B0424RS CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO
BUILDING DIVISION
BUILDING PROJECT IDENTIL' ON'
C�}rEy1RMIT No
...r- v4 cu a 1-6
BUILDING ADDRESS: l
J/5 s` / L
SANITARY NO,
APPLICATION SUBMITTAL DA
ER' Np ry1E: FHON[ ? ti
,$ t . �.1)U
CONTRACTOR'S NAME: LIC NO:
NIC
❑
CONTROL p
RCHITECTIENGINEER: / LAIC a
IP+`W,t 5 L rvl yj7Ucf i�
ADDRESS'.
.::. liEiJ
INSPECTIONS . ,3_._„.,;DATE'•
'INSPEC.
❑Consultant Fees Paid by Applicant (Initial)ELUG
-BUILDING PERMIT INFO
ELECT PLUMB MIiCH ..
❑❑� ❑� ❑
FOUNDATION/PIERS/H.D.S.
INSPECTION RECORD
NOTE: ALL GRADING AND DRAINAGE
SHALL BE INSTALLED TO COMPLY WITH
THE APPROVED PLANS AND CITY OF
CUPERTINO STANDARDS.
JOB DESCRIPTION
R CID NTIA'
❑SFDWL ❑ KITCHEN REMODEL
CIADDITION ❑PLUMBING RE -PIPE
❑MULTI -UNIT ❑MODIFI STRUCTURAL
MODIFICATION
❑ INTERIOR ❑CHIMNEY REPAIR
IMPROVEMENT 0 SWIMMING POOLS
WRATH REMODELIRBPAIR ❑DEMOLITION
❑OTHER
LIFER GROUND
PAD/SETBACK-CERT
GARAGE SLABS/PREGUNITE
POUR NO CONCRETE UNTICABOVEiHXS BEEN.SIGN,ED;,
TO ARRANGE INSPECTION
CALL. AFTERNOONS (1:00 PM - 4:30 PM)
777-3228 MONDAY TO FRIDAY 24 HOURS BE-
FORE REQUIRED INSPECTION. JOB ADDRESS
AND PERMIT #ARE NEEDED WHEN PHONING.
ATTENTION CONTRACTORS:
NO PERSON(S) SHALL PERFORM WORK ON
THIS JOB SITE WITHOUT BEING IN COM -
PLIANCE WITH WORKERS' COMPENSATION
INSURANCE REQUIREMENTS.
UNDERGROUND/SLAB
PLUMBING
ELECTRICAL
DO NOT POUR' FLOOR,UNTIL`ABOVE HAS BEEN SIGNED
COMMERCIAL
❑NEWBLDGIADDITION ❑DEMOLITION
❑M1,1ANT L•- DFOODSF.RVICE
PROVMECHANICAL
OTHER
PLUMBING
ELECTRICAL
FRAMING VENTS
INSULATION ZZ'
INSPECTION SPECIAL INSPECTION
REQUIRED ❑
DATE
INSP.
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF SHEATH/DIAPHRAM �G
k PLUMBING �a
TUBS & SHOWER PAN
CHANICAL _?t P�.j
-LECTRICAUPOOL BOND-L?t��}
FRAMING/STAIRS/E. EGRESS L
INSULATION/VENTILATION A i2 QO
1-e WJ'OV 6 /•
✓
COVER NO WORK UNTIL ABOVE HAS BEEN SI N_ED-
EXTERIAL SHEAP/HOLD DOWN -QO S
INTERIOR SHEAR/HOLD DOWN -Irb
/
SHEEI'WROCK/SHEETROCK SHE clop,
EXTERIOR LATH/W-SCREED
SHOWER LATH - -
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED.'
• SCRATCH COAT -2J -JJ A�o
OO
SEWER/WATER ” �z DU '� >
J'TEMP.ORARY'APP ROVALS „'
OCCUPANCY
ELECTRICAL
GAS
FINALSat
GAS TEST
GRADE O O ryL
FIRE
HANDICAP
ELECTRICAL
LUMBING
MECHANICAL
ENERGY
CERTIFICATE OF OCCUPANCY
❑
VISUAL FINAL ONLY
BUILDING
IMPORTANT:.
