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CITY OF CUPERTINO APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER /36 AND FOR APPLICANT TO FILL IN CERTIFICATE OF OCCUPANCY BUILDING INSPECTION DIVISION x . S g .WD..R..ESnSglOiFshR.WakC.T..: Legal Descr.i tion: Tract.....655.1..._........ Block.......... ...Lot ....... .1...7.............. . Plans ReceivedDescription of Werk: Sing.le...Family...Dw.el.l.ing................... y................. .....................Date .. . ../d7 .... j ......................p.................................... ............,.....A....a. o...8.............5..H REO.: Plans.... Survey.... Cels: Strut..... Energy.... Elect..... Mach.... 1st Strutt. Improvement on Parcel:YesX. No...Area of BIdg.24.5.6H Plans Checked By.............. ?.lV.........-.....-.-.......Date .... Separate SlructureNL ...... or Addition/Alteration to Exist. BIdg5A.0.G Application Approved By.........../9,.4..r.................Date ..{ .. . No. of Stories.........)..... Use of Building ......Residen.tial.............. Validated B . .. ................................. Date .... . . By................. ..� Valuation of Project: $.105.,Q00............................................................. Compensation Certificate Verified B , �.... Date ... P v � - � owner: BAS..Homes,_..Inc.............................._ Phone252.-20.2.2 • • $ Contractor: .as..abo.Ve.................................Cityy Bus. Lic. •110.61.. Contractor's Address:20823..Stevens._Crk.- Phone:.2.52m?.0.77 Permit Fee (plus penalty it applicable) ....................._.$......29.4...5.0. Contractor - Electrical: .Bes.t...Elect.Plcal...CO..............._......... Plan Check Fee (less deposit of$..... .... Act. #..........)$_.......... City Business License x..18.1.22.... Phone:.28.77.2.040 Energy Plan Check Fee (Dep. of $.......- Act. #........)$............ Plumbing Cx•.Ow1ey...CO.._........................_.............................. Strong Motion Fee ...................._......._.._................I......$......._.7.:..30. City Business Liceg4gge •.16641 . Phone:.245c.4.240 82 (} Heating and Cooling ..Hl._Boyer_.. 4.r.... ............_.......... Plumbing Permit Fee ................................................$.................�. .. Electrical Permit Fee ........................,:..,:.,-..r:.. .:.........$......... ....r.b9. City Business License n.........._...... Phone:.79.2. 4.328 Architect:/Designer: .an1...Qw/Bates..838-79981on ..75 92 Mach. Htg./Coolg. Permit $........{.:i:.:............. $.........31._0.0. Engineer ..McKay..and.,SOm�.S........................ Pnone:9.gs-9:9.--0 Residential Construction Tax ........................................$.....................,. Lender: . .... Unknown Misc. Fee ..........................................................._...........$...................... We11sa.FargoeBank....._................_... ❑ .. . .,. "I certify that in the penny person of the work for which thiseco permit la MISC. F:0 ........................................................................$....................... issued I shall not employ any person In any manner so as to become subject s $ 462.80 to the workman's compensation laws of California." SIGNATURE OF s • APPLICANT/OWNER .._..................___...................................... DATE........................ Environmental Status: Exempt ............ Other....................................... .. .... "I certify that as the applicant I am licensed oncethe 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 0............ Variance #............ Parking Spaces............ I certify that I am exempt from the "Licensed Required" provisions of the Approved B Contractors License Law. (State basis of exemption.) pp y................_......................................... Date ........................... I hereby acknowledge that I have read this application and state that the above is • , • _ torrecl 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 %Cw roachment Permit........................ Grant of Easement........................ against liabilities, judgments, costa and expenses which may In ny way b, Gutter, Sidewalk, Driveway: Replace.......... Repair.......... secure against ae to City 'n onsequence of the granting of in front ' ar............ Conn. Fee $................ Water.....---........ Meter $................ SIGNATURE of Agreement for Completion of Public Works Improvements .................. APPLICANT/CONTRACToP !�`a' 7 DATE ... .... ._0,..!(. 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 • s s 170 days from validation date, or should authorized constrthllon be suspended.or abandoned for a period of 170 days after work Is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION F• , PLUMBING PERMIT Light Outlets............ Switches............ Fixtures............ Receptacles............ PERMIT INSTALLATION NO. EACH FEE 7717 1 TOTAL NUMBER (less than 1000 watts) ............ $ ,50 Gas System with up to 5 outlets .........1.....................$4.00 Range........ Cooking Unit........ Oven............ ......... ....... 2.00 ........... .. Each additional outlet ............................................. 1.00............... Dryer........ Garb. Disp......... Dishwasher ............. ...... 2.00 .............. Water System linstallation, Alt. or Repair) . .-........... 4.00.-..d']5 (pQ1l7Q1} MOTORS: 1 HP or less ........................................ ........ 2.00 .. Water Closet..6 Water Heater.l. Ld. Tray...............cX.... 4,00. Greater than 1 HP not more than 5 HP .............. . 3.50 .............. - Lavatory..5 Shower Pan..) Bathtub..2 Sink..1..„....y... 3.00. . ; Temporary Power Pole or Service — 100 amp .. ..... ..5.00 .............. Wash. Mac�].1. Of h�lhef..l asGarb. Disp.....1... .3...... 3.00....9..0. —200 amp........ . 7.00............... Sewer ....1�`v..Z.b... .......................1........... .. 8.00' .. Time Clock ...................................................................... 1.60..............: Lawn Sprinkl4r Sys. $5.00 Ea. add SYS. $2.00..................... Misc. (see Ord, current l............ ........ Vacuum Breakers .................................. ............................................ ..............3.50.............. New Residential Occu panties Flet Rate Interceptor........ Water Softener........ .............................4,00.11............ Plumbing Piping without fixtures ...............1....-..1........4.00,...4...0A 0-500 sq, ft. $22.00 1501-1750 $34.50.............................. Misc. (See Ortl. Current) ............ ll 501-750 24.50 1751-20000 37.50.............................. .....................,....,.,.6.00 .... r r 751-1000 28.00 2001-226C 39.50.......... . Permit Fee ....................................:.....................................$ 8.00 TOTAL PLUMBING PERMIT FEE (plus penalt If a 1001-1250 28.60 2251-2500 42.00..........2,4.Sb......I...... HEATING/COOLING DP•Q) s 82.00 , 1251-1500 32.00 2501-2750 49.50..............................a • a PermitFee...............................................$8.0 1� TOTAL ELECTRICAL PERMIT FEE (Plus penalty if app,p) $48 PERMIT INSTALLATION NO. EACH FEE Vl Forced Air Unit......_..........to 100M .$8.00-...� •- f INSPECTION RECORD over100M................... .. . 10,00.. IO.:_O0 Wry Comfort Cooling Unit......to 3 ton/HP ........................... 5.00... ........... \ Forms /g Ground ............................. BY� ��.." � to 15 ton/HP......................... 9.50.............. Plumbing Ground Work . ....... .._.......a /;'�' 3 �l ..... to 30 ton/HP.......................... 12.00. ........... Rough Electrical . .. . M b ram: - Plumbin and Heatin to 50 ton/HP...........................17.00.............. \ 9 9 ................................... ........................... Space Heater.:...... Wall Heater ................................... 6.00.............. M u latlon 8 Energy.......................... . ... ..... Flues - other than above .............................................�.. 3.00.............. Test ...................._............ ..j�ll.t :..:::::.::�:::::.::..........:.:..::: Vent Fan: Kitchen...1... Bath 3.../Dxyex...1....5...... 3.00....15._00 em ora/ Power Gas a / Elect. . ... P Y ... ...... " ..............- ... ........-.... Commercial Range Hood . 8.00............... Final - Electrical ...._................ .. . ..... f. . . . ...7...:...�0... �..1 Misc, (See Ord. Current............... ......._..............�..........,,....................... Final - Building/ Mechanical �::PL ....... .,..._....Lg/ate/Y.......� Permit Fee ._............. $ 6.00 ............................ ............... Final - Design R:VI:W Landscaping . ... ._....... .... .......................... . TOTAL Htg./ Coolg. ermit Fee (plus penalty If app. ❑) S 31.00 Final-Pub is Works ...