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07050204 CITY OF CUPERTINO I BUILDING DIVISION PERMIT GTOR �tFORMATION: BUIL15Ny���ESS: PERMIT NO. � REDONDO CT WAGNER CONSTRUCTION 07050204 PERMIT ISSUE DATE OWNER'S NAME: ORTA LESLIE K AND JENSEN PAUL 6388 SAII ANSELMO WAY 05/21/2007 SANITARY NO. CONTROL NO. SNE: (877) 268-4980 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p Q LICENSED CONTRACTOR'S DECLARATION Job Description vI hereby affirm that I am licensed under provisions of Chapter 9(commencing ;ZU with Section 7000)of Division 3 of the Business and Professions Code,and my license is REMODEL--KITCHEN NON STRUCTURAL INCLUDES w in full force and effect )�2z Li e" a Lic.l LECTRICAL p Date Contractor F ARCHITECTS DECLARATION IGHTING, PLUMBING. 1 understand my Blans shall he used as public records )qU e U.H Licensed Professional a OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the cc following reason.(Section 7031.5,Business and Professions Code:Any city or county <,�, which requires a permit to construct,alter,improve,demolish,or repair any structure H prior w its issuance,also requires the applicant for such permit to file a signed statement Valuation _z ,.q.Ft.Floor Area that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 $28000 r I= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or i that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arry applicant for a permit subjects the applicant to a civil penalty of 3 5 6 2101 1 �Number Occupancy Type not more than five hundred dollars(5500). 0 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered forsale(Sec.7044.Business Required Inspections and Professions Code:The Contractor's License Law dries not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li. cerise Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sea B&P C for this reason RY Owner Date - SANITA WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,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 required by Section 3700 of the labor Code,for the performance of the work for which this permit is issued. My Workersq � Compensation insurances carrier and Policy number are: Carrier ,� PLWI) Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is forone hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. Z"' CONSTRUCTION LENDING AGENCY (~- 1 hereby affirm that there is a construction lending agency for the performance of a> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name a2 Lcnder s Address U O 1 certify that I have read this application and state that the above information is Lt. correct.I agree to comply with all city and county ordinances and state laws relating to Cbuilding construction,and hereby authorize representatives of this city to enter upon the U above-mentioned property for inspection purposes. C4 (We)agree to save,indemnify and keep harmless the City of Cupertino against ,F rA liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date ►'� APPLICANT_W4DERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE R U ONS. O� �. Re-roofs Signature ol'Appliontracwr r Date Type Of Roof HAZARDOUS MATERIALS DISCLOSURE yP Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. ❑Yes ° // If a roof i;installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? C)Yes )6flo I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the icy ' s which must be et 'or w issuance of a Certificate of Signature of Applicant Date Nj All roof coverings to be Class"B" or better Owner o hori-zcd agent D tc CITY OF CUPERTINO 9 ITEMS OF 9 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35621014 .00 DATE ISSUED. . . . . . . : 05/21/2007 RECEIPT #. . . . . . . . . : BS000001402 REFERENCE ID # . . . : 07050204 SITE ADDRESS . . . . . : 11250 REDONDO CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : ORTA LESLIE K AND JENSEN PAUL ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4740 RECEIVED FROM . . . . : WAGNER CONSTRUCT CONTRACTOR . . . . . . . : RYAN WAGNER LIC # 28889 COMPANY . . . . . . . . . . : WAGNER CONSTRUCTION ADDRESS . . . . . . . . . . : 6388 SAN ANSELMO WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95119 TELEPHONE . . . . . . . . : (877) 268-4980 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 349. 