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION!!
ISSUANCE DATE
'
ISSUED BY:
,OCCUPANCY OF BUILDINGIS,NOT�PERMITTED, �.r
UNTIL BUILDING 'FINAL IS SIG? EDr'BYtRUICDING
INSPECTOR:, - (,,r �' -.I?
muumfMiUVfI UmLYf11mlt•M�PfY�
CARD NEAR FRONT OF BUILDING
CITY OF CUPERTINO
BUILDING DIVISION
BUILDING PROJECT IDENTIFICATION
�, ) PERMI .3
^• �'
BUILDINGADDRESS: ..
SANITARY NO,
APPLICATION SUBMITTAL OA
VNER,S'N ME: L{.I LI L( PHONE : � T., _ ,, � ,CONT
CTOR'S NA E: /. 1 /LIC NO:
NIC
�r ❑
CONTROL p
q27l
RCHITE /ENGINEER LIC NQ / " I
ADDRESS ''
°A'15 _'
INSPECTIONS `' -k � 'DATE INSPECT
r t _% -
�, , r Z.
ElConsultant Feas Paid by Applicant(Initial)
BUILDING PER INFO
BLDG ELECT PLUMB MECH
D ❑' LJ Q-
FOUNDATION/PIERS/H.D.S.
INSPECTION RECORD
NOTE: ALL GRADING AND DRAINAGE
SHALL BE INSTALLED TO COMPLY WITH
THE APPROVED PLANS AND CITY OF
CUPERT[NO STANDARDS.
JOB DESCRIPTION
RESIDENTIAL,
❑SFDWL O KITCHEN REMODEL
❑ADDITION ❑PLUMBING RE -PIPE
CMULTI-UNIT [3 STRUCTURAL
MODIFICATION
❑ INTERIOR ❑CHIMNEY REPAIR
IMPROVEMENT' SWIMMING POOLS
CI BATH REMODEUREPAIR ❑DEMOLITION
❑OTHER .
UFER GROUND—C,
PAD/SETBACK-CERT
GARAGE SLABS/PREGUNITE
'POUR NO CONCRETE UNTICABOVE'HASBEEN SIGNED;,
'
TO ARRANGE INSPECTION
CALL. AFTERNOONS (1:00 PM - 4:30 PM)
777- 3228 MONDAY TO FRIDAY 24 HOURS BE-
FORE REQUIRED INSPECTION. JOB ADDRESS
AND PERMIT N ARE NEEDED WHEN PHONING.
UNDERGROUND/SLAB
PLUMBING
ELECTRICAL
DO NOT POURFLOOR;UNTIL ABOVE!HAS.BEEN:SIONED
COMMERCIAL
❑NEW BLDG/ADDITIoN ❑DEMOLITION
(] E.
IMPROVEMENTIMPROVEMENT[IFOOD SERVICE
COTHER
ATTENTION CONTRACTORS:
NO PERSON(S) SHALL PERFORM WORK ON
THIS JOB SITE WITHOUT BEING IN COM-
PLIANCE WITH WORKERS' COMPENSATION
INSURANCE REQUIREMENTS.
PLUMBING
MECHANICAL.
ELECTRICAL
FRAMING VENTS
INSULATION - 22
INSPECTION SPECIAL INSPECTION REQUIRED ❑
DATE
INSP.
