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1310 (2) CITY sOF CUPER•NO • -Z"P APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER /' p AND • , APPLICANT CERTIFICATE OF OCCUPANCY BUILDING INSPECTION DIVISION STREET ADDRESS OF PROJECT: DEPARTMENT USE ONLY . /0-7-0q g Legal De cri ion: Tract...0-5.er...B.lCcourt.... �oc..20........... �1.'-•s tc Description of work: .....Single...Famil.y...Dw.el ling.............. Plans Received By.............../.(..r.../.........................,Date .... ... ../�p.- ..... . .. .. .. . .. ....... ........ ......a-n.I- .........................................ea..................8..-8- . REO.: Plans.... Survey.... Calc tr c..... Energy.... Elect..... Mach.... 1st Strutt. Improvement on Parcel:YesX. No... Area of BIdg.28.98H Plans Checked By................... ... ..... . Date .... .... Separate Structure-No.... or Addition/Alteration to Exist. BIdgS.7.0.G Application L .. .. A roved B ............. ......................... Date .. PP Y No. of Stories.....2....._. Use Of Building Residential................... Validated By............................................................Date ....... ....... Valuation of Project: $123.,000 Compensation Certificate Verified By ... ''' " ' ' ' ' ' "'- - ' . Date .. .�rcd?' owner: BAS...Homes,...Inc................._............. Phone:.252-.2.077 • • rey RMIIIIIIContractor: ..BAS..Homes. ...Inc...-....._.City Bus. Lie. # .1.106.1 E Contractor's Address: .208'23...Stevens...Crk Phone:_..2S.2.c.2.Q7 Permit Fee (plus penalty If applicable) Contractor - Electrical: The...Best..EleGtrinal...CO...:....._..._ (P P ep PP ) - et. # . . )$-.......321...50 City Business License *.1817.2.... Phone:.28.7-.204.0 .Olen Check Fee (less deposit of$.......... Ret. #..........)$...................... . ...... ...... Energy Plan Check Fee (Dep, of $........ Rot. #........) $...................... Plumbing: CrOWleY..CO... .............. ........................-.. Strong Motion Fee ..........................................n:.......:.... ...Co..... ..Boyer A . li d Coongl_ ........ .. $..............8..61 City Business License #..1664.1..... Phone:.245-42.4.0 e . ...... .._.._ . .... lumbin9 Permit Fee ........................:.....:.................$...........86,.00 Heating anlectrical Permit Fee ..........._...........--........., City Business License #. .............. Phone:792...4.3.28 $...........35_.50 Architect/Designer.SwalloW..Bates..838-9.95(Phone:.7.14....752- 924 Rech, vial Construction Permit x...............:..'.: ....... $...........33_.00 I.,�. Engineer: .McKay...F,...SOm 5..............._...... ..... Phone:...98.5.-.096 Residential Construction Tax ........................................$....................... p - Lender: Wel1s..Far. o. .Bank......_................ unknown Mist. Fee ................................................... � I ....................$....................... g Misc. Foe is .artily than in the performance of the work for which this permit is ct ............................._............_................_.........$....................... issued I shall not employ an p y y person f any manner so as to become subject • $ SO4.61 to the workman's compensation Taws of California," SIGNATURE OF • • APPLICANT/OWNER ......................_..._..........._.._................_.. DATE.._._.......... ....., Environmental Status: Exempt ............ Other..............--...................... .._ "I cerOfy that as the applicant I am licensed uncle- the provisions of the Design Review Approval: Bldg. ............ Site ............ Sign ............ Contractors License Law and further that my Licens. No. ....._................... Use Zone P.D. Conditions .... ............._...................................... In Clessificaticn ....--...........--.......... is in full force and effect: or Cond. Use Permit #............ Variance x............ Parking Spaces............ - t 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 PUBLIC %orrect and agree to comply with all City Ordinances and State Laws regulating WORKS building. ) I (We) agree to save, indemnify and keep harmless the City of Cupertino croachment Permit........................ Grant Of Easement........................ against II hilltiea, Iudg sten s, ..are and expenses which may in y we 1 rb, Gutter, Sidewalk, Driveway: Replace........., Repair.......... acture against said City i consequence of the granting of thi rof %%ar............ Conn. Fee $................ Water................ Meter $................ SIGNATURE OFr� Agreement for Completion Of Public Works Improvements .................. APPLICANT/CONTRACT .._. DATE .. . Cl1 .......... 