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1312 40 CITY OF CUPERTINO APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER AND FOR APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY BUILDING INSPECTION DIVISION ST EET A_WRESS OF PROJECT: Q/iS'J._._........._Byer l.y...Court.._............................................ DEPARTMENT USE ONLY Legal Description: Tract....6551......... Block............ Lot.......2.2.......... 'J Description of Work: .$ing.le_Tami.ly...RW.ell.i.ng.................. Plans Received By................r/:... ................-.....-.Date .�_����' ... ... ...._........-............ .. .. .. ......... .... .. .......2.... REQ.: Plena.... Survey.... Calpg: tr c..... Energy.... Elect..... Mach.... 1st StrucL Improvement on Parcel: Yes.X No....Area of Bldgz.242.H.. Plans Checked By.................. ...... .....................Date...... ... Separate Structure...NO... or Addition/Alteration to Exist. Bldg.528.G Application Approved By................ .L.I...........Date No. of Stories....2......... Use of Building Residential..................... Validated B ......... ..... Date. .....� By.................................... . /./... . .. valuation of Project: $.91,.O.QD......................._..........._........_............. f7 Compensation Certificate Verified By .... 4.. Date ...... . .. .. .. Owner: BAS...Homes,...Inc........_....................... Phone 25.2.7.2.0.7.7 Contractor: .BAS...HomesInc..............City Bus. Lic. #11061. • • • • • n fqt nn nn Contractor's Address: 208n..S.tev.ens..Crk. Phone252.-20.7.7 Permit Fee (plus penalty if applicable) ....................._$.......269.,.00 Contractor - Electrical: ..BeS.t...Blectrjcal.:-CO.......................... Plan Check Fee (less deposit of$.......... Rot. #..........)$...................... City Business License #..1$.172..... Phone:..28.7-.20.4 Plumbing: ..Crowley...CO......................................................... Energy Plan Check Fee (Dep. of ......-.. ._.. #.........$.............6...37 City Business License #... Strong Motion Fee ....._.......-................................_........$.............6...37 y 1b64-1._. Phone:..245.-.424 Heating and Cooling Al_.Bo er...Co........._...................... Plumbing Permit Fee ..................................-..............$........-.7.8...0.0 g 9 e y City Business License «................... Phone:.7. -4.3 8 Electrical Permit Fee Permit $..........................................$....._...31.,.00 Architect/DesignerSwallOWBates.838-99S6Phone•71 .. .b.2-. 24 Misc. Fee k'.1........................ $..........31...(10 .. � � - $....................... Engineer: ...McKay ..$...$OmP$.............................. Phona:.98...-4.96 Mach. ....ool.... Permit....... �.......................... Residential Cons.Oruction Tax ............. l I $ Lender: . ..Wel1S..Fargo..Bank......._....................... ❑ Unknown Misc. Fee ... .. "I certify that in the performance of the work for watch this permit is '-"""" "' " ""' ""' -"" """"$"' """""— — issued I shall not employ any person in any manner so as to become subject • $ 432.37 to the workman's compensation laws of California." SIGNATURE OF • • APPLICANT/OWNER .........................._......................................._. DATE.................... .• Environmental Status: Exempt............ Other....____............._---------- .. ..... "1 certify that as the applicant I am licensed undo the provisions of the Design Review Approval: Bldg. ............ Site ..........- Sign ............ Contractors License Law and further that my Licens. 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 and Approved B Contractors License Law. (State basis of exemption.) pp y........_........_....._.... .........._............... Dale ........__............... I hereby acknowledge that I have read this application and state that the above Is • • _ correct and agree to comply with all City Ordinances and Slate Laws regulating building. (Wel agree to save, Indemnify and keep harmless the City of Cupertino %ri OBChment Permit........................ Grant of Easement.......-................ against liabilities, judgments, costs and expenses which may in a way Gutter, Sidewalk, Driveway: Replace.......... Repair.......... acture against said City n ons quanta of the granting of thi mit r............ Conn. Fee $................ Water................ Meter $................ SIGNATURF of Agreement for Completion of Public Works Improvements ........._....._ APPucANT7coNrancro I—... ,Y... ....5K Plans Checked By........ Date........ Approved By..-..... Date................... NOTE: When properly validated this form constitutes a Building Permit. This permit expires and becomes null and void should work not be commenced within APPLICATIONe 120 days from validation date, or should authorized construction 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 PERMIT, Fixtures............ Receptacles............ PERMIT INSTALLATION NO. EACH - FEE TOTAL NUMBER (less than 1000 watts) ............ $ •50 Gas System with up to 5 outlets ... .............. -....$4.00. ....... . Range........ Cooking Unit........ Oven....-...... ......... ....... 