'PLACE NO SUBFLOOR.UNTIL ABOVE HAS BEEN IG ED
ROOF SHEATH/DIAPHRAM - 7.-(6
'
PLUMBING Cy
TUBS & SHOWER PAN S
ECHANICAL __�Z-�•..� o,y
LECTRICAUPOOL BOND
FRAMING/S TAIRS/E. EGRESS ..2. tZ>%?�
n c r
INSULATION/VENTILATION Z -r10
COVER NO WORK UNTIL. ABOVE HASIBEEN'. IGNED i
EWERIAL SHEAR/HOLD DOWN -CM
INTERIOR SHEAR/HOLD DOWN
�a 7
SHEETWROCK/SHEETROCK SHEA
EXTERIOR LATH/W-SCREED Cj
SHOWER LATH -r- :5-oo
., NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED,
SCRATCH COAT '�...20•CC �h 's
SEWERAVATER 9 -.2-C, i
TEMPORARY,APPROVALS ,, Fr
OCCUPANCY
ELECTRICAL%
GAS
LFINALS;FT"I
GAS TEST
O,v
GRADE % la 00
FIRE
HANDICAP
ELECTRICAL
PLUMBING
MECHANICAL
ENERGY
CERTIFICATE OF OCCUPANCY ❑
VISUAL FINAL ONLY
BUILDING
IMPORTANT:
PLEASE READ REVERSE SIDE BEFORE
CALLING FOR FINAL INSPECTION!!
ISSUANCE
ISSUEDBY:
DATE
- ' - -'.
•OCCUPANCY„OF BUILDING
UNTIL,BUILDING FINAI.`IS.SIGN6D BY,BUICDINQ
-INSPECTOR
APPLICANT'S PUSTING UUPY
EE
A
199S)
99U06
siz o. U 55h+ '•` Pasadena Avenue
aA ittl_7�?� t
('u?x:rvno, C mifornia
'j i. ',vhGm t1 ;trSny �;,Z,77CC•171; , . '` .
=I�^•is t;7 ;xmrism that the £ound:ticn layout £or the abovc-. r:•re'renced project complus With
the
�ved pl.3ms and appro':ea bu;.lding >etbacks'.for tlie•project. 1 -
urtttf;r, this is to ccnfirrtI that tie pad el,avations were'estabtished z cdrdinl; to rile ai,i,rc>ved'
F1ant I'r.w the ateve referenced
T_.5. 49,53
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40
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FIRE DEPARTMENT
SANTA CLARA COUNTY
14700 Winchester Blvd., Los Gatos, CA 95032-1818
(408) 378-4010 (phone) • (408) 378-9342 (fax)
CONTROL NUMBER 9370
BLDG PERMIT NUMBER B0424 & B 0426
PLAN REVIEW NUMBER 99-1395
PLAN REVIEW COMMENTS
CODE/SEC.
SHEET
NO.
REOUIREMENT
Review of proposed two new 2874 square foot single family residences with
attached garages. This review covers building permit Vs B0424 & B0426.
UPC
1
Required Fire Flow: Required fire flow for this project is 1,000 GPM at 20 psi
AppAend.
I
residual pressure. The required fire flow is available from area water mains and
fire hydrant(s) which are spaced at the required spacing.
2
Lot split to be properly recorded to the satisfaction of the City of Cupertino
Planning and Building departments.
Approved for building permit issue subject to compliance with the above noted
'
comment.
DISTRICT PLANS SPECS NEW RMDL AS
OCCUPANCY
CONST. TYPE
PERMITTEE
DATE
PAGE
CUP ® ❑ N ❑ ❑
R -3/U-1
V -N
Thomas Liu & Associates
6/7/99
1 1
OF
SECJFLOOR
AREA
LOAD
DESCRIPTION
BY
1&2
2874 SQ FT
Residential Construction
Hokanson, Wayne
NAME OF PROJECT
LOCATION '
SFR
10155 Pasadena Av
A California Fire Protection District serving Santa Clara County and the communities of
Campbell, Cupertino, Los Altos, Los Altos Hills, Los Gatos, Monte Sereno, Morgan Hill, and Saratoga
Community Development Department - Building
City of Cupertino
10300 Tone Ave
Cupertino, CA 95014-3255
Subject: Single Family Dwelling
Name: Sui Hwu
Address: 10155 Pasadena Avenue
APN: 357-17-047
Control/Plan Ck. No: 9370 Permit No: 80424
Gentlemen:
The Cupertino Sanitary District has reviewed the plans for the subject project:
Sanitary sewer is available and the existing building is connected to the
• sanitary sewer, see conditions/requirements listed below.
