12070134CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 23500 CRISTO REY DR UNIT 310 D
CO NTRA6OB: BAY AREA
PERMIT No: 12070134
ENTERPRISE
OWNEWSNAME: ANTHONY PIZZURRO
2110 MANGIN WAY
DATE ISSUED: 07/17/2012
OWNER'S PION* ,: 6509690155
SAN JOSE, CA 95148
PIONS NO: (408)238-5043
❑ - - LICENSED CO.\'1'R,\CI'OR•5 DICCLAR,\'1'10..
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BUILDING PERMIT INFO: BLDG gleet PLUMB
_g17CJ1�
License Class I,le. �
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`
Contractor �tl-%�CA �/e- Datc � � Imo/
JI ECII RESIDF;N` AI, COMMERCIAL
I hereby affirm/that l a in licensed under the provisions of Cha pier 9
-10B DESCRIPTION: UNIT 310 -D -INSTALL NEW SHOWER STALLS AND
(commencing with Section 7000) of Division 3 of the Business S Professions
OUTLET
Code and that tit% license is in full force and effect.
hereh)• affirm under penally of perjury' one of the following two declarations:
1 have and will maintain a certificate of consent to sell' -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
Sq. FI Floor Area:
Valuation: $750
performance of the work for which this permit is issued.
1 have and will maintain Worke'r's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
pemllf i5 issued.
,U'N \umber. 34253092.00
Occupaney'1)pC:
.U'1'LIG\N'I' CP:IfI'1I�IC,\'ll(IN
I certifythat I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply svithnll city end coutoyordimmices mid state laws relating
to building construction, and hereby authorize rcpres atives of this city to enter
WITHIN 180 YS OF PERMIT ISSUANCE OR
upon the above mentioned property for inspection a uses. (We) agree to save
180 DANT§ F OM LASTCALLED INSI .CT ON.
indemnify and keep harmless the City of Cuperli i zinst liabilities. judgments,
costs, and expenses which muy accrue against s City in consequence of the
granting of this permit. Additi nal ', the appy run undcrstmhds m7d%ill conhpl).
with all non -point source reg tic s per the upertino Municipade, cction
Issued bv: Date: 00
9.18.��Z D� Z
RI; -ROOFS:
Signature Dalc
All roofs shall be inspected prior to mry roofing material being installed. If a roof is
- _
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ O\\•NER-BUILDER DECLARATION
Signature of ApplicanC Date:
1 hereby affirm that I am exempt from the Contractor's License 1.11" for one of
the following two reasons:
AL1, ROOF COVERINGS TO BE CLASS "A" OR BE;1-fER
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 for sale (Sec.7044,
Business d Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS dIATERIAIS DISCLOSURE
construct die project (Sec.7044, Business C Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
Cali fornia IJeff hit S Safety Code, Sections 25505, 25533, and 25534. 1,011
1 hereby affirm tinder penalty of perjury one ol'the following three
maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and the
declarations:
Health S Safety Code, Section 25532(a) should 1 store or handle hazardous
1 have and will maintain a Certificate of Consent to SCIf-insure for Worker's
material. Additionally, should I use equipment r devices which emit hazardous
Compensation, as provided for by Section 3700 of tine Labor Code, for tine
air contaminants as defined by the Bay Are i Qu:din' an District I
performance of the work I'or 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
will maintain cumpli:tree with the gherti unicipal Code. Chapter 9 12 and
the Health S Safety Cade, Sec of '_550 ,'_5533, and 25534.
permit is issued.
O%, ner or authorized a�e tl. _ _ Dater..
I certify that in the performance of the work for which this permit is issued, 1 shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of Callfornm. 11, alter making this certificate of exemption, I
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I 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 deenhed revoked.
w'ork's for which this permit is issued (Sec. 3097, Cir 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 slate laws relating_
to building construction, and hereby authorize representann es 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, judgnhenis,
ARCI11'IIiCI"S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I understand nay 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,
Signature Bate
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (i.e. Planning. Public Works, Fire, Sanilaly Server District, School
District, etc.).' These feev are based on the prefitninan information available and are onh, an estimate Contact the Dept for athbt'I info,
FEE ITEMS (Fce Resolution I1-053 Elf 7/1/11)
ADDRESS`. 23500 Cristo rey dr.
