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B-2016-1592 - Application & Fee EstCUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • bUIIding(a�CUpertlno,orQ ❑ NEw CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT X PROJECTADDRESS . ^ . 1per, APN� /q� �- f.515 E7 & L C -G, / •N OWNERNAME I PHONTE E-MAIL 1}mKvmar� _.0 lr ���s� — STREET.4DDISS I FAX Cr CITY, UATE,r2l'INQ ,-` Ch1 CLT-r♦`v�^ CONTACT NAME 25 �. I PHONE ���) r�(7^G� ,,.t^ E.MAIL�+ S tZ ,� V j�i�r�-�/A AIM I K� Qt rD fl-��='f(-I� �1 (=1 LW S'r& ET ADDRESS)J CITY, STATE, ZIP [� FAX ❑ OWNER -BUILDER ❑ OW1,ERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT e ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSENUMiBER LICENSE TYPE BUS.LICn COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEER NAMELICENSE NUMBER BUS. LIC K y� .y COMPANY NAME E-?`44IL FAX STREET ADDRESS CITY, STATE, ZIP - PHONE DESCRIPTION OF woo -�} �I,.��M trtc'n �vr-iC�d� r •s-c'�^ aJrt-�6�.cc� r3 C� S i' EXISTING USE PROPOSED USE CONSTA T}'PE STORIES USE I TYPE OCC. SQ.FT. 'VALD.ATICIN (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA C.� ✓KITCHEN AREA NET.4M.A -- BATHROOM OTHER REMODEL AREA REMODEL AREA REMODELAREA PORCHARE.4 T DECK AREA TOTALDECKTORCH AREA GARAGE .AREA: DETACH ATTACH --- — EAVELLINGUNITS; 1SA SECOND UNiT ❑YES SECONDSTORY ❑YES BEING ADDED? E]No .ADDITION? El NO R PREAPPLICATION ❑YES [FYES, PROVIDE COPY OF IS THESLDG.AN ❑}'ES REC IVEp BY _ TOTAL VALUATION. PLAN`I rMG.APPLd ENO PLANNING APPROVAL LETTER EICHLER HOME? ENO 1'. t £ 1 �A? ©/1D By my signature below; I certify to each of the following: I am the property owneror authorized agent A act on khe property owner's bebalf. I have read this application and the information I hale provided is correct, I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constinclion. I authorize representatives of Cupertino to enter the above-iid�de``ntified pt'openy for inspection purposes. Signature of Applicant/Agent: Date: Sl?PYLEMENTALINFORIv4ATIONREQUIRED CxEcr••,�rl:,.w,__ otiER TxE cooyrER '�"' iL'T SUILDI\G PI.�'. REm ]E\i New SFD or D4ultifamily dwellings: Apply for demolition permit for existing building(s). DenmolitioD permit is required prior to issuance of buildin _ permit for new building,e�PREss 3 z I eLn�vlvc riaY*. RET7Eii Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑` sT:i�-n aRn _i x µ!* POBLIC\4 oRRe __ fonn if any Hazardous Materials are being used as part of this project. LARcEeg Copy of Planning. Approval Letter or Meeting with Planning prior to ❑ _ submittal of Building Permit application. MAJOR SA_VTA;R1 SEN ER DISTRICT ❑t HEALTH E]CIRONMENT.4L G55�ss�V Bld&4pp_2011.doc revised 06121111 c��t ova i \cw CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADS: DATE: REVIEWED BY: jaDRES APN: BP#: -VALUATION: $90,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD Or Duplex 2nd Unit? �.: Yes No PENTAMATION 1R3SFDADD USE: OTC. Oyes CNo PERMIT TYPE: WORK SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP PEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 523 $2,654.00 IR3PLNCK $1,666.00 IR3INSP U (Private Gar/Ag Bldg) II-B,III-B,IV,V-B 355 $0.00 I UIPLNCK $1,290.00 1 UIINSP TOTALS: 878 $2,654.00 $2,956.00 MECH,,HdURLY 0-Yes (E) Nu PLUMB, DOURLY Yes ELEC, HOURLY C Yes t 7Vo -3 t h. fnn,a:x f'ee_ i si`. Pomir i ee� 13 F Iawi,, h'," FI> EI _:. ti riY:.Ej NOTE: This estinate does not irnchule fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreGminary information available and are only an estimate. Contact the Dent for addn'l into. FEE ITEMS (Pee Resolution 11-053 E '. Z I/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,654.00 424 I s.f. Remodel, Other CoAV2f5tcvl $503.00 IR&NRESOTII 1 C)06 Q a%-mo A Suppl. PC Fee: (@ Reg. C OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,956.00 Suppl. Insp. Fee: Reg. C OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 `vrn-cruc, tiort 7ov .qdmhn,sIranlee Fag:: C C Work Without Perm it? C Yes C No $0.00 Adv_anced_Planning Fee: IPLLONGR $122.97 Select a Non -Residential t Building or Structure C i Tr v& Zhu ana nfulz,V! 1'11es, Strong Motion Fee: 1BSEISMICR $11.70 Select an Administrative Item Bldg Stds Commission Fee: 113CBSC $4.00 SUBTOTALS:; $5,748.67 $503.001 TOTALFFEE $6,251.67 Revised: 01 i01 i2016