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12070071 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10575 MERRIMAN RD CONTRACTOR:STEPHEN JERBIC PERMIT NO: 12070071 OWNER'SNAh1E: STEPHENIERBIC 10575 MERRIMAN RD DATE ISSUED:07/102012 OWNER'S PHONE: 4082571648 CUPERTINO,CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RF.SIDENTIAI. C0;11hIFRCIAI. License Class Lic.B REPLACE 30 AMP CIRCUIT BREAKER WITH 100 AMP BREAKER AND INSTAL NEW NEMA 14 50AMP Contractor Date RECEPTACLE 1 hereby affirm that I am licensed under.lhe provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 1 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 Labra Code,for the performance of the work for whichthis permit is issued. Sq.F1 Floor Area: Valuation:$500 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the perfomtance of the work for which this APN Number:34216136.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agrc to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnity and keep harmless the City of Cupertino against Iiabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: ��,�N r� /Gy Date: with all non-paint source regulations per the Cupertino Municipal Code,Section 9.18. RF:ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed-if a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDFR DECLARATION-� Signature of Applicant: Date: 1 hereby affirm that I em exempt from the Contractor's License Lew for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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&Professions Code) I,as owner of the property,am exclusvely contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safely Code,Sections 25505,25533,and 25534. 1 wi11 I hereby affirm under penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Ilealth&Safety Code.Section 25532(x)should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the%York for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Ilealth&Safety Code,Sections.! 505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent. Dale: permit is issued. I certif} that in the performance orthe work for which this permit is issued,I shall not employ any person inany manner so as to become subject to the Worker's Compensation laws of Cal ifomha. It,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked, work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property far inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the 1 understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signaler - Date 7 O GENERAL PERMIT APPLICATION M E P COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION \ 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 A� MIs C CUPERTINO (408)777-3228• FAX(408)777-3333•buildingo)guoertinD.orD �p ❑PLUMBING G❑MECHAMCAL J/ELERCAL ❑hII\S`C fEjLM1A@YE.0U5 FROIECTADDRFSS 'oS71- iWerriotAl/[ 4J IAFNIy2 -//(/- 13( : & PHONE OU F / IOWNERNAN S teN / • •e rk/L IYQ.T(.jW STREET ADDRESS CITY, STA= .a FAX 40 CONTACT NAME PHONE E-MAIL STREETADDRESS CITY,SLATE, ZD' FAX ❑OWNER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TryANT CONTRACTOR NAME IICENSENUMBER LICENSE ME BUS.LIC 4 CONIPA.NY NAME E-MAD. FAX STREET ADDRESS CRY.STATE.ZIP PHONE ARCHTTECTIENG WEER NAME LICENSE NUMBER BUS.LIC N CONOANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE.ZIP PHONE USE OF SFO a DUPLIX ❑ MULTT-FA Y PROTECT IN WI DLAND ❑ YE$ PROJECT IN ❑ YES IS THE BLDG AII ❑ Y6 BI111DING: COMMERmA1 URBAN INTERFACE AREA NO FLOOD ZONE 0 ppILFR HON4. NO DESCRIPTION OF WORK 4*( TOTAL VALUATION: G RECEIVED BY: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is coned I have read the Description of Work and verify it is accurate. I agree,[o comply with all applicable local ordinances and state laws relating buil ' construction. I anthorize representatives of Cupertinc tc anter the above-i euti8edproperry`or inspection puiposes. Signatum ofAppliwnt/Agrnu Dare: ��o/20(L SUPPLEMENTA&WORIvfATION REQUIRED OFFICE USE ONLY OVER-THE-COUNTER f ❑ EVRE55 u U ❑ STANDARD U Z ❑ IARCE J ❑ NAJOR TIBPMiscApp_2011_dot revised 06/27/11 JUL 19 201? NEMA 14-50 RECEPTACLE ADDITION PLAN JERBIC RESIDENCE 10575 MERRIMAN ROAD CUPERTINO, CA 95014 COMMUNITY DEVELOPME CUPER7R O ENT BUILDING DIVISION- �.:I • APPROVED F Fi This set of plans and specifications MUST be kept at the ke job site during construction. It is unlawf`o deviate any changes or alterations on same,o therefrom,without approval from the Building Official. The refro .n9 of this plan and specifications SHALL NOT be held in permit or to be an approval of the violation provisions of any City Ordinance or State Law• of any G G BY ' 7. o ' �� Jerbic Residence 10575 Merriman Rd., DATE7U©71 Cupertino CA 95014 PERMIT NO. Existing Schematic 2, 8 AWG/2 +G e 0 CU , F Service Disconnect 1 AWG/3 + G D0 Al �wugv0�ru i 14 Service Disconnect Jerbic Residence 10575 Merriman Rd., Cupertino CA 95014 Planned Schematic Changes & Additions i New 6 Space/12 Ckt 1 1 i` Load Center r 1 ' 1 I zr f 6 AWG/3+G i 1 2AWG/3+G e [{ • i 00 • Cu _ =F x i V. ,. Cu f 1 _ 1 7F A 7 t } - 2-Bang plastic old work a; �. . •- . ._ - e.� box NEMA 14-SOR 1 1 Service 8 AWG/2 +G 11 y i Disconnect r i 2-gang covered y iplastic old work box - - For wire-nut splicing -JI: Notes: existing AC wire 1) Additions are within the dotted lines ------------- - 1 2) Installation is in the garage of residence 3) All new wire runs less than twelve feet Existing 8 AWG/2+G o 1 e 4) New load center and NEMA 14-50R at Cu least 18" above ground 5) Box for AC wire splicing about six feet aboveground 1 AWG/3 +G .00 AI -No Service N-�- Disconnect Jerbic Residence 10575 Merriman Rd., Cupertino CA 95014 i. Rough Location of proposed additions - 1. Covered junction box for AC wiring 2. NEMA-14-50 receptacle a- •,; - 3. Load Center p i y Y a �^ '1'! �l-..: ` 4x�"rt+�4c�.',`�y .•h ffi \ z qy a� Yrt� Yy�y�'dzr$• � z Jerbic Residence 10575 Merriman Rd., Cupertino CA 95014 6 1 a r (a_ ; Replace 30A Air conditioner i '+` °iz circuit breaker with 100A s _ t } \ ; s; breaker to new load center will supply I the air i rry Fs - rNqr r „ � conditioner and new SOA receptacle. rr , 3ak '-tic A it hrr f"I TMs EIM S tlem L � 1 Y�'1 }. I —�/ 1 t r33,�. >•ti' � le Also P byo Fi r - '.� ° �F } i � .� ''3Y' b � i ?�,�„- p4'"'1 -------------------------- }IL S .3 In / ' N R � r��>. �� •_:t]t 2` P. s tti 2= t c Jerhic Residence 10575 Merriman Rd., Cupertino CA 95014