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12040045CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10625 MORENGO DR CONTRACTOR: STARBURST CONST CO PERMIT NO: 12040045 OWNER'S NADIE: ROBINSON CHRISTOPHER S AND MARY A 1207 REDCLIFF DR DATE ISSUED: 04/09/2012 OWNER'S PHONE: 4088738837 SAN JOSE, CA 95118 PHONE NO: l408H48-1328 ❑ LICENSED CONTRACTOR'S DECLARATION r r r r l�License BUILDING PERMIT INFO: BLDG ELECT PLUMB Class Lic. t! )-- . � r r r cc'' �3� -/ MECH RESIDENTIAL COMMERCIAL Contractor _ Win a?•y°" .' Dale ". i1 I hereby affirm Thal l am licensed under Ilia provisions of Ctiepler 9 JOB DESCRIPTION: EITHCEN REMODEL(125SQFT),REMOVE AND REPLACE (commencing with Section 7000) of Division 3 of the Business & Professions R AND ITE AND INFILL ONE(I)DOOR Code and that my license is in full force and effect. R WITI REMOVE TWO(2)WINDOWSANB REPLACE WITI1 REMOVE O( I hereby affirm under penally of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $50000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 37534009.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and stale 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 authofize representatives of this city to enter upon the above mentioned prop for pection purposes. (We) agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless c i f Cupertino against liabililies,judgments, costs, and expenses which y e against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. A i ly, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point score a lions per the Cupertino Municipal Code, Section 9.18. /� Q ,�{{ Issued by: ,/ /lam /9TGf� Date:•/a— Signal � Date' // ❑ 'NER-B I.D . DECLARATION RF. -ROOFS: 1 hereby aflir that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1, as o%vner of the 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, Business & Professions Code) Signature of Applicant: Date: I, 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 penally of perjury one or the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's HAZARDOUS MATERIALS DISCLOSURE: Compensation, as provided for by Section 3700 of the Labor Code, for the 1 have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued.. California Health & Safety Code, Sections 25505. 25533, and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(x) should 1 stare or handle hazardous material. Additionally, should I use equipm to devices which emit hazardous air permit is issued. contaminants as defined by The y ea Air Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance wit a tino 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 a '6 05, 25533, and 25534. Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such or this shall be deemed revoked, O , er or a e p _ _ Date: provisions permit N. RUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that i r a c moction lending agency for the performance of work's coffee[. I agree to comply with all city and county ordinances and state laws relating for which this permit i (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, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional 8 ITEMS OF 9 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: B1k:,Lot: APN ........: 37534009.00. DATE ISSUED.......: 04/09/2012 RECEIPT #.........: BS000016489 REFERENCE ID # ...: 12040045 SITE ADDRESS .....: 10625 MORENGO DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 NEW BAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 �f OWNER ............: ROBINSON CHRISTOPHER S AND MAR ADDRESS ..........: 10625 MORENGO DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: PHILIP J CAREY CONTRACTOR .......: CAREY, PHIL LIC # 21428 COMPANY ..........: STARBURST CONST CO ADDRESS ..........: 1207 REDCLIFF DR CITY/STATE/ZIP ...: SAN JOSE, CA 95118 TELEPHONE ........: (408)448-1328 FEE ID UNIT QUANTITY AMOUNT PD -TO. -DT THIS REC ---------- -ADMIN ------------- ---------- HOURS 1.00 ---------- ---------- 41.00 0.00 ---------- 41.00 1BCBSC VALUATION 50,000.00 2.00 0.00 2.00 1BSEISMICR VALUATION 50,000.00 5.00 0.00 5.00 1PPERMITFE FLAT RATE 1.00 44.00 0.00 44.00 1PRWHEATR UNITS 1.00 26.00 0.00 26.00 1REMRESKIT SQ FEET 125.00 588.00 0.00 588.00 1TRAVDOC FLAT RATE 1.00 44.00 0.00 44.00 1WINREP EACH 8 3.00 392.00 0.00 392.00 TOTAL PERMIT ---------- ---------- 1142.00 0.00 ---------- 1142.00 NEW BAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 �f ��//� CITY OF CUPERTINO ISD' FEE ESTIMATOR -BUILDING DIVISION NOTE: This estimate does not ineludefees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These lees are based on the preliminary information available and are only an estimate Contact the Dept for addu 7 info. FEE ITEMS (Fee Rcsohnlon 11-053 E!L 711111) ADDRESS: 10625 Morengo DATE: 04/09/2012 REVIEWED BY: Sean imk APN: BPH: -VALUATION: 1$50,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Else. Lisp. Fcc: PENTAMATION 1R3SFDREM PERMIT TYPE: WORK Kitchen remodel 125 s ft remove and replace 2 doors in -fill 1 door and sidelite and remove 2 SCOPE windows and replace with (1) sliding glass door with landing. Installation of tankless water heater. NOTE: This estimate does not ineludefees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These lees are based on the preliminary information available and are only an estimate Contact the Dept for addu 7 info. FEE ITEMS (Fee Rcsohnlon 11-053 E!L 711111) Alech. Plan Check Plumb. Plan Check 0.0 1 hrs $0.00 !i/rc. P/na Check Atxir. Perwil Fre: Plumb. Permit Fee: 1PPERMIT I(fec. Permit bec: (hirer Ah,, h. Inrp, 0rs $44.00 Other Plumb Insp..0 h Odr rcInce. Lul. Ph -ch. ya'p. 1 -cf. Plumb. hop. Fra: Else. Lisp. Fcc: NOTE: This estimate does not ineludefees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These lees are based on the preliminary information available and are only an estimate Contact the Dept for addu 7 info. FEE ITEMS (Fee Rcsohnlon 11-053 E!L 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. $588.00 Remodel, Kitchen (<=300 sf) IREMRESKIT Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 3 # $392.00 Window / Sliding Glass Door 1 1IFINREP Replacement Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.001= # Plumbing IPR $26.00 IF//EATR I Water Heater PME Unit Fee: $0.00 PME Permit Fee: $44.00 Cnunvu riun Ka. Administrative Fee: !ADMIN $41.00 O E) Work Without Permit? O Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 � Travel Documentation Fee: ITRA VDOC $44.00 Strong Motion Fee: IBSEISMICR $5.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: 1 $136.001$1,006.001 TOTAL FEE: $1,142.00 Revised: 04/01/2012 I o' �1 Y \q\ e -•r}� COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO >< ' APPROVED This set of plans and specifications MUST be kept at the fob site during construction. It is unlawful to make any changes or alterations on same, or to deviate therefrom, without approval from the Building Official. The stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the violation of any provisions of any City Ordinance or State taw. /1 BY —( r� DATE y-9 •iri- ( �+ his• �' PERMIT NO. PZ�ECFXVFM �� E�;a•� �jc� pct �� APR 0 9 2012 V� BY: I �Cry+`4VZ J- 11m �Jt"t IA ` � ,�dwt � i✓,a- 1 I///�•�� V..lv 2.� �-i d e'J� moi( •1� V Q T '- 0- o S V a Q I � F F E ( i 1 {t; - • t ;'! N Y � 1 C;k IE 37 -12" 15 " 1 N 11230 W3030 II j I 3D630 F .. LL �` 'B12TDROL- 11248424SAII j PERRY STREET MS 'CHRIS / MARYANNE ROBINSON 408-873-8837 / 408-341 X5109 I 1. 2. 3. 4. 5. W3015 W2430 -J 113DB1811 ,2'. - - — -- -- - 17;' 12" I b; o: •� o . I m I 27" 30" �( 7T 22" 27" 24' All dimensions size designationsThis i an original design and not t Designed: 1/29/2012 given are subject to verification on �\ ' not b b" ' Printed: 2/13/2012 job site and adjustment to fit job ` applicable fee hasmpaid jQb -- conditions. order placed. � � � � j1�,��'• [I250FE93.kit_--=_ - - __- _ _ _- - - - -- All _ _ _Drawing R_I ate- �x:,�.—; I ERAL NOTES o m II measurements to be verified before installin %EP2484F1.5 ra.- 0 II Fillers to be field cut installed per plans. II appliance sizes to be verged before installation. ee Crown Mottling detail for installation of - punter Top to be installed by others. p III -n .r N N I 27" 30" �( 7T 22" 27" 24' All dimensions size designationsThis i an original design and not t Designed: 1/29/2012 given are subject to verification on �\ ' not b b" ' Printed: 2/13/2012 job site and adjustment to fit job ` applicable fee hasmpaid jQb -- conditions. order placed. � � � � j1�,��'• [I250FE93.kit_--=_ - - __- _ _ _- - - - -- All _ _ _Drawing R_I M 1 127" 24" 1591 3391 18'1 1 If 3311 �11 W3318 I I M W1 830R ' given are subject to verification on ''i�� not be released or copied unless Printed: 2/13/2012 job site and adjustment to lit joh ` applicable fees has been p, .at d or,jub ----- ---- conditions. order placed" 118�� Jy 12;01-r93.kit ❑❑ Drawing It: I n n 36R.RF2-BD LL I IF �IN W 24 DISHWBWB1 �11 W3318 I I W331524 W1 830R Designed: 1/29/2012 given are subject to verification on ''i�� not be released or copied unless Printed: 2/13/2012 job site and adjustment to lit joh ` applicable fees has been p, .at d or,jub ----- ---- conditions. order placed" 118�� 12;01-r93.kit Sink Drawing It: I n n 36R.RF2-BD W M w pt- . 