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13030167CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23500 CRISTO REY DR UNIT 316F CONTRACTOR: BETACONSTRUCTION PERMIT NO: 13030167 OWNER'S NAME: VIVIENNE SAUNDERS OWNER'S PHONE: 6505371503 If LICENSED CONTRACTOR'S DECLARATION License Class ( Lic.# `f% k, Contractor �c ) �� G n / Date 5/J"9//-3 I hereby affirm that I am licensed under the 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. 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. 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.. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 1611 ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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. 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 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. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 3498 CHERRY AVE DATE ISSUED: 03/29/2013 SAN JOSE, CA 95118 PHONE NO: (408) 623 -0280 JOB DESCRIPTION: RESIDENTIAL D COMMERCIALL] UNIT 316F - INSTALL 4 (N) RECESSED LIGHT FIXTURES IN KITCHEN & UPGRADE ALL OUTLET RECEPTACLES Sq. Ft Floor Area: I Valuation: $2500 APN Number: 34253139.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS F$PM175;ST C' QED INSPECTION. Date: Z RE- ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air 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 Health & Safety Code, Sections 25505, 25533, and 25534. /� s, Owner or authorized agent: Date/ `/3 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional GENERAL PERMIT APPLICATION `p� MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION �b 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 rl CiFPEEti [FEO (408) 777 - 3228• FAX (408) 777 -3333 • buildina (d- )cuDertino.org \ misc 1PT.TI mwr. MMECRANICAL fdELECPRICAL IIMISCELLANEOUS PROJECT ADDRESS .9 2. C'0 0 �,• 5,�, ,� p r �� APN# -3 q � 5; -3 1 OVrNERNAME qe /1 /7/ %��/ 5^A -lA1V�j it V[ /T� vIv PHONE / CO 53 /503 EMAII. STREET ADDRESS CITY, STATE,, IZIP I FAX CONTACT NAME PHONE E -MAIL STREETADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ,i _ 1U I m an i LICENSE NUMBER � 1 a , `� �j7� LICEINTSE TYPE BUS. L1C # COMPANY NAME a� �y fl S1 ` �l G✓� E -MAIL ej,- "�/✓1 FAX STREET ADDRESS 3 V 9 � Cite A - Jt CITY, STATE, ZIP// _ ,qj -o, � ^ ^ JGf �T PH0N f6 �� -0 - ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIIC/# COMPANY NAME' E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI - FAMILY BUILDING: ❑COMAREA ERCIAL PROJECT IN WILDLAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO ' p � DESCRIPTION OF WORK (J Kee G'T` 50 ta. 1-ir= ., TOTAL VALUATION: 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 correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constructiioon. I authorize representatives of Cupertino to enter the above - identified propei ry for inspection pu €poses. Signature of Applicant/Agent �t1 Date: -5v Do/ 3 SUPPLEMENTAL INFORMATION REQUIRED \ OFFICE USE ONLY V'ER•THE- COUNTER r' ❑ EXPRESS U y U ❑ STANDARD ❑ LARGE r. ❑ MAJOR MEPMiscApp 2011.doc revised 06121111 .� .� CITY OF CUPERTINO VIV T' ICTTM A rrn]2 _ R><T11."