DA'Z'E: 07/17/2012
REVIEWED BY: bobs.
blech. Permit Fee:
APN:
BP#:
'VALUATION:
$750
*PERMIT TYPE: Building Permit
PLAN CIIECK TYPE: Alteration / Repair
PRIMARYPENTAMATION
USE: SFDorDuplex
Flee. Insp. Fee:
PERMITTYPE: 1REAP10
WORK
install 2 new shower stalls add 4 new outlets. U
SCOPE
$0.00
NOTE: This estimate does not include fees due to other Departments (i.e. Planning. Public Works, Fire, Sanilaly Server District, School
District, etc.).' These feev are based on the prefitninan information available and are onh, an estimate Contact the Dept for athbt'I info,
FEE ITEMS (Fce Resolution I1-053 Elf 7/1/11)
blech. Plan Check
Plumb. Platt Check
Elec. Plan Check 0.0 hrs $0.00
blech. Permit Fee:
Plumb. Permit rec.,
Elec. Permit Fee: 1EPERN11T
Other,ifech. Imp.
Other Plumb Insp.Ll I
Other Elea Insp. 0.0 hrs $45.00
Mach. hap. Fee:
Plumb. hap. Fee:
Flee. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning. Public Works, Fire, Sanilaly Server District, School
District, etc.).' These feev are based on the prefitninan information available and are onh, an estimate Contact the Dept for athbt'I info,
FEE ITEMS (Fce Resolution I1-053 Elf 7/1/11)
FEE
QTY/FEF,
MISC ITEMS
Plan Check Fee:
$0.00
= #
$45.00
Electrical
1BRE,11RECEP Recep/Switch/Outlets
Suppl. PC Fee: Q Reg. O OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? 0 Yes ( No
$0.00
SuppI. Insp. Fee0 Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$45.00
Construction Tiix
Administrative Fee: 1111)MIN
$42.00
O
E)
Work Without Permit? O Yes 0 No
$0.00
Advanced Plannine Fee:
$0.00
� hours
$399.00
Inspections
isnvSP I Inspection, Hourly
E)
0A
Travel Documentation Fee: ITR.u'DOC
$45.00
Strong Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$133.50
$444.001TOTAL
FEE:
$577.50
Revised: 07/01/2012
G
10
CONSTRUCTION PERMIT APPLICATION
i COMiUUNr-jY.EVE-_ CP.MEP1-a=PARTMEN i • BUILDING C.NISiON
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
! (408) -328 • FAX (4081777-3333 • buiidir.C(dIr. a:oedno.cm
CUPERTINIC) ;
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permit for new imildiTg.
CorDmci W Bldgs: Provide a completed Houuud to Mamrai Discl=r
form if any Hazm*dous Marerials a _ bving used as ?art of this project.
Copy of Plamring Apprcval Leser or Meerzg With Pla v. --.> >rf.m to
submittal of Building Permit =IicaEce.
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3y my signature bclow, I cert y a wi of be fclicwiag-. I am'+uc 7ro0a:y Dana or as=vriei agent w ac: un a aryvcy owla'y uei¢I:. t gave rad his
appliratim and the information I have provided is cac:cc I have ,ad be DD sviman of W otic and lei Y 4 3 act I agr=m comply whh a0 amolirable !oral
ordinances and state lame rc12rin m bm7ding caosu-.a 1 mtharm ms'mrives of Cupertino a cater the above.ideti^cI soxry'or xsaxcon pmpasa.
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s;goaose of ApphaadAgmc-��4-y/y "' .
New SFD Or. Mu!tifacrily dwellings: APpiy yr demolition paw: for
.epi stag bmlding(s). Demolition perxit is !ecuired prier to issuance of building
permit for new imildiTg.
CorDmci W Bldgs: Provide a completed Houuud to Mamrai Discl=r
form if any Hazm*dous Marerials a _ bving used as ?art of this project.
Copy of Plamring Apprcval Leser or Meerzg With Pla v. --.> >rf.m to
submittal of Building Permit =IicaEce.
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❑ r2R=
❑ s- NvA
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❑ MAJOR
9_3_U 1_wc PLAN REVIEW
❑ P!.txwr PLAN REVIEW
ruDucw•omm
❑ Fm Dar
❑ wNTrARY SEWER Di5 cr
E&V-pD_2011.doc rciised 06171/11