07050142CITY OF
CUPEk INO
CITY OF CUPERTINO
PERMIT APPLICATION FORM
'N # tt
`I
r
Date:
t , e
ld_ailing
Address (if different from building address):
Building Ar1rirP`cs:
Boiler <= 100,000 Btu
MECHANICAL
BBOILER2
Boiler > IOOK to 500K Btu
MECHANICAL
Owner's Name:
Boile- > 500K to 1M Btu
Phone #:
BBOILER4
Boiler > IM to 1.75 M Btu
Lice�lse #:
BBOILER5
Bciler> 1.75M Btu
MECHANICAL
-- - -- -- -- -- _-- --
-= `
Phone:
Cupertino Business License#:
J,_ `�}^
Fax: s
Building Permit Info:
`
BUILDING
BCONSTAXH
hotel and Motel
BUILDING
Bldg ❑ Elect ❑
Pi zmb ❑ Mech ❑
Job Description:
Residential
r
b
Commercial ❑
Sq.Ft. Floor Area:
BELEC1001
Sq.Ft.:
Cost of Proje^*'"
BELEC200
Occupancy Group:
ELECTRICAL
BENERGY
Energy
BUILDING
BENERGYADD
Please check this box if the project is a
Type of Construction:
second -story addition: El
Investigation fee
BUILDING
rl R/fnirr n
.rolect size: 6ianaaru u Lal r,%,
Quantity Fee ID
Fee Description
Fee Group
BAPPLOTHER
Other Appliances
MECHANICAL
BBOILERI
Boiler <= 100,000 Btu
MECHANICAL
BBOILER2
Boiler > IOOK to 500K Btu
MECHANICAL
BBOILER3
Boile- > 500K to 1M Btu
MECHANICAL
BBOILER4
Boiler > IM to 1.75 M Btu
MECHANICAL
BBOILER5
Bciler> 1.75M Btu
MECHANICAL
BCONSTAX
Construction Tax
BUILDING
BCONSTAX
Ind'Off/Comm/Quasi
BUILDING
BCONSTAXBQ
Con. Tax for BQ Zone
BUILDING
BCONSTAXH
hotel and Motel
BUILDING
BCONSTAXR
Con stax - Resi/Mobile
BUILDING
BELEC1000
Elea 600V <= 1000A
ELECTRICAL
BELEC1001
El.c 600V > 1000A
ELECTRICAL
BELEC200
Elec Svcs 600V <= 200A
ELECTRICAL
BENERGY
Energy
BUILDING
BENERGYADD
Energy Add Multi
BUILDING
BINVESTIGA
Investigation fee
BUILDING
1 A3