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VOcroachment Permit ........................ Grant of Easement........................ , Gutter, Sidewalk, Driveway: Replace.......... Repair.......... r............ Conn. Fee $................ Water................ Meter $................ Agreement for Completion of Public Works Improvements .................. Plans Checked By........ Date........ Approved By........ Date .................... PERMIT INSTALLATION NO. CITY OF CUPERTINO APPLICATION FOR RESIDENTIAL BUILDING PERMIT AND IFCATE OF OCCUPANCY %.,LBUTILDIINGINSPECTION DIVISION ==Me , '// Plans Received By ............... leii....................... y( Date ..I.. ../_ .. REO.: Plans.... Survey.... Cato: Struc..... Plans Checked By Energy.... Elect..... Ml .... ................ :,,Q.N/..... Application Approved By .............. L:._ ................. ... ........_... Date ... ...... Date ... Validated BY .................................................. . Date ... .... Compensation Certificate Verified By Date ........... • • • '•• MI $91.000 ............ Permit Fee (plus penalty if applicable) ........................ $.......69..00 Plan Check Fee (less deposit of $.......... Rct. #..........) $....................... Energy Plan Check Fee (Dep. of $........ Rct. #........) $....................... StrongMotion Fee ... .................... ...__............................ $......... _ 6...K. Plumbing Permit Fee .................. ..:..::........... ............ $..........78.10 Electrical Permit Fee..............t....1..:............................ $...... ....4i3.,.QQ Mach. Htg./Coolg, Permit $.:.:.:....................... $..........3.1...00 Residential Construction Tax ........................................ $....................... Misc. Fee........................................................................ $ ....................... itMisc. Fee........................................................................ $ ....................... . $ 432.37 • Environmental Status: Exempt ........... Other ................. ....................... ' Design Review Approval: Bldg ............. Site ............ Sign ............ Use Zone ............ P.D. Conditions ............................................................ Cond. Use Permit ..... Variance •............ Parking Spacell ......... ApprovedBy ......................................................... Date ........................... VOcroachment Permit ........................ Grant of Easement........................ , Gutter, Sidewalk, Driveway: Replace.......... Repair.......... r............ Conn. Fee $................ Water................ Meter $................ Agreement for Completion of Public Works Improvements .................. Plans Checked By........ Date........ Approved By........ Date .................... PERMIT INSTALLATION NO. EACH IFEE Light Outlets............ Switches............ Fixtures............ Receptacles............ , TOTAL NUMBER (less than 1000 watts) _... ....... $ ,50 .. - - ..... Range ..-..... Cooking Unit........ Oven ............................ 2.00 .............. Dryer........ Garb. Disp.._..... Dishwasher ............. ...... 2.00 .. ............ MOTORS: 1 HP or less ............. ..._................ ............. . 2.00 .............. Greater than 1 HP not more than 5 HP ............... 3.50 .............. Temporary Power Pole or Service — 100 amp ..........5.00 .. ............ — 200 amp ......... 7.00 .............. TimeClock............................................................A__+. 1.50............... Misc. ( see Ord. current...................................................... New Residential Occupancies Flat Rate D-600 sq. ft. $22.00 , 1501-1750 $34.50 .............................. 601-750 24.60 1751-•20000 37.60 .............................. 751-1000 26.00 2001-225G 39.50...... ,t 1001-1250 28.60 2251-2500 42.00...... ................ 1251-1500 32.00 2501-2750 49.50 .............................. Permit Fee...............................................$5.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty If app.[]) $48.00 Forms / Foundation __........... ........ .� By:... .. Plumbing Ground� r`k .Db. Rough Elec _/�`•..:.i.6.re .1.... ... -'rams - umbin nd Heating i ........... lation 8 nergy_........................__.. ..._.... Test....................................... ... ... . porary Power Gas / Elect. .. .. Final - Electrical ..................... ................. . ............ Final - Building / Mechanical .........._......... ...._... Final - Design Review / Landscaping ...... ............ Final— Public Works ........ .....a .. ...../.J.�... Awa Qy,rnp�,�N66•��iJ FRAvu� �� ^BI r?4,0-eJ a P2 6 PERMIT NUMBER 1,31 FOR APPLICANT TO FILL IN STREET ADDRESS OF PROJECT: /0/.7.. ... 5yerly...CQ.�1 rlt.........................._................. Legal description: Tract... 155 ........... Block............ Lot ......74......_.. Description of work: .Single...F.amily...Dwelling.................. 1st Struct. Improvement on Parcel: Yes.X No... Area of BIdg226.2H. Separate Structure No...... or.Addition/Alteration to Exist. Bldg..r5 U.Q No. of Stories ...... 2....... Use of Building....Res.idential................ Valuation of Project: $.91,.000.............................................................. Owner: BAS.. Homes,...Inc................................ Phone 25.2.. 2 0.7.7 Contractor: BAS. -Homes Inc............