28360 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELERICAL PERMIT NO. 28360^ ^ O
BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL L }V( J{
BUILDING PROJECT IDENTIFICATION
BUILDING ADDRESS: .t 6 _ SANITARY NO. APPIICAnON SUBMITTAL DATE
Zo7pS /a LL/E ,�Z/ � UNIT. LOT# �1
OWNERS NAME_ PHONE_ CONTRACTOR'S NAME LIC NO:
TJ u "A' CONTRO E
ARCA TECT/FNGINEER: LIC NO: D ❑
CONTACT: PHONE_
' QTY. ELECTRIC PERMIT PEE BUILDING PERMIT INFO
ELECT PLUMB MECFI
PERMIT ISSUANCE.
LICENSED CONTRACTORS DECLARATION APPLIANCES-RESIDENTIAL LOB DESCRIPTION Iheol,,affmm lh.w l m licensed miler povisiwofQmaptv9fcunmcmcthg with
00 Section 7")of Di vitQ.Sof ds Busirc.s aM Pmfitt Code,vJ on,l imene is in PANS
uu��1F-- ful l fume and effect.
UP TO 2f0 AMPS
to ZZ, L ( cw Iic:M
y,Q1 D.m Canncwr 201-IODUAMPS
Z8 NZ ARCHITECTS DECIMATION OVER 100)AMPS SQ.FI.h1tXM AREA I.T.S/SQ.
O Z,,,^ 1 underxlarxl my pleru Jtall be tai acv public reevNn.
F v_. SIGNS ELECTRICAL
Lxxnscd Pmfasiaul
y d'6 OWNER BUILDER DECLARATION SPECIAL CIRC1RT/MIS7.
O W U 1 hmmby affirm tlw 1.exempt four the Cmtrxm ,,Mcrae Taw fa the
a13 LL y mlowing rcaum(Sm inn 7031.5,Busincvs and Prnfcrninnn Code:Any cityor county t TEMP.MITER OR POIE INSP.
which requirtr.permit to mnstrtxr,after,improve.drnwlish,wtepe'v utY stmclurt
E }� pinf W is iuwrce.Iso regiiscs the applieanl for such permit to file.si®mN,wemenw PoWbRu%noorary Permit
W �Of� that he in llmuN Oursuar,to the provision of the Contractor.license Taw(CTagcr
A. P,. 9 cammcncin SWIMMING POOL IRIiCf0.1C
XX ( gw'uM1 Semlinn]000)o(Dlviniun3of the Busircss onl Rufeaims Cute) VALUATION
y)�y or that he N exmmq therefrom mJ the hasis for the alleged exempno,Any violation of OUTLETplan fn Iw{snw
(_Z} Salion]031.5 by any"11c.fa a Permit subject,the rt liant w.civil pni of 1. F11 IGWII
< mot more dun five hudmd ddlus(S50(1).
❑ Lasownvofilrt m erry,ormyemp4oym �with wvguuthcirsdemmpcuatim, NEW R Q. MYacce R:CONSTRUCTION
ll do th
LLLLII _ wiewrk,"11rcomclureistxst,mGJcdorofmmv!forsak(Scc.T(114.Buainus r c rr (IQ—ad ffion%
vel Pmfecsluns Curie:The Conn.nor'a I,iceve Lew don not apply to en owner of MnC� C f�
pregesy who WiMs.,inrpruvca t1r. adv ,Rsta chwark himew
lf0uougll his and revisit S on
If. OCC GROUP RES.UNITS
wnmmployen.povidedthw such imgvvcrcnu.mrmtK inmmdcdmoRemlfmsele
however,the W Riling or improvement In sold wimio ane yerr of complcwion,the owner- complem Blue
Wilder will have tFc burden of ptoclo,that he did not nulld m 1lnpmve for purryac of
We.). QTY. 1 r FLOOD ONE APN
❑ 1.uowrcroflhepmopmy.Nicxclusivelycmv iMt ilhlx dconuactmto
construct the I*ojec't(Sec.7014.Busmen,W Profession Code:)Th Commorm',
Ikea¢Ltw dnunota lAytunnownerofpmputywho WlldsviniM)vicethemrn.md P[- u E
who cmwm.fur,wch project wlW econuacmgs)Ikrn,N punuvnl m t W CanwclmMs
-12
Licrnsc law. ALTER-DRAIN& FEE SUMMARY
❑ 1 em eaemrmpt uMtt Sec. .B A P C for thH ream BACK IC
OUTSIDE
Y N
(hvrcr pore RF,CE WT 0
DRAINS-Fl,OOR,ROOF,AREA.CON .