2.00 .............. Each additional outlet ............................................. 1.00............... Dryer........ Garb. Disp......... Dishwasher ............. ....... 2.00 .............. Water System (Installation, Alt. or Repair) ..1-...1..... 4.00.....4._DD MOTORS: 1 HP or less ................._....._.............. .......- 2.00 Water Closet3.. Water Heated Ld. Tray...1.......5..... 4.00. 2(1_.00 Greater than 1 HP not more than 5 HP -............ . 3.50 .............. Lavatory..5 Shower Pan.... Bathtub2. Sink....2-....9..... 3.00..2,7.,.0.0 Temporary Power Pole or Service — 100 amp . ....... .'5.00 ......... Wash. Mech.l. Dishwasher...)Garb. Disp....1.......3..... 3.00,-,•,g,_DO —200amp........ . 7.00 .. ............ Sewer ..../O. .3/_................-........-...1.............1..... 8.00.....$..00 Time Clock ......-......-.............._......_..............._......._. . 1,50'............... Lawn Sprinklef Sys. $5.00 Ea. add Sys. $2.00..................... Misc. (see Ord, current 1..:........................................... Vacuum Breakers ......................-.................... ..............3.50..-........... New Realdentlal Occupancies Flat Rate Interceptor........ Water Softener........ .............................4.00. .-..... ..... Plumbing Piping without fixtures ...................................4.00,,,,,,,,,,,,,,, 0-600 aq. ft. $22,00 1501-1750 $34.50.........:.................... Misc. (See Ord. Current) 501-750 24.50 1751-20000 37.50.............................. ..........................................6.00 .... 751-1000 26.00 2001-225C 39.50............. Permit Fee ............................................nalt.........pp..........$ 78. 1001-1250 28.60 2261-2500 42.00........22��.............. TOTAL PLUMBING PERMIT FEE (plus penalty II app.(]) f 7$.00 03 1251-1600 32.00 2501-2760 49.50.............................. APPLICATION FOR • • I PermitFee...............................................$6.00 M TOTAL ELECTRICAL PERMIT FEE (Plus penalty if app.)]) $4$.00 PERMIT INSTALLATION NO. EACH FEE T Forced Air Unit..................to 100M .......... i ..$ 8.00...-1• nn • • - r over 100M ......Y.............. . 10.00....-..Q.,.4 Comfort Cooling Unit......to 3 ton/HP ........................... 6.00............... Forms / Foundation ........_.. __ ... By:... ... . ..... . D e:... ...._..... to 15 ton/HP......................... 9.50...._._..... Plumbing Ground Work M.DW� ... ..... Li. / ....... to 30t /HP on ........................ ..12.00..... Rough Electri ..... .....................�.. . .. X13. .. .l....... to 50 ton/HP......................... ..17.00.............. OI game - umbin and Heating (2 . .' W....... Space Heater Well Heater 6.00.. .. ration nergy..._............._......... {... .. ... . . Flues - other than above ................._....................._..I.. 3.00.............. Test ............... ..........._...... . ... . . . s ...... .( Vent Fan: Kitchen...I.. Bath .3../DT.yer...1.....5...... 3.00.....15...0 mporary Power Gas / Elect. ........ .... .. .................. ............ ... Commercial Range Hood 8.00,.....,,,,,,.,, {{ g ..........................................{4... Final - Electrical ...................................1... ..-.�.��. -r.,r Misc. (See Ord. Current......_............._....._....-.............1........................... Vi Final - Building/ Mechanical ................... .-.1.1."::"-I ... Permit Fee ........................................................................ $ 6.00 Final - Design Review Lantlscaping . .... ............. ... TOTAL Htg./ Coolg. Permit Fee (plus penalty If app. ❑) f Final- Public W q 31.00 �- 7o4 S 3�Y _Q t / ROUTE SLI? File No. Date Loc atLon Su e c t Notes-ti.r��( ®� Anorcved Date s.Jector I I BUILDING INSPECTOR'S OFFICE CupertinoDisuia Copy ry CITY OF CUPERTINO O Backflow Device Sanitary Permit No. J,vver Connection Plumbing Permit No. 1:3 Zi r Plumbing Final Lot No. �Z Owner or Tenant At 0 8 Tract pp � Date Connected ��11- 19�.Da nal 4 - 11 19�_ ©MV PLUMBING INSPECTOR 1 CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE ' CITY OF CUPERTINO DATE � 19'6 t/, BLDG. PERMIT NO. tTHE BLDG. LOCATE AT / o . i OWNED BY— d HAS BEENIA1 FOR USE AS i i t , i OY BUILDING INSPECTOR ELECTRIC SERVICE NOTICE OFFICE COPY I BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO 19 To are hereby au horized to Connect electrical service for Owner or Tenant } L At No.of Wires Size of Wires Size of Switch Motor Load Voltage Phase Heating Load K.W. Voltage v Light I10_New Service Reconnect No.of Meters 1 Heat 120_Three Wire More Service 1 Power ee Phase Move Meter ITNo.of Add.Meters _ Qv Y P—TRICAL INSPECTOR z^' BUILDING INSPECTOR'S OFFICE Bldg.Dept. CITY OF CUPERTINO Office Copy ❑ Backflow Device Sanitary Permit No. V Ger Connection Plumbing Permit No. Z �IZ �. PluTbing Final Lot No. Owner or Tenant A) c- At I O U L- C/ _ r Tract Date Connected f ? 19-OLDate-Final - 19 ©� PLUMBIN INSPECTOR OFFICE CITY OF CUPERTINO COPY I GAS SERVICE NOTICE 19 �� To You are hereby authorized to connect the GAS service for Owner or Tenant _ r /N C � New Service No. of Meters Reconnect Move Service No. of Add. Meters Move Meter PLUMBING il "OECTOR v