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5030120 (2) /ssu-ev a./�/o6 CITY OF CUPERTIN O CUPEI�TINO NEW SINGLE FAMILY DWELLING PERMIT APPLICATION FORM APN# r 141 Date: SAA 05 Building A e s �,3 / �/ Mailin Address (if different from buildin address): 2 X15 aN o R�p toM Owner's Nami4e6Q �V Phone 8 ovo Contractor: C / License #: Contact Phone: Cupertino Business License#: ` OVA �109R Fax: 67110'? 2 Building Permit Info: Single Story ❑ Two-Story ❑ Three-Story $ Basement ❑ Sq.Ft. Floor Area: 2 I (A,2 $/Sq.Ft.: Cost of Project: 10 Type of Constructio • N INS . Project Size: Standard ❑ Laze ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V<-- IOOOA ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <--200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING / BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING 1 of 3 CITY OF CUPERTIlV.. cuPEr�Two NEW SINGLE FAMILY DWELLING PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING / BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain&Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc. Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Sigris Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING — BMW Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL 2 of 3 LiTY OF CUPERTINO CUPEf�TINO NEW SINGLE FAMILY DWELLING PERMIT APPLICATION FORM Quandty Fee ID Fee Description Fee Group BUSLIC Business License BUILDING Z ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL 2 MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING L PPLBG . Plumbing Fee sq foot PLUMBING Z ir 2 = PLLONGRNGR Long Range Planning/Residential PLANNING ZADDCHG Address Chane BUILDING 3of3