WORKMAN COFB'PNSATION DECLARATION (bL TAX YN
❑ IherebY.ff nn thv lluveaanifcue of eavrntro self-insurt.m.aatifrue of FIKNR P RECEIPT-
' Workai Canpvt. Iionlmmwa as ccnifMrnpy thcrtof(Ss.3g W.Lab C-)which KFEE Y - N
m ell employee's undo this permit. GAS-IA.SYSTEM-I INC.40 BTS
Policy It BUILDING DIVISION M-I S
Company GAS-EAi.SYSTEM-OVBR 4(EA) PPANCHECK FEE
❑ Cenifiodcopyisberebmish
yfued.
❑ CmlfiN copy is fled with the city inspection division. GREASFJINDUSTRI.WASTE INTERCEPTOR GRADING FEE
CERTIFICATE OF EXEMPDON MOM WORKERSGREASE TRAP SOILS FEE
COMPENSATION INSURANCE
(fbis,action nxd not be completed iflbe permit is for one hundrad da P$IBJB SEIVER-SANITARY-STORM EA.200Ff. ENERGY FEE
or I..)
I cenify tlmufln the perfonwmce ofthe work for which rids prmit la issued,I Jall WATER HEATER W/VINT/ELE-CPR
not employ any pvsor in any muurr so u to beso.oubjcl In Ile,Workai PAID
Cmpcwwian lawsdGlifomia. Dawe WATER SYSTEMORIATING Dare Receipi0
z0 NOTICE TO APPLICANT'.If,afc,mmokingthis Cenificmcof Esomryion,ynu,hwld NEW RESIDENTIAL PLMB. SQ.PT. TOTAL:
` hccvnoe subject to l Workers Conpemsvim provisimu ofthe labor Code,ym must
fonlmwith cooF,with such provioimu othi,perm shill he dxnad mcvekW. BUIIDINGFEI3
W
CONSTRUCITON LENDING AGENCY SEISMIC FFEi
:D (�
Inmrtny nrnmm than tbert tmon iaamYrtKlilemllog ngetKr rw Phmmta
c penmer of
V p rime work fmwhJh Mt is issued(Scc.3B9].CIv.C.) TOTAL: ELECTRIC FEE
Iarider's Name�L!/e
U. F tache',Adam. �C , QTY. MECHANICAL PERMIT PEE PLUMBING FEE
O U 1 cenify thorn I haven mend thla ap,11oticm me,tote that the uNwe infomwtim is MECHANICAL FEE
r�'a W cvrtect. legrtsmwmply with ill cilY mrd runty uNinarma.eml slate hweml.tingln PFRMH ISSUANCE
I-' Bowe gcrosomion,mJ hereby.utMnre ,ime, tivnof this citymcmc upon the
V Z Jwvc�vrn' fa impccrim puryoao. ALTFJt OR ADD TO METH. CONSTRUCTIONTAX
(We) m modify eM keep ,the City of Cupmino apimw
Ilebililio' WRe nq antsmdcx awh' yln ony wryacauc agvnv.raid Chy AIRIIANDLINGUNIT(TO IB,B)(ICPM)
AIR HANDLING UNIT(OVER 10.(00 CIM)
St to me MHAUSI'HOOD(W/DUCT) PAID
HAZARDOUS MATERIALS DISCLOSURE
HEATING UNIT(TO 100,000 BTU) Date Receipt M
Will the appli®ll or future buildio,ocupem swan or han,5,h.mdwu mucnJ ,..-.nNG UNIT(OVER 100,000 Jim
u dcfnd by the Colzrtmo Municil,al Calc.axpic,9.12,W the Health amt!Safety'
Co&,Sadmm 25532(0)^ VENTIIA'1'ION FAN(SINGLE NGSID)
1:1Ycs CI No
I S CE DATE
Willthc eppliuntmforma buildi"occulunmtueryuiprmuadcvicci whichmdt BOILER-COMP(3HP OR 100,000 BTU)
hnanrdaus air conmamitwns u&tined by the Boy Ater Air QuJity Mamagrnmrnt BOILER-COMP(OVIR 1w,m)BTU)
Dlstnmo ❑Yn 11 No NEWRESIDFNIIALMECH. SQ.FI'. JUL 111995
1 lave nerd robe h ,Jc a vutcrial,ro,immeocs under CMper 6.95 of,M
califord.I I.Ith S,Sarcty Cnx,Sn(lot 25505,22533 and 25534. IUMemerld that Cilfly
Ur I UrtH I INO
if Phe W ik4ng Jan na emmmly have a tmmi,that it is my mspasibilimy to mtify the
aeev,ant of rime rtqubcmtcros which mut be met pnor to isvunce a a CeNfate of
Occupucy.