�. ..... .... . .... ..c. .. ......... ..'' AA Tv �T g. I ry+A AAey, t• t�. P—1 k. k19111 - /ry /Y��U7� TS I&5 ROUTE SLIP , File No. Date i,�cation /-f Subject ` Approved 6 a -261� ��iY r Date / InspeJc�p � I BUILDING INSPECTOR'S OFFICE ., . Bldg.Dept. ' CITY OF CUPERTINO Office Copy 0n" - ckflow Device - Sanitary Permit No. mlQl "/ — / 307 Lff Sewer Connection Plumbing Permit No. I Plumbing)Final Lot NO. /r 1 I I Owner or TenantAt I � I Tract Date Connected 19 .S'n Date Final `� S- 19 / PLUMBING INSPECTOR I �I CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO E S' 19__�LL BLDG. PERMIT NO. d j 1 THE BLDG. LOCATED AT OWNED BY /"T�7n't2v HAS BEEN`\(COMPLETEDI FOR USE AS ��y`• '(ALTEREDI--- i t I, ,BUILDING INSPECTOR ELECTRIC SERVICE NOTICE oiFicEcoP'v BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO 19 ! . To You are hereby authorized to Connect electrical service for Owner or Tenant At !62/9-6 roti G�s 4 U��i's F No.of Wires Size of Wires Size of Switch . Motor Load Voltage Phase Heating Load . K.W. Voltage r /00/7�+�? A-J e, ✓ / ( Light 110__New Service � ke<onnen No.of Meters Heal 120_Three Wire More Service No.of Ad c.Meters Power Three Phase Maye Meter Qr u .CTRICALINSPECTOR � i OFFICE CITY OF CUPERTINO COPY � - GAS SERVICE NOTICE I , 1 9� II ! To You are hereby authorized to connect the GAS service for Owner or Tenant New Service L No. of Meters Reconnect l Move Service No. of Add. Meters _ Move Meter PLUMBING, .,PECTOR r ©M , t CITY OF GUPEPiYNO CITY OF CUPERTINO JAf YINp 488ATAL APPLICATION FOR RESIDENTIAL BUILDING PERMIT pAI : PERMIT NUMBER / 7 g 7 AND • . CERTIFICATE OF OCCUPANCY APPLICANT TO FILL IN BUILDING INSPECTION DIVISION STREET ADDRESS OF PROJECT: .1018.6...Eng1 is h..Oak...Way_................_......................... s • • • • Legal Description: Tract..........6551-- Block............ Lot..1-7............... Description of Work: .......... .................. ........................................... PlenaReceived BY....................................................Date ......................... .............................................solar pexmi.t........................................... REO.: Plans.... Survey.... Calcs: Struc..... Energy.... Elect..... Mach.... fat Struct. Improvement on Parcel: Yes.... No.... Area of Bldg............... Plans Checked By............_........................_............Date ......................... Separate Structure....... ._- or Addition/Alteration to Exist. Bldg Application Approved By........................................Date ......................... No. of Stories..............._ Use of Building Validated By_..........................................._............-Date ........................ Valuation of Project: $........................................ ...___........................... Compensation Certificate Verified By ..........._---. Date .............-......... Owner: ....._._..................................................._...... Phone:.................... • • • Contractor: ...........BAS._HOMES..._INC.....City Bus. Lia #r ....._...... lrmm $ Contractor's Address: ............... _................. Phone:.................... Permit Fee (plus penalty If applicable) Contractor - Electrical: ... ..._.-..........._........._....__..._....__........._....... Plan Check Fee (less deposit of$....-..... Rct. #..........)$........*............. City Business License is................... Phone:.................... Energy Plan Check Fee (Dep. of $.......: Rot. #........) $.............. Plumbing: ........_._............_.............................................................. ...... Strong Motion Fee ..........................................................$...............�. City Business License #.......... .... Phone:.................... . Plumbing Permit Fee ................................................$.....f0.:..... Heating and Cooling..... City Business License #.................... Phone:.................... Electrical Permit Fee_.....................................................$....................... Architect/Designer: Mach. Htg./Coolg. Permit $............................. $....................... .........................-... .. Phone:.................... Residential Construction Tax .......................................$....................... Engineer: .._. ._..........._.............................__....-_.__ Phone:...............wn Lender: ... . ...that i._..... . .dorm.......... the..work........which E] Unknown Mise. Fee ........................................................................$..................--... ••I certify +net In the ... ... y performance al the work for which this permit is Misc. Fee ........................................................................$...................-... issued I shall not employ any person in any manner so as to become subject • $ 24.50 to the workman's compensation laws of California." SIGNATURE OF • • • APPLICANT/OWNER ...................................................................... DATE........................ Environmental Status: Exempt ............ Other_...................................... _.. "I 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 Lieens. No. ............................ Use Zone ......