92 167. 96 0. 00 167 . 96 0 .00 BPERMFEE VALUATION 28, 000 .00 349. 92 0. 00 349 . 92 0.00 BPFIXTURE UNITS 1 . 00 9. 00 0 .00 9 . 00 0.00 BREMFIXT NO. FIXTURES 7 . 00 8 .40 0. 00 8 .40 0.00 BREMRECEPT NO. OUTLETS 4 .00 4 . 80 0 .00 4 . 80 0.00 BSEISMICRE VALUATION 28, 000 . 00 2 . 80 0 . 00 2 . 80 0.00 EPERMITFEE FLAT RATE 1 .00 38 .37 0 .00 38 .37 0. 00 MPERMITFEE FLAT RATE 1 . 00 38 .37 0 .00 38 .37 0. 00 PPERMITFEE FLAT RATE 1 . 00 38 .37 0 . 00 38 .37 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 657. 99 0 . 00 657 . 99 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 657. 99 2364 --------------- TOTAL RECEIPT 657. 99 MY1E } CITY OF C'UPERTINO 01 PERMIT APPUICATION FORM CUPEkTINO CPN# /J� �%_ � � /1,�� Date: ..JJ SL-zilo Building Address: !Mailing Address (if different from building address): RONOW C1 C0?&%%S Owner'sName:Na e:: Q Phone #: 1 `� L, V W- 06 r Contractor: License#: w a W 1 tJ ) Contact: Phone: 4cg-426-IS01 Cupertino Business License#: RYAI\� 1 A60?iZ Fax: C6—S ` Building Permit Info: � ; f c 1. ,� ,(�z,,,,�a d� -- �,, S-ire,v�-�,r- �•Wil,••c1� Bldg ❑ Elect F lumb Mech ❑ 1v 6;h Job Description Residential Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: Z. 006).©6 tz_- Type of Construction: Please check this box if the project is a S �_ second-stor addition: ❑ roject Size: Standard Large ❑ Major ❑ Quantity Fee ID lee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boilcr> 500K to 1M Btu MECHANICAL BBOILER4 Boilei > 1M to 1.75 M Btu MECHANICAL BBOILER5 Bailer> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Cor. Tax for BQ Zone BUILDING BCONSTAXH hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 EL:c 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD E iergy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 CITY OF C'UPERTINO CITY of PERMIT APPL[CATION FORM CUPEkTINO Quantity Fee ID :Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM NeiN Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME In.;pection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE B Ift Permit Fees BUILDING BPFIXTURE Pb1 Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK flan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Rfp i e Of Fixtures PLUMBING BPSEWAGE S ewa a Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn Sprinkler/Backflo PLUMBING BPSTORM S torm/Rain Water' PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER W iter Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfrn MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY R-,model Busways ELECTRICAL ? BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Rel kation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Jvlisc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pol,-/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Rc location of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remc)del Res Appliance ELECTRICAL 2 of 3 CITY OF C'UPERTINO CUP TYCW NO PERMIT APPL][CATION FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmd Signs Add Branch ELECTRICAL BREMSIGNS Rem Adel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD '-cb Specific Plan BUILDING BSEISMICOM _ Seismic Commercial _ BUILDING BSEISMICRE .seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP T,-mporary Power ELECTRICAL BTEMPPERM Tem 3orary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC E,usiness License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Meeh Permit Issuance MECHANICAL PPERMITFEE Plutabing Permit Issue PLUMBING PPLBG Phmbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING 3 A3 CUPEkTINO Assessor's Parcel Number: — Name of owner- — Project address. 