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12080257 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1014114ILLCREST RD CONI'RACI'OR:BAN MIN CONSTRUCTION PEXMITNO: 12080257 OWNISR'SNAME: WING ROGER A AND SHARON S TRUS 322 AVIADOR AVE DATE ISSUE'D:08124/2012 OWNER'S PIIONE: 4084461619 MILLBRAE,CA 94030 PHONENO:(415)716-8H0 ❑ LICENSED CON TRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB License Class Lic.N, RIECII r (-, RESIDENTIAL COMMERCIAL r Conlmctai !O 3,i i(� �(- /_alt ,te —xh .. 61/2 I hereby affi rat that l nI In Iiicenseedd under the pro%isionc of Chapter 9 JOB DESCRIPTION: REDUCE CANTILEVERED DECK BY 20 1N (commencing with Section 7000)of Division 3 of the Business S Professions Code and that me license is in full force and effect. 1 herchy affirm under penalty of perjur) one of the following two declarations: 1 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 Worker's Compensation Insurance,as provided for by Sq. Ft Floor Arca: Valuation:$4420 Section 3700 of the Labor Code,for the performance of die work for which this permit is issued. AM Number:32616054.00 OccupancyType: A PPLICAN r CERTIFICATION I certify that I have read this application and state that the above information is to Lng ree to contrcomplyid herlyautndize ntyrep ordinances of this claws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnity and expenses hick stheCit•ofCupertinoagainstliabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting ofthis permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Sedion Issued by: ��,4i1/ ��T Dale: 9.18. Signalu rej92 �-t RE-ROOFS: r-1OWNER-BUILDER DECLARATIONAll 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 hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: 1,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business K Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to A LL ROOF COVERINGS TO BE CLASS"A"OR RE"ITER construct the project(Sec.7044,Business S Professions Code). I here[)),nffirm under penally of perjurY one of the following three II.\ZARDOUS JIATF-RIAI S DISCLOSIIRI'. declarations: I have read the hazardous materials requirements under Chapter 6.9.5 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Ilealth S Safely Code,Sections 25505,25533.and 25534. 1 will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ilealth S performance of the work for which this permit is issued. Safely Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District 1 will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify That in the performance of One work for which dais permit is issued,I shall Ilealth S Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the �- 1— Worker's rro or xuthoriz 111'en - Compensation laws o(Cali fomia. If,n0er making dais certificate of exemption.1 Dole: i- become subject to the Worker's Compensation provisions of the labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CO,NSTRUC-FION],ENDING AGF;NCI' I hereby afiiron that there is a construction lending agency for the performance of work's APPLICANTCF,RTI FICATION for which this permit is issued(See.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and stale laws relating to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned properly for inspection purposes.(We)agree to save indemnify and keep hamiless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCI I[TECI"S DECLARA'T'ION granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18, Licensed Professional Signature Date a .1 Y Z RECEIVED _ AUG 2 4 2012 DO �I�-:------------------ �nT<!a,�rvoaaOMMUNITY = ELOPMENT DEPARBUILDIN DIVISION-CUPERTIN A PROVED This se f plans and specifications MUST be kept at the Job Flt during cons ruction. It is unlawful to make any c 3nges or aIle ations on same,or to deviate there om,without ipproval from the Building Official. SHALL NOT The st, nping of this Ian and specificationslof the v oiationn w be hi d to permit to be an app C Of provI, ns c f any City Ordinance or State Law. W � 4 BY _� . ' 8� DATE ! PERMI NO. m'97 PLOT PW8 QW0SW IAB UA7Ty - ( L >f'i�A'NP11NC