_..... P.D. Conditions ............................................................ In Classification ......._............................. Is in full force and effect: or Cord. Use Permit *........... Variance •........._. Parking Spaces............ . .. I certify that I am exempt from the "Licensed Required" provisions of the Approved By. ..._.... Date Contractors License Law. (Stale basis of exemption.) -""""'-----""""""""'-' """' """"""""""""' 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 State Laws regulating • • building. I (we) agree to save. Indemnify and keep harmless the City of Cupertino %Ir achment Permi ........................ Grant of Easement........................ against liabilities, judgments, costs and expenses which may In any way Gutter, Sidewalk, Driveway: Replace.......... Repair..._..... secure against sold City in consequence of the granting of this permit." ............ Conn. Fee $................ Water...............- Meter $................ SIGNATURE OF Agreement for Completion Of Public Works Improvements ................. APPLICANT/CONTRACTOR . ..........—............................._......... DATE ..._............. 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 APPLICATIONFOR 120 days from validation date, or should authorized constnicllon be suspended or abandoned for a period of 120 days alter work Is commenced. PERMIT INSTALLATION NO. EACH FEE APPLICATION • , PLUMBING PERMIT Light Outlets............ Switches............ Fixtures............ Receptacles........_.. PERMIT INSTALLATION NO. EACH FEE TOTAL NUMBER (less than 1000 watts) ..... ....... $ ,5o 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 . ....... ..5.00 .............. Wash. Mach..... Dishwasher.... Garb. Disp..... ............... 3.00............... —200 amp. ........ 7.00 .............. Sewer ............................-................................ . 8.00. . Time Clock ...................................................................... 1.50............... Lawn Sprinkler Sys. $5.00 Ea. add sys:$2.00..................... ............. Misc. (see Ord. current)...................................................... Vacuum Breakers ......................... ...3.50.. ........... ............ New Residential Occupanci ea Flat Rate Interceptor........ Water Softener........ .............................4.00. ............ Plumbing Piping without fixtures -.... ................. . 4.00............... D-500 sq. ft. $22.00 1501-1750 $34.50.............................. Misc. (See Ord. Current) .........S.Q,LB.Y..Be IP . ..4.,A .......,., 601-750 24.50 1761-.20000 37.50.............................. Permit Fee ....................................................... 751-1000 26.00 2001-225C 39.50.............................. TOTAL PLUMBING PERMIT FEE (plus penal a $ 6.00 b if PP• ❑) $ 1001-1250 28.60 2251-2500 42.00........................ ..... 1251-1500 32.00 2501-2750 49.50.............................. APPLICATION Permit Fee...............................................$6.00 TOTAL ELECTRICAL PERMIT FEE (Plus penalty If app.Cl) $ PERMIT INSTALLATION NO. EACH FEE Forced Air Unit..................to 100M .....................-........$ 6.00............... ' ' • • ' over 100M ........................ . 10.00.. ........... Comfort Cooling Unit......to 3 ton/HP ........................... 6.00,.. ........... Forme / Foundation .......... ................... 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... silillikams - Plumbin and Heating """""' 9 9 .......... ......................... ........................... 6.00 anon & Ener Space Heater..han Wall Heater ............................._....1 .............. Energy............................... ......................... ........................... Flues - other then above ............................................A.. 3.00.............. Teat ......................................................................'....................._..-. Vent Fan: Kitchen........ Bath ......................................... 3.00............... porary Power Gas / Elect. . ....... ._...................... ._................... Commercial Range Hood 8.00..- Final - Electrical .................................... .......................................... -. ............ _._...__........_... .................._-_... Misc. (See Ord. Current....................................... ..................... .............. Final - Building/ Mechanical .............. ... .. I Permit Fee Final - Design Review 1 Landscaping . ... ............................-............ TOTAL Htg./ Coolg. Permit Fee (plus penalty if app. p) $ Final-Public Works .... .............................................. ....