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1316 (2) - / CITY OF CUPERTINO a - C' ,APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER AND FOR APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY BUILDING INSPECTION DIVISION ST EET ADDRESS OF PROJECT: .... .b1 90....... ...Bye.rly..Court...._.._.........._..:_........................... DEPARTMENT r 'Legal Description Tract.. 6551 ... Block Lot .26.... . I,// �1 Description of Work .Single Fama.ly Iiwe111.Rg.. . Plana Received By..........--./f/�... .. .. .._.Date ! . �. ... .. _ REQ.: Plans.... Survey. Cal Struc. Energy.... Elect. ech... let Struct, Improvement on Parcel: Vesac_ No.-. Area of Bldg.1, 22 2 j Clans Checked By........._..---J. _...............:.....Date ..... _ Separate Structur .-NO-_ or Addition/Alteration to Exist. Bldg.S9g� Application Approved B ......../'�........�.__......_......Date ._��� .���.� G PP PP y �L�a��o. No. of Stories.... Use of Building -Residential...... ...... Validated By................. ... .... Date Valuation of Project s..9.1.,000 Compensation Certificate Verified By /7.4/..,/.... Date. Owner: BAS Homes,...Inc _...... .. Phone:z52- 077 i\• Contractor: ..BAS Homes Inc ,_ C ty Bus. Lic. # 11 61 . • • , 891,000 252-2'07 Contractor's Address 208'13..,SteVgnsrk. phone: .. Permit Fee (plus penalty if applicable) .... .. ...$ 269..00 Contractor - Electrical: ... Best-Electrical- Co.. ... Plan Check Fee (less deposit of$ ..... Rct. # )$..... City Business License #A817.2 ..- Phone 287-244 Plumbing: _Crowley.- - Energy Plan Check Fee (Dep. of $........ Rct. #........)$....................... PlumbCO.. ...---........ ................. City Business License #...16641... Phone:..24.5.-424 Strong Motion Fee ............._......_.._...._..............._.I......$..........._6.,.3.7 Heating and Cooling .. g g Al-..Bo Boyer .............._.............. Plumbing Permit Fee ................................................$...........78-00 y City Business License #.............. ... Phone:.Z92-.4.328 Electrical Permit Fee .....-it..........................$ . ..._.................$........... Architect/DesignergaYouf.Bates..838-.9.956Phone:714-752- 924 Mach. Htg./Coolg. Permit $..................:.......... $..........31.D0 K GG Sa LA0 Residential Construction Tax ..................... Engineer: .MC ay.. .. OTi S.._.........-.._-......__.. Phone:..98.5.-06 ....-$--................. k ........... Lender: We11S ..F argO...BariC......_ .................. E] Unknown Fee .......... ....... r ...,.- . ............... $.................._... r _ %l V .. . .. is I s certify that in the performance of the work /or which this permit is MISC. Fee ................. ..................:...........:'....._. _ ............$................. .... issued shall not employ any parson in any manner so as to become subject • $ 432.37 to the workman's compensation laws of California." SIGNATURE OF • , , • APPLICANT/OWNER _. .._._. DATE......---....... .. Environmental Status: Exempt ............ Other............ ...................... ..._.. "l certify that as the applicant I am licensed undothe provisions 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 Coad. Use Permit #............ Variance #............ Parking Spaces............ - - I certify that I am exempt from the "Licensed Required" provisions of the Approved 8 Contractor, License Law, (State basis of exemption.) pp y.........................._..........._..........._..... Date ........__............_. I hereby acknowledge that I have read this application and state that the above Is utrrect and agree to comply with .11 City Ordinances and State Laws regulating • • building. • I (We) agree to save, indemnify and keep harmless the City of Cupertino Croachment Permit........................ Grant of Easement......................., against liabilities, judgments, costs and expanses which may in y way rb, Gutter, Sidewalk, Driveway: Replace.......... Repair.......... acture against Bald City in onsequence of the granting of th' er . Swer............ Conn. Fee $.-............ Water................ Meter $................ SIGNATURE OF �/ � �, /�I _' Agreement for Completion of Public Works Improvements __......._ - APPUCANTJCONTRACT t ,A;,(ta, AT Plans Checked By........ Date........ Approved By........ Date.......--....... NOTE: when properly validated this form constitutes a Building Permit. This permit expires and becomes null and void should work not be commenced within APPLICATION • 110 days from validation date, or should authorized construction be suspended or abandoned for a period of 110 days after work is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION FOR PLUMBING PERMIT Light Outlets............ Switches............ Fixtures............ Receptacles............ PERMIT INSTALLATION NO. EACH FEE TOTAL NUMBER (less than 1000 watts) ............ $ .50 ......I..... Gas System with up to 5 outlets ........1................1.....