1843CITY OF CUPERTINO
APPLICATION FOR COMMERCIAL BUILDING
ANo
• CERTIFICATE OF OCCUPANCY
n �elsP_EaT1nt�lvtstnN_
Plans Received By ....... ................ .................. _...... .
Date ........................
REO.: Plans.... Survey.... Celcs: Strua._. Energy....
Elect..... Mach....
Plans Checked By ....................................................
Date .........................
Application Approved By ............... _..... .__.... --.....
Date ........ ._... --- .....
ValidatedBy ................... --.............................. _.......
Date .........................
Compensation Certificate Verified By ....................
Date _........................
fd
...,
Address: ..308 Sango. Ct..-Milpitas Phoneg46 7272
Permit Fee (plus penalty if applicable) ..
Plan Check Fee (less deposit of $ .... Rct #
..)
Energy Plan Check Fee (Dep. of $........ Rct. #........)
$................. .....
Strong Motion Fee ....... _._.—.........................
$...........x.70...
Plumbing Permit Fee ... ...... --- ..... — ..... ..........
_...... $...... ..... ..._.......
Electrical Permit Fee ......................................................
$.......................
Mach. Htg./Coolg. Permit $ ..............................
$...... __..... _..... .
ConstructionTax.............................................$.......................
.........
Sewer Conn. Fee .............. Water Conn. Fee .....
—...... $-- ......... .......
Landscape Fee .................... Street Tree Fee ....
Misc. Fee ..... ............... ._............... ....................
—.... _ $........//..............
$.....tp•1.r
_ IF
$ 5 D'R
Type Const......... Group _....... Div......... Occ. Load........ No. Exits........
Floor Loads: 1st.... 2nd.... Other.... Sprinklered...
. Area Sep. Walls....
• r
APPLICANT/CONTRACTOR........ --.................... ....................-- DATE .._.......
Environmental Status: Exempt ..... ...... Other.____
.............. .
Design Review Approval: Bldg .......... _ Site ....._.....
Sign ............
Use Zone ............ P.D. Conditions ................ --... ..
......... — .... ..................
Cond. Use Permit *...... Variance •..... Parking Spaces.... Load. Sp.....
ApprovedBy . ................. --............... ....... —........... Date ...........................
$ 4.00 .............
Each additional outlet .................................. ..........
a
Encroachment Permit .............. Grant of Easement...... .... ....... _.....
Curb, Gutter, Sidewalk,Driveway: Replace
Repair
Sewer............ Conn. Fee $... ............. Water................
Meter $ ................
Agreement for Completion of Public Works Improvements ..................
Plans Checked By........ Date........ Approved By........
Date ....................
PERMIT INSTALLATION NO. EACH
FEE
Light Outlets............ Switches....... --
....Fixtures............
All ADDRESS OF PROJECT:
Fixtures ............Receptacles............
Legal Description: Tract ... ........... Block............ Lot......................
TOTAL NUMBER (less than 1000 watts) ... ............. ... $ ,50
....... -
Range ........ Cooking Unit........ Oven ......................... .... 2.00 ..........
No. of Stories ................ Use of Building ............ ......... -- ...... ................. ..
Dryer.... Garb. Disp..... Dishwasher.... .... ........ ... ..... ... 2.00 ...........
Owner .D.e.vCOxi .... .... Phone: ..
SERVICE OR TEMPORARY POWER to ,. 2.00
...,
Address: ..308 Sango. Ct..-Milpitas Phoneg46 7272
100 amp/$5.00, 200/$7.00, 500/$9.00
City Business License #....... —.......... Phone: .......... - ........
800/$20.00, 1200/$40.00 . ......._...........
__......
MOTORS, Generators, Welders, Heaters,
City Business License #. ...... - ........... Phone:....................
per HP—KW—KVA to 1/$2.00, 5/$3.50,
Engineer: ........ ..__....... _........................ ..............._... Phone:..........
20/$6.50, 50/$10.00, 100/$12.00,
............ "I certify that in the performance of the work for which this permit Is
500/$15.00 .... ............ ........ ._....... ........... ......_.._. ......_..._.............
to the workman's compensation laws of California."
Signs with I XFMR ...................... ..— ....... .......... _. ... 2.00 ..
.........
Each additional XFMR/Time Clock ... ............. ... .50 ..
.........
Annual Electrical Maintenance .............. ... 25.00 ..
.........
Other (see Ordinance Current) ......._...___......_...... ................
..
..6.00
........................... .............................................................
Permit Fee ......................................................................$
building.
TOTAL ELECTRICAL PERMIT F E (plus penalty if app. 0) $
against liabilities. judgments, costs and expenses which may in any way
Forms / Foundation .............................
Plumbing Ground Work ......................
11K,ough Electrical ... ........... ........ ...... __-
rame - Plumbing and Heating ........,
insulation / Energy .............................
GasTest ...............................................
