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1301 CITY OF CUPERTINO �JoA/ 3o3J APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER AND � . CERTIFICATE OF OCCUPANCY APPLICANT TO FILL IN BUILDING INSPECTION DIVISION STREE ADDRESS OF PROJECT: .a-T-!r.....Anthony...Place...........................--................... • • • • • Legal Description: Tract__.6551........ Block............ Lot......1.1........... Plans Received By..............ii.............. Date Description o .. f work: ...SingleFami1y...D.we11ing................ ......... .. . ..�37 ... REO.: Plana.... Survey.... Ca cs: Struc......Energy.... Elect..... Mach.... 1st Struct. Improvement on Parcel:YesX. No... Area of Bldg..3.030H Plans Checked By............. ...L�. Date - . ....... Separate Structure. No or Addition/Alteration to Exist. Bid 639G Application Cc A roved B J r Z 4 S p g Approved y.............L9e...-�...............Date ... a._. .. No. of Stories......2....... Use of Building ........._........._............................ Validated By... . _Data ....�. .... Valuation of Project: $.129,,000....__...._............._._............................ Compensation Certificate Verified By _./ �`.L... Date _... ..... .. .0Owner: _BAS..HDmes,.-.Inc............_.......__...... Phone:.25.2.-2077 • $ 129,00 Contractor: -BAS...Homes ....Inc.. ... .......City Bus. Lic. #110b1.. • ' Contractor's Address:20..8.�3...S.teV.ens._.CTK.. Phone:.252c.2.077 Permit Fee (plus penalty if applicable) .............._. ......$......330...50. Contractor - Electrical: .The...Bes.t...El ectri Cal...Col_.............. Plan Check Fee (less deposit of$....._--- Rct. #........--)$...................... City Business License #._18172.. Phone:.28.7-..20.40 . Energy Plan Check Fee (Dep. of $........ Rct. #.......-) $....................... Plumbing: .Cro 1.ey...CO.......................................................... Strong Motion Fee ...........................-----.................. City Business License #..1664.1..... Phone:.245-..4.2.40 Plumbing Permit Fee .....$.........8.6...0.0. Heating and Cooling .Al...Boyer...Co_-............................. ......'....... ' .. ... City Business License #................... Phone:...792-.432 Residential Coolg. .ern Tax ..................._ ( t _ $ 5 0 Architect/Des ignerSwal.loo.Bates.83R-995.6 Phone:.7.1.4...75.2- 924 Electrical Permit Fee _..._........ ......_ ..._...,t.'••.....: $.........53...50. Constr Mach. Ht /Cool PermiR$................• 3 Q Engineer: McKay...$..SOmps............................_.. Phone:.985.-.0.9.60 ................. $....................... Lender: ...Wells .Fargo .Bank... ....._.............--- ❑ Unknown Misc. Fee ....................................................................... $..._.........---------- ... "I certify that in the performanceyperson of the work for which this apermit subject la MISC. Fee ........................................................................$....................... issued I shall not employ any person in any manner so as to become eubleet • $ 514.03 to the workman's compensation laws of California." SIGNATURE OF ZONING • APPLICANT/OWNER ................................._.._..................._............ DATE........................ Environmental Status: Exempt............ Other...................................._- "1 certify that as the applicant I am licensed unclethe provisions of the Design Review Approval: Bldg. ............ Site ......... Sign ....._..... Contractors License Law and further that my Licens, No. ...Use Zona P.D. Conditions ...... ........................__.__---...._..... in Classification ............................---- is in full force and effect: or Cold. Use Permit #............ Variance #.......... _.. Parking Spaces............ I certify that I am exempt from the "Licensed Required" provisions of the Approved By. Date Convamom License Law. (Stale basis of exemption.) ""'""""""""""'""""'""""""""""""""" """""""'"""""""' I hereby acknowledge that I have read this application and state that the above It • .:orrecl and agree to comply with all City Ordinances and State'Laws regulating balding. t (We) agree to save, indemnify and keep harmless the City of Cups Inc C/08Chm80t Permit......_.:.............. Grant of Easement........................ against liabilities, judgments, costs and expenses which may#,;� y w �b, Gutter, Sidewalk, Driveway: Replace.......... Repair.......... occurs against said City n onsequence of the granting of thml . 7 ISer............ Conn. Fee $................ Water................ Meter $............... SIGNATURE of ment for Completion of Public Works Improvements .... APPucANTicoNTRncT l .La;!!�!t0. i!..! ,�pTE _. .......... Plans Checked By........ Date........ Approved By........ Date.................... NOTE: When properly validated this form constitutes a Building Pam . This permit expires and becomes null and void should work not be commenced wlthl • • 120 days from validation date, or should authorized constmclion be suspended or abandoned for a period of 120 days after work is commenced. PERMIT INSTALLATION NO. EACH FEE Light Outlets............ Switches............ APPLICATION FOR PLUMBING PERMITti 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 ...........-.............................. 1.0o............... Dryer........ Garb. Disp......... Dishwasher ............. ._... 2.00 ........__- Water System (Installation, Alt. or Repair)1..........1... 4.00......4....QO MOTORS: 1 HP or less ................_.................__. ....... . 2.00 - ........... Water Closet..4 Water Heaterl. Ld. Tray...I----------5... 4.00. .. *,'...0 Greater than 1 HP not more than 5 HP .---........ 3.50 .....--.... Lavatory.6 Shower Par l Bathtub..3 Sink...1._...11... 3.00....3.3.,.Q0 IL Temporary Power Pole or Service — 100 amp . ....... ..5.00 .............. Wash. Mac 1 ishwasher..l Garb. Dial.....1.......3.... 3.00.......9...&0 Iii —200 amp. ........ 7.00 .............. Sewer ..IF .20....47F._...:.....................1........1.... a.00 ......8...DO Time Clock ..............--.._._.......... ..................._............, 1,50............... Lawn Spr nkl r Sys. $5.00 Ea. add Sys. $2.00......: . ................ Misc. (see Ord. current 1...................................................... Vacuum Breakers .....-.........-................. ...........................3.50.............. Now Residential Occupancies Flat Rate Interceptor........ Water Softener........ . . 4.00. ............ Plumbing Piping without fixtures .................1.............4.00_,,,,,Q,-Q 0-500 sq. ft. $22.00 1501-1750 $34.50.............................. Misc, (See Ord. Current) .......................... —i 501-760 24.60 1751-20000 37.50.............................. .................................................... if 5.00 .••• r 4 751-1000 25.00 2001-2250 39.50.............................. Permit Fee ...........................................nalt.........pp....1) 1001-1250 26.50 2251-2500 42.00.............................. TOTAL PLUMBING PERMIT FEE (plus penalty if app. �) $ 86.00 •? I 1251-1500 32.00 2501-2760 49.50.............3.030......... a • . • • PermitFee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty If app.0) $ PERMIT INSTALLATION NO. EACH FEE 55.50 Forced Air Unit..................to 100M .........................2...$ 6.00 .12...0.0 • ' x over 100M ........................ . 10.00.. ........... Comfort Cooling Unit......to 3 ton/HP ......-...--.......... .. BOO_. ............ f!g undation .......... . .�.... By: .- . Date:. ...... to 15 ton/HP.._..................... 9.50.............. round Work e.. . • !/.r./r' .. to 30 tori.....--..................12.00.............. . ...... .._.... .. ......._._.... ..1..r.. 9'!Q.1_.... �` to 50 ton/HP...........................17.00.............. mbing and Heating ......... ...................... Z./..'.��........... Space Heater........ Wall Heater .................................. 6.00„ . Ener ”" "" 9Ytl .. .... . ...11 Flues - other than above .............................................1.. 3.00.............__..................._..... ...._.. _. . .... _! 7 .^ ��-�.1... Vent Fan: Kitchen...I... Bath 3...../.Dryer...1..._5.,,. 3.00....15...0.0 Power Gas / Elect. . ........ .... ... -. Commercial Ran a Hood 6.00,____.trical ........_._..__..__................ �1 �.-^"j%..-t�� 9 ..........................._...._ ....... ........ ( ........... ..7- Misc. (See Ord. Current.............._...__.................................................... � Final - Building/ Mechanical ...-._._. ............. .. -7r{=� Permit Fee .................._. ....................................... $ 6.00 Final - Design Review r Landscaping . ... .... .. .................... ....... TOTAL Htg./ Coolg. Permit Fee firs penalty if app. ❑) $ 33.00 Final-Public Works .......................... ....... ... . ........ Isla.� , t cwt* po�T v,c. w9 far.law ,t... �,►,�-�o j vF, LwreiT 116 1 LT.JTT rr^ ? Loca'tion —�'=y— Z Sub e _ �� ( �• ' 0—✓l NTTOteS ---- Approved Date I ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO E I- 7 19 To 5 i j You ore hereby authorized to Connect electrical service for EM 6 Owner or Tenant At u No.of Wires Size of Wires Size of Switch OMotor Load ^^ Voltage Phase a = j Heating Load K.W. VoltageIS INo.of Meters Light-1 10_New Service Reconnect m � 1(11 Heat � 120_Three Wire More Service No.of Add.Meters Power n Three Phase Move Meier I 1 ©M ELECTRICAL INSPECTOR ��/ �