The following Conditions/Requirements are made:
1. Cupertino Sanitary District Fees or Permits are required for the subject
improvements, please do not issue any building/grading permits.
2. Locate and raise to grade a property line cleanout (verify serviceability
if existing.)
3. Install a backflow protective device (verify serviceability if existing.)
4. Sanitary sewer lateral to be extended to new property line by a District
permit.
Storm water from surface or roof drains, other general surface runoff water or
condensate from any residential HVAC equipment shall not be discharged to
the sanitary sewer.
Yours very truly,
MARK THOMAS & CO. INC.
District Manager -Engineer
by Carl H. Beckham
• CHB:Iw
cc: Versatile Construction Company.
Hermie Bacus - City of Cupertino, Public Works Dept.
SUPPLYING SANITARY SEWERAGE SERVICES FOR:
CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE AND LOS ALTOS
AND SURROUNDING UNINCORPORATED AREAS
CUPERTINO SANITARY DISTRICT
SANTA CLARA COUNTY
DISTRICT MANAGER -ENGINEER 20085 STEVENS CREEK BOULEVARD, BLDG. C BOARD OF DIRECTORS
MARK THOMAS d CO.
CUPERTINO, CA 95014-2950 CURTIS B. HARRISON. FRES.
IN
DISTRICT COUNSEL
53-7071 • FAX (408) 253-5173 RICHARD A. FELLOWS, SECTv.
I
1 r' I'^ DR. JOSEPH F. BROWN
PHILIP D. ASSAF OF
LS �% L� GARY G. STOKES
D
I WEN DELL H. KERR, JR.
STURGIS. NESS, BRUNSEL
ASSAF
JUN 10 1999
June 8, 1999
File: CuSD -MOP
Building Department - Cupertino
Community Development Department - Building
City of Cupertino
10300 Tone Ave
Cupertino, CA 95014-3255
Subject: Single Family Dwelling
Name: Sui Hwu
Address: 10155 Pasadena Avenue
APN: 357-17-047
Control/Plan Ck. No: 9370 Permit No: 80424
Gentlemen:
The Cupertino Sanitary District has reviewed the plans for the subject project:
Sanitary sewer is available and the existing building is connected to the
• sanitary sewer, see conditions/requirements listed below.
The following Conditions/Requirements are made:
1. Cupertino Sanitary District Fees or Permits are required for the subject
improvements, please do not issue any building/grading permits.
2. Locate and raise to grade a property line cleanout (verify serviceability
if existing.)
3. Install a backflow protective device (verify serviceability if existing.)
4. Sanitary sewer lateral to be extended to new property line by a District
permit.
Storm water from surface or roof drains, other general surface runoff water or
condensate from any residential HVAC equipment shall not be discharged to
the sanitary sewer.
Yours very truly,
MARK THOMAS & CO. INC.
District Manager -Engineer
by Carl H. Beckham
• CHB:Iw
cc: Versatile Construction Company.
Hermie Bacus - City of Cupertino, Public Works Dept.
SUPPLYING SANITARY SEWERAGE SERVICES FOR:
CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE AND LOS ALTOS
AND SURROUNDING UNINCORPORATED AREAS
Rli
------ --- ---- -------
C) t S I AP
UTA AM-) P T.
