Loading...
1846PERMIT INSTALLATION NO. EACH FEE Light Outlets............ Switches............ JAN Fixtures............ Receptacles............ TOTAL NUMBER (less than 1000 watts) .................... $ .50 ........... Plans Received By ........ _ .......................................... Date ......................... REO.: Plans.... Survey.... Calcs: Struc..... Energy.... Elect..... Mach..... PlansChecked By __ ............................................... Date ......................... Application Approved By ......................................... Date ......................... ValidatedBy.............................................................. Date ......................... Compensation Certificate Verified By .................... Date ......................... $2,000 Permit Fee (plus penalty if applicable) ........................ $........ . Plan Check Fee (less deposit of $.......... Rct. #..........) $....................... Energy Plan Check Fee (Dep. of $........ Rct. #........) ....... ..... $............ �...... Strong Motion Fee .......................................................... $........• Plumbing Permit Fee................................................$....................... ElectricalPermit Fee ...............................----.................. $....................... Mach. Htg./Coolg. Permit $ .............................. $ ................. Construction Tax.............................................$....................... Sewer Conn. Fee .............: Water Conn. Fee .............. $ ................. Landscape Fee .................... Street Tree Fee ............ $ ..... Misc. Fee .......................................................... $.....�,..Q (%....... onsomorre $ 39.50 Type Const......... Group........ Div......... Occ. Load........ No. Exits........ Floor Loads: 1st.... 2nd.... Other.... Sprinklered.... Area Sep. Walls.... ZONING REQUIREMENTS Environmental Status: Exempt ............ Other ........................................ • Design Review Approval: Bldg ............. Site ............ Sign ............ Use Zone ............ P.D. Conditions............................................................ Cond. Use Permit #...... Variance #...... Parking Spaces.... Load. Sp...:. -. Approved By ........................................................... Date ........................... i roachment Permit ........................ Grant of Easement........................ rb, 'Gutter, Sidewalk,. Driveway: Replace Repair Sewer............ Conn. Fee $................ Water................ Meter $ ................ Agreement for Completion of Public Works Improvements .................. Plans Checked By........ Date........ Approved By........ Date .................... PERMIT INSTALLATION NO. EACH FEE Light Outlets............ Switches............ Fixtures............ Receptacles............ TOTAL NUMBER (less than 1000 watts) .................... $ .50 ........... Range........ Cooking Unit........ Oven ........... ................. 2.00 .......... Dryer.... Garb. Disp----- Dishwasher.... ...... ............... .... 2.00 ........... SERVICE OR TEMPORARY POWER to ... 2.00 . . 100 amp/$5.00, 200/$7.00.-500/$8.00 800/$20.00, 1200/$40.00............................................................ MOTORS, Generators, Welders, Heaters, per HP-KW-KVA to 1/$2.00, 5/$3.50, 20/$8.50, 50/$10.00, 100/$12.00, 500/$15.00 ............................................. . ... _ ........ ................ .......... Signs with 1 XFMR...................................... ............. ... 2.00 ........... Each additional XFMR/Time Clock .. .........__ ... .50 .......... Annual Electrical Maintenance ................25.00........... Other (see Ordinance Current) PermitFee........................................................................ $ 8.00 TOTAL ELECTRICAL PERMIT FEE (plus penalty if app. ❑) S Forme / Foundation .............................. Plumbing Ground Work ....................... sough Electrical ................................... me - Plumbing and Heating ......... I atlon / Energy .............................. esTeat ............................................... Temporary Power Gas / Elect.......... Final - Electrical ................................... Final - Building / Mechanical ............. Final - Design Review / Landscaping Final - Public Warks ................... M PERMIT NUMBER FOR APPLICANT TO FILL IN GSfiSET ADDRESS OF PROJECT: Portal,_. Ave....., &$t.even.S....G.e.ek....Rd................... Legal Description: Tract......, ................ Block........... Lot........,............ Description of work: Revs. --- to...rooX....Sp.X']J kLe flat Struct. Improvement on Parcel: Yes.... No.... Area of Bldg ............... Separate Structure............ or Addition/Alteration to Exist. Bldg........... No. of Stories ................ Use of Building .... _............................................ Valuation of Project:$..2.,.0.0.0............................................................. Owner: Terra.;.Nomics................................. Phone: ...... -.-........ Contractor: Or.vin... E CJ........... City Bus. Lic. #........... Address:...32.7.1...Ri er.,.S...C.................... Phone722:-219 Contractor - Electrical: .............................................................................. City Business License #.................... Phone:.................... Plumbing: ...................................................................................... City Business License #.................... Phone:.................... Heatingand Cooling.........................................:........................ City Business License #.................... Phone:.................... Architect/Designer:.............................._.................. Phone:.................... Engineer: .................................................................... Phone:................. Unknown Lender: ....................................................................................❑. ....... XX.... "I certify that In the performs of the work for which this permit is. issued I shall not employ any n In any manner so an to become subject to the workman' a Ballo we of Calif rnia." SIGNATURE OF •t APPLICANT NE ...... ....................... DATE ..�q3,,.qL1 8_l }til.... certiy at s the split a I am licensed under the p lV LS Bte ont ons License rthat that my License No... V 7S.1 eaaillcation ..............-... ................... is In full force end effect: or ............ I certify that I am exempt from the "Licensed pact. -ad" provisions of Ute Contractors License Law. (State basis of exemption., I hereby acknowledge that I have read this application and elate that the above is correct and agree to comply with all City Ordinances and State Laws regulating building. I (We) agree to save, indemnify and keep armless the City of Cupertino against Ilabililiea, judgme s, costa a expenses which may In any way occurs against said City ae a of the gr ling of this permit. SIGNATURE OF APPLICANT/CO CT ....:_... . .... ....._... DATElz2 a.]._ NOTE: Wh props v idat•d Ihls rm risk a Building permit Tides permit expl • en acts a null en void cold work not be citsim maned atadn 120 days Idation data, or should authorized cemssuclbn be suepand•d as abandoned for a period of 120 days dt•r work 1• commenced. APPLICATIONe• PLUMBING PERMIT PERMIT INSTALLATION NO. EACH FEE Gas Sytem with up to 5 outlets .......................... ..........$ 4.00 ............. Each additional outlet ............................................ 1.00 ............. Water System (Installation, Alt. or Repair) ................ 4.00 .......••.... Water Closet.... Water Heater..- Ld. Tray .................... 4.00 ............. Lavatory.... Shower Pan.... Bathtub.... Sink .................. 3.00 ............. Wash. Mach..... Dishwasher.... Garb. Disp................... 3.00 ............. Sewer.............................................................................. 8.00.............. Lawn Sprinkler Sys. $8.00 Ea. add Sys. $2.00 ......... ........................... Vacuum Breakers . ................ :............... ........... .......... ... 4.50 .......... Slop Sink........ Floor Sink........ Floor Drain .... ............ 4.00 ............ Urinal.... Interceptor.... Water Softener... . .......... ......... ... 4.00 .......... Plumbing Piping withou! fixtures......................1............ 4,00 Misc........................................................................................................... PermitFee..........................................................................$ 8.00 TOTAL PLUMBING PERMIT FEE (plus penalty if app. ❑) S APPLICATION••HEATING/COOLING PERMIT INSTALLATION NO. EACH FEE - Forced Air Unit ............... to 100M ................................. $ 8.00 ............... over 100M ............................ 10.00 .............. Comfort Cooling Unit..... to 3 ton/HP........................... 8.00 .............. to 15 ton/HP ........................... 9.50 ............... to 30 ton/HP .......................... 12.00 ............... to 50 ton/HP .......................... 17.00 ............... Space Heater........ Well Heater ...................................... 8.00 ............... Flues - other than above ................................................ 3.00 ............... Vent Fan: Kitchen........ Bath .................................... ...... 3.00 ............... Commercial Range Hood ..8.00 ............... Misc............ ......... ............................ ...................._.......... ............ ............... PermitFee........................................................................ $ 8.00 TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. ❑) $