D DAA,._ —----moo �tdlG 11R�'A 0th\ �2 .4� /Qiate � 1 2k9 %� Sf�Ko ,y,1 e ,�c,l ply_ woad CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10141 HILLCREST DR DA'Z'E: 08/24/2012 REVIENVED BY: Sylvia ` APN: BP#: 'VALUATION: $4,420 *PERMIT"TYPE: Building Permit PLAN CHECK TYPE: Addition PRINIARI' SFD or Duplex PENTANIATION USE: pPERNIITTVPE: 1GENRES , YORK REDUCE CANTILEVERED DECK BY 20 IN SCOPE ,blech. Plan Check Phunh,Plon Check F/ec.Plan Chock htech.Permit Fee: Plumb.Permit Fee: F.lec. Permit Fee: Other mech.Insp. Other Plamh/nvp. Other Elec.Insp. L1 I Mesh.bap. Fee: Plumb. lnrp. Fee: Elce.Insp.Fee: NOTE: This winaue does not includejees due to other Departments(i.e. Planning, Public Illorks, Fire,Sanitary Sewer District,School District, etc.). T hese eev are based on the prelindnari information available and ore only an ectinutte. Contact the Den for addit info. FEE ITEMS (Fee Resnhuion 11-053 Eff 711/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Deck/Deck Railing Suppl. PC Fee: (j) Reg. O 0T 0.0 hrs $0.00 $467.00 IDBCKRA/L I Deck Railing PME Plan Check: $0.00 Permit Fee: $0.00 SupPI. Insp. Fee0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constntction Tax Administrative Fee: 0 Work Without Permit? O Yes (2) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Travel Doaunentation Fu•.s: Building or Structure O Strong Motion Fee: IBSFISMICR $0.50 Select an Administrative Item Bldg Sids Commission Fec: IBCBSC $1.00 SUBTOTALS: $1.50 $467.001TOTAL FEE: 1 $468.50 Revised: 07/01/2012 ► oZS� CONSTRUCTION PERMIT APPLICATION - COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION , 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228• FAX (408)777-3333• buildingecuoertino.oro ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT N V PROJECT ADDRESS APN N /^ OWNERNAME LNCICW-JPHONE f Y o E- L I R .v0 9 on! Wi41 STREET ADDRESS D/q/ ctTY ATE.ZIP r//Vb 64 13-D"Y FAX CONTACT NAME M[J PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX OWNER ❑ OWNER-BUILDER .D OWNERAGENr ❑ CONTRACTOR ❑CONTRACTORAGE ❑ ARCWMCf ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS,LIC k COMPANYNAME l E-MAIL FAX STREET ADDRESS II CITY,STATE,ZIP PHONE ARCHITECT/ENGMEER NAME I LICENSE NUMBER BUS.LIC tl XCOMPANYNAME AAl"J � e'„ T/ 1 E-MAIL FAX I STREET�ZS ,U-'I nOU2 ,LI(3W ayl/ CITY, ZIP %4 U-B //T r.4 Cn A/_ PHONE 7/�, Q/Vp DESCRIPTION OF WORE: i (y /-, J� II �O C 12e p l e4c e 5 -r'u c c i7 N h o, - Id R L't, ?J L Yv.D $ rb/t y er cle w r rH c ron.�( lL0U6Y> / Y16N /&/� EXISTING USE PROPOSED USE CONSTA TWE kSTORES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG KREA NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN iOTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA I DECK AREA TOTALDECKMORCH AREA GARAGE AREA: DETACH ❑ATTACH tl DWELUNG UNIT$: ISASECONDUNIT []YES SECONDSTORY []YES DELCGADDED? []NO ADDITION.• []NO PRE-APPLICATION ❑YES IF YES,PROVmE COPY OF ISTUEBLDGAN ❑YES i�RECEIVE BY ;P:— TO PLANNING APPLtl ANO PLM`NDJG APPROVAL LETTER FENCER FlOME? ENO {.' �jj7/� r'sy'y tlF=F"T 'Z^'F in,:.._'%/ x'14,. "--. .��a•f 1-700 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. 1 have read this application and the information I have provided is correct. 1 have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rela i oto buildin nstruction. authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicaMA en[. Dat,% /2-C/ �/2 SUPPLEMENTAL N1FORMATION REQUIREDI'IEROU1f ''%- New SPD or Multifamily dwellings: Apply for demolition permit for 'a' a OvtR 1111 COUATG 1 BUILIJ11fI WvRT VtR :;','I't� existing building(s). Demolition permit is required prior to issuance of building3�cz .,4� ,•�.,�y' r permit for new building. I © 1 v uls 1 +'� ? e d rl +nNINe TUA x Re\ All ^ X1!`ANci _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑D f"sr\w+RD 5"'->~ ' �.,©� UDLIe Tom if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Planning prior to p t1AJOR4z+ ❑O sA.I rAR1 sL\\rR mSFRI submittal of Building Permit application. 'r(�,� t_�_s \ � FN\IROYA76YTAL`IIEAL711c��� BldgApp_2011.doc revised 06/21/11