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1296 CITY OF CUPERTINO P -a APPLICATION FOR RESIDENTIAL BUILDING PERMIT PEERMITRMIT NUMBER • AND FOR APPLICANT TO FILL IN CERTIFICATE AND OCCUPANCY - BUILDING INSPECTION DIVISIONSTR�EOT�D RESS OF PROJECT: .. !o ... ..Anthony...Place....................1111........................ a • • • • Legal Description:Description of Work: ....._S�,ngle...Family...Dwelling............ Tract....66551......... Block............ Lot.....6............... PlanaReceived BY....................................................Date ......................... ............................_:............_......................_.._._............................................ REO.: Plana.... Survey.... Coles: Struc..... Energy.... Elect..... Mach.... 1st Struct. Im rovemgnt on Parcel: YesXX No...Area of Bld 2$. . H. Plans Checked By....................................................Date ......................... Separate Structure....N4... or Addition/Alteration tq Exist. Bldg.. 9_OG Application Approved By.........................................Date ......................... No. of Stories.._._2....., Use of Building .....Re.S,7.Slential............... Validated By...........................................__...............Date .........__........... Valuation of Project: $..123.,00.0.........................__......._.................... Compensation Certificate Verified By . Date ...........1 ...1. owner: A ...Homes .Inc ......... Phone:75.2-.2077 • • • • • $ 123,000 Contractor ... BA$ �lppmes Inc.. _. City Bus. Lia # 11. 61. �) Contractor's Address 20825 Stevens_ Crk. Prypne252-2077 Permit Fee (plus penalty If applicable) Contractor - Electrical .... Best Clectrlcal...Co, ,,,,,,,,,,,,,,, (P P e t o ) . Rct. ..-- - $........321...50 City Bu�sll'ness License #...1.8.1.72.... Phone:._2$7-.2.04 Plan Check Fee (less deposit . f $....... R c #..........)$....................... Plumbing: .:rOWle l,O.. Energy Plan Check Fee (Dep. of $........ Rct. #........) $..................... 9: ....... ... .....y.......... ..................................................... City Business License x...1664.1... Phone:_24$,-4.4 Strong umbi Motion Fee ....................................................._...$...........86...61 Heating and Cooling Plumbing Permit Fee ...............>`::'...........................$..........H6...O0Boyer .. c . - City Business License #................... Phone79.2.-4.32.8 Electrical Permit Fee ........................__................._. ......$...........55...5.0 architect/Desigper,SwalloWBate5..838.-.99.56Phone:7.14....752- 924 Mach. Htg./Coolg. Permit $......,,r.::..,..I......... $...........33...00 K Residential Construction Tax t",.L:. ... ':.....................$....................... Engineer: MC ay..$...SompS... .......................... Phone:9.85.-.09.60 Lender: Wells..Fargo..Bank.................................. ❑ Unknown Mist. Fee ............................! .........__................_........$....................... . . • .. ... "I cattily than in the y any person of the work for which ethisco permit is Misc. Fee ......................................................:.................$....................... issues I shall not employ any person in any mentor so as to become subject • $ 504.61 to the workman's compensation laws of California." SIGNATURE OF ZONING • APPLICANT/OWNER ........................................................................ DATE........................ Environmental Status: Exempt............ Other........................................ .. 1111 "I certify that as the applicant I am licensed unde the provisions of the Design Review Approval: Bldg. ......_.... Site ._......:.. Sign ............ Contractors License Law and further that my Liters, No. _................ Use Zone ............ P.D. Conditions _..._..................................................... In Classification .........._1111........ ............. Is in lull force and effect: or Cond. Use Permit hi............ Variance #............ Parking Spaces............ - . certify that I am exempt from the "Licensed Required" provisions of the Approved B Contractors License Law. (State basis of exemption.) pp y..............._..............1111..._.__............. Dale ......._......_........_ I hereby acknowledge that I have read this application and state that the above Is !orrect and agree to comply with all City Ordinances and State Laws regulating • • building, I (We) agree to save, Indem fy and keep harmless the City of Cups no / ncroachment Permit....................--- Grant of Easement........................ against nebiiitles. iudg s, costs end expenses wnlcIn may in b, Gutter, Sidewalk, Driveway: Replace.......... Repair ........ acture against said C co equance pt the granting of ihi r............ Conn. Fee $................ Water................ Meter $....__........ SIGNATURE OF �- YY ement for Completion of Public Works Improvements 11_11............ APPLICANT/COIN ......... ..................................... �"c.a.Z TE 1111.....Y7 Plans Checked By........ Date........ Approved By........ Date.................... NOTE: When properly validated this form constitutes a Building Permit. This 'Q permit expires and becomes null and void should work not be commenced within 1 APPLICATION • . 120 days Iran validation date, or should authorized cansnrdillon be suspended or !G abandoned for a period of 120 days after work is commenced. lT PERMIT INSTALLATION NO. EACH FEE APPLICATION • • PLUMBING PERMIT �• Light Outlets....... Switches............ PERMIT INSTALLATION NO. EACH FEE ... Fixtures............ Receptacles y TOTAL NUMBER (less than 1000 watts) 1111.1111... $ ,50 Gas System with up to 5 outlets .... .1................1....$4.00. .•.QO Range........ Cooking Unit........ Oven........... ........111.... 2.00 ............_ Each additional outlet .................................... . 1.00.. ' Dryer........ Garb. Disp......... Dishwasher ............. ....... 2,00 ..1.111_...... Water System (Installation, Alt. or Repair) I........1..... 4.00......4...0. MOTORS: 1 HP or less ._......._...... ... ......... _._1.. 2.00 ............ Water Closet4. Water Heater..1 Ld. Tray....I........6.... 4.00. .2.4.•.00 (�s Greater than 1 HP not more than 5 HP ....... ._.... . 3.50 .... ......... Lavatory6. Shower Pan.l. Bathtub.3. Sink....1..11... .. 3.00...33...DO Temporary Power,POle or Service - 100 amp ._...... ..5.00 .............. Wash. Mach..l. Dishwasherl. Garb. Dlsp....1........3..... 3.00.....9...0.0 N J -200amp........ . 7.00 .............. Sewer ..../O.F./S..,ESP__..........................1.....1..... 8.00.....$...0.0 N Time Clock .............._...._................_....._..._......__...... . 1.50..._..._.... Lawn Sprinkle Sys. $5.00 Ea. add sys. $2.00..................... ............. Misc. (see Ord. current)....................... .............................. Vacuum Breakers ............................................ ..............3.50.............. New Residential Occupancies Flat Rate Interceptor........ Water Softener........ .............................4.00. ............ 0-500 sq. ft. $22.00 1501-1750 $34.50.............................. Plumbing Piping without fixtures .............1..........1.......4.00.....4...0.0 Misc. (See Ord. Current) .................................................... ,^ 501-750 24.50 1751-20000 37.50..........................1111 Permit Fee .................................................... 751-1000 28.00 2001-225C 39.60.............................. ......................$ 1001-1250 28.60 2251-2500 42.00.............................. TOTAL PLUMBING PERMIT FEE (plus penalty If BDP• ❑) $ 86.00 1251-1500 32.00 2501-2750 49.50...........289.8.... ............ APPLICATION FOR HEATING/COOLING PERMITQ• Permit Fee...............................................$6.00 TOTAL ELECTRICAL.PERMIT FEE (Plus penalty If app.0) $ 55.50 PERMIT INSTALLATION NO. EACH FEE M Forced Air Unit..................to IOOM ...........2........ ..2....$6.00.....12-.0 aj INSPECTION • " ' over t00M ........................ . 10.00.. ........... Comfort Cooling Unit......to 3 ton/HP ........................... 6.00... ........... Forms / Foundation ............... ......1111. . By;�..... 1111.. Date:............... to 15 ton/HP......................... 9.50 .. ............ Plumbing Ground Work . ................... ). .7K..._......_...`J. �.,........ to 30 tori..........................,12.00.............. f Rough Electrical .................................... . 1111.. . pp to 50 ton/HP...........................17.00.............. n 6.00 N . uletion 8 Ener ............ ...... . Space Heater........ Wall Heater ...................................11 .. ............ gY........................... 1111. Flues - other than above ............... ............................1.. 3.00.. ............ Teat ._................_............ 3 .9.SL. -�-------� ovary Power Ges / Elect. ........ .... ........./............. ....... ........r.... 1111. Vent Fan: Kitchen1Bath ..3.../.O.rye.T.. 15t ..L..S.....0....0 80 Commercial Range Hood ......................._ ' 00 J - Electrical ....._............................ ��b Misc. (See Ord. Current......_.................... ...................L.-........................ J ......... ... ,� Final - Building/ Mechanical ................... . .......... ...�..7�6_T._df. Permit Fee ......................................'............._._.............. $ 6.00 Al, Final - Design Review / Landscaping . .. .......... .......... TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. ❑) $33.00 Final-Public Works 1111. 1111.. ... ......... .. ��.. . . . try L�w � PrAQ. �•Lyo,�•►' B° �a� .6L!'tt vt� LiJ.epa0 c4^gyp fNE� t WI.��lu ��L�t�k�v1=. 4-sis.W-S i . T'OiS1^9 Qf � SLIP Rile No .-- D a t c eo .._Date 30 �xati^n c c b � - Date i t., 77 - CERTIFICATE OF COMPLETION �;- - BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO L' DATE — y I9�t BLDG. PERMIT NO. :THE BLDG. LOCATED AT OWNED BY-134 S ,.- HAS BEEN OMP.L-ETEF31 FOR USE AS (ALTERED) 4 4 OM UILDING INSPECTOR �r OFFICE 1 CITY OF CUPERTINO COPY -C GAS SERVICE NOTICE To Youorehereby authorized to connect the GAS service for Owner or Tenant 6^-a k/'"^'� New Service— No. erviceNo. of Meters Reconnect Move Service No. of Add. Meters { Move Meter PLUMBING INSPECTOR / ` a ° 0M I I ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO 19 -Q)� To You are hereby uu-th�orriizzed two Connect electrical service service fo Owner or TenantAt �/ e— / D2-W(a V No.of Wires Size of WX Size of Switch Motor Load Voltage Phase Heating Load K.W. Voltage i v / Light 110_New Service Reconnect No.04 Meters Heot 120-Three Wire More Service No.of Add.Meters Powe,---- Three.P Move Meter OO • ELECTRICAL INSPECTOR /y BUILDING INSPECTOR'S OFFICE Bldg.Dept. CITY OF CUPERTINO Office Copy ❑ Backflow Device Sanitary Permit No. 50 Sewer Connection Plumbing Permit No. 2 `[-&3 Plumbing Final Lot No. 6 Owner or Tenant (("I c—" At tr y p A Tract Date Connected f LI 19p-�Dat)Final q "t 6 19B ©� 0 —FLUMt5lNU INSPECTOR T