_FNf_' DlVlClnN 1%ch. Plan Check Plumb, Plmi Check Elec. Plan Check 10.0 1 hrs $0.00 1Lteck Penn id Fee: Plumb. Permit Fee: Elec. Permit Fee: IEPERMIT Other ,Wech. Insp, Other Plumb Insp. Other Elec. Insp. 0.0 hrs $45.00 llech. Insp. Fee: Plumb. brsp. Tee: Illec. Insp. Fcx: w )TF. This nctimnte dov_.c not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn't info. ADDRESS: 23500 CRISTO REY DR # 316F DATE: 03/29/2013 REVIEWED BY: MELISSA APN: 342 53 139 BP #: "VALUATION: 1$2,500 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Du lex p PENTAMATION 1 REAP11 USE: PERMIT TYPE: WORK INSTALL 4 N RECESSED LIGHT FIXTURES IN KITCHEN &UPGRADE ALL OUTLET SCOPE RECEPTACLES 1%ch. Plan Check Plumb, Plmi Check Elec. Plan Check 10.0 1 hrs $0.00 1Lteck Penn id Fee: Plumb. Permit Fee: Elec. Permit Fee: IEPERMIT Other ,Wech. Insp, Other Plumb Insp. Other Elec. Insp. 0.0 hrs $45.00 llech. Insp. Fee: Plumb. brsp. Tee: Illec. Insp. Fcx: w )TF. This nctimnte dov_.c not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn't info. <3 15-6 0 5 t-,o r p f yd 12-- This set of i6b site d, Storage TO' x No! Ava;.'able on Corner Units Balcony 7'5' z T2 Bedroom 10'11" x 13'7' 11 DEVELOPMENT DEPARTMENT H 7p and PING IVISION - CUPERTINO 0' R E ED s ecificat! s M ST be kept at th coon. It' I to make any s I alt 'ations on a e, or deviate 11 al from 1, out hDDroval a B Iding Official. stamping ! f this �to 1amr4Weqf1 r r m m held to p be an appto any of any City Ord ii Rw 8.11° I r�41� jw/D1 Close 2' x -2— Living Room 1;,'x 150, Dining Room 12'5' x 8*9' a7. " 0" F !"Xw Entry 5, 0, x 9,5" xj /v rr to - -:S- 3 M FTi 0 n © S Emergency Responsc, Syste,,4"17" Elec!rical oLiriel Cable Tpio-visinn ,)uL,cr Tr Ta FF1 W 1RIOP 800 S CE S-Fg, qua Oe t ,ftftQAL_C0NY SPACE e 00 luxe h 6e bU A'. FA HO SAS' 10 ST011tAGE S4PAQClr-t'--�N 17 Square Feet '0000�v 77 15CC—p /—W< (D 0 01 M r%3, 4C 0 C= :3 0 M: U (D Kitchen 0 z ! Z 1 7'0' x 11'0" 0 M CD 01 :3 © S Emergency Responsc, Syste,,4"17" Elec!rical oLiriel Cable Tpio-visinn ,)uL,cr Tr Ta FF1 W 1RIOP 800 S CE S-Fg, qua Oe t ,ftftQAL_C0NY SPACE e 00 luxe h 6e bU A'. FA HO SAS' 10 ST011tAGE S4PAQClr-t'--�N 17 Square Feet '0000�v 77 15CC—p /—W< CITY OF'C/ UnPERTINO BUILDING PERMIT BUILDING ADDRESS: 23500 CRISTO REY DR �7 r� !j 1 CONTRACTOR: BETACONSTRUCTION PERMIT NO: 13030166 OWNER'S NAME: HOADLEY LEON W TRUSTEE & ET AL 3498 CHERRY AVE DATE ISSUED: 03/29/2013 OWNER'S PHONE: 6505371503 SAN JOSE, CA 95118 PHONE NO: (408) 623 -0280 M11 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALS License Class_ Lie. # Contractor -t hed ��� /MGr r _ Date I hereby affirm that I am licensed under the 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. 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. 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. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. / Signature Date 34251 ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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. 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 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. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature, Date INSTALL 4 (1) RECESSED LIGHT FIXTURES IN KITCHEN UPGRADE ALL OUTLET RECEPTACLES OAJ rT //qtS Sq. Ft Floor Area: I Valuation: $2500 APN Number: 34253009.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAY- N- FROMTAST CALLED INSPECTION. Date: RE- ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air 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 Health & Safety Code, Sections 255Q5, 25533, and 25534. Owner or authorized agent: Date:3 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional ( (1L( . GENERAL PERMIT APPLICATION � COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 0 .10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 /�•,1, CEJPERTIFfO (408) 777 -3228 - FAX (408) 777 -3333 - building a0cuoertino.org q Q MPT.TTt'MTNG MNMCHAMCAL ❑ELECTRICAL ❑MISCELLANEOUS MEP misc PROJECT ADDRESS.),,? J Cn 5 " q `I APN # 2 Z 5 OWNERNANE / �+Jj �► J �(,� �I / ` / v PHONE /t�j� . 