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1270 CITY OF CUPERTINO APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER AND CERTIFICATE OF OCCUPANCY • BUILDING INSPECTION DIVISION STREET ADDRESS OF. PROJECT: 10!90,L.... _L©c .u7o.00�......lOr__ ................ •-- ...._ Date Legal Description: Tract....... _............. lock ... Lot......_ ............ Plans Received By........ -!!..r...F. Description of Work: _r'Qa.W.00 ..._y Cc-.L(......_.-_-. - .-- ..... ...... �..��.�D REO.: Plans.... Survey.... Cates: Struc._... Energy.... Elect..... Iviech.... 1st Struct. Improvement on Parcel: Yes.... No.... Area of Bldg............... Plans Checked By.... Date .... .......... .. Separate Structure............ or Addition/Alteration to Exist. Bldg........... Application Approved By...........�c--r..............._Date ..�r�/�. No. of Stories..............., Us f Building ........_........_.............................. Validated 8 _ ... Date ... Valuation of Project: $.._. 00C) r _.... ... Compensation Certificate Verified By X �{ Date 6//�A.. Owner: /17 fs. ...GNrAbP Ili Phone -_... .... F" Contractor: CSS Ce L. Cotes r. Cit Bus Lic # - • • " • $ d " Contractor's Address t(03 W 1�7.Y..`Q JSS ✓C Phone 733r93b•I Contractor - Electrical: ......... - Permit Fee (plus penalty if applicable) .._..............._...$.... .6*0 City Business License #.................... Phone:..__......._..... Plan Check Fee (less deposit of $.._..__ RCL #_........)$...... ..... ..� �.. Plumbing: Energy Plan Check Fee (Dep. of $........ Rct. #........)$............. 9Busi.....................e #................_._Phone:.... j-'a City Business License ................_._ Phone:.................... Strong Motion Fee ...---_.................._........._.....`...-.:n.$.........r._.......... Heating and Cooling _....._ . Plumbing Permit Fee ..........._...._ ._'..-......:...........$-................._.. Electrical Permit Fee ..__..._............__......... ...... .. . ..�$.................._.. City Business License ...... .....- Phone:.................... Mach. Htg./Coolg. Permit $.......... ..:.^ �D �$ Architect: Designer _........ _ ... __._ Phone: .... Residential Construction Tax .. _ HV U t ...... Engineer ..._ ... ................ __. Phone: ....... Lender .... . . .. . . _. _.. .. . __........ . ❑ Unknown Misc. Fee ..................__...--.......--__.. ........I....... .... ..,$..... .- _ Mise. Fee n A____1 }�$ --�� -- - "I certify that it the performance of the work for which this permit Is -- ------------ ---- ---/- -'• - issued shall not ampl y any person in an manner so as to become subject • ; $ / y�Q to the workman' reun ion laws OI Cal ornia / SIGNATURE OF • • APPLICANT/OWNER .. ._........_. _. ..... _....__ DATE ___ .. .. .. Environmental Status: Exempt . Other . .___. .__. ... I roroly that as me ap m m u used unde me provision. of the Design Review Approval: Bldg ...... Site ....... Sign .......... Contractors License Law and further t at my Licees No ................ Use Zone ............ P.D. Conditions __. - In Classification ...._..........._............_. .. is in full force and effect: or Cond. Use Permit #.._._._.. Variance #............ Parking Spaces.... __ _ I certify that I am exempt from the "Licensed Required" provisions of the Approved B ..... Date _ Contractors License Law. (State basis of exemption.) pp y-....-.--.-----.-.--- --"""...... -""......--- -'-"" I hereby acknowledge that I have read this application and state that the above Is PUBLIC wrrect and agree to comply with all City Ordinances and State Laws regulating WORKSbuilding. I (We) agree to save, indemnify and keep harmless the City of Cupertino croachment Permit__ ............. Grant of Easement........._..._._ .... against liabilities, judgments, costs and expenses which may in any way urb, Gutter, Sidewalk, Driveway: Replace.......... Repair......... acture against said City ' sequence of t e/9r tin of this agrm�itf' Sewer...._...... Conn. Fee $................ Water................ Meter $...-...... SIGNATURE. OF /n,� Q/IO/ D Agreement for Completion of Public Works Improvements .......