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CITY QF CUPERTINO
APPUCAT104 FOR RESIDWIAL 5Ut4DNG1feERMIT ,kl :; t �,. /r y ,, -. PERMIT NUMfBER> //(e
CERTIi1CATE G OCCUPANCYr ,t.'
BUMDUMAS IMSPSOTTON Ottl9tiW1{ r.nrgr p >e,. rs AODR Q�'PR E T
•rt w iYA f e v '.),:'<xIO.7S/Q M7 PFICI
• Jx Ligai lona Tract a > Bock lel .
Plans Rae~ft. ......
Otto"^, + 9a:y„ t> Via„ pe ,rtPtiwawas S�SiPfltf.6. �rdrpN+�+fa „ (,
REO.: Plans... 8tpveY._ Cake enol. Ea f ' ,. '
agy,_ 61a0t„...MOW„_, 1st Stnwt,uttpnwemeni on Parcel: No Area d Bldp� Ir
Plata Chocked BY...... . -Dab' y. Separate Structure .-. Or AOOIIkn/Altaretbn to Elf Bt I..
Application Approved BY Q. r Dat4m7 �° lien or Sioncs. Use of Bulldl
v,lidated h Dab VMitailon of tech. 3..: ' x
C/m0e11aa1k1n Certificate Verified BY ...DeM'ruyy7� ',e. 1'A; p�tyt; ...�://H:Ld)' �rRj4i ;.Mans�.5�.;34'0'1 ;�i
• .t
Ail o CCndtllttanw. .., Chi B1a. Lk
a or r`e CCRheCMr+a Addres9' ( ,1J 0 ' TPhoneI i•.,
Permit Fee iglus penalty It amiteaba) t1ga +r ax COxtraets. F14tlrleal:' t to`�„.r ! I';
POP Check Fee(hat deposit of S ... RC1 a;, )tom,.„, r, t :City Wauross License • + c. Phone 1
E"Or Plan Chock Fro .•-• ,
OY (�. W S, ficL4 )3 a, < h J " PaaxWttg „r..:. .. ..n,h ..r.. rye , 1
Strong Motion Fee . 1..:"..+... " v CityBusiness LkeMe e a vPhone
Plumeinq Permit Ft* 4, 1 St t + V0 .r. Healing and Calling
Electrical PermCity Business Llaen
lt Fee u u .,4u ta, 4d 3 n a.Cd t -rA +--7 X110
RvaWontinl Corlstuurtlon Tal .,.„,,,,,, s ,1.�Y�N to a'�,z,•{ rr,r'f ' ,ATr^+3teU'.,i'xlt wr1 1, '1utt't' °I"
...........
f�?
risen.
4FFa.. ' JAN: PhOae'
MLsc. Fes ... ..� .:.,,.,, uC,"w*C =v'f'^'.W,Ir7" r1 a; LCnCar , s. n"l0.Un1[nown
Mlle. Foo " �,'H" yNrc''�at y' } 1 001, mho (n."tae a 'Ortetka M da aga'tp road+-aft parrit a
... .. - -,.,....w tt S 0,. + .� (FT, ,y IMffe01 alae n01 dmabl ver/Onedet In sm •a d a trloar ereiert
aYusi•Iwmena'
• � .... �i• aW�L+tcAlRrtlWN9a c r[(/�
Environmental Stehu: ExanDl rwC4r rr Other T„ +,r. tar+. ,2't�f 'i'E.m�r kJa.0 a. woa.w_;,r„ adeaa.e:ad. w serieare a r» ' ".
Design Rrnitw A11A10`tal, Bldg. iriF...- 31t0L r,.-,rSsrS10n •caw d f 3T,?r. Oew:cron lkaaa Lw ria it~as no Ucwr ea..:._r._...
Use ZOtw . P.D.Gestations 4... w..L�.i••,it�k 't 1 n� i ,y " ,to dwaaenbn.+.:r .l..r.: h Y 4a 1010 eat Mlw.e'or 'y
" Cond. Uee "omNl a ,�. Vadenco e r �.PalkMg-8pacea 5 ..X..i reniry mal I taw-e.e•at twa tui•";Lkw•e n.eetwa':trier�en•rn n,. :I
A onto B + . 1 '. ' Odwrsetwe LkwO L".(steel sen a
tri Y'. ... ._.:... .„„i. Orb Jw'...r. thew.MaMe100•tern I here wed M• 4
<. • 4orem
• le cap•/ sot as GIF OrOrta•ntlaad 9A Lines 9Jlr<K
toklow a0d
a
nermMnwnt Permit Grant fel Eaxensnl n� tin ,t,m k r' 'I p1n1 tldN 1•an•,indawnnone,Wp earallaes,Wi cry w copal e
•�.- +>Gka1 naelnllaa )0gpaameras a+A•xpamp:wakk wall in rn n
tub, Gutter, Sidewalk Drte lf” Replace :+, RCPBIt �+k N )apotpe'regional asid City In c of ti' ma d mho am t
I.