1 1/911 3 11 11 11 11 F 15 3 �18 -�3 14 44;6" 5016" w All dimensions size designations - _-• -' This is an original design and must Designed: 1/29/2012 given are subject to verification on ''i�� not be released or copied unless Printed: 2/13/2012 job site and adjustment to lit joh ` applicable fees has been p, .at d or,jub ----- ---- conditions. order placed" 118�� 12;01-r93.kit Sink Drawing It: I 372"-12 1 1/2" Tall Filler R BPP120 GAS RANGE C 3DB30['{}L®'L}�`^a{� �I 7_ LL i�.TAIv " Cf 00 ' " J CO 30" 12" 7 , 6 v to ,-6 m 04 N 0=0 (y� T Ofi ! m m b' —AFI dimensions size designations given are subject to verification on job site and adjustment to fit job conditions. I'_50FL93.kit „ 75 511 2 06 6 711 ,6 172" I This is an original design and must Designed: 1/39/2012 not berreleased or copied uDless Printed: 2/13/2012 applicable le • hns•been d yro r order pla q N tS �Rangc IDraxving ll:I R BPP120 GAS RANGE C 3DB30['{}L®'L}�`^a{� 3DB18 7_ i�.TAIv " — 3 ' " 1 30" 12" 7 , 6 11 ,-6 0611 -2 TL1G IrIf` ,Tn a IiAnr —AFI dimensions size designations given are subject to verification on job site and adjustment to fit job conditions. I'_50FL93.kit „ 75 511 2 06 6 711 ,6 172" I This is an original design and must Designed: 1/39/2012 not berreleased or copied uDless Printed: 2/13/2012 applicable le • hns•been d yro r order pla q N tS �Rangc IDraxving ll:I CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DMSION 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 (408) T7-3228 • FAX (408) 777-3333 • buildinU(cbcupeftina.DrG ❑ NEW CONSTRUCTION ❑ ADDITION R[I ALTERATION/ Ti ❑ REYL4ION I Da -m= nRlriNAT. PFR Vrr I PROJECT ADDRESS APN a OWNERNAME I / PFIONE ( �J E-MAIL SCREETADORESS QTY. STATE ZIP FAX _ CONTACT NAME PHONE EMAIL r r STAFETADDRESS QTY. STATE ZIP FAX ❑ OWNER ❑ OWNER-surLDER ❑ OWNER AGENT CONTRACTOR ❑COMRACTORAGENT ❑ ARCHITECT ❑ PNGLI F ❑ DEVELOP,, ❑ SENA,, C°NTRACTORNAME r I1GEME ,) II EUS. LIC» �(! 1 COMPANYNAME N E-WAM FAX STREET ADDRESS /''J ) QTY. STAIR IIP ` PHONE t �+ I d / > / v'� ARCIDTEC DENGINEERNAME _ A' LICENSE NUMBER BUS. LIC Y COMPANY NAA$ E-MAIL FAX STREET ADDRESS QTY. STATE. ZIP PHONE DESCRIPTION OF WORK % ` / ; 9\ / i A\) ;� IAti�1G USE PROPOSED USE CONSTR. TYPE »STOR<FS — 1 ; 5 USE. TYPE _ OCC SQ -FT. VALUATION (S) -\ EW TRO J E=TG =71a!( AREA / 0 AREA a! DEW) AREA / D � TOTAL N61' AREA ✓ EATFIRCOM KITCHEN ��\\ CTNER RB40Dm.AREA REN[ODELAREA) C7(;J IUadODEL AREA PORCHAREA DECRAREA TOTAL DECUPORCTAREA, GARAGEAUT- DETACH ATTACK I I » DWELLING UNITES: 13A SR CUM ONTT YES Sr.CON'DSTORY YES a1mSCADD®T ❑NO ADDITION' NO A PRE -APPLICATION ❑YES IF YES. PROVIDE COPY OF. P[.aMNRNG,PPC» CI PLANNING APPROVAL IJ_l-LFII i is aLDCAN ❑ ar HOME! RECEIVED / TOT VALUATION: ^ _ jz, zG/U ^` By Dry sigaanae belaW, I certify to each of the f0➢ 1 the property OWRer Or authorized a r to act on the F;vm1ynaf. DW's behal-Ihave Read this application and the mfD®adou I have provided is have Lead a Desaiptim of Worfc and verify it is accurate. fag= to comply With an applicable local ordinances and state laws relating g I aurho ' repr�entadv of Capers o0 to enter the above-ideati5ed property far' ecdau pmpases. . tY /msp Signature Of Applicant/Age¢D Date: — — 7/ SUPPLEMENTAL INFORMA NREQUMED PLANCaECKTYPE RCOLING9.[P °�-�`CO° NTER - El H°D'°LVG Pun REVIEW New SFD or Multifamily dwellings; A y far demolition permit for adsang bmlding(s). Demolition permit is remrirnd prior to issuarne of building for Dew building.❑ EXPRESS ❑ PLAXMG PLAN REVOrW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORIO form if say Hazardous Materials are being wed as part of this projecL ❑ LARGE ❑ ME DEFT _ Copy of Plazming Approval Letter or Meeting with Planning prior to ❑ MANOR I ❑ sANTi'aRSEWER submittal of Building Permit application. OrsmTuer ❑ ENvmOKMEN'TAL HEALTH. Bldg4pp_2017.doc revised 06121171