B-2016-1390 APP, FEE EST���_�---�-��-- CITY OF CUPERTINO 5g016 15q0
Ifirf.��J FEE ESTIMATOR — BUILDING DIVISION
JAFDRFSS:
10200 Miller Ave DATE: 02/17/2016
APN: 375 03 005 BP#:
REVIEWED BY: PAUL
"VALUATION: $50,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY Multi -Family Dwelling
USE:
Buildinq is
-3 Stories 0 Yes � No
PENTAMATION 1R2ROOF
PERMIT TYPE:
WORK
RE -ROOF BUILDING H WITH NEW PVC ROOFING (8,930 S.F.. INSTALL SLEEPERS AND NEW
SCOPE
SHEATHING TO RAISE ROOF PITCH FOR DRAINAGE.
it 4_ Nan Ch"" I
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tch_ Per z1Peer
t 17jai. 1vw:z'e 12:er
z :f;f Far.
zitra r 11,"h,".sp-
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ti Imp Fer
NOTE., This estimate does not include fees (lite to other Departments (i.e. Planting, Public Works, Fire, Sanitmy Seaver District, School
District, etc.). These fees are based on the arelimivary information available and are only an estimate. Contact the Dent for addn'I into.
FEE ITEMS (Fee Resoiu[io717-053 L 711113)
FEE
I FEE
MISC ITEMS
Plan Check Fee:
$0.00
EEO s.£ Re -roof
$1,530.00 IReRooF'AME
Suppl. PC Fee: (F) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fce:(E) Reg. Q OT
p,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
(Tprd c�rYA;FFLJR 7"nS
.'�l.�rtt7771 ifriLt i-,? l°s?t::
0
0
Work Without Permit? ® Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select allon-Residential Q
Building or Structure
7Xeva1 D,.> fii,,wari, r f, ?Fs
Strone Mot on Fee: 1BSE[SM 1CR
$6.50
Select an Administrative I ni
Blde Stds Commission Fee_ IRCBSC
$2.00
SUBTOTALS;
$8.50
$1,530.00
TOTALF
EFL $1,538.50
Revis : 01101/2016
CUPERTINO
CONSTRUCTION PERMIT APPLICATION I3',-1066 -NO r
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 ' build! no(a cupertino.oro
❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS /6 ZQ L)
APN#
OWNERNAME
6�nAN
PHO E
6-
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STREET ADDRESS
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CITY, STATE, ZIP
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FAX
YI& o!(z.
CONTACT NAME
t4l/l� TIC�t FEZ
PHONE
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E-MAIL
GfUVCe ®epe, C
STREET ADDRESS
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CITY, STATE, ZIP
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�'
❑ OWNER ❑ OWNER -BUILDER O T'ERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTppRNAME LICENSE MR aao LICENSE TYPE_A
CClInj'iyUC- �
BUS. LIC#
l 4-700 /oYr _ b
FAX
COMPANYNAME E-MAIL
STREET V49 1S ao
(y So ✓ rU�I fi� f (a
CITY, STATE, ZIP
P14ONE
—Zo "j i Z
ARCHI'1'F,CT�/ENG1ynN`EQR-NAME� �/ LICENSE NUMBER '/' ��f�
SS
BUS. LIC#
COMPANY NAME E-MAIL
c a s7 (i2� v 4 e 146114
12s
STREET ADDRES / ..�
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CITY,STATE,ZIP
PHONE
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DESCRIPTION OF WORK
EXISTING USE
PROPOSED USE
CONSTR. TYPE.
#STORIES
USE
TYPE
OCC.
SOFT,
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODELAREA REMODEL AREA
PORCH AREA
DPCKAREA
TO'TALDECKMORCHAREA
GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑YCS
SECOND S'rORY ❑VLS
BEING ADDED? NO
ADDITION? ❑NO
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑YES
VED BY '' -'
TOTAL VALUATION:
PLAN'NINGAPPL# [NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑NO
b0
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf I have read this
application and the hdomration I have provided is correct. I have read e Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to build' c sh'uction. �1-autho.iz Resent Lives upertino to enter the above-identi5ed property for inspection purposes.
Signature of Applicant/Agent Date: �It A k ( 4
SUPPLEMENTAL INFORMATION RF,Qttl) 77J-PLAN
cHECK'rreE
.'= Ro ` me sDIP .' *-
-BUILDING
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(B). Demolition permit is required prior to issuance of building
OVER -THE coU,'TER
,
J P%An RE�IE,w
i
permit for new building.
❑ EXPRESS _
PLA.vuNF'REinw.-
_ Connnercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑' YUBLIc nio�Gs - -
form if any Hazardous Materials are being used as part of this project.
-❑_ -
=-
'
LARGE
[1 FIRE DEFT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑ IyL470R
❑ SANITARY SER ER DISTRICT
submittal of Building Permit application.
tJ ENVIRONMENTAL HEALTH
Bld App_20l1.doe revised 06121111