Sea•M..._....,,. Coral. Fac S _. Water..:..: ' Mater-S.[r. '3.1:1 1.11... i Mt, SKMT/tae oe. ,* , 5_;,a'
Agreement ton Comptobon of Poblk Works ImprVuamML1. ) -V swatcaaricowim _ . . ,_. _.. : ,.(r.�.. :_... ”
9y,._ - Approved BY ..Data.. u^""�;�},,x .o7ai �ilw.oray.rN.alaa•a;w. aa..•�r.+r.'a�t ver. nu, '.
Plans Chocked Data._.,,. t 4�Y,:w3'P✓.i,✓
• 'a 1 't>M plat ee.,enMnka✓W�ar'Mwa7'rYerhea aeareluilw 4Isomk •4 it
rr aanaaaaatMl - of; ad"snwe le�sa4r y..'}J._.. •I,•
PERMIT INSTALLATION .: �NG EACH FEE r r c
a
Light Outlets ...... Svnethea .. _, y J:rPERMIT,INSTALLAT1pH, +N0. FAF.1( ( FFE
FirNnes . .. Receptadaa.__.._.. < 3,
TOTAL NUMBER (lase than 1000 watts) .....i...._. i AO -:. 'r - Da,System'wlth up.ab�oupeb
Rw g.-. Cooking Unit ... Wen 200 7-'EoOh adrlillonal outlet .... '1A0
Dryer Gans. Diss .. . Dishweahtr r 200 t,• Waai System (Installation,JAIL'or.Fbpeir► .. A0 i
- , MOTORS: 1 HP Or less .. .. .._,. - 200 Wetei CksM- Water HaaMr td., 4,00
Greater•han t HP not more Ihan S NP •.. 3.90 '. Blower Pan Bathlteb Sh* 3,00
t 7er,.Mrnry Power Pole Or Service— 100 amp - 500 J-1--l-'. Wash,k1a011 DlaMlaaaer Gart,DIOp.,r.."' 3,00
—200 amp.; 700 8ewr. ..... 1.00
" Time Cock _ .. 1.50.3 '' Lawn Sp Witter SYs. It C 00 Ea add aye S2 00 ...
pe
Mate •n< Ord.current 1............t..........:.... . ......... Vacuum Betaken,_. ... ;'._..... 3.30
Me <mdlntier Occupant ice haets >" •`.. tlaefCapipr.«.,... Water egtlenar.: r
- " '
4 00
PhpnbbV Piping without fixtures `�' 4.0D..
0-500 v0. rt. 122.00 1501-1750 934.50................ w«. (Sae Ord, Current)
I 501-:50 24.60 1151-20000 t 37.90................ . + •d-.:., ti I.
� 751-1000 26.00 2001-2760 39.60................ i Permit Pa,, ;._ ....... . 9 B o0
,s. 1001_:250 29.50 2251-2500 42.00................ TOTAL'PL UMBINO OERMIT•FEE(pita peralp C MCL:CD a IJ�j
1251-1500 32.00 2501-2750 49.50.....................:........ . APPLICATION } '}it Pet mil Foe...............................................91.00.`' n ` i}
TOTAL ELECTRICAL PERMIT FEE (Plus penalty it app-CID Qy PERMR INSTALLATION .6Yx 520- "Or EACH FE 41.0
/ Fenced Ail Unk..:...
+ ; • • , r who t00M .r.�. am /0.00
Camlott C1011nq Unit.....b 3 lan1HP .'1.00 t L1
Fwmo / Foundation I By6. Oate to ton/
1411i
Groun� Warr Hp q-60 �r
to 30
Rough Elxhrcnl to SO tOrt/tW
�', i ... I ,. ., $pace Heater %Z.:,Wall Hater. - w av v r e { 1�
name - PlUmbinO and Heating " ..
simian A Enway " f Flues other than above .
One Tesl
}•" Elertncal aV't�:. Void Fen. Kitchen Bak
eo Iptu, Pe^nthy a1'W 3.00
nr Elect./ Commercial
. MIoOrren
Fnau,laing/Mwchnnical Permit ....
FnnUn,lc / ve + Lonrsca mo TOTAL H / C Farmit•F
91nAl- PnPIIC works "• . ...
' ( '�':% 't t• ♦�, �' +I,k
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+ ira•{Y rr - i }I t IJP. .I
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