The URL can be used to link to this page

1306CITY OF CUPERTINO APPLICATION FOR RESIDENTIAL BUILDING PERMIT AN; CERTIFICATE OF OCCUPANCY BUILDING INSPECTION DIVISION Plana Received By...............1114.'%........................., Date ../u/c{d... REO.: Plana.... Survey.... Cel : Struc..... Energy.... Elec... _. Mach.... Plans Checked By .................. .fL%..). Date ... ,r. ------------.... Application Approved By.......... 4x..G.r..........-_ _ _ - Date .. 14�U5� Vel idated BY .................. -- ......................... ... . Date ...... .......... Compensation Certificate Verified By ...!�%... Date .....Ja,r� r •. $ EACH IFEE Permit Fee (plus penalty if applicable) ........................ $......294.50, Description of Work: Single ... Family ... DW.el.lxng................... Plan Check Fee (less deposit of $.......... Rct. #..........I$ ....................... Energy Plan Check Fee (Dep. of $........ Rct. #........) $....................... ............ Strong Motion Fee .......................................................... $................X4fX1 Plumbing: I.TOWl ey......... ... ... . .................................. Plumbing Permit Fee ..........................._................:.. $......... . ...4.U. Electrical Permit Fee ...................................................... s ......... , Mach. Htg./Coolg. Permit $......./' I.!:.:.�.. �:.:...... $.........3.1...0.0. to the workman's compensation laws of California." Residential Construction Tax ....................... --..........., $-..................... . ... "I certify that as the applicant I am licensed unde, the provisions of the Misc. Fee ............... ......_........................ ......... -.............. $....................... . I certify that I am exempt from the "Licensed Required" provisions of the AMisc. Fee........................................................................ $ ....................... wrrect and agree to comply with alt City Ordinances and State Laws regulating . $ 462.80 e . NOTE: When 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 validation date, or should authorised construction be suspentlad or Environmental Status: Exempt ............ Other ........................................ INSTALLATION NO. EACH Design Review Approval: Bldg ............. Site ............ Sign ............ Use Zone ............ P.D. Conditions ............ ...............................--.......- Lavatory -5 Shower Pan..l Bathtub... Sink.. 1,_. .9 .. 3.0.: �.Y. Cond. Use Permit #............ Variance #............ Parking Spaces............ Lawn Sprinklef Sys. $5,00 Ea. add Sys.$2.00.................................. ApprovedBy., ..................... -- .............. - -......-- Date ........................... Plumbing Piping without fixtures.........1............ .1 .... .... 4.00....4...Qfl roachment Permit ........................ Grant of Easement .... --...7........... , Gutter, Sidewalk, Driveway: Replace.......... Repair.......... er............ 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........... .... ...1 Legal Description: Tract........................ Block............ Lot...16............... Description of Work: Single ... Family ... DW.el.lxng................... Fixtures............ Receptacles............ Separate Structure.1NO.... oor9Addition/ Alteration to Exist. BIdg540.5x. TOTAL NUMBER (less than 1000 watts) ............ $ ,50 .. ............ Range........ Cooking Unit........ Oven ............................ 2.00 .............. Plumbing: I.TOWl ey......... ... ... . .................................. Dryer........ Garb. Disp......... Dishwasher ............. ...... 2.00 .............. City B`I,siness LicnseI- ..............7gg6ne:.79.2.-QuB MOTORS: 1 HP or less .......................................... ..... 2.00 .............. Lender: ...Wells, F.ar.go .Bank ...............-................ ❑ Unknown Greater than 1 HP not more than 5 HP ............... 3.50 .............. to the workman's compensation laws of California." Temporary Power Pole or Service — 100 amp .........5.00 .............. . ... "I certify that as the applicant I am licensed unde, the provisions of the — 200 amp ......... 