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12020004 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10717 LINDA VISTA DR CONTRACTOR:COSTA BELLA BUILDERS PERMIT NO: 12020004 OWNER'S NAME: LOENS EDMUND A AND HEDI PO BOX 2963 !9 DATE ISSUED:02/01/2012 Ott NE PHONE: 4084464140 SANTA CRUZ,CA 95063 PHONE NO:(831)818-9847 [,IC'ENSED C'ONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ' ELECT ' PLUMB License Class— Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date_- J JOB DESCRIPTION:SINGLE FAMILY DWELLING KITCHEN 1 hereby Affirm that I am licensed under the provisions of Chapter 9 REMODEL(96SQFT)INON (commencing with Section 7/000)of Division 3 of the Business&Professions STRUCTURAL Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's C(lulpensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this pertllit is issued- I have and will maintain Worker's Compensation Insurance,as provided for by Valuation:$14525 Section 3 700 of the Labor Code,for the performance of die work for which this Sq.Ft Floor Area: permit is issued. APPLI CATION APN Number:35607008.00 occupancy Type: A a I certify that I have read this application a d state that the above information is correct'.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives Of this city to enter upon the above mentioned property'for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED itideruniN and keep harmless the City of Cupertino against liabilities.judgments. WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence Of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point sours regulations per the Cupertino Njunicipal Code,Section Issued Date: Signature D ate ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one Of All roofs shall be inspected prior to any roofing material being installed.If roof is the following two reasons: installed without.first obtaining all inspection,I agree to remove all new materials for 1,as owner of tile property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date: Business&Professions Code) L as,owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSUREI have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of tile Compensation.as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the-work for which this peril-tit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation insurance,it,;provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District t will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,1 0 become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPL IC�NT CERTIFICATIONtic cc,f wo rk's I hereby affirm that there is a construction lending agency for the performance o I certify that[have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgincrits, Lender's Address costs.and expenses which may accrue against said City in consequence of the granting I of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all tion-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN 35607008 .00 DATE ISSUED. . . . . . . : 02/01/2012 RECEIPT #. . . . . . . . . BS000015902 REFERENCE ID # . . . : 12020004 SITE ADDRESS . . . . . : 10717 LINDA VISTA DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : LOENS EDMUND A AND HEDI ADDRESS . . . . . . . . . . : 10717 LINDA VISTA DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4019 RECEIVED FROM . . . . : COSTA. BELLA BLDRS CONTRACTOR . . . . . . . : JEFF THRANOW LIC # 32636 COMPANY COSTA BELLA BUILDERS ADDRESS PO BOX 2963 CITY/STATE/ZIP SANTA CRUZ, CA 95063 TELEPHONE (831) 818-9847 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ----- 1BCBSC VALUATION 14, 525 .00 1 . 00 0. 00 1 .00 0 . 00 1BSEISMICR VALUATION 14, 525 .00 1.45 0 .00 1.45 0.00 1REMRESKIT SQ FEET 96 .00 588 . 00 0 . 00 588 .00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 590 .45 0 .00 590 .45 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 590 .45 #3563 --------------- TOTAL RECEIPT 590 .45 1/26/2012 COSTA BELLA BUILDERS BY JEFF THPANOW COMMUNITY DEVELOPMENT DEPARTMENT A Division of Pacific Compass, Inc BUILDING DIVISION-CUPERTINO P.O. Box 2963 Lic# 654886 APPROVED Santa Cruz, CA 95063 Set of plans and specifications MUST be kept at the (831) 462-0580 0 ,r)g construction. It is unlawful to make any (831) 462-0590 Fax BIMDERS jeff(cbcosta bella builders.com -,:')-s or,same, or to deviate fl�out aopcvai from the Building Official. P',%n -An(! sPecifications SHALL NOT Permit r rt �e-�n approval of the violation a.'y,"4 Ordinance or State Law. Ed & Hedi Loens 10717 Linda Vista Drive AT- ��E ............ Cupertino, CA 95014 CJ 1. Demolition: Includes demolition and removal of kitchen cabinets, tile countertops,, vinyl flooring and underlayment and appliances. 2. Electrical: 2,& A^r • Run two (2) new circuits for the micro/hood and the countertop outlets. • Provide and install one (1) new recessed LED can light above kitchen sink on new stacked switch in same box with disposal switch. 3. PllumbinSC. Provide and install new recessed water supply box for refrigerator. 4. Drywall: • Patch drywall as needed for remodel work in kitchen. • Match existing texture. 5. Cabinets: Install cabinets per plan. C6 L-/ .0)c-'Q- 6. ARRHances: Install new appliances. a C, 0 t 0 k' '-0 / 0 CMC C- . I I I I I I I i 186,„ -: —2 ft: �� 24„ 6,0 wie I i I li_E 4k, I I FIS a� i i� f E —I � J7 . 56 41 I O -r-7_.( I I I � i I ; - l0.3au L Ir=1- I I I I I All ditecmdon.R_size designations i _ic i :r_c::'_�::,a;Q83i snd must 1�2si ed:1J3012t11�i given w.subject to verification on i no'1�ra;e,scd or copied unlexs Yrizitzd: 12/30/2011 job sits ail adjustment to fit if-lbI app:_ca:`te%r.has bccn paid or job I COttciidons_ or i�r piacc3. I� I 1 �� ► 'I �I A04U1 F?O.KTT -�LegcndDrawing N;11j 56/6 d L « �LWL580 S IVISNI WI- L 6Z-ZL-LLOZ CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10717 linda vista dr. DATE: 02/01/2012 REVIEWED BY: bobs. j APN: BP#: VALUATION: 1$14,525 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY I-PiENTAMATION 1 R3SFDREM USE: SFD or Duplex PERMIT TYPE: WORK sfd kitchen remodel non structural. SCOPE L_j LLJ NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These.Lees are based on the relinina in ormation available and are onl an estimate. Contact the De. t or ttddn'l in o. FEE ITEMS (Ee,' _,c>= , ' E" , "'1' 1i FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.0096 s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 $588.00 1REMRESKIT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. 0 OT O.Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00- 0 Work Without Permit? 0 Yes No $0.00 d,;331 t_,!d Plarmirig I ,e( W: $0.00 Select a Non-Residential G Building or Structure 0 StLom, KOH In re-11: IBSEIS'MICR $1.45 Select an Administrative Item EIdtf t � irni si.� ;'fie;, IaCBSC $1.00 SUBTOTALS: $2.45 $588.00 TOTAL FEE: $590.45 Revised: 1119/2012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: !c 717 PERMIT# OWNER'S NAME: ��q jk PHONE#( Z-OS"f-P GENERAL CONTRACTOR: r��_ l amu.�� BUSINESS LICENSE# ADDRESS: 44,1-0 9s'eio CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Date Signature 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 Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Owner/Contractor Signature CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• buildingCcDcupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# APN# 01 _ U C/O PROTECT ADDRESS / 17 6n),04 �/i,17'u A� OWNER NAME /-r Q! L.F�•C�.S PHONE D t 6 t l 1 E-MAIL STREET ADDRESS l CITY. STA'TEE,ZIPu� � 0�(/ FAX CONTACT NAME ` PHO E MA u fd �rk �Ju��NPn/1 (� t7✓1 �o� � / if 9d r ��P ear STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT _O CTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LIC SE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME EMAI�� 1ct / J>� � C F AX STREET ADDRESS��f-D Sj t(i �U 7i0 1✓ CITY,STATE ZIP v/��' PHONE 3/ y L G 1�e� ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK J EXISTING USE PROPOSED USE CONS ;TYP #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) AREAL AREA AREA ADAF_AO OTAL AREA _ BATHROOM KITCHEN !.�� OTHER REMODEL AREA REMODEL AREA- REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑DETTAAATTCH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION [IYES IF YES,PROVIDE COPY OF IS THE BLDG AN I-]YES RECEIVED BY: 7�J TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO /!�S�o2 S ke By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prrperty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bui ding con n. I authorize r/epresentatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: ��yGIJ `�" Date:_ /// SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for t- p R-:HE_COUNTER -E-�G PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building 1:1ExPREss ❑ PLANNING PLAN REVIEW permit for new building. _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD El PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ Ma WEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR C1SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11