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1588 CITY OF CUPER•O0 aR0 � APPLICATION FOR COMMERCIAL BUILDING PERMIT �VU� PERMIT NUMBERAND ' CERTIFICATE OF OCCUPANCY 7 FOR APPLICANT TO FILL IN BUILDING INSPECTION DIVISION I STR TAhRESS OF P ......_.._........... Plans Received By..............._..................._......_..... Date ......................... Legal DesTract.... ....... BJ.pck........... t........... .... REQ.: Plans.... Survey.... Calcs: Siruc..... Energy.... Elect..... Mach.... Description of Work: ...... 4M'2....../'a4.urt✓+...... Wt........... Plans Checked By.............. ...............................Date ......................... 1st Struct. Improvement on Parcel:Yes.... No.... Area of Bldg............... Application Approved By.. ._... Date ......... ... Separate Structure............ or Addition/Alteration to Exist. Bldg........... Validated By... _.........._...........Date .../..L..-/..a`0-0 No. of Sto r'as............_.. Use�+t uil ..................-_...................._...... Compensation Certificate Verified By..�.-..1..�............. Date ......................... Valuation�, e�t $.'. ...�.C�Q ... . ..-. .. Mllil • • . $ ..LyJO ., Owner: ._..( (/...N.�t.0 !I?'Li..._! .1./f!/� �PR3Rer................... W V Permit Fee (plus penalty if applicable) $......„ G.`. ._. Contractor: .. .. . ... City Bus. *................_............. IP P Y PP ) . ----. ..--. - Address: . Phone: - ..-.y/,,!��,M� Plan Check Fee (less deposit of $.......... Rct, #..........1$-......--.......-. �4��� - ' Or Contractor - Electr(c . .. . �*.. .... ... ... ... ... Energy Plan Check Fee (Dep. of $........ Rct. #.....-..)$..._.._............. /........*0............... City 8 Canso .................... Phone:.................-.. Strong Motion Fee ..........................................................$........-.. '.5.U.. Plumbin ' Plumbing Permit Pee 9: ......................n'se................................... :.................... ................................................$.................... City Business License *.................... Phone:......-............. Electrical Permit Fee ....................................................-$....�.�.:.(�-(/. Heating and Cooling .................................................................. Mach. Htg./Coolg. Permit $ ..............................$....... ........... ... City Business License #.................... Phone:.................... Construction Tax.............................................$....................... Architect/Designer: Phone:.................... Sewer Conn. Fee .............. Water Conn. Fee ...--......$..........._........... Engineer: Phone:..-...... Landscape Fee --............... Street Tree Fee ............$.....................- Lender:. ...............................................-. n.Unknown ......................................................................$.............. ....... M I9C. Feecertify that he p mance of the work lar which this permit is ............ • • . . ; JE,•j(� $1 G ,� is-sued I s ell mpl an person In any an so as to become subject to the we in tofu satl n I we of California." Type Const....._... Group........ Div......... Occ. Load........ No. Exits........ slGkarugE OFj�� ,( Floor Loads: 13L... 2nd.... Other._. Sprinklered.... Area Sap. blahs.... ,APPLICANT/OWN ...J._.... ....... /lN...........!DATE /ons ........... certifythat as the applicant I am licensed under the provi o the Contractors License Law and further that my License No. ............................ Environmental Status: Exempt ............ Other.............. in Classification ........................................ Is In full force and effect: or .n ......--.... Design Review Approval: Bldg. ..._....... Site Sign �����.--- I cadily that I am exempt from the "Licensed Reg.'•etl" provisions of the '..."""-"" ......."""" Contractors License Law. (State basis of exemption., Use Zone ............ P.D. Conditions ............................................................ I hereby acknowledge that I have read this application and state that the above Is Cond. Use Permit *...... Variance *...... Parking Spaces.... Load. Sp..... correct and agree to co y with all City Ordinances and State Laws regulating ApprovedBy........................................................... Date ........................... building. I (We) agree to save/i4mn'Uunce mless the City of Cupertino • ; • • • " against liabl liti s,�l' en enses which may in any wa secure against a'd r in ha/a ruing of this rmit. •nCroachment Permit..........._........... Grant Of Easement........................ SIGNATURE OF //q 64 Curb, Gutter, Sidewalk,. Driveway: Rep19Ce Repair APOLICANT/CONT C R .... . ................. DATE ...... . ..... .a..... Sewer............ Conn. Fee $................ Water................ Meter $............... NOTE: When properly validated this form constitutes o Building ormk. This Agreement for Completion of Public Works Improvements .................. pormit expires and becomes null and void should work not be commenced within Plans Checked By........ Date........ Approved By........ Date.................... 120 days from validation date, or should authorized construction be suspended or abandoned for a period of 120 days atter work Is commenced. lei I mviimAq�61= PERMIT INSTALLATION NO. EACH FEE APPLICATION L;.-,h: COtlets............ Switches............ PERMIT INSTALLATION NO. EACH FEE Fixtures............ Receptacles............ Gas Sytem with up to 5 outlets .__.............................. $4.00 --.----.— TOTALNUMBER(leisthan1000watts) ... ............. ... $ ,50 - .......... Each additional outlet .................-....................... 1.00 ............. Range........ Cooking Unit._...... Oven............................. 2.00 ............... Water System (Installation, Alt. or Repair) ................ 4.00 ............. Dryer.... Garb, Disp.... Dishwasher.... ........ ................. 2.00 ............... Water Closet.... Water Heater.... Ld. Tray.......... .......... 4.00.............. S�PORARY POWER to . ............. .... 2.00 . .---....... Lavatory.... Shower Pan.... Bathtub.... Sink.................. 3.00,,,,,,,.,,,,,, 5 200/$7.00, 500/$0.00 Wash. Mach..... Dishwasher.... Garb. Disp..... .............. 3.00 ...........-- B00/ 20. 0. 1200/$40.00 ................................... ..5 .. ...�.r..•. .....--.. 8.00. ............. .. Sewer ..................................................-................. MOTORS,Generators,Welders, Heaters, Lawn Sprinkler Sys. $6.00 Ea. add Sys. $2.00.................................... per HP—KW—KVA to 1/$2.00, 5/$3.50, Vacuum Breakers ......—..........-....................... .1............ 4.50 •.... 20/$6.50, 50/$10.00, 100/$12.00, Slop Sink........ Floor Sink........ Floor Drain ....1{1III............ 4.00 ............. 500/$15.00 ...-................-......................_.............. ................ ............... Urinal.... Interceptor.... Water Softener.... .........-1......--.... 4.00 ............. Signs with I XFMR ....................................... ............. ... 2.00 . Plumbing Piping without fixtures .................................. 4.00 ............. Each additional XFMR/Time Clock ................. ... .50 ......._....... Misc. .................................._.....-._.._.............................. .......................... Annual Electrical Maintenance ............. ..1 25.00 .. .............. Permit Fee ..........................................................................$ 6.00 Other (see Ordinance Current) ............--. ...—...................................... TOTAL PLUMBING PERMIT FEE (plus penalty If app. ❑) $ ............. APPLICATION •. HEATING/COOLING ...................................................................................... ......... ... .. ...... Permit Fee .__.................._.............................................. $ 6.00 PERMIT INSTALLATION NO. EACH FEE TOTAL ELECTRICAL PERMIT FEE(plus penalty if app.E]) $ H.e-{J Forced Air Unit...............to 100M —........................ I........ $ 6.00 se• r over 100M ............................. 10.00 ............... Comfort Cooling Unit.....to 3 ton/HP......:.................... 6.00 ............... Forms / Foundation............................... BY:... /HP ............... Date:...-............ to l5 ton ........................... 9.50 ............... Plumbing Ground Work ............................. ............................................ to 30 ton/HP.......................... 12.00 .......------.- 'lough Electrical ....................................................................--................ to 50 ton/HP................ .......... 17.00 ............... lame - Plumbing and Heating .......... ................-----.-........................ Space Heater........ Wall Heater ......................................8.00 ............. insulation / Energy.................................................................................. Flues - other than above ................................-.-......... ...3.00 . .............. GasTest ................................................. ................................................... Vent Fan: Kitchen........ Bath .............................-............3.00 ............... Temporary Power Gas / Elect............. Commercial Range Hood „6.00 ... FinalFinal - Electrical ........................................................................................ Misc. ........................—.............................................-.................................. Final - Building/ Mechanical .................................................................. Permit Fee ........................................................................ $ 6.00 Final - Design Review / Landscaping ......................... ........................... TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. p) $ Final — Public Works...........................................................