Loading...
1313 (2) lit F, CITY OF CUPERTINO APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER �3�3 AND , . CERTIFICATE OF OCCUPANCY APPLICANT TO FILL IN BUILDING INSPECTION DIVISION S.76 EET ADDRESS OF PROJECT: • , L��Descriiption: T act..x.....551t....131...... ck..............LDt....23............ ''rrff Description of work: .Single_FainiTy.„Dwelling, ,,,,,,,,,,,,,,, Plans Received By...............H/........................,Date ..... ._�.7L. t. .......................................................................................-............................... RED.: Plans.... Survey.... Calcs: Struc..... Energy.... Elect..... Mach.... 1st Struct. Improvement on Parcel: Yes.X No... Area of BIdg24.$.6H- Plane Checked By......._.c`�l./y... Date ....: ... . ..... Separate Structure...No.. or Addition/Alteration to Exist.ggldg..54_QG Application Approved By...........4...�....._..._._...Date .. .,C di. No. of Stories_._..1_... Us,p ofgp'ding ..Resid...... —.................. Validated By.................... . . .......... Date �.. Valuation of Pro act $..1 J�5.,UU� ...................... • Compensation Certificate Verified By Lyl�1. ._ Date ... �?yl.. owner: .BAS..)-fomes.g,—}yInc......- .. . Phone 2S220.77 $ Contractor: ... a5 flHs .....................City Bus Llc * 1.1061. ' • ” ' MIIIIII Contractor's Address: .Z.U... Z.....St.evens...Cr.k. Phone:252-.2,077 Permit Fee (plus penalty If applicable) Contractor - Electrical: ..Best.-Electric...CO...._........... ............ (P P Y PP ) - -_ - $........299....5.0 Cit Business License *.18.172..... Phone:..2$.7-204 Plan Check Fee (less deposit of$.......... Rct. #..........)$....................... y Energy Plan Check Fee (Dep. of -...... -... .-........$....................... Plumbing: -CCowley...CO............._._......._............................ Strong Motion Fee ......................................_.-................$......_.._.7...3.0 City Business License *...166.41... Phone245-.424.0 Plumbing Permit Fee --.................:.........................$...........82...0.0 Heating and Cooling ..Al...Boyer...CO........—...................2 Electrical Permit Fee ....__..-.._...........%:r: (,',:.'.`...,........$...........48....0.0 City Business License #.................._ Phone:.Z92.-..4.3.28 Mach. Htg./Coolg. Permit $............. l..... $...........31...00 Architect/Designer:Swallovr.Bates.838-7.956Phone:714....752- 924 """"" Engineer: .McKa Residential Construction Tax ..............:.........................$....................... y .argot.Ean .....—.................... Phone:..9 .5.-. . Misc. Fee .__._....$__.__.._............ Lender: ..Wells..in th performance the................whic ❑ Unknown Misc. Fee ���������������������'�����������������'-""""""��' "I certify That in the pedormence of the work far which This permit is ........................................................................$...........-.... issued I shall net employ any Y I f """ p y y person f al manner so as to become subject s $ 462.BO to the workmen's compensation laws of California." SIGNATURE OF • ! APPLICANT/OWNER ._....... ...........................................:.............. DATE........................ • Environmental Status: Exempt ............ Other........................................ . . ..... "i certify that as the applicant I am licensed unde the provisions of the Design Review Approval: Bldg. ............ Site ............ Sign ............ Contractors License Law and further that my Users, No. ............................ Use Zona P.D. Conditions in Classification ...-...._.._....... -......... is in full force and effect: or Cond. Use Permit *.......---- Variance *........ Parking Spaces............ ..... I certify that I am exempt from the "Licensed Required" provisions of the Approved By Date Contractors License Law. (State basis of exemption.) "'"'"""'...."'"'"""'" "..... "".......... I hereby acknowledge that I have read this application and state that the above Is _ correct an agree to comply with all City Ordinances and State Laws regulating s ' ! building. • I we) agree to nave, indemnify and keep harmless the City of Cupertino li c roachment Permit....................... Grant of Easement..............._....... against liabilities, judgments, costs and expenses which may In a' we b, Gutter, Sidewalk, Driveway: Replace........... Repair.......... secure against said City consequence of the granting of th' mi Br.........._ Conn. Fee $....-_......... Water..........._... Meter $................ SIGNATURE. OF ( 1 Agreement for Completion of Public Works Improvements .................. APPLICANT/CONTRACT TE70. .._*....." Plans Checked By........ Date........ Approved By........ Date............ NOTE: When properly validated this form constitutes a Building Perri This permit expires and becomes null and void should work not.be commenced within APPLICATION • 120 days from validation date, or should authorized construction be suspend abandoned for a period of 120 days after work is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION , • r Light Outlets............ Switches.......... . PLUMBING PERMIT Fixtures............ Receptacles............ PERMIT INSTALLATION NO. EACH FEE TOTAL NUMBER (less than 1000 watts) ..... ....... $ .50 ....... Gas System with up to 5 outlets .................................$4.00. .......,..... Range........ Cooking Unit........ Oven............ ..._.... ....... 2.00 .............. Each additional outlet ............................................. 1.00............... Dryer........ Garb. Disp......... Dishwasher ......- ..... ...... 2.00 .. ............ Water System (Installation, Alt. or Repair) I.............. 4.00,.....4... 0 MOTORS: 1 HP or less ........................................ ....... . 2.00 -... Water Closet3. Water Heated. Ld. Tray....1........5..... 4.00. .2.Q.... Greater than 1 HP not more than 5 HP .............. . 3.50 .. ............ Lavatory$. Shower Pan.1. Bathtub.2. Sink..1........9..... 3.00...2.7..00 Temporary Power Pole or Service — 100 amp .. .......5.00 -...........I Wash. Mach..l Dishwasher.l. Garb. Disp....1.......3..... 3.00......9...00 200 amp. 7.00............... Sewer .../Q.p3.2.....................................L.............. 8.00......8...00 Time Clock ...........................-..... ..........--...... 1.50............... Lawn Sprinkler Sys. $5.00 Ea. add Sys. $2.00..................... ............. Misc. (see Ord. current 1.............................................. Vacuum Breakers ............................................ ..............3.50.............. New Residential Occupancies Flat Rate Interceptor........ Water Softener........ .............................4.00. .......... 0-500 sq. ft. $22.00 1501-1750 $34.50.............................. Plumbing Piping without fixtures ...........1............. .......4.00......4.r.�0 Misc. (See Ord. Current) .................................................... 501-750 24.50 1751-20000 37.60.............................. Permit Fee ........................ . ...... 751-1000 28.60 2001-2250 39.50....... .. .. t -�-app.-•-- $ 8.00 1001-1250 28.60 2251-2500 42.00.......Z4.S.�1................ TOTAL PLUMBING PERMIT FEE (plus penalty II app.[1) E 82.00 1251-1500 32.00 2501-2760 49.50...........................*** APPLICATION FORHEATING/COOLING PERMIT PermitFee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty If app-0 $ 48.00 PERMIT INSTALLATION NO. EACH FEE Forced Air Unit...-............to 100M .............................$8.00 •INSPECTI ' ' ' over 100M ....................1._. 10.00.. .IO.... x� -3>' c , Comfort Cooling Unit......to 3 ton/HP ................ .. 6.00,........... Forms ... Rough Electrical /0 By: "( t to 15 ton/HP......................... 9.50.............. Rouge Electrical Work ylq..C.9..ft//�A� �. �.�/� � � to 30 ton/HP........................ 12.00. . ... `771C�J _ .. ............ n I on .. 1 to 50 ton/HP......-.................. 17.00.............. •ems lumbetloand He in, ... Y. . .1...:........ .. a./. ��......... Space Heater........ Wall Heater............................ 6.00, v� J .... 9Y....._......_..._..... ..... ... 1 s Test Flues - other than above ............................................`.. 3.00.............. ................. ..._. .. . .. . .. . .... .... Flues emporary Power Ges / Elect. . ....... .. Vent Fan: Kitchen_1.... Bath3.../Dx:yex...l........5..... 3.00......1.5..Q -r- � "------ Commercial Range Hood .. 6.00..... / 9 ........................................ .. Final - Electrical ................................... .. ..... ... Misc. (See Ord. Current......................................-.�................................... v� ........... Final - Building / Mechanical _.._...._.. .. t ..c. �..1.... ..._......... Permit Fee ..._........................._........................................ $ 8.00 Final - Design Review / Landscaping . ... .................. ....................... TOTAL Htg./ Coolg. Permit Fee (plus penalty If app. ❑) E 31 00 Firi Pu lic Works ... .... .. .. �... QI./I............................ ' 1AfyU�•S.A.,.; 1)f.Ofi3� i-i3�3f � Tb/�S �- s�E-4i l��"dP 1K7-er I- - ! ROUTE SLI? File No . Date Locat=on _ A-1-1 R Xptes .� , Annroved Date Lector ROUTE SLI? File No . 4 Date Local`en S s e c t \o.es D A.,r.,oved 5 Date i ' CITY OF CUPERTINO' COPY GAS SERVICE NOTICE 19 To You are hereby authorized to connect the GAS'service for Owner or Tenant I//'�,F}`�7 At I of 7 �l D Ll C_ New Service No. of Meters / Reconnect No. of Add. Meters Move Service Moves Meter PLUMBING INSPECTCa-�If. ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO Z� 198/ To You are hereby/authorized to Connect electrical service for Owner or Tenant !/ /rr"� L //yG No,of Wires Size of Wires Size of Switch Motor Load Voltage Phase Heating Load K.W. Voltage i Light L' I10New Service Reconnect Noy of Meters r Heat-1 20-Three Wire More Service No.of Add.Meters Power (� Three ,Ph�a/se�� Move Meter Q• ELECTRICAL INSPECTOR CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE DATECITY OF CUPERTINO 7 -7 . 19E—/ BLDG. PERMIT NO. 3 �j i THE BLDG. LOCATED AT 79 LrZ C"" J3,4s OWNED BY,,�_�,�p����—''�_ � HAS BEEN (95KE--�-- FOR USE AS (ALTERED) i � ; ©M UILDING INSPECTOR i I BUILDING INSPECTOR'S OFFICE Bldg,Dept. CITY OF CUPERTINO Office Copy ❑ Backflow Device Sanitary Permit No. QJ. Sewer Connection Plumbing Permit No. Plumbing Final Lot No. 3 Owner or Tenant L// //� ""° �f� c- " At 0 Tract Date Connected �-.L�"f�-14�J Date Final__ 199/ O• PLUMBING INSPECTOR