7.00 .............. . I certify that I am exempt from the "Licensed Required" provisions of the TimeClock ...... .............................. ............... .- ........ ...... ... 1.50............... wrrect and agree to comply with alt City Ordinances and State Laws regulating Mlse. (see Ord. current)...................................................... I (We) agree to save, indemnify and keep harmless the City of Cupertino against liebllt ties, judge , costs and expenses which may in y way ..cure against said Cit I con equence of the granting of thl rmit SIGNATURE. OF r}��.'r� New Residential Occupancies Flat Rate D-600 sq. ft. $22.00 1501-1750 $34.50 .............................. 501-750 24.60 1751-20000 37.50 ...........................:: 761-1000 26.00 2001-2260 39.50 .............. .......... 1001-1250 28.60 2251-2500 42.00..............�A56........ 1261-1500 32.00 2501-2760 49.50 .............................. ., PermitFee...............................................$8.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty If app.p) $48.(10 •• r ~� I Forms Ion ........ rf �. BY :............ Date:................ rr' Plumbing Grewtd-tlyolk� .. 3- Rough Electrical ................................ ....... ."y.'."j7.... IiIIJIrame - Plumbing and Heating.............................................................. 1 ,,Wetlon 11 Energy ...................... .. ... .. . . Test........... .... ...... ._..._.._..3://lk4l.................................. her orary Power Gas / Elect . ....... . .�..J.. ........... ..... .._9 _..... .... ,,,�11�..+ Final - Electrical ............... ...._............ .. �� _../... �.. G.'.;....... `eT Final - Building / Mechanical ............... ..... (........ .... ............................. .� Final - Design Review / Landscaping . ......._........ ........... ..................... Final -Public Wor wsP -...I.'.f.a.-. ... .. om..... .... lia... `11 ... I 12-IJ—"�- SNGaIL WIDE 4LS61 - — >a•C/s�l -Z �v PERMIT NUMBER 136 jo FOR APPLICANT TO FILL IN S REET �4DRREJS C F 2RQJECT: OJ o n. s........ a. .... ...1 Legal Description: Tract........................ Block............ Lot...16............... Description of Work: Single ... Family ... DW.el.lxng................... ......'..............._..............................................................._......... _._... 1st Struct. Improvertrtttggnt on Parcat: Yes.X No ... Area of Bldg.24.5614 Separate Structure.1NO.... oor9Addition/ Alteration to Exist. BIdg540.5x. Valuation of Project; $.0 )1y.z Ul-..........................................gResidential.-.-............. .. Owner: ..BAS _Homes ..Inc. _.......................... _.. Phone:.2 - 77 Contractor:..... _as... }h�qy .....,.._ . Ity Bus. Lic. _� Uffl St'evenS...�rr c... Phone: 97 Contractor's Atldress:............................................ ...- ._.. .. Contractor - Electrical: Best. elec.txical ................28.7-.20.4.0 City Byy,sinesg Lice a #....1817.2... Phone:8[S.X 11.11 Plumbing: I.TOWl ey......... ... ... . .................................. City Business License ..1664.1..... Phone:.2.45-.4.2.4.0 Heating and Cooling .... Al ... Boyer ... Co ..... .......................... City B`I,siness LicnseI- ..............7gg6ne:.79.2.-QuB Architect/Designer:.Wa1loWej,Bat@5...8.38,-. Phone:714.__...._.- Engineer: McKay ... gg...Somps .... ..................... --... Phone:.9B5-.0960 Lender: ...Wells, F.ar.go .Bank ...............-................ ❑ Unknown "I 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 to the workman's compensation laws of California." SIGNATURE OF APPLICANT/OWNER ........... .....,.._................. ............ ........... ........ DATE........................ . ... "I certify that as the applicant I am licensed unde, the provisions of the Contractors License Law and further thal'my Licens. No ............................. in Classification ....... .... --- ...... ............... is in full force and effect: or . I certify that I am exempt from the "Licensed Required" provisions of the Contractors License Law. (State basis of exemption.) I hereby acknowledge that I have read this application and state that the above Is wrrect and agree to comply with alt City Ordinances and State Laws regulating building. I (We) agree to save, indemnify and keep harmless the City of Cupertino against liebllt ties, judge , costs and expenses which may in y way ..cure against said Cit I con equence of the granting of thl rmit SIGNATURE. OF r}��.'r� APPLICANT/CONTRAC ........ .............'.Y..!...-. 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 120 days from validation date, or should authorised construction be suspentlad or abandoned for a period of 120 days after work is commenced. APPLICATION s INSTALLATION NO. EACH EEGasPERMIT —FEE— GasSystem with up to 5 outlets ..................... ........ .. $4.00 .A: ..... Each additional outlet ............................................. 1.00..... Water System Instal lation, All. or Repair) .1 .............. 4.00...4.....0 Water Closet... Water Ffeater.L. Ld. Tray.....1... .mo5i 4.OU. any A�lg1 J. Lavatory -5 Shower Pan..l Bathtub... Sink.. 1,_. .9 .. 3.0.: �.Y. Wash. Machl.. Dishwasher..) Garb. Disp..... 1... .3...... 3.00. ...Q...QQ Sewer .... /,".z5 .. ..............1.-.....................- .......... 8.00-3 —Q.0. Lawn Sprinklef Sys. $5,00 Ea. add Sys.$2.00.................................. Vacuum Breakers ............................................ ..............3.50.. ............ Interceptor........ Water Softener.....................................4.00............. Plumbing Piping without fixtures.........1............ .1 .... .... 4.00....4...Qfl Misc. (See Ord. Current) .................................................... PermitFee.......................................................................... $ 6.00 TOTAL PLUMBING PERMIT FEE (plus penalty i1 app. ❑) 182.00 APPLICATION s•HEATING/COOLING PERMIT PERMIT INSTALLATION NO.EACH FEE Forced Air Unit .................. to IOOM ..............................$ 6.00--- over 100M ..................1.... 10.00.. Comfort Cooling Unit ...... to 3 ton/HP ........................... 9.00.............. to 15 torl ......................... 8.50 .............. to 30 ton/HP ........................... 12.00. .- ...... - to 50 Ion/ HP ........................... 17.00 ............. Space Heater........ Wall Heater...................................1 6.00.............. Flues - other than above .................................... ........{.. 3.00....... . Vent Fan: Kitchen ... I... Bath 3.. Q.F.ye.F...l._-.....5....4.. 3.00....1.5.,.00 Commercial Range Hood ................................... .......I.. 6.00............... Misc. (See Ord. Current... ............:................................................ ...... PermitFee ...................... -............... ............. ................... $ 6.00 TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. ❑) It 31.00 !101:7r SLrp Pile no. Date :,oca.tl m /( S I Su. J c,c \Otes I :1 iDprove.: I� �g Date thspector (� CITY OF CUPERTINO oo vE J14, (� GAS SERVICE NOTICE '19 To You are hereby authorized to connect the GAS service for Owner or Tenant x New Service ! No. of Meters - / Reconnect Move Service ','No. of Add? Meters _ •� ,i ,- ; Move Meter ' - �•` :. PLUMBING INSPECTORde ' O I BUILDING INSPECTOR'S OFFICE r Bldg. pi. C CITY Of CUPERTINO Office copy At /o i �2 (, QA/k Sanitary Permit No. Plumbing Permit No. //— Lot No. b Date Connected _,�� '" /� 19-&—U Date Final ©M PLUMBING INSPECTOR Backflow Device 7KI, Sewer Connection Plumbing Final Owner or Tenant d5h At /o i �2 (, QA/k Sanitary Permit No. Plumbing Permit No. //— Lot No. b Date Connected _,�� '" /� 19-&—U Date Final ©M PLUMBING INSPECTOR CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO 7 / DATE ---6 1.9 ( BLDG. PERMIT NO. / } 0 THE BLDG. LOCATED AT/ 2 6 0(o ci5N ' 'OWNED BY HAS BEEN OMP FOR USE AS (Al TFRFDI I Ti You are hereby Owner ar Tenantj At / Q/ ,� No. of Wires Motor Load Heuting Load ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO to Connect electrical service for 1 No: of Meters . I__ No. of Add. Meters Size of Wires Voltage _ K. W.__ Size of Switch Voltage Light a-- 110 _New Service Recon Heat 120 -Three Wire More QQ • ELECTRICAL INSPECTOR