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2031 CITY OF -CUPCRTINO • r C TYOF CUPERTINO PPLICATION FO COMMERCIALiBUILDING PER 1 PERMIT NUMBER -;-?Q' J ANO GERTIFIC TE OF OCCUP NCY _� .c FOR APPLICANT T' FILL IN WILDI G INSPETIUN DIYISIUN STREET ADDRESS OF PROJECT: DEPARTMENT USE ONLY 20400 Mariani Dr_. Plans Received By.................... ...............................Date ........................ Legal Description: Tract........................ Block............ Lot...................... REQ.: Plans.._ Survey.._ Calcs: Struc..... Energy.... Elect..... Mec .... Description of work: Prefab._Re.frigerat ion........-............... Plans Checked By.........._?erifl!ed .._......._........__.Date .... let Struct. Improvement on Parcel: Yes.... No.... Area of Bldg... Application Approved By_ ..........................Date . �d�.. Separate Structure............ or Addition/Alteration to Exist. Bldg........... Validated By...................... ...........................Date ...... .... No. of Stories................ Use of Building .....................-....... .................... Compensation Certificate By...................Date _....................... Valuation of Project: $...5.7,000._........................................................ MTIllmlyilbdielllgo • - • $ 57,000 Owner: .... ......................... ............................... Phone:.................... 201.00 'CContractor: All3TIN.-..CA.M.rQ....!....City Bus. Lic. •.._..... . ... j Permit Fee (Plus penalty If applicable) _......................$............... ._.. 'A Q ...- 1.... /1 eu........... ddress: ...P,((,6.k lOR. ML��..V_ I„t.gy...._. Phon 't(a:��.@.:a 6Z Plan Check Fee (less deposit of$ - Rct. #.... $_.130..65... Contractor - Electrical: ...._......... ... .............:................... .................... . Energy Plan Check Fee (Dep. of $........ Rct. #........)$.................. ... City Business License #................... Phone:.................... StrongMotion Fee ........................._.......................__...$........3..99.... Plumbing: ...................................................................................... Plumbing Permit Fee ..... ................................... .....$................... City Business License #................. Phone:............ ........ . Electrical Permit Fee ............................__.........._........ .$.... ....... .. Heating and Cooling ..... .............................. ............................. Mach. Htg./Coolg• Permit $ ..............................$........._............. City Business License #.................... Phone:.................... ConstructionTax.............................................$.._.................. Architect/Designer: ................__................ ............. Phone:.................... Sewer Conn: Fee .............. Water Conn. Fee ... $_..............._.... Engineer: ................ ..........................__......_..._._..... Phone:.................. Landscape Fee .................... Street Tree Fee ............$......... ........ Lender: Unknown .._........._...M1M.Yn... Misc. Fee .._......._..................._........_.._................._.....$._.....-6..0.0.... ........... "I certify that in the performance of the work for which this peril Is • $ 341.64 Issued I shall not ploy any person in any manner so as to become subject to the workmen' o pe ati r Tawe California." Type Const......... Group........ Div......... Occ. Load........ No. Exits........ SIGNATURE of �opp F Floor Loads: let.... 2nd.... Other.... Sprinklered.... Area Sep. Walls.... APP/LIOANT/OWNER ... ...._..1....b'.k T'.._.................DATE 3.'13...�..(........ ZONING REQUIREMENTS s(...... 1 certify that as the applicant I am licensed under the provisions pf,the Contractors License Law and fyrther that my License No. a,9.1._3.gh...... in Classification _8-17-Ce.-.3..0......_.. is In full force and effect: or Environmental Status: Exempt ............ Other...... ............................. Design Review Approval: Bldg. ............ Site Sign certify that I en exempt from the "Licensed Rtion., " provisions of the ----- """""" Contractors License Law. (State basis of exemption., Use Zone ............ P.D. Conditions ............................................................ I hereby acknowledge that 1 have read this application and state that the above Is Cond. Use Permit #...... Variance #...... Parking Spaces.... Load. Sp..... correct and agree to comply with all City Ordinances and State Laws regulating Approved BY __... Date ............_.r._........ building. ...................................................... I (We) agree to save, indemnify and keep harmless the City of Cupertino r • • against liabilities, judgments, sts and expenses which may in any way secure against said City in c n e�/o5en of th granting of this permit. Hr,ncroachment Permit....................... Grant of Easement......_................ IGNATURE OFV 1urb, Gutter, Sidewalk,. Driveway: Replace Repair PLICANT/CONTRACTOR .. .. ........ ...... DATE 3....1.3.E ../.... Sewer............ Conn. Fee $......._....... Water................ Meter $................ NOTE: When properly validated this for constitutes a Building Peri. This Agreement for Completion of Public Works Improvements .................. permit expires and becomes null and void should work not be commenced wihle Plans Checked By........ Date........ Approved By........ Date.................... 120 days from validation data, or should authorized construction be suspended or abandoned for a period of 120 days after work is commenced. APPLICATION FOR PLUMBING Pi • e• PERMIT INSTALLATION NO. EACH FEE PERMIT INSTALLATION ItNO. EACH FEE Light Outlets............ Switches.......... Fixtures............ Receptacles............ Gas Sytem with up to 5 Outlets ................................... $ 4.00 ........... TOTAL NUMBER(less than 1000 watts) ... ......_.._... $ ,50 --- Each additional outlet ............................................ 1.00 ............. Range........ Cooking Unit..... Oven....._..... ...... ...... .... 2.00 Water System (Installation, Alt. or Repair) ...... ......... 4.00.............. Dryer.... Garb. Disp..... Dishwasher.... 2.00 Water Closet.... Water Heater.... Ld. Tray.......... .......... 4.00.............. SERVICE OR TEMPORARY POWER to ... 2.00 Lavatory.... Shower Pan.... Bathtub.... Sink.................. 3.00......----.... 100 amp/$5.00, 200/$7.00, 500/$9.00 Wash. Mach..... Dishwasher.... Garb. Disp..... .... ......_. . 3.00 ............. 800/$20.00. 1200/$40.00 ............. ._........_..............._ ....... Sewer ................. . . .. .........__......._.......... 8.00. ............. MOTORS,Generators,Welders, Heaters, Lawn Sprinkler Sys. $6.00 Ea. add Sys. $2.00......... ........................... per HP—KW—KVA to 1/$2.00, 5/$3.50, Vacuum Breakers ................. ....... ............. 4.50 .............. 20/$6.50, 50/$10.00, 100/$12.00, Slop Sink........ Floor Sink........ Floor Drain ................ 4.00 ............. 500/$15.00 _. ...................__....... Urinal.... Interceptor.... Water Softener.... ...................... 4.00 I_.......... .....................__..............__...._......_ 4.00 Signs with I XFMR ....................................................... 2,00 .....__....... Plumbing Piping without fixtures ...._....._........- ....._.... ............. Eachadditional XFMR/Time Clock .. ............. ... .50 ................ Misc. ........................................................................................................... Annual Electrical Maintenance . ............. ...25.00 .. .............. Permit Fee ..._........................._..........................................$ 6.00 Other (see Ordinance Current) .................. .............. ............................... TOTAL PLUMBING PERMIT FEE (plus penalty if app. EJ) S ............................................ PERMIT ......... .... .................. .. _.................................. ........... ......I............._ Permit Fee .........................._....................................._... $ 6.00 PERMIT INSTALLATION I NO. EACH I FEE TOTAL ELECTRICAL PERMIT FEE(plus penalty if app.0) $ Forced Air Unit...............to 100M ........................ ......... $ 6.00 ----------- INSPECTION RECORD over 100M ............................. 10.00 ...------------ Comfort Cooling Unit.....to 3 ton/HP................. ........... 6.00 ............... Forms / Foundation.-...........__........._ By:.................. Date:................ to 15 tan/HP................ ........... 9.50 ............... PlumbingGround Work ......................... ........................ ........................... to 30 ton/HP..........................12.00 ............... ughElectrical .................................._._..._._........_._........._........_....... to 50ton/HP.......................... 17.00 ............... �. me - Plumbing and Heating .............................................................. Space Heater........ Wall Heater ................................... ...6.00 ......:........ sulation / Energy................................................................................... Flues - other than above ................................................3.00 ....-.......... GasTest .........._..........._..._.........._.......................................................... Vent Fan: Kitchen........ Bath ............................-............3.00 ............... Temporary Power Gas / Elect............................................................... Commercial Range Hood ............. 6.00 ............... ..................... ......... .. Final - Electrical ........................................................................................ Misc. .........:................................................................... ........................... Final - Building/Mechanical .................................................................. Permit Fee ........................................................................$ 6.00 Final - Design Review / Landscaping .................................................... TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. (]) $ Final — Public Works...........................................................