Loading...
1737 (2) CITY OF CUPERTINO -- APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER /73, AND FOR APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY BUILDING INSPECTION DIVISION SET RE J�F ROJ. 0 f. . ...... ............... ....... E .......W..e..s....i. ..... 3...... r • • • . Legal Description: Tractp..................... Block...I........_Lf I.......... Description of Work: C/ C'.G[!9S���i.c. l..,Q.y... ;_e. PlansReceived By....................................................Date ......................... ...................-............................................................y.. .................................. REO.: Plane.... Survey.... Coles: Struc..... Energy.... Elect..... Mach.... 1st Struct. Improvement on Parcel:Yes.... NofArea of Bldg............... Plans Checked By.:............................. Date ..� Separate Structure............ or Addition/Alte1ation to'Exist. Bigg........... Application Approved By................�a...._.�.._.......Date .... ..r! _��.... No. of Stories.... .......... Use of Building .'.r"J�flfa ie.................. Validated BY..............................................................Date ........................ Valuation of Project: $......2.-S'OP ........................ Compensation Certificate Verified 8 P Y ............. Date ............ y Owner: -'Z147. U Contractor: ...../!Jl..ZfZeL-0?h46'17......G..�.�. ..City BuPsh.oLniec. • f Contractor's Address: Phone• �....J......c.........L.. Permit Fee (Plus penalty if aPPlicagle) ...0 ...............$',.. ...... Contractor - Electrical: ......S:,9- —.................................................... City Business License •.................... Phone:.................... Plan Check Fee (less deposit of V. .. FICI ,........)$....................... Plumbing: Energy Plan Check Fee (Dep. of f�.. Rct. ...)$............... 9: ...................................................................................... ...... ,� City Business License #.................... Phone:.................... Strong Motion Fee .................................... 1 $--........_<.,�. Plumbing Permit Fee !.... ..... r✓ Heating and Cooling ...........................................................:...... JO- Business License «.................... Phone:.................... Electrical Permit Fee ...... $.......... $....................... Architect/Designer* �/ Phone:.................... Rech. Htgmill Construction tion Permit x.........rj. .............. $.......................'� Engineer: .....fJ.f/.................................................. Phone:.................... Residential Construction Tax ........................................$....................... Lender: . ... _C71,& Misc. Fee - $...... at .........perf.......................................w c [3 Unknown "I cantly that in the performance of the work for which this permit Is Misc. Fee ........................................................................ ...... ...a.......... issued I shell not employ any person in any manner so as to become sublets • f 3 Q•sD to the workman's compensation laws of California." SIGNATURE OF ZONING • APPLICANT/OWNER ... ............................................ DATE.................... Environmental Status: Exempt............ Other........................................ .,. . . "I certify that as me applicant I am licensed unde- the provisions of the Design Review Approval: Bldg. ............ Site ............ Sign ............ Contractors License Law and further that my Licena. No. ................._......... Use Zone ............ P.D. Conditions ............................................................ in Classification ........................................ is In full force and effect: or Cond. Use Permit e............ Variance +t............ Parking Spaces............ I certify that I am exempt from the "Licensed Required" provisions of the Contractors License Law, (Stale basis of exemption.) Approves BY .......................................................... Date ........................... I horeby acknowledge that I have read this application and state that the above is _ correct and agree to comply with all City Ordinancesand State Laws regulating • • building. I (We) agree to save, indemnify and keep harmless•the City of Cupertino roachment Permit........................ Grant Of Easement........................ against liabilities, judgments, caste and expenses which may In any we Gutter, Sidewalk, Driveway: Replace.......... Repair........., acture against said City In consequence of the granting of this permit." er............ Conn. Fee §................ Water............... Meter$................ SIGNATURE OF /� reement for Completion Of Public Works Improvements .................. APPLICANT/CONTRACTOR CP.(.i^Kf:...Y...�..._ ........... DATE�..lp ..�.� Plans Checked By........ Date........ Approved By........ Date.................... NOTE: Wham properly validated this form constitutes a building Permit. This permit expires and becomes null and void should work not be commenced within APPLICATION •• ELECTRICAL PERMIT 120 days from validation data, or should authorized construction be suspended or abandoned for a period of 120 days alter work Is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION •, PLUMBING Light Outlets........._. Switches............ PERMIT INSTALLATION - NO. EACH FEE Fixtures............Receptacles....4 . TOTAL NUMBER (less than 1000 watts) ....../... $ •50 •'s� 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) ................. 4.00. ............. MOTORS: 1 HP or less ......................................... ........ 2.00 .............. Water Closet.... Water Fleeter.... Ld. Tray..................... 4.00. ............. Greater than 1 HP not more than 5 HP ............... 3.50 .............. Lavatory.... Shower Pan.... Bathtub.... Sink.................. 3.00. ............. Temporary Power Pole or Service— 100 amp ........ ..5.00 .............. Wash. Mach..... Dishwasher....Garb. Disp..... ............... 3.00. ............. —200 amp......... 7.00............... Sewer ............................................................................... 8.00. ............. Time Clock ..................................................................... . 1.50............... Lawn Sprinkler Sys. $5.00 Ea. add Sys. $2.00..................... ............. Mw` see Ord. current ...................................................... Vacuum Breakers ......:..................................... ..............3.50. -'----._:- New peel entlal Occupancies Flet Rete Interceptor........ Water Softener........ ........................._..4.00. ............ Plumbing Piping without fixtures ...................................4.00. ............. 0-600 eq. ft. $22.00 1501-1750 $34.50.............................. Misc. (See Ord. Current) .................................................... 501-750 24.60 1751-20000 37.50.............................. Permit Fee ..........................................................................$6.00 751-1000 26.00 2001-225C 39.50.............................. TOTAL PLUMBING PERMIT FEE (plus penalty If app. ❑) $ 1001-1250 26.50 2251-2500 42.00.............................. 1261-1600 32.00 2501-2750 49.50.............................. APPLICATION FOR HEATING/COOLING PERIVIII Permit Fee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty If app.m $ PERMIT INSTALLATION NO. EACH FEE Forced Air Unit..................to 100M ............................ .$6.00... .....:..... INSPECTION RECORD over 100M....................... . 10.00.. ........... Comfort Cooling Unit......to 3 ton/HP ........................... Sim................ Forme / Foundation .............................. BY:........ ........ . Date:................ to 15 ton/HP......................... 9.50.. ........... Plumbing Ground Work ....................... ..... ...............I ........................... to 30 ton/HP........................ ..12.00.. ........... Rough Electrical ...................................... .. . . to 50 ton/HP................ ....... .17.00............... r -'vas - Plumbing and Heating .......... ... a1.�.�.... Space Heater........ Wall Heater ................................... ......... . 8.00 ation & Ener •• •••••••••• 9Y............................... .................................................... Flues - other than above ............................................ .. 3.00.. ........... Test ............. .............................. .......................... .......................... Vent Fan: Kitchen........ Bath ......................................... 3.00... ........... porary Power Gas / Elect. .......................... Commercial Range Hood - 8.00.,,,.,.•....... 9 Final - Electrical .................................... ........................ ........................... Misc. (See Ord. Current............................................... ........................... Final - Building/Mechanical .............. ....................................:............ Permit Fee ........................................................................ f 6.00 Final - Design Review / Landscaping . .... ........................................... TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. ❑) S Final-Public Works ................................. . ....................