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08020033 CITY OF CUPERTINO **twva tis T- �-za;" ,•- auaowcorvls3oN• PERMIT CU1VTRt�CTORIIYIORI�► f1�I BUILDIt�G� VEsHERMOSA AVE JM CONSTRUCTION PERMIT 08020033 Isr LR•S NAME: PERMITISUEDATB JW MAGDALENA SOLORIO 562 DIVISION ST 02/05/2008 PHONE: SANITARY NO. CONTROL NO. (408) 379-9852 ARCHTIEC IENGINISM: BUILDING PERMITINFO BLDG ELECT PLUMB MECH 38 Zp LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby same that I me Iimved under provialnm of Clap er 9(mnamcneing P i IN Section 70M)ofDivision 3offtBusinnssand Pmfeui.Code.and myIt...is REPAIR JOIST FLR DMG BY FIRE, , ,REPLC 2 WNDWS & r< in full ince and.act li 3M3 U.eauchO, Lm.a 73Os6 REWIRE OVR LIVNG RM,RPLC LGHT FIXTRS W/FLRSCNT OR C Data 2— contractor t ARCHf1ECPSDECLARATION DMR &REPLC FURNACE WALL & DOORS L I undmuand my pian shall be used as public records 5 Issed Lictrtrcd Professional See OWNER-BUILDER DECLARATION <S 1 Wely elfiran Nu I am exempt from the Contractors License Law for the i0O following mown.(Section 7lDI.S.Business and Profusions Cole:Any City at mmny S$ which repuma a permit an umswet,altar.Wp eve,demolish,or repair any structure Z�^ prior to its issuance.sum acquire+the applicant rorsuch Permit to file aligned slalemenl < that he is licensed ImenamtoN.poviamaaftboCanuacme.Ur..Law(Chap.9 Sq.Ft. Floor Area Valuation �$ (emnmeneingwiNSecdan7000)of DivWon3oftho Busineuwd Pmfeasiou Code)or $44215 Nat he Is Catnaps therefrom and the basis for the alleged exemption.Any ledialan of Section 7031.5 by any applicant far a penult subjects the applicant to a civil Penalty of Number Occupancy Type nm more to five hundred doll.(5500). 357160551 o 0 1,a wnor df IW pmpmty,or my emes ploywith wgas u they vele emnPewtion, willdo themekandthesuumua dn"tinmadedoraaemd fmmle(Sec.70a,Bwima Required Inspections and Pmfmdom Codc The Contractors U.taw dal net apply m an owner of 9 P property who builds or im plows thereon.and who dens such wnh himxi f or trough his own emplayw,provided thasauch Impmvemenu art nm intended oroRe sl fma,le If, however,the building or Improvement is sold within om you of mmpletian,the awmr. holder will have the burden of paving that he did trot build or Improve for purpose of =Is.). 0 1,as awmr of the Property am exGwivaly contracting with licensed emtramon In construct the project(Sec.7041.Business aM Profession Code:)The Conuacines U. Coma law does set apply to an owner of property who Wilda Or hnpmws thereon,and who contracts for such projects with a cenvecmr(s)licensed pursuant to We CmUr temet, Lice"Law. ❑I am exempt undus See ,B&P C fm this40 reason m Date WORKER'S COMPENSATION DECLARATION I hereby AM.under Pendry of perjury oat of the following declaastimae ❑Ihaw and Mllmainain.CeNRmm of Comentmelf-imamfmWmkeraCompen- Onion.as provided for by Section 3700 of the Labor Code.for the Performance of me work for which this Permit u issued. 0 1 have and will maintain Workers Compensation Ioaarams.as required by Section 37110 of the Labs Code.fm the Perfmmmc.fule won fm which to permit is issued. ' My Workeres/s Compensation Insumme carrier and Policy number am: Carrier, K'nGf(097 Policy No.: CERTIFICATEOF EXEMPTION FROM WORKERTjq lei f/ /'yZ COMPENSATION INSURANCE O . finds section need not bocompleted Ifshe permit is fmone hundred dollars(SIO ) Cir law) I unify Was in 1W performamec of the wort for which this pmmlt is lamd.I shall net - employ any person in any manner an as at become subject to to Workers'Compena udon Laws of California.Dam Appllant NOTICE TO APPLICANT:If.after making this CeniOcale of Eaemption,you should become subject be the Worker,ComPensstion provisions of to labor Cade,you must .JO foMwith comply with such provisions or this permit shall W dermad revoked. CONSTRUCTION LENDING AGENCY y [.a Iearthy aRrm that tem I..construction lending agency for tie Performance of gY 7 to won far which this Permit Is issued tSce.3097,Civ.C.) QLmdaes Name .