93,70
Ciddy wordeli
7/19/99
you tbl. Yc Lir rcSl�
un�
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I k \-P Ai &ICKA
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I L99,4 1
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R,, -L tro Tc— i
n
LJ
JUN -29-00 03:29 PM HARTLETT.TREE.ExPERTS 40S 350 9779 P.02
)ARS' � � 7''X'
':EE E 'I;RI'S
Los Ga.
l "Itos, (',%
June 29, 2000
Nathan Claus
versatile Construction
i 10 S. Mathilda Avenue, Suite #4
Sunnyvale, Ca 94086
Fax Number: 408-737-0970
-7888
Re:
Re: :Privacy Protection Planting on new home construction at 21731 and
21741 Lomita Avenue, Cupertino, California
Dear Nathan,
I inspected 21731 and 21741 Lomita Avenue to determine if pr ivacy protection
planting requirements were met, These new homes are next door to each
other,
21731 Lomita Avenue has five Glossy Privet L/gustrum licidurn planted along the
rear fence at the north end of the property, Aleppo Pine, Pinus alepensrs are
planted on the east side of 21741 Lomita Avenue and serve as adequate
Screening for the west side of 21731 Lomita Avenue,
Ni trees are planted on (10) feet centers, are non -deciduous, and in compliance.
in addition, existing Coast Redwood Sequoia, sempervirens and California Pepper,
Schinus molle meet compliance standards on the east side of 21731 Lomita
Avenue.
21741 Lomita Avenue has (5) Glossy Privet, Liqustrum licidurn along the rear,
fence at the north end of the property, (4) Glossy Privet on the west side and (7)
Aleppo Pine on the east side. These trees are planted on (10) foot centers,. are
non -deciduous and in compliance with the privacy protection ordinance.
Tnank you,
Bob Kelly
CertifiedArbonst #WC528
ti
' oilm Tree I 11.0. I1o.\ 3067—Stanford, Counccticul 06901 l %
l isit our wehsrie at wwwbarticuxnm
APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
r,vv nc rnucuTtnln BUILDING - ELECpRICAL
BUILDING DIVISION APPLICATION/PERMIT
!/ SS A'7 006?n q /tdd-.
CSI iv
nallurxnnasnluaaaf
,INTACT': ^ n' ry , O
5 w1 N 1 It ' Clgt,s 7 37_0y
LICENSED C( N'1 ACTOR'S DECLARATION
I hereby action Iia I in. licensed under pow,,iom of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Cod, and my license is
in full force and effect.
License Class Lic.N
Darn Contractor
ARCHITECTS DECLARATION
1 understand my plans shall be used as public records
V OWNER -BUILDER DECLARATION
UI hereby anion Thal I am exempt from the Commetor's License Law for the
following reason. (Section 7031.5, Bosuns, and Professions Cole: Any city or campy
ywhich requires a Permit to construct, aper, improve, demolish, or repair any structure
prior to its issuance, alxa requircx the appicam lin such percent to file a sign ed statement
tKid he 1, licensed pursmwt N, Ov pnrvlsiom of the Contractor's Liccme Law Wer,m, 9
(co mnercing with Seelioo 700(8 ofDivision 3 of the Bnsineo and Profession, Code) or
That he is excmpl therefrom and the basis for the alleged exemption. Any violoion of
a Section 703 l 5 by any applicant for a permit subjects the applicant to a civil penalty of
ynot more than five hundred dal to,, ($500),
C❑ I, as owner of the propeny, or my employees with wages as their sole con,pensmion,
e will do the work, and the structure is not intended or offered for sale (Sm. 7044, Business
W
and Professions C(Ne: The Conamtod License Law does not apply to an owner of
property who builds or improves thereon, and who does such work himself or through
his own employees, provided that such impmvenwas are not intended or uttered for
sale. IL however, the building or itnpro eno,in ix sold wi tin nuc year ofccon,leior, the
owner-Nilder will have the burden of proving that he did not build or improve for pur-
pose of sal,}
1, as owner of the property, am exclusively contracting with licensed contractors m
instruct the project (Sec. 7044. Bu.siono and Protections Cade:) The Cotmmclor's Li-
m Law does not apply to an owner of pmpeny who builds or improves thereon, and QTY.
who contracts for such projects with a com acum,) licensed pursuant to the Contractors
License Law.