_.City Bus. Lic, 011061. Contractor's Address: 208D..Ste.vens... Cr.k. Phone:..252-.2.0.7 Contractor - Electrical: ..Best. Electrical... Co_ .... _.................. City Bust ass Licens x,..1817.2.... Phone2.57-.2Q4.0 Plumbing: ....,I:TOWl ey.,o,_. ................................................. City Business License •.....16641. Phone245-4.2.40 Heating and Cooling ......Al.. BOyeT...CO...... ........................ City Business License 0 ..... ............. Phone:..792-.432 Architect/Designersya110 Bates.838.-9956Phone7�x4 75z $ Engineer: .McKay...$..,SOIn.5. ....... :....................... Phone:.y$5,-�!.99 Lender: We1.1s..Fargo.. ank...._............................. ❑ Unknown - .. "I certify that in the performance of the work for which this permit Is issued 1 shall not employ any person in any manner so as to become subject to the workman's compensation laws of California." SIGNATURE OF APPLICANT/OWNER ..... ....... ....................................... .......................... DATE........................ ... "I certify that as the applicant I am licensed once the provisions of the Contractors License Law and further that my Licens. No. _.......................... in Classification ....... ...... ...-._ .... ............ is in lull force and effect: or ... I certify that I am exempt from the "Licensed Required" provisions of the Contractors License Lew. (State basis of exemption.) I hereby acknowledge that I have read this application and state that the above Is :orreot and agme to comply with all City Ordinances and Slate Laws regulating building. I (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may In y we acture against said Cily naequenca of the granting of th' SIGNATURE. OF ,of the gr APPLICANT/CONTflACTO NOTE: Whcn properly validated this form constitutes a Building Permit. This permit expires and becomes null and void should work not be commenced within 120 days from validallon date, or should authorized construction be suspended of abandoned for a period of 120 days alter work Is commenced. APPLICATION•. PLUMBING PERMIT PERMIT INSTALLATION NO. EACH FEE Gas System with up to 5 outlets .............1.................$4.00....4.x... Each additional outlet ............................................. 1.oO..... .......... Water System (Installation, Alt. or Repair) ..1.....1..... 4.00.......,.OQ Water Closet3.. Water Heater.) Li Tray. .....1.....5 .... .. 4.00. Lavatory..5 Shower Pan.... Bathtub2. Sink ... 2.....9. ... .. 3.00..27.. 00 Wash. Mac .1. Dishwasher.. ) Garb. Disp...l ..... .. 3..... 3.00.....9..L10 Sewer .... C>439 ........................... 1................1..... 8.00.._.B..QQ Lawn Sprinkle Sys. $5.00 Ea. add Sys. $2.00........... Vacuum Breakers ............................................ ..............3.50.. ............ Interceptor........ Water Softener.....................................4.00............. Plumbing Piping without fixtures ....................... ........ ....4.00-.............. Misc. (See Ord. Current) ..........................................'......... PermitFee.......................................................................... TOTAL PLUMBING PERMIT FEE (plus penalty if app. Q) $ 78,00 APPLICATION••HEATING/COOLING PERMIT INSTALLATION N0. EACHFEE Forced Air Unit .................. to 100M ..................... .........$ 6.00............... over 100M ...................1.... 10.00 .. .1.0...0 ' Comfort Cooling Unit...... to 3 ton/HP ................. ........`.. 6.00............... to 15 ton/HP ......................... 9.50 .............. 1 to 30 ton/HP .......................... 12.00 ............. to 50 torl ........................... 17.00.............. , Space Heater........ Wall Heater ....................... I ... ....... 6.00 ,, .,,._,,.,,,. Flues - other than a eve .......... ............. ....I.. 3.00 .............. ................... Vent Fan: Kitchen........ Bath .........Dry.er.... „$....`.. 3.00._ ..1.5...Q ` Commercial Range Hood ................................... ......... 8.00............... Misc. (See Ord. Current ...... ................... ...............�....... ............................ PermitFee........................................................................ $ 6.00 TOTAL Htg./ Coolg. Permit F e (plus penalty It app. ❑) $31 .00 ....................... u.F 24 i l T ROUTE SLIP File No Date /S— b/ S -b, f e c t —;? :Z A,cproved Dat- e ector I: To OFFICE CITY OF CUPERTINO COPY GAS SERVICE NOTICE L1 �Z I19 � d to connect the GAS service for Owner or Tenant 7, —' At MI -Q /j New Service No. of Meters_ Reconnect ' '-t No. of Add. Meters Move Service Move Meter PLUMBING INSPECTOR �✓!�// ©-; BUILDING INSPECTOR'S OFFICE Bldg. pr. CITY OF CUPERTINO Office Copy i ❑ Backflow Device Sanitary Permit No. `0 Sewer Connection 'm Plumbing Final Owner or Tenant (OW -s % ./(,C At 1017-2 /7 yElLc-7 C.% r Plumbing Permit No. Lot No. Tract Date Connected 1980 Date_ Final Z� —`' 9 196 PLUMBING INSPECTOR CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO 6 Z DATE 19 AjL BLDG. PERMIT NO. THE BLDG. LOCATED AT OWNED BY HAS BEEN OM LETP EDI OR USE AS S IALTEREDI ELECTRIC SERVICE NOTICE OFFICecOPY BUILDING INSPECTOR'S NOTICE 1 CITY OF CUPERTINO n /LGI 19 To i You ore hereby authorized to Connect electrical service for Owner or Tenant 1� At /o/7 No. of Wires Size of Wires Size of Switch Motor Load Heating Load No. of Meters No. of Add. Meters Voltage K. W 110 --New Service — Reconnect_ 1 Hear.] ear Heat 140_Three Wire More Servic Power— three Phase Move Meter (D . ELECTRICAL INSPECTOR