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1534X0 ' !� ,c :e:n:aG ¢ CITY OF CUtERTINOC -� PERMIT NUMBER �-f (� u APPLICATION FOR RESIDENTIAL BUILDING PERMIT AND. -5 /' •. APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY , BUILDING INSPECTION DIVISION T E A DRESS OF PROJECT: 5p........C'A.AL.Yay...lr............D eivE .......... ....................... • . • , Legal Description: Tract.. Block............ Lot.....,3............. Description of Work : .......................................... -- ........... Plena Received By................../VL:r....................... bate ..(�.��!-.._............................ ....._........_...._........�a mmyt� REO.: Plans.... Survey.... Calcs: Struc..... Energy.... Elect..... Mach.... tat Struct. Improvement on Parcel: Year. No Area of Bid g..c��..O.R.... • #4 Plans Checked By ......................... Date ......... d / _. Separate Structure.. ✓....•.. or Addition/Alteration to Exist. Bldg........... Application Approved By...-......./y/; /Z..�...--....Date V/C�p Mb No. of Stories............ use�9f Building&M??For.PYf0!!f.?f.................. `} ValidatedB ....-_.......=. /.....-......_...........Date........................ Valuation of Project:$.../..FIR.J0.0..........._............._........._........... Y .................. I C Compensatlon Certificate Verified By ................. Date ........................ Owner.Tc!r,�fp.A!.ON(CA. Cob{;..R..... ...... .._.... Phone:........ • � Contractor: DEr84.tiR.. ., City Bus. Lic. a , • ' • • $ 1'74 %0�"c7 67b Contractor's Add ressd 1O ieEE„V! ?TRD..... ..... Phone-V -` Permit Fee !yU� ♦ (Plus penalty it applicable) .................... $3s..%....... Contractor - Electrical: .... ...... ........ ........ - ............................................. less deposit of $.......... Rct. #..........)$......... City Business License #.................... Phone: ................... Plan Check Fee ( >Y L Energy Plan Check Fee (Dep. of $........ Poll. #........)$ ...... ./. Plumbing: ..............................#.... ................... ......... .................... City Business License #.._....... _—..... Phone: .................... Strong Motion Fee... ........ .......... ....... - ....... ..................... $...........c.a?-9 Heating and Cooling �Plumbing Permit Fee $...... O'O _.._....#...._......_...._.. _....ne:.............. City Business License #.................... Phone:................... Electrical Permit Fee.............. —........ ..................... .... .... $...... .. -S.-Phone295.7./J15. Architect/ Designer: R•..5•eNwc�V/[�'__,,,._..... Kmech. Htg./Coolg. Permit S............................. $........... .ri..d'd Engineer: ... ..... .. C7 Resid'antial Construction Tax... ................. ................... $... _......._................_.._.....__........_..._._........__.. Phone:.................... ______________________ LendersgeKR/ry.OliC•r IF7C 84v.I...-ev%4"A_.. .. ❑ Unknown •� Misc. Fee....-.................................................................$. ..I certify that in the performance of the work for which the permit is .. .. .. e • Mlsc. Fee........................................................................ $....ec.,_�j.........,.). I issued I shall not employ any person in any manner so as to became subject ' 1• $ V / 6- pC9m to the workman's compensation laws of California_" / I SIGNATURE OF x • • N APPLICANT/OWNER .. DATE........................ N Environmental Status: Exempt ....... Other........... -........ ----------- 1 ^I certify that as the applicant I am licensed unde the provisions of the 4 sell Review Approval: Bldg. ....... Site ............ Sign ............ Contractors License Law and further that my Licens No 3$r.'7.1Z.,... Uae ZOne P.D. Conditions ............ In Classification .._... _8....................... is in full force and effect: or (� .__....... _...._.................. _...._.._....... *Gond. Use Permit #........... Variance #..... Parking Spaces............ I certify that 1 am exempt from the "Licensed Required" provisions of the (^�A foVetl B ..........._ Date Contractors License Law. (State basis Of exemption.) -- ,, Approved y.......----.-.--... ........ ---....-..---�-........ hereby acknowledge that I have read this application and slate that the above Is :orrect 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 echment Permit........................ Grant of Easement........................ against liabilities, judgments, costs and expenses which may in any way Gutter, Sidewalk, Driveway: Replace ......... Repair.......... occurs against said City in consequence of the granting of this permit." Sewer............ Conn. Fee $................ Water................ Meter $................� SIGNATURE OF D�geG.0 e04,0- �' /0-27—M Agreement for Completion of Public Works Improvements .................. MWE. •#T'/ CONTRACTOR�e �,-Z _e .—//,g, DATE ...............T...... y� Plans Checked By........ Date........ Approved By........ Date.................... NOTE: When properly validated this form constitutes a Building Permit. This sp permit expires end becomes null and void should work not. be commenced within APPLICATION• . 120 days from validallon date, or should authorized construction be suspended or abandoned for a period of 120 days after work is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATIONe• PLUMBING PERMIT Light Outlets-- ....... N Switches. _...... _ I PERMIT INSTALLATION NO. EACH FEE Fixtures ........Recec eptacles....... ..... TOTAL NUMBER (less than 1000 watts) ............ $ ,50 ....... in Gas System with up to 5 outlets ............................. .. $4,00'. ....... y Range........ Cooking Unit........ Oven..... .... ........ ....... 2.00 .. ............ n 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 --- ...... . b.. .. 4.00. ...... Greater than 1 HP not more than 5 HP ....... ....... . 3.50 .. ............ Lavatory•' Shower Paril. Bathtub3. Sink.!..... /0... .. 3.00. 4....... A • Temporary Power Pole or Service — 100 amp ..........5.00 ............. Wash. Mach./. Dishwasher./. Garb. Disp../...-..-3...... 3.00. -.... — 200 amp......... 7.00............... Sewer . 8.00.....8....... ........................................................................... Time Clock..............-................_........__................ ........ 1.50...._......_11 Lawn Sprinkler Sys. $5.00 Ea. add sys. $2.00........ ............. ............. Misc. see Ord . current ...................................................... a Vacuum Breakers..........-................:..........-..... .. .... .3.50...-.�.t. .. New Reslderf Occupancies Flat Rete Interceptor........ Water Softener.... t.................. ... �:. .-..4,00. ...7.....- Plumbing Piping without fixtures ...................................4.00............... 0-500 sq. ft. $22,00 1501-1750 $34.50............. ..............:.. Misc. (See Ord. Current) .................................................,,• 501-750 24.60 7751-20000 37.60 ................. ............� Permit Fee ...................-- ............. $ 6.00 f751-1000 26.00 2001-2250 39.50............................. . 1001-1250 28.60 2251-2500 42.00 .............................. TOTAL PLUMBING PERMIT FEE (plus penalty If app. Q) = I SIL 1251-1600 32.00 2501-2750 49,50 .............................. v HEATING/COO N PermitFee..............................................$8.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty if epp.0) $ Ty rForce RMIT INSTALLATION =I—EXACT-1—RET-11 J�nit..................to 100M ...................... 6. 0.. ......•... I .RECORD over 100M ................../... 10.00 ....I....... ling UniL.....to 3 ton/HP ...... ........... .�.... .. 6.00,.. ....ix..... Forme/Foundation.. ! BY: Date:k'�y � / to l5 ton/HP.......................9.50.............. `...........Plumbing GtcuR�iYDrk �IdQ:itQ...T` 7r 8f .. •.............t,7/_#/ 30ton/HP ...........................12.00.ough Electrical ....._..................... .. [.,.... .. ......_ ..._y�/... �DM •ZA O ton/HP.�........................17.00............. Plumbing and Heating �LA.......¢i'i•/.. Space Heater...... Wel ater .....— .................. ....... 6.00.............. 1 � Plumbing & Energy. ...... .................. .. _......_.........�o. ......._ Flues - other than above....._.............................. ........�.. 3.00.............- F r as Test ..........................P ._ ................ o-`yam 1._ Vent Fan: Kitchen.../... Bath .3........._............. .. ......_t.. 3.00... ..L.%^... Tem orar Power Gas -•_........_L .Z.-. �-JL. jl B.OD,,, Commercial Range Hood................................... ......... FI al - lectrlcal ...... . .....:.......... /�.. Misc. See Ord. Current _.........._..........__— ....... ........ ,........... .. ........._ l P Final - Building, , Mechani............ _......_. #. % fj +.. Permit Fee . f................... ._ ........... ...... ...$ 6.00 v Final - Design Review r Landscaping ....— ... .... I..... . _........................ TOTAL Htg./ Cool Permit F (plus penalty If ap ❑) $ 7J Fin I — Publ Works ............................ ..... I�rJA �fir QTL g jt �c 11.1 �er — 8—S WIN`gip uFP�Q sM� 12 3�"Cj a 1 t{, 1-b 8l 6 %G1Y( . �. fy�uc-�"� 0 Cl 10300 Torre Avenue Cupertino, California 95014 Telephone: (408) 252-4505 0 DEPARTMENT OF PLANNING AND DEVELOPMENT Richard Childress 22025 Regnart Road Cupertino, California 95014 Dear Mr. Childress: 0 CitM of Cupertino January 15, 1982 P.O. Box 580 Cupertino, California 95015 JAN 15 198 D 2 BLDG. INSPECTION DEPARTMENL CITY OF CU.PERTINO - The Planning Department checked the landscaping at 22245 Canyon View Circle and noted an area on the west side of the private road which needed smoothing and remulching. The Public Works Department has agreed to accept responsibility for this area as part of the Faithful Performance/ Materials and Labor Bond. Prior to release of this bond, the Department will verify that smoothing and remulching has occured. Upon your acceptance of the above agreement, the $500.00 landscape bond posted for 22245 Canyon View Circle will be released. Please call if you have any questions. SB/TW:mc Sincerely, CITY OF CUPERTINO Sonia Binnendyk, Planner I Travice Whitten Assistant City Engineer R01J%I p File Date -- .x�te Anoroved Date I�sgeccor BUILDING IkOktOR',S OFFICE?: '•r Bldg. Dept. Ic CITY OF_CUPERTINO: Offic.Covy l. "Backflow Device _ - - ' ASonitory Perm it. No 1 Plumbing Permit No3„• O Sewer Connection,. ` - ,. : - ., -t Lot No ._ n. Plumbing Final '.” -: ' Cry ' rfir >fG�Iil Owner orTenant"At • ' n ' Tract 1 jrDate Connected' 61– W 19—Date Fi(nal`-,r,�! ! 19 ?I ©M PLUMBING INSPECTOR. . . r OFFICE COPY] ELECTRIC SERVICE NOTICE BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO icy... 171,, You are hereby authorized to Connect ele<tncol service Eor Owner or Tenant' At Size of Wires No. of Wires Size of Switch ' Motor Load V6 age ---Phase: t. W,, : 'Voltage �1 Heating Load - �. /110 New Ser ce ` Reconnect - ( r Na. of Meters 1) 140 Three w re r Mme Service__ H / Ugheaf Move Meter Power three Phase I Na. of-Add. Meters �N ELECTRICAL INSPECTOR f -. r