Loading...
09010114 CITY OF CUPERTINO iT BUILDING DIVISION PERMIT BUILDING ADDRESS: PERMIT NO. OWNER'S NAME: FERMrr ISSUE DATE O A CONTROL NO. (510) 538-5288 ABUILDING PERMIT INFO RCH1TECf/ENGINEER: BLDG ELECT PLUMB MECH u o p LICENSED CONTRACTOR'S DECLARATION IOU Description 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is =y in full farm and effect ter)- 1' RMDL KTCHN,NON—STRUCTRL, ELECTRC UPGRADE CABNETS j vn Z License Claw - Lic.+� F'o Dam— Contractorc o' u, (216 SQ) , PLMBNG&MECH r„i+ ARCHITECTS DECLARATION 1 understand my plans shall be used as public records �C6 oy Licensed Professional y OWNER-BUILDER DECLARATION ' 1 hereby affirm that 1 am exempt from the Contractor's License Law for the COO following reason.(Section 7031.5,Business and Professions Cafe:Any city or county K m which requires a permit to construct,alter,improve,demolish,or repair any structure zr prior to its issuance,also requires the applicant for such permit to file a signed statement _< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation Xt- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of 816000 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(M). 36626028 . 00 ❑I,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 for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply m ns an owner of q P 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.). ❑I,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- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. ❑1 am exempt under Sea B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insure forworkees Compen- -don,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 Cafe,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number are: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one 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 Workcrs'Compensation Laws of Califemt Date Applicant tsar'r z �u•L NOTICE TO APPLICAA If after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Coda you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY Fr ter I 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.) WGL Q Lender's Name Z Lender's Address U Q 1 certify that I have read this application and state that the above information is LL►" cormCL I agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorim representatives of this city to enter upon the a above-mentioned property for inspection purposes (We)agree to save,indemnify and keep harmless the City of Cupertino against ►F-t liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in conseque ce of the granting of this permit Date ■ APPLICA UN ERSTANDS AND WILL COMPLY WITH L NON-POINT Issued by: SOUR GULThfts. LA'.1 h44, Re-roofs Signature of Applicant/Contra&or Date T of Roof HAZARDOUS MATERIALS DISCLOSURE Type 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 Cede,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. C]Yes 9No Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. dict? ❑Yes (�No 1 ave read the hazardous materials requirements under Chapter 6.95 of the Califor. nia Heal &Safety Code,Sections 25505.25533 and 25534.1 understand that if the building does not urrently ave a tenant that it is my responsibility m notify the occupant of the mqui ts wnic rbc met prier to issuance of certificate of occupancy. Signature of Applicant Date e All roof coverings to be Class'/W'or better ownrtharixcd agent Dam CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36626028 . 00 DATE ISSUED. . . . . . . : 01/27/2009 RECEIPT #. . . . . . . . . BS000007047 REFERENCE ID # . . . 09010114 SITE ADDRESS . . . . . : 21090 RAINBOW PL SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER MR & MRS ANG ADDRESS . . . . . . . . . . : 21090 RAINBOW PL CITY/STATE/ZIP . . . : CUPERTINO CA, 95014 RECEIVED FROM . . . . : ROERTO & GRACE ANG CONTRACTOR . . . . . . . : AFTAB S GILL LIC # 27297 COMPANY . . . . . . . . . . : A2Z CONSTRUCTION INC ADDRESS . . . . . . . . . . : 22331 MEEKLAND AVE CITY/STATE/ZIP . . . : HAYWARD, CA 94541 TELEPHONE . . . . . . . . : (510) 538-5288 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 16, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 16, 000 . 00 1 . 60 0 . 00 1 . 60 0 . 00 1BUSLIC FLAT RATE 1 . 00 114 . 00 0 . 00 114 . 00 0 . 00 1REMRESKIT SQ FEET 216 .00 551 . 00 0 . 00 551 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 667 . 60 '0 . 00 667 . 60 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CASH 667 . 60 --------------- TOTAL RECEIPT 667 .60 CITY OF CUPERTINO ADDITION/REMODEL CUPEkTINO PERMIT APPLICATION FORM APN # Date: Building Address: L� Mailing Address (if different from building address): Owner's Name: Phone# R cA Co km Q t 412- Contractor: Contractor: 1 Phone#: 2 \ �_; � o' t 1�t?b'1 Fax#: O (ol SZ cA Contractor License#: ��' r1 f Cupertino Business License#: k, Contact: _ Phone#: �jg 30 93�Q t-v >OOY� \A� Fax #: - l Building Permit Info: Bldg. ❑ ElecAz Plumb. NHillside ❑ Job Description: c• , Addition-What is being added?