Temporary Power Gas / Elect..........
Final - Electrical ...................................
Final - Building / Mechanical .............
Final - Design Review / Landscaping
Final — Public Works ...................
By:. ................. I Date: ................
....-................ ............ ....... ...... -
OF, C PERTINO
N2
N
Q 0
1981 PERMIT NUMBER
�� 3
All ADDRESS OF PROJECT:
10161 Bubb Rd. ........................................ _................ —........
Legal Description: Tract ... ........... Block............ Lot......................
Description of work: ......Fire_ Sprinkl.Er.s.................................
1st Struct. Improvement on Parcel: Yes.... No.... Area of Bldg ... ............
Separate Structure ....... or Addition/ Alteration to Exist. Bldg...........
No. of Stories ................ Use of Building ............ ......... -- ...... ................. ..
Valuation of Project: .... .... ...... ................
Owner .D.e.vCOxi .... .... Phone: ..
Contractor: Superior. Auto �Ijy1HtA19�. COrp.,
...,
Address: ..308 Sango. Ct..-Milpitas Phoneg46 7272
Contractor - Electrical: ............. ...... ..................... ................. ....... .........
City Business License #....... —.......... Phone: .......... - ........
Plumbing: . ... ................... ... -- ......................................................
City Business License #. - ................ Phone:....................
Heatingand Cooling ... ........ ......... —...........................................
City Business License #. ...... - ........... Phone:....................
Architect/Designer:............__.............._......_.......... Phone:....................
Engineer: ........ ..__....... _........................ ..............._... Phone:..........
Lender: .................................................................................. n... n nown
...............
............ "I certify that in the performance of the work for which this permit Is
issued I shall not employ any person In any manner so as to become subject
to the workman's compensation laws of California."
SIGNATURE OF
APPLICANT/OWNER............. ....................................... --........... DATE ...........................
....._..... I certify that as the applicant I am licensed under the p[,o la1Qn; of the
Contractors License Law and further that my License No. I ........
In Classification ..... — .... ... _-- ... --- ....... . to In full force and effect: ar
............ I certify that I am exempt from the "Licensed Reg. '•ad" provisions of the
Contractors License Law. Isms basis of exemption.,
I hereby acknowledge that I have read this application and slate that the above Is
correct and agree to comply with all City Ordinances and State Laws regulating
building.
I We) agree to save, indemnify and keep harmless the City of Cupertino
against liabilities. judgments, costs and expenses which may in any way
acture against said City in consequence of the granting of this permit.
81GNATURE OF
APPLICANT/CONTRACTOR........ --.................... ....................-- DATE .._.......
NOTE: When properly validated this form constitutes a Building Penna. This
permit expires and becomes null and void should work not be commenrxd lvllhln
120 days from validation dam, or should authorized construction be su°pandi or
abandoned for a period of 120 days after work Is commenced.
PERMIT INSTALLATION NO.
EACH I FEE
Gas Sytem with up to 5 outlets .......................... .........
$ 4.00 .............
Each additional outlet .................................. ..........
1.00 .............
Water System (Installation, Alt. or Repair) ................
4.00,,,,..........
Water Closet.... Water Heater.... Ld. Tray ....................
4.00..............
Lavatory.... Shower Pan.... Bathtub.... Sink..... ... .........
. 3.00., ............
Wash. Mach..... Dishwasher.... Garb. Disp...................
3.00 .............
Sewer..............................................................................
8.00
Lawn Sprinkler Sys. $6.00 Ea, add Sys.$2.00....................................
VacuumBreakers ............................................ ..........
... 4^ 50..............
Slop Sink........ Floor Sink........ Floor Drain .... .........
... 4,00..............
Urinal.... Interceptor.... Water Softener .............. ............
1
4.00 1 ........
PlumbingPi in without fixtures ....... .....
4.00
Misc......... p..........................................................1....................................
PermitFee..........................................................................$
6.00
TOTAL PLUMBING PERMIT FEE (plus penalty if app.
p) S
PERMIT INSTALLATION NO. EACH FEE
Forced Air Unit ............... to 100M ........................ ......... $ 6.00 ---------------
..............over100M
over-100M.............. --.......... 1 o.00 ...............
Comfort Cooling Unit..... to 3 tan/HP ............................ 6.00 ...............
to 15 ton/HP ........................... 9.50 ...............
to 30 ton/HP .......................... 12.00 ...............
to 50 ton/HP .......................... 17.00 ...............
Space Heater........ Wall Heater .......................... ............ 6.00 ...............
Flues - other than above .................................... ............ 3.00 ...............
Vent Fan: Kitchen........ Bath .............................. ............ 3.00 ...............
Commercial Range Hood ............. 6.00 ... _..._.......
............................... .
Misc............................................................................................................
PermitFee........................................................................ $ 6.00
TOTAL Htg./ Coolg. Permit Fee'(plus penalty if app. p) $