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1315 (2) Cis L/L/ /�'. �. F/ / CITY OF CUPER•NO • '�`� `� APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER AND • , APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY BUILDING INSPECTION DIVISION STREET ADDRESS OF PROJECT: 10! ..v� . Byexly-Court_... . ............_.. ......_.._.. r • Legal Description: Tract.......65$1..... Block............ Lot....2.$............. ��[[ Description of Work: ....Single...Family...Dwelling-............ PlansReceived BY...............G7./�.'f........................Date .. .���.... ......_.........._....._._................._....._.........._.................................................... REO.: Plans.... Survey.... CgLgs: Struc..... Energy.... Elect..... Mach.... 1st Struct. Improvement on Parcel:Yes...N.a... Area of BIdg24.5.6y. e Plans Checked By...._.------- . .......................Date .... _..... Separate Structure....NO.. or Addition/Alter tion,tp Exis{. B)d�.4.OG- Application Approved By....._/J,<<........-..........Date .. ?... No. of Stories.._1....._,.. Use of Building .....A,eSld entia..........._..... Validated By................................................ Date . r Valuation of Prefect $..1. 5 000 Compensation Certificate Verified By /i-/ ... Date Owner: BAS.,Home S_,.,-Jn .. Phone:2.5-:n 2077 Contractor: ... ag g} Spv .. S.City Bus Llc x 110217 • • • $ Contractor's Address' 4.OiS.23. Stevens .M. phone .2$._.- Permit Fee (plus penalty if applicable) ................. $........294....50 Contractor - Electrical: ...Best..Ele.C.trical...Co.......................... Plan Check Fee (less deposit of$.......... Rct. 0..........)$....................... City Business License x181.72...... Phone:28.7-.2.04.0 Energy Plan Check Fee (Dep. of $........ Rct. #........) $....................... Plumbing:CroWley...Co..............................._.......................... Strong Motion Fee ....................................I.....:..:..........$.............7_.30 City Business License •....1664.1... Phone:-24S-/324 1 - Heating and Coolie Al...Boyer.-Co................................. Plumbing Permit Fee ..........._...................................$......._.82.,. 9 9 e 44 City Business License x.................... Phone:.792-.4.328 I Electrical Permit Fee ..........$..............:..........................$........_... 8....... Architect/Designer:SwalloW..Bates..838-.795161one:...Z14....752 8924 Htg Residential mill Construction Permit x ......................--... $...........31_.00 Engineer:McKa .... . ......... Phone:9.85.-.0960 Residential Construction Tax ........................................$....................... .. Lender: Wel s.. Fargo ................... unknown Misc. Fee .......................................................................$....................... g ❑ Misc. Fee "I certify that in the performance of the work for which this permit Is • ""'"""""""""""""'""""""""""""""""""""$"""""""'...... issued I shall not employ any person in any manner so as to become subject • $ 462.80 to the workman's compensation laws of California." SIGNATURE OF • • APPLICANT/OWNER ._........ ....................................................... DATE .................. I Environmental Status: Exempt............ Other.............:.......................- ,.. '1 certify that as the applicant I am licensed unde the provismna of the Design Review Approval: Bldg. ............ Site ............ Sign ............ Contractors License Law and further that my Licens, No. ............................ Use Zone ............ P.D. Conditions ............................................................ in Classification ................._...........-.... Is in full force and effect: or Cond. Use Permit x............ Variance x............ 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 and agree to comply with all City Ordinances and State Laws regulating - ' bnildmg. �• and keep harmless he City of pertino costs and OF Ancee GB meO DOFee r, Sidewalk, rl'BWay: Waterepl2Ce.SemMCIerR$Pa.Ir.......... pPPLICANRT bCONITRACjudgments, T 9Y entsrynsequenc(e/of�heaq etwhn9hof may nuanin 9 Completion o Public Works Improvements ....... o9/� rL.LLVC.L. a'aTE + Plans Checked By....... Date........ Approved By.... Date ......_- NOTE! When properly validated this form constitute• s BuIlEing Perrot. TMs permit expires and becomes null and Vold should work not be commenced within APPLICATION • 120 days from validation date, or should authorized construction be suspended or abandoned for a period of 120 days after work Is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION • • PLUMBING Light Outlets............ Switches............ Fixtures............ Receptacles............ PERMIT INSTALLATION NO. EACH FEE TOTAL NUMBER (less than 1000 watts) ..... ....... $ ,50 .....1.......... Gas System with up to 5 outlets ...... ..........$4.00 .......ti. Range........ Cooking Unit........ Oven............ ......... ....... 2.00 .............. Each additional outlet ............................................. 1,00....... Dryer........ Garb. Disp......... Dishwasher ........ .... ....... 2.00 .............. Water System (Installation, Alt. or Repair) .1............... 4.00. MOTORS: 1 HP or less ... ... ........................ ....... 2.00 Water Closet-3. Water Heater..l Ld. Tray....1.......5.... 4.00 .20.-DI) Greater than 1 HP not more than 5 HP ....... ....... . 3.50 .............. Lavatory$. Shower Pen.l Bathtub.2. Sink..l.......9..... 3.00..27...00 Temporary Power Pole or Service - 100 amp ....... ..5.00 .. ............ Wash. Mach.1 Dish w her.l. Garb. Disp....1.......3..... 3.00. .....9....00 -200 amp......... 7.00 .............. Sewer .....�a.9J�.................................... .............. 8.00. .....8.._00 Time Clock .................................... ................................... 1.50............... Lawn Sprinkle/Sys. $5.00 Ea. add Sys. $2100..................... ............. Mlec. (see Ord. current l...................................................... Vacuum P Breakers ............................................ ..............3.50.............. ia,n at ate D-500 sq. ft. $22.00 Occupancies 150 R$34.50.............................. Misc. Ord9 without fixtures .•..•..•••.•.�..••... ..•..4.00•..•4.�.�0 501-750 24.60 1751-20000 37.60.............................. Permit Fee $6.00 751-1000 26.00 2001-2250 39.50......... .......................................................................... TOTAL PLUMBING PERMIT FEE (plus penalty 1001-1250 28.60 2251-2600 42.00.........zav5:4::::::::::.::: p Y it app. �) $82.00 1251-1500 32.00 2601-2750 49.50.............................. APPLICATION FOR HEATING/COOLING PERMIT PermitFee...............................................$8.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty if app.p) $48.00PERMIT INSTALLATION N0. EACH FEE Forced Air Unit..................to 100M ..............................$8.00.. ............ • RECORD over 100M ....................1.... 10.00 . .. ..1.Q.,. Comfort Cooling Unit......to 3 ton/HP ........................... 6.00,.. ............ Forms / Founded n .... .. .. 10 . By:... ./, Datq ���/// to 15 ton/HP......................... 9.50.............. L Rough EI Plumbing Ground Work...Mro,..(A), .../v /L//7 .... to 30 torl................. ....... ..12.00. _.......... . . /J ....._ ... - _ n Ltr game Plumbin and Heating Y~" to 50 ton/HP...........................17.00.............. I g P /..' 1..... Space Heater........ Wall Heater ................................... ......... .... 3.:. 6.00 tion 9Y.............................. ...... ................... Qtr Flues - other than above .............................................�.. 3.00.............. ^1 est .........._............. ........_.... . ...... . /9'7�i I T rary Power OR. / Elect. .._.... . ( 71 - Vent Fan: Kitchen.....1. Bath -3-./Dryer..1-1...5..... 3.00......15..0 ...... .......... ... ............... Commercial Range Hood ._..._._....._............. 6.00 ........ Final - Electrical i ........._._......... ..... ............_ ....�....:/..�..... .Misc. (See Ord. Current.....................__......_.......�.........-............ ......._... \Final al - Building /,Mechanical .........._......._.. .......... �. Z...`�. Permit Fee ........................................................................ $ 6.00 al - Design Review / Landscaping . ............. ................ TOTAL Htg./ Cool Permit Fee (plus penaltyif app. 31.00 -rub llc Werke ..... ...... .......... .......... . .. ow»• 4a iG=H-96� T6SO •3-ZY - rLq ufj If$Ih, U ORA1,6lw ((Ld u.C 'L yLu.� -+?-r, $w FPS.J4W R6TJTE SDI? File No . Date aj- ADo„oved ^ Date ' r gector I OFFICE CITY OF CUPERTINO COPY GAS SERVICE NOTICE I To You are hereby authorized to connect the GAS service for Owner or Tenant /�� S•. 1'Lc.� V ' New Service c • No. of Meters / Reconnect ' No. of Add. Meters Move Service MoveMe er PLUMBING INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO . 19 •� (, To You are hereby authorized to Connect electrical service for Owner or Tenant��////A.1 At / RiLN No.of Wires Siz�res Size of Switch Motor Load Voltage Phase Heating Load - K:W. Voltage No.of Meters Light — 110=New Service Reconnect Heol-120—Three Wire More Service N0.of Add.Meters Powe, \l Three Phase/ Move Meter ©� ELECTRICAL INSPECTOR ' /7 CERTIFICATE OF COMPLETION "BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO I � DATE 19R( BLDG. PEQQRMITNO.y/�� �I ' THE BLDG. LOCA ED AT 1 DI3OC/J gsOWNED BY 11 ��- � HAS BEEN GILO&iP_'GlrLE4.?t� FOR USE AS (ALTERED) - BUILDING INSPECTOR I BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg.Dept. Office Copy ❑ Backflow Device Sanitary Permit No. Q Sewer Connection Plumbing Permit No. r/ :7/ 1 Plumbing Final Lot No. z1 Owner or Tenant /dam 7� /711 C . At I / t7 /ISH-cy,JYAn Tract i Date Connected 1 1 - 17 19L Dote Final 7 I '7 19 el �" /-PLUMl3I G INSPECTOR