1 am exempt under Sec. . B & P C for this mason
Owner Dole
WORKERS COMPENSATION DECLARATION
1 hereby affirm under Penalty of perjury acre of the following declarations:
�anave and will numuin a Certi ficam of Consent o self -insure for Worker's Compen-
its provided far by Section 3710 of the Luhor Code, for the perfornnmce of the
10, A for which this permit is issued.
Fl I have and will maintain Workers Compensation Insurance, as required by Section
37M of the labor Code, for the Iterforciance of die work for which this permit is issued.
My Workers Compensation Insurance carrier and Policy number me:
Canner. Policy No.:
CERI'11-ICATE OI' EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section acrid not becompleted if the Permit is for one hundteddollars (8100)
or less.)
I ecnify that In the perlimnunec of the work lorwhich this permit is Issued., shall
nal employ any person in any manner xo as m her re subject o the Worker.: Compen-
O Z sodium lawsyfCullfnmia. Doc
Z Q NOTICnfX� /%
r_ become! O APPIJe W..l IL a dor making This Cen m, of the
Exemption, you should
baennm subject va the Wnrh po Campensm is Pnwn shat of dde Labor Calc, you most
�
forthwith emnply with such pmvi.anns or his permit shall be Jamul revoked.
6.Q CONSTRUCT ION LENDING AGENCY
I hereby affine flo, them is u construction lending agency he performance of
W'f--I the work for which Ibis permit is miced(Sec. YAP. Civ. C.)
O }U-� lender's Name
lender's Address
I ecnify that 1 have read this application and cute that the above information is
hcorrect. I agree to comply with all city and county ordinances and state lawn relating to QTY,
V Z building construe,ion. and M1ereby uinhon,ereprescmativesol this city in com, upon the
above mentioned property for inspcc,ion purposes.
(We) agree to save, indemnify and keep harmless the City of Cupcnino against
lishili i les, judgments, costs and expenses which may in any way accrue agaimt said City
in m,tocace of the branting of do, hermit.
APPLICANT UNDERSTANDS A D WILT, COrrr,,,nnnyyynnnrrrffp ITH ALL N9N-POINT
SOURCE REG It /
HAZARDOUS MATERIALS DISCLOSURE
Will the applies., or fuwre building occupant nom or handle haurdme, material
us dcO.ed by he Cupertino Municipal Cade. Chapter 9.12, ..it the Health and Safety
Cedc. Swim 25532(x)'!
❑Yes F-1 No
Will the applicant or future building avcupant use equipment or devices which
coni, huurdous air conmminants as defined by the Bay Arca Air Quality Management
'trio°
[:1 Yr, 0 N
I have mad ,he foramens materials no cimmenu under Chapter 6j95 of the Cali
forma Health & Safety Code, Sections 25505, 25533 and 25534. 1 understand that if ,he
huilding does aid correctly have a¢nuyyd�W� nary respnn' na dy lbs)ecupotn
of lie ,.u�ra Ixvalbx hrfiit vre imuan "dw.te"LI), aureC
,cl
PLUMBING PERMIT I FEE
PERMIT ISSUANCE
ALI ER - DRAIN & VIiNT - WATER (EA)
BACK FLOW PROTECT. DEVICE
DRAINS - FLOOR, ROOF, AREA, COND.
FIXTURES - PER TRAP
GAS - FA. SYSTEM I INC. 4 OUTLETS
GAS - EA. SYSTEM -OVER 4 (FA)
GREASMNDUSTRL WASTE INTERCEPTOR
GREASETRAP
SEWER - SANITARY - STORM EA. 200 FT.
WATER HEATER WNENT/F.LECTR
WATER SYSTEM/TREATING
WATER SERVICE
NEW RESIDENTIAL PLMB. SQ. FT.