- . APPLICANT/CONTRACTOR .�. ATE a [.((7711.. Plans Checked By........ Date........ Approved By..... Date.................... NOTE: When properly .alid ato. to m z gtutes a Building Permit. This permit expires and becomes null an voi sl Id work not,be commenced within APPLICATION FOR ELECTRICAL PERMIT 120 days from validation date, ar should authorized construction be suspended or sal mmomm, abandoned for a period of 120 days after work is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION •. PLUMBING Light Outlets......_.... Switches............ Fixtures__._..... Receptacles............ PERMIT INSTALLATION NO. EACH FEE TOTAL NUMBER (less than 1000 watts) ..... ....... $ ,50 Gas System with up to 5 outlets ................._.... ..........$4.00. ............. Range_...... Cooking Unit........ Oven............ ......._....... 2.00 ..... Each additional outlet .___.__......................_...... ..`1.00............... Dryer...__ Garb. Disp......... Dishwasher ........ .___. 2.00 .... Water System (Installation, Alt. or Repair) _._.......... 4.00.._........... MOTORS: 1 HP or less .........................._............,.._.... 2.00 - Water Closet.... Water Heater.._ Ld. Tray......__.......... 4.00 ---- Greater than 1 HP not more than 5 HP .... .._._- 3.50 ......___. Lavatory.... Shower Pan.... Bathtub.... Sink................... 3.00............... Temporary Power Pole or Service — 100 amp I.......�..5.00 .. ............ Wash. Mach..... Dishwasher.... Garb. Disp..... ..- -........ 3.00............... —200 amp..'.'... . 7.00..........._.. Sewer ............ ..................._.....__---......._.._.._...._._... .. 8.00._..-........ Time Clock ....._......__................... ........... ._......._ . ......... 1.50.. 1, -...... Lawn Sprinkler Sys. $5.00 Ea. add Sys. $2.00...:................ ............. Misc. (see Ord. current)•• •. ................................................ Vacuum Breakers ..................__._...................- ..............3.50.............. New Residential Occupancies Flat Rate Interceptor........ Water Softener........ ......._.._... ............4,00. ............ Plumbing Piping without fixtures ....................... ............4.00............... 0-500 sq, it. $22.00 1501-1750 $34.50.............................. Misc. (See Ord. Current) .................................................... 501-750 24.50 1751-20000 37.50.............................. Permit Fee ..........................................................................$6.00 751-1000 26.00 2001-225C 39.50.............................. TOTAL PLUMBING PERMIT FEE (plus penalty if app. '_) $ 1001-1250 28.50 2251-2500 42.00.........'..................... 1251-1500 32.00 2501-2750 49.50.............................. APPLICATION FOR HEATING/COOLING PERMIr Permit Fee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty if app.p) $ PERMIT INSTALLATION NO. EACH FEE Forced Air Unit. ......to 100M _..._.......................$6.00............... INSPECTION RECORD over 100M .......................... 10.00.............. Comfort Cooling Unit......to 3 ton/HP . 6.00 ...... Forms / Foundation __ ... .I By Date _ .. to 15 ton/HP. .... 9.50 .... Plumbing Ground Work - (__. __. -----.. to 30 ton/HP. ... - 12.00 . ....... Rough Electrical __ ... -�._.. ... _- -.. to 50 ton/HP. .. 17.00 . ........ - - ane - Plumbing and Heating L_.. .. . ---- Space Heater........ Wall Heater .........._......__.:..........I 6.00,,,_-_---,-• •nu lation & Energy. ... ._4 - Flues - other than above .. .. 3.00 dos Test ....... .. ... . . ._. - Vent Fan: Kitchen........ Bath _.__ _ 4 3.00 Temporary Power Gas / Elect .. -. .. ._ Commercial Range Hood _ .. .. J,. 6.00 Final - Electrical ...... .. ._ - Misc. (See Ord. Current.. -.. l Final - Building / Mechanical ...._.__ .......... _---......L.................__.-- Permit Fee ............ _........_ $ 6.00 Final - Design Review / Landscaping _ ..._. ..........._._-....................__ TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. ❑) $ Fi al- Pub lWorks .... ...................................................... 10 . ,--l-4 -sem (319,11 • 810•9e