Loading...
1640 PERMIT NUMBER FOR APPLICANT TO FILL IN STREET ADDRESS OF PROJECT: 2..0.l.3.S....S + Ks.C.r..«k..QQ��D....................................... ............ Plans Received By....................................................Date ......................... Legal Description: Tract........................ glcick............ Lot...................... REQ.: Plans.... Survey.... Calcs: Struc..... Energy.... Elect..... Mach.... Description of Work:'MrxeQOR ..A2 .LC..We.............................. Plans Checked By............................. .. Date ................. Tat Struct. Improvement on Parcel:Yed.... No.... Area of Bldg............... Application Approved By............... ...�-e.-.-.....Date /.�-..:±-.�0.... Separate Structure............ or Addition/Alteration to Exis . Bldg........... Validated B Date .....�� g ................. .. ,�y By.................................. ............. .. Se r Stories...ure....... Use of ditio n .f7� �........: f,1+'G'+fr Compensation Certificate Verified By....................Date .�. ..... .T.... Valuatio Pro' ct• $............ -..107V................... I.2...' . .1 5 r 5`..... s •• . S �O-d O-o Owner: N... ..,.. ...�.��.................................... Phone• .�i:Z7... Permit Fee (plus penalty if applicable) Contractor: ..SQLF....................... City Bus.Lic.+r. ..q. .I.:JZ1� 015- Permit pP ) ........................ ,... f..... ............... Phone:..........-. Plan Check Fee (less deposit of$.......... Rct. #..........)$....................... Address: . :'�!.. . .................... ........ Energy Plan Check Fee (Dep. of $........ Rct. #........)$................ Contractor - Electrical: ............................................. ............................ Strong Motion Fee ..........................................................$.........s- Plumbin Business License �'.................... Phone:.................... Plumbing Permit Fee $......... .......... 9Busi..............-......................................... e:.................... ............................................... City Business License e...-................ Phone:.................... Electrical Permit Fee.•.......... :........::...............................$..L.`. O.C.. Heating and Cooling Mach. Hig./Coolg. Permit $ ..............................$....................... City Business License a.................... Phone:.................... Construction Tax.............................................$....................... Architect/Designer: .................................................. Phone:......-. .............................................. ............ Sewer Conn. Fee .......... Water Conn. Fee ..............$....................... Engineer: - Phone:.....-............ g .................................................................... Unknown Misc. Fee ........... Street Tree Fee ...-........'$............... Lender: .................. S.I.G.N. la o ..........h-.......rmit..s Landscape Fee ... :. $ � ,-- _ "I certify that in the performance of the work for which this permit le IIIIIIIIIIIIIIIIIIIII[roUffiff RX337T. - $ Issued I shall not y arson In any manner so as to become subject to the workman' at News of California." Type Const.:...:... Group........ Div......... Occ. Load........ No. Exits........ SIGNATURE OF tl p p Floor Loads: 1St.... 2nd.... Other.... Sprinklered.... Area Sep. Walls.... APPLICANT/OWNER ...... .......................................................... S ZONING • ......-..... certify that a the applicant I em licensed under the provisions of the i..,. Contractors L ansa Lew end lunher that my License No. ............................ Environmental Status: Exempt....--...... Other............... In Classification ........................................ Is in full force and effect: or Desitin Review Approval: Bldg. . Site Sign I certify that I en exempt from the le of exemption.,Req. ed" provisions oft e """"" """""" """"" Contractors a trate Law. (Stere basis li exemption., Use Zone ............ P.D. Conditions ............................................................ . I hereby acknowledge that I have read This application and state that the above is Cond. Use Permit e...... Variance #...--. Parking Spaces.... Load.Sp..... correct and agree to comply with all City Ordinances end State Laws regulating rovedBy............._----.----.----.....-.-"----..........---.--. Date ..-.-...................... building. I (We) agree to save, indemnity and keep harmless'the City of Cupertino e• • agairst liabilities, judgments,costs and expenses which may in any way i - acture against said City In consequence of the granting of this permit. roechment Permit:....................... Grant of Easement......--.----........... SIGNATURE of rb, Gutter, Sidewalk,.Driveway: Replace Repair APPLICANT/CONTRACTOR........................................................ DATE ......................... Sewer..........-- Conn. Fee$................ Water................ Meter$................ NOTE: When properly validated this loan constitutes a Building Permit. This Agreement for Completion of Public Works Improvements .................. permit expires and becomes null and void should work col be commanged within Plans Checked By........ Date........ Approved By........ Date.................... 120 days tram validation dab, or Mould authorized construction be suspended or i abandoned for a period of 120 delta after work Is commenced. APPLICATION FOR ELECTRICAL PERMIT - APPLICATION •• PLUMBING PERMIT ' PERMIT INSTALLATION NO. EACH FEE Light Outlets............Switches.---........ 'PERMIT INSTALLATION NO.I EACH I FEE Fixtures............ Receptacles............ Gas Sytem with up to 5 outlets ................................... $4.00 ... TOTAL NUMBER(less than 1000 watts)................. ... $ ,5o 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/$gss nnnn.. 500/$9.00 a Wash. Mach..... Dishwasher.... Garb. Disp..... .............. 3.00 ............. 800/Uu.* 2�. ,...... ... /D... r... ......... 8.00. ........ ........................... Sewer ...................-........................................-........ MOTORS,Generators,Welders, Heaters, Lawn Sprinkler Sys. $6.00 Ea. add Sys. $2.011................................... per HP-KW-.KVA to 1/$2.00, 5/$3.50. Vacuum Breakers ........................................... ............. 4.50 ............. 20/$6.50, 60/$10.00, 100/$12.00, Slop Sink........ Floor Sink........ Floor Drain ................ 4.00 ............. 500/$15.00 ........................................................... ............................... Urinal.... Interceptor.... Water Softener.... .........:-......-.... 4.00 ............. Signs with I XFMR ..:................................... ................ 2.00 ................ Plumbing Piping without fixtures ...................-..�..........-. 4.00 ............. Each additional XFMR/Time Clock .. ................ .5o ................ Misc. ............................................................--..-.......-.-..... ............. Annual Electrical Maintenance .................25.00 ................ Permit Fee ..........................................................................$ 6.00 Other (see OrdLnance.C,urrent) ................................................ .............. TOTAL PLUMBING PERMIT FEE (plus penalty If app. p) S .............. APPLICATIONFOR HEATING/COOLING Permit Fee ......................._............................................... $ 6'00 r PERMIT INSTALLATION NO. EACH FEE TOTAL ELECTRICAL PERMIT FEE(plus penalty if app.p) $ 1#0 Forced Air Unit...............to 10OM ...............--................ $ 6.00 ............... • . •• r over 100M .................... ........ 10.00 .............. �• Comfort Cooling Unit.....to 3 ton/HP............................ 6.00 .............. Forms / Foundation............................... By:-................. Date:------.......... to 15 fon/HP........................... 9.50 ............... tubing Ground Work ............................................................................ to 30 ton/HP..........................12.00 ............... gh Electrical ................................................ ........ ..................... ........... to 50 ton/HP.......................... 17.00 ............... Gane - Plumbing and Heating ..................................:...............:............ Space Heater........ Wall Heater .....................................6.00 ............... u lotion /Energy............................... ................................................... Flues - other than above .................................... ............3.00 ............... aTest .................................................................................................... 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...........................................................