10080087 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18325 CHELMSFORD DR CONTRACTOR:KENWAY&KITTY W TAM PERMIT NO: 10080087
OWNER'S NAME: KENWAY&KITTY W TAM 18325 CHELMSFORD DR DATE ISSUED:08/12/2010
OWNER'S PHONE: 4089969663 CUPERTINO,CA 95014 PHONE NO: -
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB
License Class Lic.#
MECH RESIDENTIAL COMMERCIAL
Contractor Date
I hereby affirm that I am licensed underthe provisions of Chapter 9 JOB DESCRIPTION: REMODEL KITCHEN(2035Q)&MASTER
(commencing with Section 7000)of Division 3 of the Business&Professions BATHROOM(142SQ)&
Code and that my license Is in full force and effect. WINDOW REPLACEMENT(KITCHEN/FAM RM/MASTER
BEDROOM);NO RE-ROOF&NO STRUCTURAL
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
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
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$80000
APPLICANT CERTIFICATION - .
I certify that I have read this application and state that the above information is APN Number:37522106.00 Occupancy Type:
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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date Issued by: Date:
Il! OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code). VIA
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
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. Owner or auth�o�Ized ee exit: O
O
�Date: 1L12U1 0
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and slate laws relating I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
p( I understand my plans shall be used as public records.
Signature_,--
ignature1 `�1..' ' Date O J 1424 L O
Licensed Professional
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: B1k: Lot :
APN • 37522106 . 00
DATE ISSUED • 08/12/2010
RECEIPT # • BS000011168
REFERENCE ID # . . . : 10080087
SITE ADDRESS • 18325 CHELMSFORD DR
SUBDIVISION
CITY • CUPERTINO
IMPACT AREA
OWNER • KENWAY & KITTY W TAM
ADDRESS • 18325 CHELMSFORD DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM KENWAY W TAM
CONTRACTOR • MONIQUE AND PAUL BURTON LIC # 30651
COMPANY • WEST COAST BUILDING AND DEVELO
ADDRESS • 6455 ALMADEN EXPWY STE 213
CITY/STATE/ZIP SAN JOSE, CA 95120
TELEPHONE • (408) 997-0428
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL
1BCBSC VALUATION 80, 000 . 00 4 .00 0.00 4 . 00 0 . 00
1BSEISMICR VALUATION 80, 000 . 00 8 .00 0. 00 8 . 00 0 . 00
1REMRESBAT SQ FEET 142 . 00 570.00 0. 00 570 . 00 0 . 00
1REMRESKIT SQ FEET 203 . 00 570.00 0. 00 570 . 00 0 . 00
1WINREP EACH•.8 1 . 00 380.00 0 . 00 380 . 00 0. 00
TOTAL PERMIT : 1532 :00 0 . 00 1532 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CHECK 1, 532 .00 #1029
TOTAL RECEIPT : 1, 532 . 00
•
^"1// OWNER-BUILDER DISCLOSURE FORM
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333• buildinq(Ocuoertino.orq
Dear Property Owner(s): -
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified at: ����ff Pu,
SITE ADDRESS ;€3325-e h Of t-l7ra�fi5Lf / APNj7�"c375 -K/� "az, tf- 00 ?
7
OWNER NAME / OWNER ADDRESS -
Kpnu y 4 IC Taw,— Sate as So--c. acid efS'S
In
'' adro
DESCRIPTION OF WORK: Ktiry22Oeh, Oct n,�r71.t>G(Q.f�%� ki�LILQ,,, , hist 94 wa�KrR .-
c,.,_
/ '��%Iy .
tvPtc(Int) reek> it-a rrl-• Thn+r Y pcprio d av,- rep(aCPnten4 . ink 54-e-ba 12 �
hlTndrrw rep?,
We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of
your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We
will not issue a building permit until you have read, Initialed your understanding of each provision, signed, and
returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless
you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
(DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.)
(f( 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-
Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material
personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by
an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not
provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my
insurance coverage for injuries to workers on my property.
161 2. I understand building permits are not required to be signed by property owners unless they are responsible for
the construction and are not hiring a licensed Contractor to assume this responsibility.
re( 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may
protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her
name instead of my own.
VI 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the
• total value of my construction is at least five hundred dollars($500), including labor and materials, I may be
considered an "employer"under state and federal law. . _ --
01 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and
federal government,withhold payroll taxes, provide workers' compensation disability insurance, and contribute to
unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject
me to serious financial risk.
0 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by
licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work
is performed under contract with a licensed general building Contractor.
n 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for
any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction
defects in the workmanship or materials.
OwnerBuilderFor,n 2010.doc revised 04/14/10
�' CITY OF CUPERTINO
ADDITION/REMODEL
CUPERTINO FEE SCHEDULE
APN# 315 -22.— tab _co Date: O�/lZ�lO
Is a 2"d unit being added? Yes ❑ No rvf If yes, please fill out the permit application for 2nd unit.
Building Address: 18325 CltttMSfoRD DR G&etERTzWo, CA a5°
1
4
.
Mailing Address (if different from building address):
Owner's Name: KiTT� t�6NWA4 TAM Phone # : 4v6 99b 9663
Contractor: WT:rSTCPPST SWt >10C& AND poNslizik Tl4N Phone #: 4O899"1 0428
PAUL 6uRTo$ Fax #: 40B 991 9558
Cupertino Business License: 30b5 State Contractor License #: 15$35551-
Contact: PM&L BtARZON Phone #: 40% 491 0,03-7cRU
Fax #:
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated areas): N.A.
