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11090202 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1158 SCOTLAND DR CONTRACTOR:CHRIS DONATELLI PERMIT NO: 11090202 BUILDERS OWNER'S NAME: CINDEE CHRISTENSEN 534 HORNING ST DATE ISSUED:09/28/2011 ='S PHONE: 4089961969 SAN JOSE,CA 95112 PHONE NO:(408)287-4886 LICENSED CONTRACTOR'S DECLARATION r F ,__7 // BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class V Lic.# b�L/V MECH F RESIDENTIAL COMMERCIAL Contractor.&W C,5L'k)g o f e/( Date �� U I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: SINGLE FAMILY DWELLING BATHROOM (commencing with Section 7000)of Division 3 of the Business&Professions REMODEL(62SQFT) 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 Sq.Ft Floor Area: Valuation:$6000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION APN Number:36228008.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. 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. 7 Issued by :'� _---, Signature (4Date !� OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Own r author' ea t: become subject to the Worker's Compensation provisions of the Labor Code,I must /t Date: [ I' forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address i-aPmnify and keep harmless the City of Cupertino against liabilities,judgments, ,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION a_..iting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•building a-cugertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# } { / l /�!nQf N# PROJECT ADDRESS (4922i - 008 . O0g OWNER NAME l 1 r PHONE y� ( l YJ • E-MAIL STREET ADDRESS CITY, STATE,ZIP / C^` FAX � f / � � � l r CONTACT NAME DCVO PHOtN)E , a E-MAIL STREET ADDRESS TY J ❑OWNER ❑ OWNER-BUILDER r V❑ OWNER AGENT X CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER/']'��/ LICENSE TYPE Ig BUS.LIC# l5 r7 Com] COMP NY NAME t`lO YJ�IP/l/r �(�7f/U t / E-MAIL Q ��►M l�� d FAX STREET ADDRESS -//- CI Y,STATE,ZIP �� PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ;�- �, EXISTING USE OPOSED USE CONSTR.TYPE #STORIES �� O USE TYPE nOCC. SQ.FT. VALUATION(S) AREA 3 TAREFLOOR DARER 3/ !�7 NET AREA �. S� l �I� �C 3 3 G G(� r BATHROOM KITCHENff OTHER REMODEL AREA 3� REMODEL AREA/A REMODEL AREA ` PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: /DETACH / ATTACH #DWE�G UNTTS � IS A SECOND UNIT ❑YES SECOND STORY OYES BEING ADDED? O ADDITION? KNO PRE-APPLICATION [IYES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: T TpJL VALUATION: PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? �NO to /00 D•O a 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 corm have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin ilding const do authorize representatives of Cupertino to enter the abbfove iidentified property for inspection purposes. Signature of Applicant/Agent: Date: ( Z %D) SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ER-'rKE-COUNTER -BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS 0 PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS, -In if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 PROJECT DATA - RESIDENTIAL 10 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildingQcupertino.org PROJECT ADDRESS l�c t A PN# / _ 28 OWNER NAME (UJ l / PHONE {� E-MAIL > V (J STREET ADDRESS ? CITY, STATE,ZIP FAX CASSU l APPLICANT NAME PHONE E-MAIL STREET ADDRESS - CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUII.DER OWNERAGENT CONTRACTOR 1:1CONTRACTOR AGENT ❑ ARCHITECT ElENGINEER 11DEVELOPER ❑ TENANT DESCRIPTION OF WORK, IAIIU t/10 �26( j rte► S C'&'L' '' EXISTING USE(S): PROPOSED USE(S): OCCUPANCY(S): TYPE OF PARCEL CONSTRUCTION: AREA: FIRE Y N WUI AREA: Y N FLOOD AREA: Y N SIESMIC AREA: Y N SPRINKLERS: ExistingProposed Floor Area: First Floor: s.f. s.f Second Floor: s.f s.f Garage s.f. s.f TOTAL: s.f. s.f. Are there at least two 10 feet by 20 feet clear spaces inside the garage? Y N Is privacy protection planting required for the project? Y N Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code(based on the 2009 Uniform 1141 11ffiPd/ELOPMENT