Loading...
1791 0 MwiphwATI"' 0 CITY OF CUPERTINO JAN 10 >4g1 APPLICATION FOR RESIDEN TIAL BUILDING PERMITPA� PERMIT NUMBER / 7 9 • APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY FOR BUILDING INSPECTION DIVISION STREET ADDRESS OF PROJECT: ...10.19.9..Byer.ly..... our.t............................................: ....................... a • Legal Description: Tract......6551....... Block............ Lot....21............. Description of Work: ................................................................................ PlenaReceived By....................................................Data ----------------- .... - sola.r...permit._...................._............... REO.: Plans.... Survey.... Calcs: Struc----- Energy.... Elect..... Mach.... tat 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:.................... $ ...._ Contractor: ...._ ._BAS..HOMES.•...1NC.,City Bus. Lia # . .. ......... Contractor's • • • - • Contractor's Address: .........._._............................_. Phone:.................. Permit Fee (plus penalty if applicable) 24.lSO Contractor - Electrical: ........ _..................... ............................................ Plan Check Fee (less deposit of$.......... Rct. #..........)$....................... City Business License #...... Phone:....-............... Energy Plan Check Fee (Dep. of $........ Rct. #........) $....................... Plumbing: ...................................................................................... Strong Motion Fee ..........................................................$...........t.S'D... City Business License #...:................ Phone:.................... _ _ Heating and Cooling ...__._......... ..._. ......................... .......... Plumbing Permit Fee ................................................$....111:..ii .......... City Business License #.................... Phone:.................... Electrical Permit Fee Permit $....................................._......................_.._._.$....................... Architect/Designer: ...............__......._..............._.... Phone:.................... $....................... Mach. Htg./Coolg. Permit $ Residential Construction Tax ................................__.._$....................... Engineer: .... . ....._..._......................._..................__.. Phone:..................n Misc. Fee $....................... Lender: ... .. ._....:...___............._............_........_................ ❑ Unkno ....................................................... "I ISC. Fee ........................................................................$....................... certify that In the performance of the work for which this permit Is issued I shall not employ any person In any manner so as to become subject • $ 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 unde the provisions of the Design Review Approval: Bldg. ............ Site ............ Sign ............ Conlmclors 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 #............ Variance If............ Parking Spaces............ - I certify that I am exempt from the "Licensed Required•' provisions of the Approved 8 Contractors License Law. (State basis of exemption.) pp y..............__.................._.................... Date ........._................ I hereby acknowledge that I have read this application and state that the above Is WORKS REQUIREMENTS correct and agree to comply with all City Ordinances and State Laws regulating PUBLIC 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_........ secure 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 farm constitutes a Building Permit. This permit expires and becomes null and raid should work not.be commenced within APPUCATIONFOlIELECTRICAL PERMIT 120 days from validation date, or should authorized constrii tlon be suspended or abandoned for a period of 120 days alter 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 I...................................................... Vacuum Breakers __...................... _............... .. ............3.50.. ............ New Residential Occupancies Flat Rate Interceptor........ Water Softener........ ................. ............4.00. ............ Plumbing Piping without fixtures ...................................4.00ry, D-500 sq. ft. $22.00 1501-1750 $34.50.............................. Misc. (See Ord. Current) .....SA.132'..pB>; Zr.......4, ......... 501-750 24.60 1751-20000 37.50.............................. Permit Fee $ e.00 751-1000 26.00 2001-2260 39.50.............................. ............................................ ................0 1001-1250 28.60 2251-2500 42.00.............................. TOTAL PLUMBING PERMIT FEE (plus penalty if app. �]) = 10.00 1261-1500 32.00 2601-2750 49.50.............................. APPLICATION • • HEATING/COOLING PERMIT Permit Fee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty If app.(]) $ PERMIT INSTALLATION 11 0.1 EACH FEE Forced Air Unit..................to 100M ..............................$ 6.00............... • • ' over 100M................. ....... . 10.00.. ........... Comfort Cooling Unit......to 3 ton/HP ....................:...... 6.00............... Forms / Foundation ...................... ... . . By:........ ....... . Date:................ to 15 ton/HP......................... 9.50.............. Plumbing Ground Work . ................_-. ..... .... ..........I......__...... to 30 ton/HP........................ ..12.00.............. Rough Electrical ....................................J... ..................... ........................... to 50 ton/HP......................... ..17.00.............. Aftra la - Plumbing and Healing ...._....1.. _.... ........_...._..__.... Space Heater........ Wall Heater ................._................ 6.00.. sulation & Ener __.. ................_...._. _........ .............. ........... 9Y...__............._.. ....... ...................._..... Flues - other than above ............................................... 3.00.. ............ Gas Test ..._........ ......_................. ... .-............. .......... .......................... Vent Fan: Kitchen........ Bath ....................................... .. 3.00............... Temporary Power Gas / Elect. . ...... Commercial Range Hood 6.00.................................... . .............. . ....... .. Ina - 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. E)) $ Final–Public Works ...........................................................