112,500 sq. ft. or less, compliance with the Landscape Water-Efficiency Checklist is required.
If more than 2,500 sq. ft., a complete Landscape Project Submittal is required.
Compliance Method: ❑ Plant Type ❑ Water Budget
Building Permit Info:
Bldg. [y]i Elect. Q Plumb. 2. Mech. g Hillside ❑
Job Description:
Addition-What is being added?(Be Specific): N.A.
What is being remodeled (not including addition)?
• V-rrct tr4 RSMo 6t..... 203 SeAFT • W'NDOW 2oPlAc.cn' 'fl (KerU t Y
MAsnn R
re&4AtARoO504--rMoblI- 147_ 50 -v M+n'E2 ocMRawl
Remodel Includes Re-Roof: Yes ❑ No F,/ If yes list number of squares
Remodel Includes Structural: Yes ❑ No %
Do you have the pre-application planning approval? Yes ❑ No ❑
If yes, please provide a copy of your planning approval letter. Planners name:
Square Footage:
Addition: PLA. Porch: Deck: Garage: Detached Attached
Remodel: Kitchen 2.03 Tatar Bath tka SGS'T Other
Type of Construction (Usage Class): _/ Occupancy Type: R-3
1-A, 1-B ❑ II/IIIN-A ❑ II/III B, IV-HT, V-B ✓ Valuation: 4 $0,000
�/ Please check this box if the project is a
Project Size: Express I VI Standard ❑ Large ❑ Major ❑ second-story addition ❑
Please complete relevant portion of the Green Building
Checklist & attach it to the application or if applicable, Green Building Points Achieved:
include in plan set& the sheet index.
Revised 05/18/10
RESIDENTIAL PROJECT COVER SHEET
Assessor's Parcel Number: 3 7 S--2—Z- !G
Name of owner. ICRnwat�a (cictt,a Yates
Project address. Chelyxsforcl Or. r Co-ferktt n o , CKj 173'19- •
•
Contact person. • Phone.
•
Fax.
Net square footage of lot. 61 _
•
Existing ( Proposed
Square footage: First floor:
Second flo
Garage:
Garage:
TOTAL:
Are there at least two 10 foot by 20.foot clear spaces inside the garage?
CEIv�'
�_� AUG 12 2010
Is privacy protection planting required for the project?, N
Build it Green Total Pointe'
•
On what floor(s) is work being done?
Brief description of work. IS an ck tna54er t)C(_kc. ret.. ode,\CAS g o 9"UctL`•"'o4 Cc;c'>4 .
(Arad 6(4) Y2f(GtCPh—¢Ent = \ K i' ytprl 3 RbYea @ Set•neoKr t (kk41O ( CPC t� -(-aw, rt.,
w;ncicw .n •'arw: i� rM
Code editions: 2007 CBCN)2007 CFC r N)2007 CMC 3
, Cr! msa-
aer bath
2007 CPC N)2007 i Ov4-
IN ACCORDANCE WITH THE CRI,OF
CUPERTINO CODES
AND ORDINANCES �,. k.e �" 4 \tic.,.9.\t..uc..•
Effective 1/1/08 DATEk/iZfao= d
•
be kept on�m s and ira�on_ T
•
unlawful to make ebb at all times and ills
on same withoutan�tteanges or alterations
the Ruiltling Deliartm permission from .
The stomping f ent.Clry of Cupertino.
P ng o this Plana specification9
•
SHALL NOT be held to permit or to be.an
apof an I of the violation of any Provisions
Y Crty Ordinance m State Law.
•
•
•
Plan Review Process Work Book Page-8-Revised 8/05/08
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18325 Chelmsford Drive, Cupertino, CA 95014 /\ -
Elevation viewing from the backyard (outside) of the house.
2/F windows not shown here.
Ref: Model with 2741 sq ft. 4 bed/3bath
•
•
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Family Room window& patio door Breakfast Nook Kitchen
• I-
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18325 Chelmsford Drive, Cupertino, CA 95014
Elevation viewing from the backyard (outside)of the house.
2/F windows not shown here.
. Ref: Model with 2741 sq ft. 4 bed/3balh
Proposed window/door style: without grids.
Proposed window ext color. while (same as existing color).
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.
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Family Room window& patio door Breakfast Nook Kitchen
U' 1 Casement
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18325 Chelmsford Drive, Cupertino, CA 95014
Elevation viewing from the right side (outsider) of the house.
1/F windows not shown here.
Only the master bathroom windows are shown here.
Ref: Model with 2741 sq ft. 4 bed/3bath
•
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Master bath shower Master bath Master bath toilet
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18325 Chelmsford Drive, Cupertino, CA 95014
Elevation viewing from the right side (outsider) of the house.
1/F windows not shown here.
. ..h." . :
Only the master bathroom windows are shown here.
Ref: Model with 2741 sq ft. 4 bed/3bath
Proposed window/door style: without grids. •
Proposed window ext color. white (same as existing color).
•
•
•
. ._ .
. • .
Master bath shower Master bath (sliding). Master bath toilet
Casement(obscure) '14 circle not being replaced Casement
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