1�rJ��� 7 E -MAIL STREET ADDRESS . � 3 5 " D J Cr �J r ` CITY, STATbr,ZIPv FAX CON''TACT NAME PHON!j � E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OwNER.B=FR ❑ OVITIF.RAGENT ❑ CONTRACTOR ❑ CONTRACTORAGE 7 ❑ ARCHITECT ❑ENGINEER ❑ DEN PER ❑ TETTAI•`T CONTRACTOR NAME n i �4 i (Cl`►Gt9 LICINSE NUMBER 17\2e� (7 � L ! g LICETSE TYPE e0 .I BUS. LIC i COMPANY N !3 n� �1 G1 �7/� E 21 �ct(ilS_ GO vvk FAX STREET ADDRESS (� �q L - -_ _ CITY, STATE, ZIP S 7,.� e_ / �� �-T PHONE ARCHITECTIENGLNEERNAME LICENSENUMBER BUS. LIC# COMPANY NAME ' E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD . DUPLEX ❑ MULTI - FAMILY BUILDING: ❑ COMvIERML PROJECT IN WILDLAND ❑ YES URBAN INTERFACE AREA 13 NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN El YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK • 40- tZe %O S Arn 7� G i TOTAL VALUATION: V RECEIV 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' b f. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin co tru lion. I authorize representatives of Cupertino to enter the above-identified propel& for inspection purposes. Signature of Applicant/Agent: �� Date:.-3 / o "mil /o�W3 SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY OVER- THE - COUNTER ❑ EXPRESS U v U ❑ STANDARD ❑ LARGE L ❑ MAJOR MEPMucApp_2011.doc revised 06/21/11 PTTV nF ClITPF,RTINO Ltech. flan Check Plumb, Plan Check Elec. Plan Check 0.0 hrs $0.00 �1ech. Permit Fee: Plumb. Permit Fee: Elec. Permit Other Alecrh. Imp. Other Plumb Insp. Other Elea Insp. 0.0 hrs hlech. Insp. Fee: Plumb. Insp. Fee: Elec, InT, Fee: n,___._ - -- D..LI.- W-4- Firo Vasitary .Cower District. School NOTE: This estimate aoes not inetuae fees aue w usDe. I «. . »......_a, District, etc). These fees are based on the preliminary informs tion availableaand an FEE ITEMS (Fee Resolution 11 -053 E . ZILI-21 FEE ESTIMATOR - BUILDING DIVISION QTY/FEE ADDRESS: 23500 CRISTO REY DR # 114B DATE: 03129/2013 APN: 342 53 009 BP #: REVIEWED BY: MELISSA *VALUATION: J$2,500 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1 REAP11 PERMIT TYPE: WORK SCOPE I INSTALL 4 N RECESSED LIGHT FIXTURES IN KITCHEN & UPGRADE ALL OUTLET RECEPTACLES APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES PME Permit Fee: Fixtures, Lighting 1BREMFIXT Constr-ztction Tax Administrative Fee: IADMIN 4 # $67 Recep /Switch /Outlets 1BREMRECEP 20 # $45 Travel Documentation Fee: 1TRAVDOC $45.00 Strong Motion Fee: 1BSEISMICR $0.50 Bldg Stds Commission Fee: IBCBSC $1.00 TOTALS: _ ' " $112.00 z , Ltech. flan Check Plumb, Plan Check Elec. Plan Check 0.0 hrs $0.00 �1ech. Permit Fee: Plumb. Permit Fee: Elec. Permit Other Alecrh. Imp. Other Plumb Insp. Other Elea Insp. 0.0 hrs hlech. Insp. Fee: Plumb. Insp. Fee: Elec, InT, Fee: n,___._ - -- D..LI.- W-4- Firo Vasitary .Cower District. School NOTE: This estimate aoes not inetuae fees aue w usDe. I «. . »......_a, District, etc). These fees are based on the preliminary informs tion availableaand an FEE ITEMS (Fee Resolution 11 -053 E . ZILI-21 FEE QTY/FEE Plan Check Fee: Suppl. PC Fee PME Plan Check: $0.00 Permit Fee: Suppl. Insp Fee PME Unit Fee: $112.00 PME Permit Fee: $45.00 Constr-ztction Tax Administrative Fee: IADMIN $42.00 Work Without Permit? ® Yes Q No $0.00 Advanced Planning Fees: Travel Documentation Fee: 1TRAVDOC $45.00 Strong Motion Fee: 1BSEISMICR $0.50 Bldg Stds Commission Fee: IBCBSC $1.00 $245.50 $0.00 an estimate. Contact the Dept for addh I MISC ITEMS Select an Administrative Item. #1;, $245.50 1 Revised: 01/01/2013 ,;3 C 4,--, �F C: J V NcT— *-r— 11 L-f I,> A-o.A X142 573 009. 5(��o or t5� : /NS A /tge, o U toot Available on Corner Units rv,,yi[ G eV 7013 a