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12120006 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 922 SEPTEMBER DR CONTRACTOR:VALLEY HOME PERMIT NO: 12120006 BUILDERS,INC. OWNER'S NAME: GIOVANNONI TONY G AND JOANN M 1850 WAR13URTON AVE STE 103 DATE ISSUED: 12/042012 OWNER'S PHONE: 4082052714 SANTA CLARA,CA 95050 PHONE NO:(408)248-8000 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIALD COMMERCIAL License Class Lie.q � REMODEL 2 BATHS REMOVE AND REPLACE ALL I FIXTURES 88 Contractor M,6 ha i ulalc o r Date (Z 0 Z SQ FT I hereby affirm that I am licensed under the provisions of spier 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 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. Sq.Ft Floor Area: Valuation:$18000 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 APN Number:36214007.00 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 agree 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. indemnify and keep harmless the City of Cupertino against liabilities,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: Date: with all non-point source re lati a the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date Z �� 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-BUILDER DECLARATION liver/Y/art.that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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&Professions Code) 1,as owner of the property,am exclusively 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&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I 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 work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2550 ,2553 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dater permit is issued. ' 7 I certify 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 Compensation laws of California. If,after making this certificate of exemption,I C/ UCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a concoction 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 for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I 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. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildingacupertino.orG oc�)- �( PRO❑IECTA D�sNEW STR�Tzt/O/N ❑ ADDITION ❑ ALTERATION/Ti ED-REVISION �D� ORI^�rERMITn Wr OWNER NAME .•LL// r PRONE 11E-MAIL(JLJ �o C�tbv an --z05-2.71If STREET ADDRESS CITY, STATE,ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX 11 OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 1 omer ^ LICENSE NUMBER LICENSE TYPE BUS.LICK \ (i COMPANY NAME ' /�I I &xl 0'r EMAIL FAX STREET ADDRESS `/ CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC k COMPANY NAME ErMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK t 4 my-noiVnq and n_-nlac�mel a// a I c44N `� oY ea )Vxrl � i1t 1�r ii me EXISTING USE PROPOSED USE CONSTR.JYPE kSTORDiS USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL- AREA AREA AREA NET AREA C BATHROOM KRONEN OTHER REMODEL ARE REMODEL AREA REMODELAREA PORCH AREA I DECK AREA TOTALDECK/PORCH AREA GARAGEAREA: DETACH ❑ATTACH N DWELLENG UNITS: IS A SECOND UNIT OYES SECOND STORY ❑YES BEING ADDED? ONO ADDITION? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEI $ 1 �+a TOT ALUATION: PLANNINGAPPLN ONO PLANNING APPROVAL LETTER EICHLER HOME? ONO By my signature below,I certify to each of the (lowing: I the property owner or authorized ag t to act on the property owner's behalf. I have read this application and the information I have provid is co ct. av read the Description of WorA and erify itis accurate. I agree to comply with all applicable local ordinances and state laws relating to buil ' orize representatives of Cupertino to enter the above-identif d property for inspection purposes. Signature ofAppl icanUAgent Date: I Oµ I Z SUPPLE RMATION REQUIRED � --'r`RL�'C�}ECI(TXREi ,,;.,AOG,TING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building, OVER THE-COONTER ❑;BUILDINCPlAN REV1Ew ermit for new building. - P g ❑ EXPRF�9 ��PLANNING PLAN REVIEW' _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANi3nRn "❑ PUBLicwtiliKs form if any Hazardous Materials are being used as part of this project. ❑ LARGE �`FmEnEr"T.' _Copy of Planning Approval Letter or Meeting with Planning prior to " submittal of Building Permit application. ❑ Mnaon SANITARY SE){ER Dt�STRICT T ❑cENV1A�INMENTAL HEALTH B1dgApp_2011.doe revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 922 September Dr I DATE: 12/04/2012 TRFVIEWED BY: mendez APN: BP#: *VALUATION: 1$18,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: lR3SFDREMJ wORK �EMODEL 2 BATHROOMS 88 SQ FT SCOPE �fech. Plan Che�k Plumb. Plan Check Elec.. Plan Chock kfech, Permit Fee: I Plumb.Permit ree: I rle ' Perinif re�: 011ie, Aluch. Insf'). Other Plumb Insp. Other Elec.Insp, Ej 1 ,11ech.Insp.few Plumb. Insp.Fee: Elcc.Insp.Fee. NOTE:This estimate does not includefees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School Districtietc.). 