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1876 CITY OF �UPERTIN. .O APPLI TION FOR . • MMER -IAL BUILUIN PERMI / PERMIT NUMBERFOR APPLICANT TO FILL IN AND EERTI)rF,ICA E OF OCCUPANCY BUILQINQ INSPECT QN IV1810N STREET ADDRESS OF PROJECT: STEVENS CREEK BUILDING C ''OAKS SHOPPING CT." .............................. _..... ......_....__....._......_......................._....................... Plans Received By.._.................................... Date ...............:........ Legal Description: TraG{, g7�k............ Lot...................... REO.: Plans.... Survey.... Calcs: Struc..... Energy.... Elect..... Mach..... Description of Work: ?"LING-WC)K1C. ...............„_.......__..__......,,,- .................. ..... . Plans Checked By..................:............ ..........Date .... ..:. ...: 1st Struct. Improvement on Parcel:Yes.... No.... Area of Bldg............... Application Approved By.............._.�.<.......:.......... Date .._ /.... Separate Structure........... or Addition/Alteration to Exist Bldg......... Validated B --.Date ............. ..._ ... No. of Stories................ Use of Building r �OOKIE U ." Compensation Certificate Verified By Date ......................... Valuation of Project: $................................................................................ • • • • • $ Owner: ..................... _........_.........._......................... Phone:.................... Contractor: Permit Fee (Plus penalty if applicable) .......... . ........ ..$............_ ........... ............ ........ City Bus.Lic. #.................... _......... Address: ...__....._ . . .. Phone:.................... Plan Check Fee (less deposit of$......_.. Rct. #... $.._................... . . ._. ..........._....._.. ............_....... Energy Plan Check Fee (�. of $........ Rct. #........) $..........._.......... Contractor - Electrical: .............................................................................. Stroll Motion Fee :.............. $...._ ..,.,.. City B i es # hone:.................... Strong ................................. . ........ �Y..���Pt� SONS.....'IN Plumbing: ... ............................... t. Plumbing Permit Fee ....-.:... .o-'C Dit`.........."..................$.. .. .r.. ........ City Business License #....0154..pnone 73.6'=49.3 Electrical Permit Fee ... .. $.............. . ..... Mach. Hig./Coolg. Permi G.... .. Heating and Coaling ................................ . ............_................_ �..........P�r..............$....................... City Business License #...."-"............. Phone:.......----......... Construction Tax........... ...fl........•.%.t $....................... • / -Architect/Designer: .................................................. Phone:.................... Sewer Conn. Fee ......._.. Water CC�n. F*... .................._... Engineer: Phone:........ ......... 9 i Landscape Fee ....._........9 treat �,Fee ........._.$...:..............._.. Lender: •� Unknown Mise. Fee .............................!h_......-_.............-.........$.................-.-... ............ "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." Type Const......... Group........ Div......... Occ. Load........ No. Exits........ SIGNATURE.OF Floor Loads: 1st.... 2nd.... Other.... Sprinklered.... Area Sep. Walls.... APPLICANT/OWNER .___........................................................... DATE ............................ I certify that as the applicant I am licensed under the prRY511,22f the Contractors License Law and further that my License No. ..._........................ Environmental Status: Exempt ......_.... Other........................................ In Classification .......C36... ... ...... Is in full force and effect: or Design Review Approval: Bldg. "'""-""- --"" Site Sign ............ i certify that I em exempt from the "Licensed Req.'•ad" provisions of the """"""'-""' """'""" Contractors License Law. (State basis of exemption., ;Use Zone ............ P.D. Conditions ......................................... ............... I hereby acknowledge that I have read this application and state that the above Is Cond. Use Permit #.-.... Variance #...... Parking Spaces.... o d. S ..... correct and 'Agree to comply with all City ordinances and Stele Laws regulating ApprovedBy.................................................._......- Date ....__. . .... ....... building. _ I (We) agree to save, indemnity and keep harmless the City of Cupertino • • agairst liabilities, lud me nts, o is and expenses which may In any way occurs against saitl Cily In c s quanta of the granting of this permit. ncroachment Permit........................ Grant of Easement.. .. ............. SIGNATURE OF Y(7 Curb, Gutter, Sidewalk,. Driveway: Replace R air 11` / APPLICANT) 4S7?.L... .�tY 55;e..IWT .....[z-4-8.}... Sewer............ Conn. Fee $................ Water................ er $.......... .. NOTE: When properly validated this form constitutes a Building Ferrell. This Agreement for Completion of Public Works Impr ve a is .... .... permit expires and becomes null and void should work not be commenced wlthinM Plans Checked By...... Date........ Appro d By... . ate.................. 110 days from validation date, or should authorized construction be suspaed 11,11. abandoned for a period of 110 days after work Is commented. APPLICATIONFORMI ELECTRICAL PIE"IMIT PERMIT INSTALLATION NO. EACH E APPLICATION Light Outlets............ Switches............ PERMIT INSTALLATION NO. EACH FEE Fixtures............ Receptacles_.......... Gas Sytem with up to 5 outlets .............._.........."'A. ....$4.00 - TOTAL NUMBER(less than 1000 watts),.. ....... ..... $ .50 Each additional outlet ...................................... 1.00 Range........ Cooking Unit........ Oven........... ............. _.. .00 .............. Water System (Installation, Alt or Repair) .....-...f .. 4.00, 4:00 Dryer.... Garb. Disp..... Dishwasher.... ......................... ............... Water Closet.... Water Heater..' Ld. Tray...... .. 1 4.00. 4:00 z 0 '. 3" 9':00" SERVICE OR TEMPORARY POWER to . ................. .............. Lavatory..Q 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/$8.50, 50/$10.00, 100/$12.00, Slop Sink........ Floor Sink........ Floor Drain 1....:a...1-...4.00 .. 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 .. ............. ... .50 ......__...... Misc. ........................._...... .................................... .. ......................g.....p...... Annual Electrical Maintenance . ................25.00 .. .............. Permit Fee .......................-------------.............................. ........531.OUO Other (see Ordinance Current) .._.............. .............._......._.... .............. TOTAL PLUMBING PERMIT FEE (plus penalty If app. E) $ ............. APPLICATION • . ss HEATING/C LING PERMIT .......................................................................... ............. ................. ............... Permit Fee ........................................................................ $ 6.00 PERMIT INSTALLATION TOTAL ELECTRICAL PERMIT FEE (plus penalty if app.E) $ Forced Air Unit...............to 1NO. EACH FEE 00M ................................. $ CH .............. • . • • s over 100M ............................. 10.00 ............... Comfort Cooling Unit.....to 3 ton/HP............................ 6.00 ............... Forms / Foundation............................... By:.................. Date:................ to 15 ton/HP.......................... . 9.50 ............... mbing Ground Work ................................................. ........................... to 30 ton/HP............_.............12A0 ............... gh Electrical ........................................................................................ to 50 ton/HP..........._...:� . 17.00 ............... me - Plumbing and Heating .............................................................. �" sulatlon / Ener ...................... Space Heater Wall Heater ..............--....................8.00 ..-............ 9Y............................................................. 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. E) $ Final — Public Works...........................................................