`J z Leaders Adders, U O I aN(y that I have mad this application and sum Nal thc above information u {T. H Comm.I+lime to comply with all city and county ominanem and sum I.vn relating to �U Wilding ematuection.and hereby..,Wrim reprms.126M of 0116ky m enterupm the W .hove-mmadomd property fm inspection purpose& f•L (We)agree to sew,indemnify and keep harmless the City of Cupertino against fA liabilities,judgments,costs and expenses which may In any any accrue against said City U Z in coomqumtt of to grating of tis permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date ?� " SOURCE R��uu,�no�+s. ✓/ ��` �- 0�OR Re-roofs Sigmas o HAZARDOUS MATERIALS DISCLOSURE vele Type of Roof Will the applicant or future Wilding occupant amre or handle havadau na.mrial u doOned by to Cupemn"Municipal Cade.Chapter 9.13,and to Health and Safety Scctiea 25532(a)?0y. No All roofs shall be inspected prior to any roofing material being installed. Will then applicant or future Wilding mreupant um eluipmcnt ordeviza which If a roof is installed without first obtaining an inspection,I agree to remove emit heardou air contaminants as defined by the Bey Area Air Quality Management all new materials for inspection. District? ❑Yes Nu 1 havereal the haadom maedab mquimmenu undo r Chapmr 6.95 of the Cali fm- nts HaO&S.fctyC"de,Smd.25S05.25533uuM34.Imdcnandt VLhe building dean not currently have a moan,that it is my rcamesh iby m notify 1W aceupent of the mqulremcnts which am W mCi prior m iumnm of.Certificate of Occupancy. Signature'of Applicant Date - All roof coverings to be Class"B"or better Ownero a .gent Dom. . o�o � X0 .33 CITY OF CUPERTINO • CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM APN#,3 ( 0� 5 I J Date: Building Address: z (.? Mailing Address (if different from building address): Owner's Name: Phone#: O rC9 Clog clbl-bl, - lq3 I Contract6f: n J Phone: �"l ��'vc7 ton Fax: of _ 7g, 4 Contractor License#: �-3 6�QS6 • Cupertino Business License#: Zo9sS Contact: Phone-009)' 6`3?— 115`16 e Fii� �✓ re Fax: (//v 3 7?- Residential -Residential Commercial Job Description: 2e,,Oq al;Y J o Is Flo o x IV mol jo- by fl re. p ��a�� Z w l it oho «/S c7 i?4Z y e �./i l�-e O ✓ - Y L,-- ; cr dd-.v�vva�. Acr/acc F�rncxcc wall U/IOI 00021E Building Permit Info: / Bldg ( Elect � Plumb Mech [5' Type of Construction (Usage Class): Occupancy Type: 1 FR, I1FR ❑ 11, 111, V-lHR ❑ 11, 111, 1V V-N [`" (---3 Valuatio cG Square Footage: Ll 2 r SProject Size: Standard Large 0 Ma'or ❑ CITY OF CUPERTINO CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 113TEMPPER Temporary Building Permit(good for B 30 days) 1BBOILERI For the installation or relocation of ea M boiler/compressor to & including 3 horsepower, or ea absorption sys to & incl 100,000 Btu/h 29.3kw 1 BBOILER2 Installation/relocation of ea M boiler/compressor over 3 horsepower to & incl 15 horsepower, or ea absorptions s over 100,000 Btu/h 1BBOILER3 Installation/relocation of ea M boiler/compressor over 15 horsepower to & incl 30 horsepower, or ea • absorption sys over 500,000 Btu/h to & incl 1,000,000 Btu/h IBBOILER4 Installation/relocation of ea M boiler/compressor over 30 hosepower to & incl 50 horsepower, or for ea absorption sys over 1,000,000 Btu/h to & incl 1,750,000 Btu/h IBBOILER5 Installation/relocation of ea boiler or M refrigeration compressor over 50 horsepower, or ea absorption sys over 1,750,000 Btu/h 1BAPPLOTH For ea appliance or piece of equip M regulated by this Code but not classed in other appliance categories, or for which no other fee is listed in this code. IELECINSP Other Electrical Inspections (per hour) E IMECHINSP Other Mechanical Inspections (per M hour) • 1PLMBINSP Other Plumbing & Gas Inspections P (per hour 1MEETINGIHR Application Meeting B i CITY OF CUPERTINO CUPEf�TINO GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or I GENCOM ACOUSTICAL REVIEW lACOUSFDW SFDWL/Duplex New B lACOUSRESAD SFDWL/Duplex-Addition/Alteration