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12110077CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: 23500 CRISTO_ REY DR UNIT 223D CONI'RACI'OR: HANKINS CONSTRUCTION PERMITNO: 12110077 : INC OWNER'S NAME: BROGLIATTI GEORGIA H TRUSTEE 38227 FREMONI' BLVD DA'Z'E ISSUED: 11/15&12 OWNER'S PHONE: 5107723152 FREMONT, CA 94536 PI ZONE NO: (510)795-9654 ❑ LICENSED CONTRACT'OR'S DEICLARATION r 0 rJ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class ,Li.t1 r ❑ COMMERCIAL r Contractor Date MECFI RESIDENTIAL hereby affirm that I a f licensed under the provisions of Chapter 9 •JOB DESCRIPTION: UNIT 223D- REMOVE TUB AND INSTALL A SHOWER (commencing with Section 7000) of Division 3 of the Business S Professions Code and that my license is in full force and effect. hereby affirm under penalty of perjun. 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, Tor the performance of the work for which this permit is issued Sq. F1 Floor Area: Valuation: $6500 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 permit is issued APN Number: 34253069.00 Occupancy Type: APPI.ICANI' CER'1'IFIC,\'PION 1 certify that I have read this application and state that the above information is correct. l agree to comply with all city mid county ordinances and state laws 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 indemnify and keep harmless time City ofCupertino against liabilities, judgments. 180 DAYS FROM LAST CALLED INSPECTION. costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per line Cupertino Municipal Code, Section, �,ryV Z /�nV Issued by: �4/ 41 Date: //-/ j '/ a 9.18. / f% Signature G -/' Date f`%G'y�, RF: ROOF'S: ❑ OWNER-BUILDER DECLARA'T'ION All roofs shall be inspected prior to miy 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: I, 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 &'Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to ALI. ROOF COVERINGS TO BE CLASS "A" OR BET`T'ER construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three IIA"/.ARDOUS MATERIALS DISCLOSURE declarations:' I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Ilealth S Safe". Cade, Sections 25505, 25533, and 25534. I 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 Health & performance of the work for which this permit is issued. Safety Code, Section 25532(a) should I store or handle hazardous material. 1 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 I will maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and the permit is issued. Ilealth & Safety' Code. Section425505. 25533, and 25534. 1 cenify 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 Worker's Owner or n thoriz.genu CompensationlawsofCalifornia. If, after making this certificate of exemption,I Dam: become subject to the Worker's Compensation provisions of the Labor Code, I must�- farthwith comply with such provisions or this permit shall be deemed revoked. CONSI'RUC11ON LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's .APPLICANT CERTIFICATION for which this permit is issued (Sec. 3097, Cie C.) I cenify 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 state laws relating to building construction, and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for 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 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 Nov 15, 2012 BY: COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO APPROVED This set Of plans and specifications MUST be kept at the Job site during construction. It is unlawful to make any changes or alterations on same. nr In �a„ Imre 0- Emergency Response System 9 MIMIC AT RANCHO SAN ANTONIO ONFICE C'0mP2`Y-. © Electrical Outlet 11 Cable Television Outlet ^n Telephone Outlet 1 1 = I foot Model E INTERIOR LIVING SPACE 1,100 Square Feet Two Bedrooms • Two Baths BALCONY SPACE 167 Square Feet Flwr plmu rrre rr(neser�rau,e. ricu,al mrasurcmeno aiul lawrur �wT,my. SCOPE OF WORK: Change tub into a shower. Project shall comply with the 2010 California Building (Base code 2009 IBC), 2010 Residential (2009 IRC), Plumbing (2009 UPC), Mechanical (2009 UMC), Electrical (2008 NEC), Fire (2009 IFC) and Energy Codes (2008 Building Energy Efficiency Standards) Plumbing plan notes: 1. Shower heads shall have a water flow not to exceed 2.5 gallons per minute. (CPC 402.1.1) 2. Shower stalls shall have a clear interior finish area of 7.1 sq. ft. and be able to accommodate a minimum 30 inch circle at the threshold level. These clearances shall be maintained up to a height of 70 inches above shower drain. (CPC 411.7) 3. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches (6 ft). (CRC R307.2) 4. The maximum hot water temperature discharging from the bathtub, shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered a control for meeting this provision. (CPC 414.5 & 418.0) Electrical Plan Notes: 5. The installation of smoke alarms in all of the following areas shall be provided: (R314.3) a. On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms. b. In each room used for sleeping purposes. 