[TvncrmeuthmrWagcnt D TOTAL_ ISSUFDBY:
OFFICE
VI I I Consolidated Engineering Laboratories Report V I I I
August 4, 1995
City of Cupertino
Building Inspection Dept.
10300 Torre Avenue
Cupertino, CA 95014
RE: Apple Computer Valley Green 6 Inspection Date: 07/21/95
x20705 Valley-Green Drive— Location: Shop
Cupertino, CA Inspector: A. Hodge
Permit #28360 Report # 01
CEL #9265
LMN
"MM , 6M MNt
On the above date, our representative inspected the referenced project as reported below:
Reported to Romak Iron.
Checked welder and procedure qualification papers. Visually inspected the in progress
welding performed by two qualified welders using FCAW process with E71T-11 wire.
Verified proper electrode storage. Weldments consist of complete penetration groove welds
on base plates to tube steel columns and single pass fillet welds on connection plates to tube
steel columns.
Note: Full penetration and fillet welding performed on various pieces; 1/2" plate, 3/8"
plate, 3-1/2" tube steel x 3-1/2"x1/4". All for columns as follows: A4 - 16 columns; B4 -
3 columns; ASK2 - 4 columns; and ASK1 - 2 columns. Total 25 pieces fabricated in
accordance with drawings and specifications and with AWS recommendations.
Work inspected was in compliance with approved plans and spe ' ns ,
REVIEWING ENGINEER: CHRIS N. KAVALARIS, R.C. POFESS/p��`
Q\�\A. KA V F2�
cc: City of Cupertino N
Apple Computers, Inc. a
Exp. 6130)98
Rudolph and Sletten 1 ,
Forell/Elsesser Engineers, Inc. `�r5;r � i
ICY'
All reports are submitted as the confidential property of diens Publication of stetetnente,condusians or c rnerved pending our
written approval.
•
1
P.O. Box 9131, Pleasanton, CA 94566, Phone 510/460-5100 Fax 510/46G-5118
I I I I I I Consolidated Engineering Laboratories Report I I I I I I
August 14, 1995 _
City of CupertinoBuilding Aub N i 1995
0300 Torre pection Dept
Avenue
WBULDINGYDEPt�
Cupertino, CA 95014
RE: ,Apple Computer Valley Green 6 Inspection Date: 07/31-08/02/95
_ 20705 Valley Green Drive Location: Shop
j Cupertino, CA Inspector. A. Hodge
Permit #28360 Report # 02
CEL #9265
On the above dates, our representative inspected the referenced project as reported below:
Reported to Romak Iron. Checked mill certificates and verified against material heat
numbers. Checked welder qualification papers. Visually inspected the in progress welding
performed by one qualified welder using GMAW process with E71T-11 wire. Verified
proper electrode storage. Weldments consist of single pass fillet welds on connection and
stiffener plates to wide flange beams.
Note: Fillet welding performed on various pieces in accordance with drawings and
specifications and with AWS recommendations. The following items were fabricated: A5,
B5, C5, D5, F5, A7, B7, C7, A10, B10, C10, Al, Bl and Cl; all with W12x26 with 3/8"
plates.
Material identified prior to fabrication. Mill certificates on file at L office.
REVIEWING ENGINEER: CHRIS N. KAVALARIS, R.C.
pFES51pNA(
cc: City of Cupertino N.KA v4
Apple Computers, Inc.
Rudolph and Sletten 'T
Forell/Elsesser Engineers, Inc. x P.6
dT CNO- @`P
gJFOF CA0EOP
All reports are submitted as the confidential property of clients. Publication of statements,conclusions or recta is rescrved pending our
written approval.
•
1
P.O. Box 9131, Pleasanton, CA 94566, Phone 510/460-5100 Fax 510/460-5118