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 APPLICATIONs 110 days from validation date, or should authorized construction be suspended or abandoned for a period of 110 days after work i•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 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..... 4.80 ,. MOTORS: 1 HP or less ................_....._..........._.. ...._ . 2.00 ..-. Water Closet-4 Water Fieater.l Ld. Tray...l........._G.... 4.00. -24.r..U.- J Greater than 1 HP not more than 5 HP .............. . 3.50 .............. Lavatory.6 Shower Panl.. Bathtub..3 Sink...1.....11.... 3.00....3.3...0. Temporary Power Pole or Service — 100 amp ........ .,5.00 .. ..... ...... Wash. Mach...I Dishwasher.,) Garb. Disp......}........ .... 3.00.......9...00 4 200 amp......... 7.00 .............. Sewer ...-/of z ......................................I ...1... 8.00. ......8...0.0 Time Clock ........................................ ......._......... 1.50............... Lawn Sprinkler Sys. $5.00 Ea. add Sys. $2.00..................... ............. Mist. (see Ord. current)....................... .............................. Vacuum Breakers ......................................_..... I ...3.50..............New Realdentlel Occupancies Flet RataInterceptor........ Water Softener........ ........ . ...4.00. ............Plumbing Piping without fixtures ..............1......:....1.. ...4.00......4.,.OQ � 0-500 sq. ft. $22.00 1501-1750 $34.50.............................. Mist. (Sea Ord. Current) .................................................... .00 LA 1051'10500 OLING PERMIT P21250 A00 2251-2500 t Fee 2501-2750-.•q•2:0050........ 98.,...•..SB�pO TOTAL rPLUMBING PERMIT•FEE (plus penalty ifapp. Q) $ 886,00IJ li TOTAL ELECTRICAL PERMIT FEE (Plus penalty if app.0) $ PERMIT INSTALLATION 770. $AeCHO FEE • ,_ Unit IASPECTI • BY RECORD 5�a50 Forced Air oling Uni ..to 30 e00MHP.......... ... 1B 50.... ..... el Fl 1 Q r Comfort Cooling Unit.. to 3 ton/HP ... 6.00.... ton/ Garzpc oundatT .. -ViV Plumbing Ground Work Rough Electrical ...... ......... �. ......... -r..19,-.� ... ................. 12.00. ............ QJ lame - Plumbing and Heating I__ to 50 ton/HP...........................17.00.. ........... Zt 9 9 .......... .. .................. .......................... Space Heater........ Wall Heater .................................. 0.00.... ulation & Energy..........................__.1... ................... .. Flues - other than above .......... ............ ...._............ .... 3.00.............. I s Test ... ... ..^Q ... �:�.3 .. i Vent Fan: Kitchen...l... Bath 3...../Or yer...1.....5.. .. 3.00....15...00 eml - aryElectrical Power Gas / Elect. ....... ...... .........._.... Commercial Range Hood 8.00._,... Final - Electrical ..................._. ............. . .. -...... .Lo_8 I.... Misc. (See Ord. Current...._.........................__............. ... ........................ Final - Building/ Mechanical ......._........... . _......... -/-- Permit Fee $ 0.00 Final - Design Review / Landscaping . .................. ........................................................................ """""-""-"-" - - TOTAL Htg,/ Coolg. Permit Fee ( lus penalty if app. I]) E Final-Public work .......... ... . . .............. ......... .. 33.00 1 �. ��7• J 'Maaaa��w.e. �-1�..�• . 5.e�4r.,«. /1-Y)-�+Qra �txG.j/� / /#- �^� �� ROUTE SLIP File No. Date Location Subject �Droved C./ Date I 9 for - OFFICE CITY OF CUPERTINO COPY GAS SERVICE NOTICE I 19 I To 7 You are hereby authorized to connect the GAS service for Owner or Tenant 1AA S �"n-N.-2, /y C" ,� AtdJJtiU il�_t `� New Service No. of Meters / Reconnect No. of Add. Meters Move Service Move Mere PLUMBING INSPECTOR I BUILDING INSPECTOR'S OFFICE Bldg.Dep CITY OF CUPERTINO Office Copy ❑ Backflow Device Sanitary Permit No. Sewer Connection Plumbing Permit No. l (� Vim: Plumbing Final Lot No. i Owner or Tenant T At V Tract Date Connected �/ ' —19-SL—/ Dote FinolG/`lb/ 19 j I 1 ©M PLUMBING INSPECTOR CERTIFICATE OF COMPLETION I BUILDIII INSPECTOR'S OFFICE CITY OF CUPERTINO DATE — 19 L BLDG. PERMIT NO. e'3 I J l THE BLDG. LOCATED AT /6)7-0 I ! ' OWNED BY HAS BEEN CIALTER T FOR USE AS I I BUILDh. , INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO / 6 U 119 To ' You are hereby authorized to Connect electrical service for Owner or Tenant At / 1 -I-a No.of Wires Size f Wires Size of Switch Motor Load Voltage Phase Heating Load K.W. Voltage I Light I10_New Service Reconnect it Na.of Meters Heat 120 Three Wire More Service .I No.of Add.Meters Power Th Phase Move Meter QM ELECTRICAL INSPECTOR �- v