$4.00 --.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) ...1.....1..... 4.00....,4.•.D.O MOTORS: 1 HP or less .....................-................ ...... . 2.00 _............ Water Closet3. Water Freater-1 Ld. Tray....1........5..... 4.00. .2.0...110 Greater than 1 HP not more than 5 HP .............. . 3.50 .. .._.-__.. Lavato ry_.S Shower Pan.... Bethtub.2. Sink....2.. ...9..... 3.00...2.7...110 „/ Temporary Power Pole or Service - 100 amp .....- 5.00 .. ............ Wash, Mach-1. Dishwasher...lGarb. Disp....I........3..... 3.00........x.0..0 r -200 amp.-..-. . 7.00 .. ............ Sewer .....V.f3"r.7--...-.................................1..... 8.00........•.Q.0 Time Clock ............._._..........._..._ .._......__.._....__ ......... 1.50.............. Lawn Sprinkle Sys. $5.00 Ea. add Sys. $2.00.................... .............. Misc. (see Ord. current).......................................... ......... Vacuum Breakers ............................................ ........... 350.............. New Residential Occupancies Flat Rate Interceptor........ Water Softener........ ................. ..........:...4..00. ............ �v Plumbing Piping without fixtures ...................................4.00............... 1n 0-500 sq. ft. $22.00 1501-1750 $34,50.............................. Mise. (See Ord. Current) .......... 501-750 24.50 1751-.20000 37.50.............................. .......................................... 751-1000 26.00 2001-2250 39.60 ....... Permit Fee ..........................................................................$8 TOTAL PLUMBING PERMIT FEE (plus penalty iy8pp• Q) $ .700 8.00 1001-1250 28.50 2251-2500 42.00........... z.� .............. 1251-1500 32.00 2501-2750 49.50....:......................... APPLICATION Permit Fee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty if app.[]) $ PERMIT INSTALLATION I NO.I EACH FEE 48.00 Forced Air Unit,............ ...to IDOM ... .........................g 8.00............... • • ' ' over 100M ....................1. . 110.00- Comfort 0.00-Comfort Cooling Unit......to 3 ton/HP ........................... 6,00............... Forms / Foundation . .. By:.... Date:. ... .., to 15 ton/HP......................... 9.50.............. rams - Plumbing and Heati-na-. - fa-� to 30 ton/HP...........................12.00. ............ Plumbing 6romC-W.. -. N,"wr''.._.....i .. ._...... ... ... .._ to 50 ton/HP............................17.00.............. -Jr Rough Electrical ......_.... . _......_....._ d ......_. 7'.'3 ..$�.......... Space Heater........ Wall Heater .....--.......--............ 6.00.............. ulat ion & Energy_................_.......... ... . ._.... ...... Flues - other than above _...........................-............�-. 3.00.............. a Test ...._ ...... - f7 �7.... Vent Fan: Kitchen..I.... Bath3 /.D.ryer 1 '.5.4. 3.00.....15.•.0 y'1 emporary Power Gas / Elect . ... .- g Commercial Range Hood 1l 6.00 Final - Electrical . .. ..... . .. . Z, .._........ -.. ...... . ..... Mise. (See Ord. Current.......--.................................................$ 6......... Final - Building/ Mechanical _................ ................_. . _c'?cr.:g./..... Permit Fee ..._..............._._.............._............................. $ 6.00 Final - Design Review / Landscaping . ......_..._...................... TOTAL Htg./ Coolg. Permit Fee (plus penalty if gpp. ❑) $31.00 Final- Public Wor ...... ..... ... - 44. 1� ,I #... nr�fat,;.. ftp.8o nti p w li ad ., v' .s.w,-� 041, Y-4 K /v/v ROUTE SLIP t File No. Date Location 1ta 6 Subject Notes Approved 77— Date inspedtOTI I i CERTIFICATE OF COMPLETION < < BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO _ DATE 19 LL BLDG. PERMIT NO, 316 I y/ THE BLDG. LOCATED ATZUI o OWNED BY HAS BEES(ALTERED) OR USE AS �• / .ivy✓Lr1 r I p,. v 1 BUILDING INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO jjJJ II To s You are herebyauthorizedto Connect electrical service for Owner or Tenant . 04:6 &711 le,'4" /N C_ . At -ka—I /b/'J AV C--2L '��A No.of Wires Size of Wires Size of Switch Motor Load Voltage Phase „iea ling Load K.W. Voltage No.of Meters Light L_ 110 New Service Reconnect 11 Heal 120ihree Wire More Service No.of Add.Meters Pa., Three PPhhaassee) Move Meter. ©� ELECTRICAL INSPECTOR /� ✓�N (o CITY OF CUPERTINO COPe' a GAS SERVICE NOTICE —/cP a7 19 P, To U I You are hereby authorized to connect the GAS service for I Owner or Tenant 6� s, At Z0/Lill a,,-,Q '� jNew Service_ No. of Meters / Reconnect ' No. of Add. Meters Move Service Move Meter PLUMBING INSPECTOR Q BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Bldg.Dept. Office Copy ❑ Backflow Device Sanitary Permit No. Sewer Connection Plumbing Permit No. -3 16 ❑ Plumbing Finales� aa - Lot No. Z Owner or Tenant_!3L z At IUKi Tract 'Date Connected—LZ It g 19`� o Daate Final 7--c. 19 / — I 'LUMBING INSPECTOR