6. The installation of carbon monoxide alarms in the following areas shall be provided: (R315.1) a. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on every level including basements in dwelling units that have fuel -fired appliances or attached garages. IC�' CUPERTINO M NEW CONSTR1JCrION ( 2I 1 -7 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE' CUPERTINO, CA 95014-3255 - (408) 777-3228 • FAX (408) 777-3333 • buildiinno cuoertino.oro F-1 ADDITION IItI AITFRATION/TI FI RFVISVIN/r)FFFRp PT) GRIT INA1 PPPMTT� PROJECT ADDRESSD .{� J uS (/ APNN A93 - .s • 069 .el OWNER NAME PHONE E- D(OJ STREET ADDRESS �'��vaCITY, STATE, ZIP �- /^ I FAX CONTACT NAME PHO 1V E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑OV.'NEA ❑ OW'NFA-autimER ❑ OWNER AGENT 'CONTRACTOR Cl CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSENrUMBER LICENSE TYPE BUS. LIC4 COMPANY NAME E-MAIL F �7� /G /USG O /j — LiJ STREETADDRESS CRY, STATE, ZIP PHONE ARCHITECT/ENGINEER. NAME I LICENSE NUMBER BUS. LIC a COMPANY NAME E-MAIL FAX STREET ADDRFSS CITY, STATE, ZIP PHONE DESCRIPTION OF WORE: N 5 c.2 EXISTING USE PROPOS USE CONSTR. TYPE I STONES Mle Vj3 �J USE TYPE OCC. SQ.FF. VALUATION (S) EXISTo NEW FLOOR DEMO TOTAL AREA AREA AREA NTT AREA a OTHER IODU-AROOM RENT DE AENfODEL AREA REMODEL AAF.\ RFJ.f00EL AREA ' PORCH AREA DECX AREA TOTALDECIUPORCH AREA G.AIIAGEAREA: DETACH I ❑ ATrACH p DWELLNG UNITS: IS A SECON-D UN IT ❑}FS SECONDSTORY ❑YES BEING ADDED? r1NO ADDITION? PN6 PRE -APPLICATION OYES IF YES. PROVIDEOPY OF PLAI.NR'G APPL. PLANNn:G APPROVAL LETTER IS THE BLDG AN ❑RECEIVEDH EICBLER NOME' >, "?�`-'RID SY t TOTAL VALUATION: �}NO ^- Y'�M��lc By my Signature below, I certify to each of the following: I am the property owner or authorized agent to act on Inc property owner's behalf. Alive read this application and the information I have provided is correct. 1 haleread the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building onstructi -. 1 orize epresematives of Cupenino to enter the above -identified property for inspection purposes. Signawre of Applicant/Agent: Date: f SUPPLEMENTAL ITrFORr¢ATION REQUIRED 0 T SCUP New SFD or Multifamily dwellings: ,/Kp/ply for demolition permit for••'�n'` esistine building(s). Demolition permit is required prior to issuance of building O\ ER THF COUNTER y. BUILDING PLM AEA1C\\ a perms[ for new building. a❑ - LY n Ell. PIY PLAN REPIEw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure yEA'Ress £❑1siAn�oA ''+y'.pF.'�cx ®_• r�u¢LIC\\ oRls i� •vtri: _ form ifany Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to --'`t; �'--`" KLARGE 'L xt -FIRE UEP,F' S' submittal of Building Permit application.�AUJOR r S 9,. f'c LO $-. SNITAR!i DISTR r `� ' :s ii. .,S n+.:Ir.A .>~ ?l O,�t-"EN}1 3.NME'NTAL HE LTM BldgApp_2011.doc revised 0601/11 CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION im FADDRFSS: 23500 Cristo Rey Drive DATE: 11/15/2012 REVIEWED BY: Sean UNITS BP FEES BP#: 'VALUATION: $6,500 *PERMIT TYPE: Plumbing Permit PLAN CHECKTYPE: YPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: $10 PENTAMATION 1RPFIX PERMIT TYPE: it WORK Remove tub and install a shower. SCOPE APPLIANCE / EQUIP TYPE FEE ID Plumb. Plan Check 0.0 1 hrs $0.00 QTY UNITS BP FEES Flec•. Permit Fee: Fixture or Trap 1BPFIXTURE Other Elce. htsp. 1 # $10 Permit Fee: SuppL Insp Fee PME Unit Fee: $10.00 PME Permit Feer $178.00 Cousnvction Tax: Administrative Fee: IADMIN $42.00 Work Without Permit? O Yes Q No $0.00 TOTALS: A Travel Documentation Fee: ITRA PDOC 1 $10.00 Strong Motion Fee: IBSEISAIICR - NOTE: This estimate shies trot includejees due to other Departments (i.e. Planning, Public Works. Fire, Sanitary Sewer District, School District etc These fees are based on the prelintinart information available and are onli, an estinmte. Contact the Dept for addn'I info. FEE ITEMS (Fee Resolution 11-053 E f 711112) Alech. Plan Check Plumb. Plan Check 0.0 1 hrs $0.00 F.lec. Plan Cheek Atech. Permit Fee: Plumb. Permit Fee: IPPERMIT Flec•. Permit Fee: Other Alech. Insp. Other Plumb Insp. 1.0 hrs $45.00 Other Elce. htsp. Adcch. Itup. Fee: Plumb. Insp. Fee: IPLAIBINSP $133.00 F.ler. Insp, Fee: - NOTE: This estimate shies trot includejees due to other Departments (i.e. Planning, Public Works. Fire, Sanitary Sewer District, School District etc These fees are based on the prelintinart information available and are onli, an estinmte. Contact the Dept for addn'I info. FEE ITEMS (Fee Resolution 11-053 E f 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: SuppL PC Fee PME Plan Check: $0.00 Permit Fee: SuppL Insp Fee PME Unit Fee: $10.00 PME Permit Feer $178.00 Cousnvction Tax: Administrative Fee: IADMIN $42.00 Work Without Permit? O Yes Q No $0.00 Adt,nucecl Planning Fees: A Travel Documentation Fee: ITRA PDOC $45.00 Strong Motion Fee: IBSEISAIICR $0.65 Select an Administrative Item ` 131de Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $276.651 $0.001 TOTAL FEE: $276.65 Revised: 10/01/2012