Loading...
1796 CITY OF. CUPEPTINO • SUPPLEMHNW.1 • JAll 1 `55 CITY OF CUPERTINO APPLICATION FOR RESIDENTIAL BUILDING PERMIT PAID' PERMIT NUMBER l �, • AND FOR APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY q p BUILDING INSPECTION DIVISION STREET ADDAESS F PR?JE C ___________________________________________________ r • Legal Description: Tract.. ._._6551 Block........... Lot 26.... ........ - _....._._. ..._...... .... Plana Received By....................................................Date ........................ Description of Work: ....SO'Lar permit . . ........ .... . F REO.: Plana.... Survey.... Cates: Struc..... Energy.... Elect..... Mach,... 1st Struct. Improvement on Parcel:Yes.... No....Area of Bldg............... Plans Checked By................................................. ...Date ......................... Separate Structure..... .. or Addition/Alteration to Exist. Bldg........... Application Approved By.........................................Date ......... No. of Stories.............._ Use of Building ValidatedBy............................................_...............,Date .......----........... Valuation of Project: $......................................_._............._...................... Compensation Certificate Verified By ................. Date ......................... Owner: .............. .. Phone:.................... . ._...._........:......... .INC-_.....'City Bus. Lic. x ._.......... Contractor: • • ' • • $ Contractor's Address: . ......�..................... Phone:.......:............ Permit Fee (plus enact If applicable) 24®0 Contractor - Electrical: ..._......_......................_...........:.......:...._..._..._:.... lP penalty PP ) Rct #...........$..------_--------- City Business License *._...._.._....... Phone:.................... Plan Check Fee (less deposit . f ....... Rct. #..........)$....................... Plumbing: . . Energy Plan Check Fee (Dep. of $........ Rct. #........) $.....__...... _......_.... ...................................._............................ Strong Motion Fee ....... .......................... ...... $......._ S. City Business License s...--._...--_..... Phone:.................... ` Heating and Cooling ........... ..................._. ....... Plumbing Plumbing Permit Fee ........................__........__........$.... _Q:. ......... City Business License #..__...._..._:.. Phone:.................... Electrical Permit Fee ................................_.....................$............ Architect/Designer: .._._..._. .......................__.._..... Phone:.................... Mach. Htg./Coolg. Permit $............................. $....................... Engineer: _ ._........._.._,... ............. .. _.. .... Phone:.................... .. ........_._... Residential Construction Tax .._..._..................._.. ...__$..........._......_.. Lender: ... ._.._ ..._.........._.........._._..........__._......._.. ❑ Unknown Misc. Fee ....._............_._.............................................$.._................_. ^I certify that in the permit is Misc. Fee - Y performance of the work for which this '""""""'"""'"""""""""""""""""'""""""'""""""""""'"'$ """"""""""-""" issued I shall not employ any Person in any manner so as to become subject • s 24.50 to the workman's compensation laws of California." SIGNATURE OF • ! APPLICANT/OWNER ............._......................._.._........................ DATE._................... Environmental Status: Exempt............ Other.... ........... ... _.. "I certify that as the applicant I am licensed ands the provisions of they Design Review Approval: Bldg ............ Site ........ Sign ............ Contractors License Law and further that my Licens. No. Use Zone P.D. Conditions in Classification .........._............_......_.._- is in full force and effect: or' Cond. Use Permit e......... Variance *............ Parking Spaces............ , . - I certify that I am exempt from the "Licensed Required" provisions of the Approved B Contractors License Law. (State basis of exemption.) pp Y..._....................._.._.._........_......_.._. Date ........_.._...._._._. I hereby acknowledge that I have read this application and state that the above la ! correct and agree to comply with all City Ordinances and State Laws regulating building. I (We) agree to save, indemnify and keep harmless the City of Cupertino ncroachment Permit...................... Grant of Easement........................ against liabilities, judgments, costs and expenses which may in any way Ufb, Gutter, Sidewalk, Driveway: Replace.......... Repair..... accure against said City In consequence of the granting of this permit." Sewer............ Conn. Fee $................ Water................ Meter $................ SIGNATURE OF Agreement for Completion of Public Works Improvements .................. APPLICANT/CONTRACTOR .,..........................................._........... DATE ............... ........ Plans Checked By........ Date........ Approved By.-...... Date.._......_........ NOTE? When properly validated this form constitutes a Building Permit. This permit expires and becomes null and void should work not.be commenced within APPLICATION • ri• 120 days from validation date, or should authorized construction be suspended or abandoned for a period of 120 days after work Is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION •. PLUMBING Light Outlets............ Switches......._... Fixtures......_.... Receptacles...... PERMIT INSTALLATION NO. EACH FEE TOTAL NUMBER (less than 1000 watts) ..... ....... $ ,50 Gas System with up to 5 outlets .................................$4.00 Range........ Cooking Unit_..__ Oven............ ......._ ....... 2.00 . ............ Each additional outlet ........................_...........---_.. 1.00............... Dryer......_ Garb. Disp....__. Dishwasher .____..- . ... 2.00 ............ Water System (Installation, Alt. or Repair) ......._........ 4.00............... MOTORS: 1 HP or less ..._..... .............................. ....... . 2.00 --- Water Closet.... Water Heater.... Ld. Tray..............._.... 4.00. ............. Greater than 1 HP not more than 5 HP .............. . 3.50 .. ............ Lavatory.... Shower Pan.... Bathtub.... Sink................... 3.00............... Temporary Power Pole or Service — 100 amp . ....... ..5.00 .............. Wash. Mach..... Dishwasher.... Garb. Disp..... ..... .......... 3.00................ —200 amp.__._- 7.00 .............. Sewer ......_....... ............................................___........... 8.00................ Time Clock .............._....____........................._.__..._.... . 1.50........___. Lawn Sprinkler Sys. $5.00 Ea. add Sys. $2.00..................... ............. Misc. (see Ord. current 1...................................................... Vacuum Breakers ......-............................... ...... ..............3.50........-.... New Residential Occupancies Flat Rate Interceptor........ Water Softener....... 00 0-500 aq. ft. $22.00 1501-1750 $34.50.............................. Plumbing Piping without fixtures$ .Misc. (See Ord. Current) .SA.4r1S,.RPxKN7,. ......... r. .......... 601-750 24.60 1751-20000 37.50.............................. Permit Fee .............. .. 750-1000 26. 0 2001-2260 39.60.............................. TOTAL PLUMBING PERMIT FEE (plus penalty if app. ❑) _$1600 1001-1250 28.660 2261-2500 42.00.............................. 1251-1500 32.00 2501-2750 49.50.............................. APPLICATION FOR HEATING/COOLING Permit Fee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty if app.p) $ PERMIT INSTALLATION NO. EACH FEE Forced Air Unit..................to 100M ..............................$6.00............... • • ' ' over 100M ........................ . 10.00............... Comfort Cooling Unit......to 3 ton/HP . . ..... . 8,00.............. Forms / Foundation .. ........... By Date _. .. .. to 15 ton/HP .. .......... . .... 9.50 Plumbing Ground Work "" -�� � -- { ��� � -"- - - - to 30 ton/HP . . . ... 12.00. . Rough Electrical . ...-. - �... ... .. .. - ... .. to 501on/HP.. ..... ... . 17.00.. ........... tame - Plumbing and Heating 8.00„ .... .. ....__........... .. _ Space Heater........ Wall Heater............._._................./ sulation 8 Energy .... . .-. ... - .... Flues - other than above . .. .......{ 3.00. as Test ...... . .'.. . --c -- -- -" Vent Fan: Kitchen. .. Bath 3.00. Temporary Power Gas / Elect ... - Commercial Range Hood ... .. ., 8.00,,,,,, Final - Electrical .. .... .. ..- - .. Misc. (See Ord. Current .. .._. - ... .... .. ... Final - Building/ Mechanical . . ... Permit Fee ........................ $ 6.00 Final - Design Review / Landscaping .... .. .. .. .. ..... TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. ❑) $ Final-Public Works ...........................................................