50 Contact person. �?A f V) �g --Phone. t 'Q"' ��- "�� ✓r Fax. 14003—T i�-'fy�� 7 Net square footage of lot. Exi:>t Proposed Square footage: First floor: Second floor: f Garage: T--- TOTAL: Are there at least two 10 foot by 20 foot clear sp ices inside the garage? -Y Is privacy protection planting required for the pr)ject? N On what floor(s) is work being done? iC LrP $aUrnn�l Brief description of work. 2 ( N)2001 CMC O N) Code editions: 2001 CBC 0001 CFC- 2 -N)2001 CPC �-N) 001 NEC Effective 11/1/02 APPROVED "I ACCORDANCE WITH THE CITY C- "PERTINO CODES AND ORDIPJANC[5 DATE SIGNED this set ra p a nd be kept on the jot,at �i'`k-Iicat►ons MUS, ...a:I times and it is i r, In same e make arty chFm,es or atteratio 1• �n sa """ me with0lit s -i;+ „ r thc- huiidin C� '"r't permission U11 The c p., City of C;:por#ino. � tamp,, cf this iin 2RJ Specificatiop )Ii�tll NJI be Fia p 'Nrovai of the VlG f�� pe�rriit or t0 ar 'Ink/ (`rt. n Of any (Jrovacgnr� �1 n n:MC2 cr- Plan Review Process Work Book Page-'8-Revis-d 4/28/04 I I it A2436 oil S13 3 LSA36R.WLS CO / =-- J -- - -- - -- - — Ch m � CO O CA NCO (� p N 00 M J Cn w OP ni PINUM j u&R mfo oUL w-e-z'Wr 2 -26 A MP WRTCAMP C`.;-QCr�i K 1 -22b VOZ W SIJ p AM? C RC6 6AR6AU �SMA L4-7 ;p I w N I I I i t ni I --------------------------------- I I I ISL rlrY(�1`1J�A All dimensions size designations gi✓en are This is an original design and must not be Designed:2/9/2007 subject to verification on job site ani released or copied unless applicable fee has Printed:5/3/2007 adjustment to fit job conditions. been paid or job order placed. 101Ocb55.kit Fp 1 Drawing#: 1 CUPERTINO - - - -- Assessor's Parcel Number: — Name of ow ner_ �UL �?kA59-A — Project address- p Q � 11� WALLED Phone. Contact erson. Fax. -�© 5 Net square footage of lot. Ex:stir Proposed Square footage: First floor: __-- Second floor: Garage: T— TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the garage? � N Is privacy protection planting required for the p roj ect? N On what floor(s) is work being done? �!!. _ �I`Vl.���__ � 1�1C� lf1l' 6 Brief description of wo k. .-� 2001 CF(: N)2001 CMC- ((Y-N) Code editions: 2001 CBC � 1 NEv �- N)2001 CPC -N )200 GO Effective ll/l/02 CJ_ 0 .G q 4 Plan Review Process Work Book Page-B-Revised 4/28/04 I i I I j co / A2436 CO N s . f � SB 3 LSA36R.WLS [ ---- .. ------- --- ---- -- - ----- --- J CY) CO 0 � CO O NCO CO I i r ni Llb�'f5fj6 14LL f-wouwi- 2. -26 AM? W,16CAf VD C'QCc�i K ft� 1 -22LD �-OV 6J SIJ 1 - 20 AM? CfV Cu'-i 6AWA6? W5FVALcV9LJ � CA) N i I r ni -----------------------------------—- I' AtL i All dimensions size designations gi-en are This is an original design and must not be Designed:2/9/2007 subject to verification on job site and released or copied unless applicable fee has Printed:5/3/2007 i adjustment to fit job conditions. been paid or job order placed. Drawing 1010cb55.kit Fp 1 #: 1 FROM :CUPERTINOSANITARYDISTRICT FAX NO. :4]82535173 Dec. 11 2007 02:30PM P1 DISTRICT MAN AGER-ENGINEER BOARD OF'DIREG70R5 MARK THOMAS&COMPANY,INC. (10-50 STEPHEN C.ANDREW$ DAVID E.ROSS WILLIAM A.BOSWORTH DISTRICT COUNSEL YFA'AS'47 JOHN M.GATTO ATKINSON•FARASYN,LLP. �f�e�l jyQ 1�� CUR715 B,HARRISON HAROLD S.TOPpEL, WENDELL,H.KERR.JR. 20833 S'TRVENS CREE<BOULEVARD,SUITE 104 CUFF-kT1NO,CAL F'ORNIA 98014,2154 (408)253.7071 PHONE • (408)253-5173 FAX www,0Upertin0Sanitarydistrict.com l ilc: GUST)—MOP Building Dept, —Cupertino City of Cupertino Attn.: Building Department 10300 Torre.Ave. Cupertino, CA 95014-3202 Subject: Residential Addition/Remodel Name: Orta Residence .Address: 11250 Redondo Ct APN: 356-21-014 Permit No.07050204 Videotapc and Property Line Clean ou t waived. No additional conditions/requirements by the District. �Cv�+" Inspector: George Santos/Roger Santos aG.................•.........t...................• ......... ....... . .. ... .. V14 Date: 12-11-2007................... Sanitary Sewer Location: cc: Property Owner SUPPLYING SANITARY SEWERAGE SERVICES FOR:CITY OF CUPERTINC,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALF,LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CIT1f OF Fax(408)777-3333 "UPEkTINO Building Department JOB ADDRESS: t I ZSO V0,K)M C,F PERMIT j,7 D S'd 2a 41 OWNER'S NAME: VAQL PHONE # GENERAL CONTRACTOR: W z FAX # I am not using any subcontractors: (S) S 2 8 Si€nature Date Please check applicable subcontractors and com Tete 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 6-2,Z:f n , ( `Z (-)Owner/Contor Signature Dat