MECHANICAL PERMIT
PERMIT ISSUANCE
ALTER OR ADD *E METH,
AI R HANDLING ON IT (TO I0,(NN CPM)
AIR HANDLING UNIT (OVER 10.000 CFM)
EXHA UST FOOD(W/DUCT)
HEATING UNIT (TO TOB," BTU)
HEATING UNIT (OVER 100,001 BTU)
VENTILATION PAN (SINGLE RESID)
BOILER - COMP (3HP OR 100.000 BTU)
BOILER-COMP(OVER 100,00)li'1'U)
AIR CONDITIONER
NEWRESIDENHALMECH. SQ. ET.
OFFICE
TOTAL:
#,j-000 r —
BUILDING DIVISION FEES
PLANCHECK FEE G
ENERGY PER
GRADING FEE
SOILS FEE
FEE
fd:TRIC FEE
MECHANICAL PEE
CONSTRUCTION TAX
HOUSING MITIGATION FET?
PAID
Dam Receipt#
Cl Q' _ 'P/P
BUILDING PERMIT
INFO
Consultant FecS Paid by Applicant
(Initial)
BLDG / ELECT
PLUMB MECH
I
LJ EE
❑ ❑
ELECTRIC PERMIT
FEE
JOB DESCRIPTION
RESIDENTIAL
PERMIT ISSUANCE
❑SFDWL
[]ADDITION
❑MULTI -UNIT
❑ KITCHEN REMODEL
11 PLUMBING RE -PIPE
❑STRUCTURAL
APPLIANCES - RESIDENTIAL
PANEIti
MODIFICATION
UP1'0200AMPS
❑INTERIOR
IMPROVEMENT
❑ BATH REMODEL,REPAIR
❑OTHER
El CHIMNEY REPAIR
0SWIMMING POOLS
[I DEMOLITION
201-I0NIAMPS
OVER 1001AMPS
SIGNS ELECTRICAL
_
SPECIAL CIRCUI*UMISC.
TEMP. METER OR POLE INST.
COMMERCIAL- '
❑NEWBLDG/ADDITION
❑DEMOLITION
POWER DEVICES
❑TENANT
IMPROVEMENT
❑ FOOD SERVICE
SWIMMING POOL ELECTRIC
OTHER
OUTLETS - SWI I CHES - FIXTUR
calf
J;I
NEW RESIDENTIAL ELECfR
SQ fT.
O. IT FLOOR AREA
SISO, FI'.
PLUMBING PERMIT I FEE
PERMIT ISSUANCE
ALI ER - DRAIN & VIiNT - WATER (EA)
BACK FLOW PROTECT. DEVICE
DRAINS - FLOOR, ROOF, AREA, COND.
FIXTURES - PER TRAP
GAS - FA. SYSTEM I INC. 4 OUTLETS
GAS - EA. SYSTEM -OVER 4 (FA)
GREASMNDUSTRL WASTE INTERCEPTOR
GREASETRAP
SEWER - SANITARY - STORM EA. 200 FT.
WATER HEATER WNENT/F.LECTR
WATER SYSTEM/TREATING
WATER SERVICE
NEW RESIDENTIAL PLMB. SQ. FT.
MECHANICAL PERMIT
PERMIT ISSUANCE
ALTER OR ADD *E METH,
AI R HANDLING ON IT (TO I0,(NN CPM)
AIR HANDLING UNIT (OVER 10.000 CFM)
EXHA UST FOOD(W/DUCT)
HEATING UNIT (TO TOB," BTU)
HEATING UNIT (OVER 100,001 BTU)
VENTILATION PAN (SINGLE RESID)
BOILER - COMP (3HP OR 100.000 BTU)
BOILER-COMP(OVER 100,00)li'1'U)
AIR CONDITIONER
NEWRESIDENHALMECH. SQ. ET.
OFFICE
TOTAL:
#,j-000 r —
BUILDING DIVISION FEES
PLANCHECK FEE G
ENERGY PER
GRADING FEE
SOILS FEE
FEE
fd:TRIC FEE
MECHANICAL PEE
CONSTRUCTION TAX
HOUSING MITIGATION FET?
PAID
Dam Receipt#
Cl Q' _ 'P/P