BREMVENFAN VENT FAN SINGLE DUCT MECHANICAL BMNEWMULTI NEW MULTI -FAMILY RES IMECHANICAL BMNEWSF&2 NEW SF&2F RES SLOGSMECHANICAL I o[2 P—V=a V10199 ISREMACOVER JACUNIT >ICGCGCFd•1 Im1_,.nANiLALI JBREMAIRHAN JA/C UNITS — 10.0GCCFNI IMECHANICA:_ IBRENIFURN IRELOCATION OF FURNACE IMECHANICAL BREMFURNOV IRELO FURNACE > ICK STU IiNIECHANICAL BREMINHOOD JINSTALLATION OF HOOD IMECHANICAL BREMRELOCA IRELOCATION OF HOOD IVIECHAN[CAL BREMREPALT REPAIR/ALTER HEATING MECHANICAL BREMVENSYS IVENTILATION SYSTEMS 11YIECHANICAL IPPERMITFEE JPLUMBNG PERMIT ISSUE PLUMBING 11 BNUMULTI NEW MUUFAMILY RES PLUMBING BNUSFD NEW SINGLEFAMILY RES PLUMBING BPBACKFLOW ATMOSPHERIC VACUUM PLUMBING BPCESSPOOL CESSPOOL PLUMBING BPFIXTURE PBLG FIXTURE PLUMBING BPGAS GAS PIPING SYSTEM FEE PLUMBING INTERCEP IND WASTE INTERCEPTOR PLUMBING. REPIPE REPIPE OF FIXTURES PLUMBING SEWAGE DISPOSAL PLUMBING S R SEWERS PLUMBING SPRINK LAWN SPRINKLER/BACKFLO PLUMBING STORM STORM/RAIN WATER PLUMBING TRAP KITCHEN TRAP PLUMBING VENT AL•T OF DRAIN & VENT PLUMBING WATER INSTALUALTER WATERPIP PLUMBING WHEATER IZLIMAMEND WATER HEATER/VENT PLUMBING WSVCS MAIN WATER SERVICE PLUMBING EVAGREE DEVELOPMENT AGREEMENT PLANNINGIRTM DIR TENT MAP PLANNING ULLHR FULLAPPLBASE+.HR PLANNING ULLTM FULL APPL TENT MAP PLANNING ULLUP FULLAPPL USE PERMIT PLANNING ULLZONE FULLAPPLZONING PLANNING PAMEND GENERAL PLAN AMEND PLANNING LIMITED AM D PLANNING ZLIMTM LIMITED TENT MAP PLANNING ZLIMUP LIMITED APPL USE FERMI PLANNING ZMATEMPUP MIN AMEND TEMP USEPERM PLANNING ZMINHILLEX MINOR APPL HILL EXC PLANNING ZMINSIGNEX MISC SIGN EXCEPTION PLANNING MINOR APP TENT MAP PLANNING INUP MINOR APPL USE PERMIT PLANNING ISCASA MISC ARCH SITE PLANNING IINTM SCEXT MISC AND UP PNNING LA ZMISCFENC MISC FENCE EXCEPTION PLANNING ZMISCG MISCELL APPL GENERAL PLANNING ZMISCPCINT MISC PC INTERPRETATIONPLANNING ZSIGN SIGN PERM[ PLANNING PSIGN . PO Y SIGN LANNING ZVARIANCE JOIRECTOR VARI/WC PLANNING 2 of 2 Revbed l/IW" '• • n U