B IACOUSCOM Multi-Family/Commercial B CHIMNEY'S 1CHIMNEY Chimney B 1 CHIMNEYR Chimney Repair B FENCES 1FENCE>6FT Non-masonry, over 6 ft in height B 1FENCEMAS>6 Masonry, over 6 ft in height B FIREPLACES 1FIREPLMAS Fireplace Masonry B 1FIREPLFAB Fireplace Pre-Fabricated/Metal B 1FLAGPOL>20 Flag pole (over 20 ft in height) B 1MODUSTRU Modular Structures B FOUNDATIONS 1FOUNDREP Foundation Repair B 1PMECAST Pile Foundation Cast in place concrete B 1PILEDRIV Pile Foundation Driven (steel,pre- B stressed concrete 3 of 5 CITY OF CUPERTINO 4w CUPEf�TWO GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1 GENCOM RETAINING WALL(CONCRETE OR MASONRY 1RETSTN Standard(up to 50 ft) B 1RETSP310 Special Design, 3-10' high (up to 50 `) B 1RETSPIO Special Design, over 10' high (up to B 50' 1RETCRB< Gravity/Crib Wall, 0-10'high (up to B 50 ft 1RETCRB> Gravity/Crib Wall over 10' high (up to B 50 ft SIDING 1 SIDESTBK Siding, Stone & Brick Veneer B • interior/exterior 1SIDEOTHER Siding all other B SKYLIGHTS 1SKYL<10 SF Skylight less than 10 sf B 1 SKYL>1 OSF Skylight greater than 10 sf or B structural 1STAIRS Stairs-first flight/ea addt'l B STORAGE RACKS 1 SRACKS<=8 Storage Racks 0-8' high (up to 100 so B 1 SRACKS>8 Storage Racks over 8' high (up to 100 B so 1STUCOAP Stucco Applications (up to 400 so B additional stucco application • 4 of 5 CITY OF CUPERTINO CUPERF GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1 WINREP Replacement windows/sliding glass B door (ea 8 windows) 1 WINMEWSTR New Window-structural shear B wall/maso includes plan ck fee IEPERMITFEE Electrical Permit Fee E / 1MPERMITFEE Mechanical Permit Fee M (/ 1PPERMITFEE Plumbing Permit Fee P IELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1PLMPLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone / 1BSEISMICR Seismic Residential B r 1BSEISMICO Seismic Commercial B / 1TRAVDOC Travel &Documentation B 1BUSLIC Business License B • 5 of 5 • 'CITY OF 'CUPERTINO 9 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35716055 . 00 DATE ISSUED. . . . . . . : 02/05/2008 RECEIPT #. . . . . . . . . : BS000003861 REFERENCE ID # . . . : 08020033 SITE ADDRESS . . . . . : 21820 HERMOSA AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MAGDALENA SOLORIO ADDRESS . . . . . . . . . . : 21820 HERMOSA AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JM CONSTRUCTION CONTRACTOR . . . . . . . : EDENS, JIM.. LIC # 20955 COMPANY . . . . . . . . . . : JMCONSTRUCTION ADDRESS . . . . . . . . . . : 562 DIVISION ST CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 • TELEPHONE . . . . . . . . : (408) 379-9852 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 44, 215 . 00 4 .50 0. 00 4 .50 0. 00 1BUSLIC FLAT RATE 1 . 00 110.00 0 . 00 110.00 0. 00 1ELECINSP HOUR 1. 00 122 . 38 0. 00 122 . 38 0. 00 1EPERMITFE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 1MECHINSP HOUR 1. 00 122 .38 0. 00 122 .38 0. 00 1MPERMITFE FLAT RATE 1 . 00 40 .79 0. 00 40 .79 0. 00 1PLMBINSP HOURS 1 . 00 122 .38 0. 00 122 .38 0 . 00 IPPERMITFE FLAT RATE 1. 00 40.79 0 . 00 40.79 0. 00 ITRAVDOC FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 644 .80 0. 00 644 .80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 644 . 80 .#38524 --------------- TOTAL RECEIPT 644 .80 . • ,V.k,W��c.�s, t � � l hf{k � �.i PSN `��s� `'�,�'t�jtt'j�tr".ryt,N "i'S l� .I.§'t+�f �-iF•ni}'s 51 k�,�t�F�bt�.Y'ta�,� X.tT.��'! -x4� SZ'�3',.r..•�— �.�, k� t���, 1 �--r .� �.Il a'r1. i �V' yt�R�.". '�4l yv Yh` Citi 4`a g. '�n �tl ."'