(Be Specific): �� © What is being remodeled (not including addition)?. Remodel Includes Re-Roof. Yes ❑ No 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 Foo e: n Addition: 'Arch: Deck: Garage: Detached Attached Remodel: Kitchen Bath Other Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ IUIIUV-A ❑ IUIII B, IV-HT,V-B Valuation: Please check this box if the project is a IU 001r* second-story addition ❑ Project Size: Ex ress Standard ❑ Large ❑ Major❑ 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. ***For Office Use Only*** Over-the-Counter ❑ Revised 01/07/09 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type S Ft DECKS 1R3SFDADD OR 1 DECKWOOD Deck (Wood)-Each B 1R3SFDREM (Each) 1 DECKRAIL Deck Railing-Each B (Each) GARAGES 1R3SFDADD OR F:::- DETACHED 1 GARDTW<=1 K Wood Frame up to B 1R3SFDREM 1,000 SF (each) 1 GARDTM<=1 K Masonry up to 1,000 SF B (each) BCONSTAXR Construction Tax Res (new detached garage) PATIO'S OPEN 1R.3SFDADD OR 1 PATIOWOOD Wood Frame up to 300 B 1R3SFDREM SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR & SUN ROOMS IR3SFDREM IP ATIOENCLW Enclosed Wood up to 300 B SF 1 PATIOENCLM Enclosed Metal up to 300 B SF 1 PATIOENCLO Other Enclosed Patio up B to 300 SF 1 COVPORCH Porch Covered-Each B (Each) REMODELS 1R3SFDREM - 1 REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 1 300 SF check 1 REMRESBAT Bath Remodel up to 300 B « SF 1REMREOTH Other Remodel up to 300 B « SF CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group S Ft P Permit Type 1MECPLNCK Stand Alone Mechanical Pln Ck (hourly M 1 PLMPLNCK Stand Alone Plumbing p Pln Ck (hourly) / 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICRE Seismic Residential B 1TRAVDOC Travel &Documentation B ` IBUSLIC Business License B RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: cc Name of owner. 10 Project address..;?, \ ©gam Contact person.. Phone. Fax. .Net square footage of lot. Existing Proposed Square footage: First floor: > Second floor: Garage: ------� ._ TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the ? — � N g g, ara e privacy protection planting required for the project? Y-4 On what floor(s) is work being done? Brief description of work. <A ( Code editions:2008 CBC -N)2008 CFC -N)2008 CMC QV N) 2008 CPC 9-N)2008NEC -N) Effective 1/1/08 Aj BY z.. . ._. Plan Review Process Work Book Page-8-Revised 1/1/08 M IE o£ - o 0 N N r � OCD —� --- - CD �-- (D o) N _ -- U') ,� COL. E I c0 }� cc O I o co LL. .00 LO / O O N z 0 Q s� ar 5 WE 99 17/£ 61? Z/1 917 tet., I r N o c .� J J E SIDE �IA� YJTCHEN LIGHTIN ORKSHIEE� 3a5R Project Title Date INTERIOR ALTERATION At least 50%of the total rated wattage of permanently installed luminaires in the kitchen r_�ust be in luminaires that are high acy luminaires as defined in Table 15.0-C. Luminaires that are not high eiircacy must be switched separately, Itchen Lighting Schedule. Provide the following information for all luminaires to be installed in kitchens. i�If IT High Efficacy? Wates x Quantit-�r = High Efficacy Watts or Other Watts Yes No ❑ _ x = or 'V� _ Yes n No❑ x = or ` �' -- Yes❑ No❑ x = or > Yes❑ Na❑ x = or 1 _Yes❑ No ❑ x = or Total: A: B: COY-PLIES IF A >B Yes No ❑ " ENERAL NOTES I� Fl " o I ✓M GS L TERMINARON OF ALL ENVIRONMENTAL AR DUCTS SHALL BE A MIN. OF 3' 0 o \ FROM ANY OPEN'G INTO THE BLDG. PER UMC SECT. 504.6 FOR DRYERS & COOKING UNITS , THE CONDUCTOR WIRES W/ AN INSULATED -J NEUTRAL & FOUR—PRONG OUTLET ARE REQ'D. — — KIT.1T . TWO SMALL APPLIANCE BRANCH CIRCUITS FOR THE TN %At;d . IiI� ...TO I�c SUPPLYING WALL & COUNTER SPACE OUTLETS ONLY. �L ANGE I 3'x4.5 O C HOOD DISPOSAL DISHWASHERS DINING ROOM OR MICROWAVES. I ISLAND. I i � A DEDICATED 20—AMP CIRCUIT TO SERVE THE REQ'D THROOM OUTLETS. I A -FAULT CIRCUIT-INTERRUPTER PROTECTION AT BEDROOM:- ERE - DID; BRANCH CIRCUITS THAT SUPPLY 125-VOLTS, SINGLE-PHAS 15 & L RS M GI: I LUORSC. UGI: II � 20—AMPER OUTLETS. �.. ALL SMOKE DETECTORS SHALL 8E INSTALLED PER NFP 7 _ — REQUIREMENTS. Zyratjer ALL SWITCHES ARE TO BE OF THE GROUNDED TYPE AS PER E. (380-9) - - -- - - - - - -- -- - - - - - - - - - - -- �' M, BR. OP U DEDICATED RC GFl GFlj I 15X15" -MOTOP. J CU' I TJ i s' ACCESS — b—� SCOPE OF WORD _ M. B A,�� 2INTERIOR ALTERATION 3' HIGH- 1 . MASTER BATHROOM REMODEL. a �W- QGra 1 2. KITCHEN REMODEL - S WER CERAMIC TILE OR EQ. 0/ �(j I /p� D Ad I — _ E&�VL MP G CEMENT WONDER BD. 0/ ;n (,i BUILDING PAPER W.I.C '� _ 24' MIN. MIN. 70' ABOVE DRAN INLET. TYP. ,�j :1�.!�` 5 v GAL. MAX T. P&S ER FLUSH _ `� M.Indoor Air Ouality an Finishes 1•Useta*ilo-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use Lovift VOC Ades 3 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 p 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7.Seal allW 4 IAQ/Health. pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts yeses 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0 i ! ! Total Points Available: 1 1401 1301 57 Total Points Project Received: 1 01 01 0 - f ) G:data/progs/greenbuilchngguidelines/remodelerslgreenpomtsfinal2 2.04protected. s Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 rUPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: R cb vZ'� ._t f��� ;� c PHONE # --- � Z GENERAL CONTRACTOR: jam, z,L �A CW,,( FAX # I am not using any subcontractors: Signature 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 ,i er/Contractor Signature Date