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12060153 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1206 STAFFORD DR CONTRACTOR:CONIFER CONSTRUCTION PERMIT NO: 12060153 OWNER'S NAME: ENRIGHT MARK A AND ALARID-ENRIGHT M 1320 SELO DR DATE ISSUED:06252012 OWNER'S PHONE: 6506906171 SUNNYVALE.CA 94087 PHONE NO:(408)245-9154 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class Lie q GQ 7 6 r r r MECH RESIDENTIAL COMMERCIAL Contractor CUeArSLG_ et s 6772K/?(,—Date 6-z5--/'L 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:SINGLE FAMILY DWELLING REMODIi1.TWO (commencing with Section 7000)of Division 3 of the Business&Professions BATHROOMS 130 Code and that my license is in full force and effect. SQFf 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 Workers Compensation Insurance,as provided for by Section 3700 of the Labor Codc,for theerfornance of the work for which this p Sq.FI Floor Area: Permit is issued. APPLICANT CERTIFICATION APN Number:36211017.00 acupancy Type: I certify that I have read this application and stale that the above information is cored.I agree to comply with all city and county ordinances and slate 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 PERM1P E F WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, Qp x�r. costs,and expenses which nmy accrue against said City in consequence of the WITHINJ 80 DAYS OF PERMIT ISSUANCE OR granting of this permit- Addilionall ,the applicant understands and will comply Igo DAYS FROM LAST CALLED INSPECTION. with all non-point source regula ,per the Cupertino Municipal Code,Section 9.18. / Simat Date g 6 L f-�t Issued bDate:p-2fi�Z c ❑ OWNER-BUILDER DECLARATION RF:ROOFS: 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 a roof is the following two reasons: installed without first obtaining an inspection.I agree to remove all new materials for 1,as owner 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: 1,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: I have and will maintain a Certificate of Consent to self-insure for Workers 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(a)should 1 store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 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,Se ' as 255051 25533,and 25534. Compensation laws of Cali Ibrnia. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must nt: forthwith comply with such provisions or this permit shall be deemed revoked. O or autho '.e Dale: 0/'- APPLICANT APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct, I agree to comply with all city and county ordinances and stale laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,mid hereby authorize represemalives 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 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION -� ADDRESS: 1206 stafford dr. DATE: 06/25/2012 REVIEWED BY: bob s. APN: BPtl: 'VALUATION: 00 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM USE: PERMIT TYPE: WORK sfd 2 bathroom remodel SCOPE .11",:11 Ph", j"I P/1"W, P1un Chaok 1Jre. l'l,rn Chrrk U"lr_ l'rnni(Fet: I'Imnh. Po ow F,t•: lildr 1°rru.if lir: 01hr"'.I/rrh. 1"y Other PGimL lnsp, 01/1rr0, Imp. .bl:r h, imp, 1_.c 1,111" , hnp_Ft"': lil<r. NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District,etc). These fees are based on the relimina information available and are only an estimate. Contact floe Dept for addn'I info. FEE ITEMS (Fee Resohnion 11-053 E(l' 7/1/I1) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 D30 s.f. Remodel, Bath (<=300 sf) Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $588.00 IREAMESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.0 Reg. 0 OT O.0 Vhrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Con,cn-(nviun firth: :1ri1ni1i.'11u1i " h"r: 0 Work Without Permit? 0 Yes (E) No $0.00 Advanced Plannine Fee: $0.00 Select a Non-Residential Q Building or Structure 0 7r,n-cl 1Jnc-mrn'watinn Fees: A Shone Motion Fce: IBSEIS,NICR $0.50 Select an Administ5 ! ({e,(, BldL Sids Commission Fee: 18CBSC $1.00 SUBTOTALS: 1 $1.50 $588.00 TOTAL FEE: 589.50 Revised: 06/30/2012 1Z401oC)I�3 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE'AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX �((4508))7777.3333 • buildino(a)cuoertino.orD ❑NEW CONSTRUCTION ❑ ADDITION LYALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT'% TER.ADDRESS AFNf __7 �/� OWNER NAME ry- ,e OftE6/v —�(V E-MAIL STREET ADDRESS P CITY. STATE ffiJ FAX CONTACT NAME PH IyE —6 0_ 17' E MAIL STREET ADDRESS CITY,STATE 23? FAX C I7 OWNER ❑ OWNER-BUILDER ❑'OWNER AGENT ❑ CONTRACT.OR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑84CWM ❑ DEV PER ❑TENANT CONTRACTOR NAMi��C' LICENSENUMnER LICENSE TYPE BUS.[1C p CONBANY NAME E-MALI. FAX STREET ADDRESS CITY,STATE IIP PHONE ARCHITECT/ENGINEER NAME J f10EtJ5E NUMBER BUS.IlCq COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE ZIP PHONE J DESCRIPTION OF WORK Gu�/ i t G �� o✓% sMO - - rCFD /�1�s9� Z/G/f`� G USE PROPOSED USE STRTYPE 0STORM />/Go USE TYPE OCC SQ-Fr. VALUATION(S) EXISTG NEW FLOOR DEMO' TOTAL AREA /t AREA AREA NET AREA a tt/ 9 /'3 6 . — BATHROOM KrrCHEN OTHER ( t` RPMODELAREII SF �ODELAREA REMODEL AREA PORCHAREA OECKAREA TOTALDECK/PORCHARPA' GARAGE AREA. DETACH ATTACH M DWELLING UNITS: ISASECONDUNTr YEs SECOND STORY ❑YES BMG ADDED?. []NO o ADDITION? ' []NO PRE-APPLICATION ❑YES IF YES PROVIDE COPY OF .TI THE 9LDG AN - [3 YES RECEIVED BY: TOTAL VALUATION: PLWNINGA?PLd ❑NO PLANNING APPROVAL LETTER'S EICHr en SOM. NO _/ /Z CCD, cfZJ By my signature below,I certify to each of the.following: 1 am the property owner or authorized agent to act on the prrrVetTy owner's behalf. I have read this application and the information I have provided is correct.,t read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to g con= thorn' Hues of Cupertino to enter the abov e-identified property for inspection purposes: Signature of Applicant/Agent: / Date: SUPPLENEWALINFORMATIONREQUIRED PLkNCE[ECKTYPE ROurmcsr.� New SFD or Multifamily dwellings: Apply for demolition permit for M—OVE=COUNTER B0 mow, existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW —Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ srANDARD ElPUBUCwORHB Tom if any Hazardous Materials are being used as part of this project. Cl LARGE ❑ FIRE DEPT —Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MANOR ❑ SAINITARY SEWER DISTRICT submittal of Building Permit applicaIton. ❑ ENVniONhff.NT.AL HEALTH Bld App_201 Ldoc revised 06/21/11