�zz'�'•'' 4 - Y Assessor's Parcel Number: Name of owner. /d�p fty ng//// �D /O /Cj Project address. Z. 1,42Z C? h'ey/nosr7 A✓e'-. Contact person. / &/i'i✓lo 191✓oYrey Phone. Cy00) 6/'37— 4/5'1/6 Fax. ( Vv.B) 37c( — 4856 Net square footage of lot. Existine Proposed Square footage: First floor: Second floor: Garage: TOTAL: we there at least two 10 foot by 20 foot clear spaces inside the garage? Is privacy protection planting required for the project? i, � lv \ On what floor(s) is work being done? Brief description ofwork. /acc 3 1ixR �(aor io f� oorf , curtYey /v_ f✓Y/l cC (2 alo o YS el Code editions:2008 CBC �-N)2008 CFCN)2008 CMC �N) 2008 CPC (�-N)2008 NEC N) CD Effective 1/1/08 C�RQ��N CIO 0 F COo as NO lA��` d 5P`�ttt eg°fid 1L 18�O5 °os au t s\tcn oc a\t°t t<o�' d� \oNPya\°t P�010�a' °ces o �� 1 �aA®tcy ttea pC ped'�CccaaOnS Op • p\ao ,ne but'W4ittt@t°\hold to Pot e�Y � Plan Review Process Work Book 'Ta gF s$=Revised I/1/08 ----------- -2 now '-- ........... ii ir 6 17qce wq/1 ' oral -Ido is ,7i, ZCupertino Community Development 10300 Torre Avenue CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEkTINO Building Department All Cupertino building permits must meet certain conditions related to maintaining environmental quality and public peace and safety. The two most common conditions are described below. STORMWATER POLLUTION CONTROL State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and the Santa Clara Valley Water District control stormwater pollution. Educating local residents and businesses and enforcing stormwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's up to us In northern Santa Clara Valley, storm drains flow directly to local creeks and San Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife dependent on our waterways, for people living near streams and baylands, and for the local water supply. Common sources of stormwater pollution include: • Dripped oil, fuel, and antifreeze from vehicles and heavy equipment; ® • Construction debris, including dirt, concrete and paint; • Landscaping runoff containing pesticides or weed killers; and • Any material dumped or spilled into streets or storm drains The property owner and the contractor share ultimate responsibility for activities occurring at a construction site and will be held responsible for any environmental damage caused by subcontractors or employees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section of the City of Cupertino web site at: htti)://www.cupertino.orci/city government/departments and offices/ environmental services COMMUNITY NOISE CONTROL The basic noise control requirements for construction sites are as follows: • Typical construction work hours are: - Weekdays - 7 a.m. to 8 p.m. - Weekends - 9 a.m. to 6 p.m. • Construction other than street construction is prohibited on holidays. • Residential daytime noise levels from complaint site - 60 dBA • Nonresidential daytime noise levels from complaint site - 65 dBA For more information on noise control, please see Chapter 10.48 of the Cupertino Municipal Code, which can be accessed at http://www.amlecial.com/cupertino ca/ • Greg Casteel Building Official ,mm®rl, Assessor's Parcel Number: Nameofowner. -50 /0 r Project address. 2- 1,4;92-0 lqex-177o3a AVG. Contactperson. 2f4/,no )q1VCr;--6z- Phone. (90R) 63 'j— Y3-'16 Fax. f 41 c).9) 3 7 ef — 4856 Net square footage of lot. Existing Propose Square footage: First floor: Second floor: Garage: TOTAL: 0-re there at least two 10 foot by 20 foot clear spaces inside the garage? Is privacy protection planting required for the project? �N On what floor(s) is work being done? Brief description of work. 160-- 3 2,YR 4�U�11 Code editions:2008 CBC N)2008 CFC X2008 CMC 2008 CPC N)2008 NEC��J es0 1 Sol Effective 1/1/08 O�p 60 5 000�0 0 \60 Plan Review Process Work Book Page-8-Revised 1/1/08 Im 2 /_9 Z!O ...... ------------ 41 -x 91 i Acp�1acc-; L 2.':X.9 r10 ox: orsLol Flao Y- �:o yeu / yam _ -1 VLI t! U-,Ici P.L.r";1(3( .',do�q _ , ,. I rel' I I . I. 7 T Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 UPERTINO Building De artment JOB ADDRESS: PERMIT # OWNER'S NAME: 50107-(o PHONE #a!3V 6 GENERAL CONTRACTOR: J. . Can 4'y✓o+to FAX # 403 7 2 - `I8S f- I am not using any subcontractors: 7 -OV -0 ture Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting • Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile 'OQaContractor Signature Date