77tesefees are based on the preffinWn information available and are only an estimate- Contact the Dept for addn'I info, FEE rrEMS (Fee Resolution 11-053!ff. 7111121 FEE QTY/FEE MISC ITEMS Suppl. PC Fee: (D Reg. 0 OTT 0.0Thrs; $0.00 $600.001 IREMRESBA2- PNIE Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. 0 OTEO hrs $0.00 Consfruction Tax: Administrative fee: 0 Work Without Permit? 0 Yes 0 No $0.00 E) Advanced Planning Fee. $0.00 Select a Non-Residential 0 Travel Documentaiion Fees: Building or Structure 0 Strong_Motion Fee. IBSEISA17CR $1.80 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 Revised: 10101/2012 RESIDENTIAL KITCHEN/BATH REMODEL POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 950143255 _" ^pan^ and sp CUPERTINO J:Istru (408)777-3228•FAX(408)777-3333•building(a�cuoertino.org _ �7 '� �!ter;tI wiinout app GENERAL INFORMATION rq of This.pla ;rmit or to A building permit is required for all kitchen and/or bath remodels except when the scope of work ONLY ::-y pr vi ions of an involves the installation of cabinets and/or the replacement of countertops [CBC Section 105.2 ex 7] without altering any electrical,plumbing or mechanical systems or altering any existing walls. PLAN REQUIREMENTS r. :1.1IT,NO. 1. Provide a completed `Addition/Remodel' building permit application. 2. Provide three sets of completely dimensioned floor plans (both existing and proposed) showing the area of alteration(s). Floor plans shall indicate the following: a. Location of existing and new walls showing existing and new windows. b. Location and sizes of all doors. c. Location of all upper and lower cabinets. d. Location and use of all adjacent rooms. e. Location of smoke alarms and carbon monoxide detectors. Smoke Detectors and carbon monoxide detectors are required to be installed in accordance with Section R314 and R315 of the California Residential Code. 3. Ceiling Plan. Provide ceiling plan (three sets) to show ceiling heights, as well as, existing and proposed electrical and/or mechanical work at the ceiling level. 4. Structural Framing Plan. Provide three sets of the structural framing plan if any walls are being removed or relocated. Plan shall show all walls existing, removed and added and verify how new framing members are supported as a result of the removal of any bearing walls. 5. Plumbing,Mechanical and Electrical Plans. Provide three sets of plans showing electrical receptacles, electrical fixtures and switching, and ventilation. 6. Energy documentation. Two sets including the CFIR-ALT Residential Compliance Form. 7. Owner-Builder Disclosure Form (for property owners applying for their own building permit) 8. Details and Notes: Provide all details and notes required to explain the proposed scope of work. NOTE: All drawings must be signed by the person preparing them. All work shall comply with the 2010 California Building Code, 2010 California Residential Code, 2010 California Plumbing Code, 2010 California Mechanical Code, 2010 California Electrical Code, 2010 California Energy Code. OA FEE ESTIMATE The calculated fees are only an estimate. Contact the Bldg Dept for additional inf , �I *SCOPE OF WORK: Select Scope of Work Permit Fee *VALUATION: $0 Strong Motion Fee *AREA OF WORK:O S.F. Bldg Stds Commission Fee TOTAL ResKi1Ba1hPo1icy_2011.doc revised 07/01/11 iiNo xisting Window to Remain is NIUST be kept at the unlawful to meke any e, or to deviate f,,ii,the Building Official. Ine ns SHALL NOTnthe violation ''iy,Or or State Law. - O t t t � LA 1 5 � J f J J J J J J Existing Skylight to Remai Scope of Work: REC�I�TED -Remove and replace all existing fixtures in both bathrooms in same location, except for Hall Bathroom Toilet. DEC 0 4 ZO1Z -Relocate existing Hall Bathroom toilet by 6"to meet current code clearance. -Upgrade fan in Hall Bathroom / 1 GX►`54 I h cUprRTIMO Building Department Giovanonni Residence Nov 2 9 2012 922 September Dr. lac`�19EV'JED FGR C "�� ` Cupertino, CA 95014 Reviewed�Y -Relocate existing Hall Bathroom toilet by 6"to meet current code clearance. -Upgrade fan in Hall Bathroom r . E isting Window to Remai AOO 6 � • I Existing Skylight to Remain , Scope ofWork: 3 �® -Remove and replace all existing fixtures in both bathrooms in same location, except for Hall Bathroom Toilet. r -Relocate existing Hall Bathroom toilet by 6"to meet current code clearance. -Upgrade fan in Hall Bathroom Pro 0OSe GUPFRT'MO Giovanonni Residence Building Department 922 September Dr. REMEWED Fci` Cupertino, CA 95014 Reviewed'-v Building Department City Of Cupertino 10300 Torre Avenue Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST P SS: PERMIT# AME: PHONE# ONTRAG ;R3 a BUSINESS LICENSE# } CITY/ZIPCODE: al code requires all businesses working in the city to have a City of Cupertino business license. ING FINAL OR-FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR. BUSINESS NAME BUSINESS LICENSE# Cabinets &MillWorkl Cement Finishing Electrical 07Y1 E(ecrfrto Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping _ Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date