DEPARTMENT 2010 California Mechanical Code(based on the 2009 Uniform Me&A.1 PUASJON-CUPERTINO 2010 California Electrical Code(based on the 2009 International ElectricAOVED 2010 California Energy Code This set of pians and specifications MUST be kept at the 2010 California Green Building Standards Code job site during construction. It is unlawful to make any Cupertino Municipal Code changes or alterations on same,or to deviate therefrom,without approval from the Building Official. The stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the viol iticn of any provisions ooff any City Ordinance or State La,ur. DATE PERMIT N0. FC- Mstr. Bedroom Zg" A I (�to Bath i o O CO Ll C ti CO (N) N (9rr(:j, (E) 4811 Scope of Work: 1) Remove and replace toilet, sink & shower valve. 2) Repipe vertical plumbing with copper. 3) Install (N) exhaust fan. 4) (N) tile in shower OIS DONATE! Chris Donatelli Builders Christensen Bath z Title: 4� Lj 534 Horning St. 1158 Scotland Dr. Page: Iz BUILDERS San Jose, CA 951g Cupertino, CA 95011 CoRPURAREO 408-z87-4886 p11n 4o8-z89-8714 fax Date: 9/z8/II ALTERNATE MATERIALS AND METHODS / MODIFICATION FORM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildinq(U-)cupertino.org CUPERTINO X REQUEST FOR MODIFICATION OF CODE(CBC 104.10) ❑ REQUEST FOR ALTERNATE MATERIAL, DESIGN OR METHOD OF CONSTRUCTION(CBC 104.11,CFC 111.2.4) To apply for this request,complete sections 1,2,&3 ink ortype) SITE L ` 7 APN _ v DATE- : ADDRESS l 7i 1 .)..)- .W......L.�'.+.r:S 4.1:1 .'.�' ........................................................ YO Owner..... PC#: ..................................... T e: Address.1./.:S...Ct...... ? .+kU:'.J.......0 ........'LQ ''� .. �.a....... .: !......... tJ.�..rjj � Permit#: ................................ Stones: ........L........................ .� Email..............................................................Phone PLN#: ................................... Occupancy:.5.f.-. .............. 1 n �{t. } Dept./Div................................ Floor Area:............................. Applicant.:r�tlV. �:1......C.�i..t..�: L: ................Title....�C:�:f.............; ...�.......... � Job Status: ............................ Occ.Load: ............................. Address ..... (,� Use of Bldg:.�..0.. ............. Email..c. S'.�,�::1..k� 2 REQUEST: For code modifications,please state the applicable code requirement and the extent of relief desired. For altemate requests,state the type of system ro osed and design methods. Submit plans if necessary to illustrate request. Additional sheets or data may be attached. t17 �% 4' � �i `�Y��c.E'/ 1 �' ! `% ✓l�r2c ; Y�' C�<_'/� j�c 4 tc -4-Ve 3 JUSTIFICATION/FINDINGS OF EQUIVALENCY: For code modifications,applicant shall demonstrate that Code Section(s): special,individual reasons exist that make compliance with the strict letter of the ordinance impractical and that /1 r/�/+ equivalency is provided. For alternate requests,applicant shall demonstrate suitability,strength,effectiveness,fire O 0!/�• C f v resistance,durability,safety and sanitation that is equivalent to the code for a similar use. Attach additional sheets if necessary. A0 k-ti' ` L t, C� c �)i " J`Z " _}'.•� l f r/ i 0 v 'tc. -1--`v, i ! ��( (�iCb�)-4- t; ,J:1N,)5 Petitioner's �- Reviewed �� Signature: .'�, "l��1..... .. .4 ................... Position:C(.)a. ( :.a' ......Date:t.L. ..�L. By:...................................................Date:.../:.,?Y,-- L The Request is: GRANTED ❑ DENIED Dept.Comments: CONDITIONS OF APPROVAL: No.of Items: ......''.''.jj................. Fee Due:$.......1....1. .l..Y.�!.... DatePaid: ................................. Receipt No.: .............................. `,p Processed by:............................ BuildingOfficial:.... Print:.. .�1�..Y...i".V...5. �!.Y{1. .................Date'TV ... .1............ FireMarshal:......i..............................................................................Print: ...................................................................................Date:................................... DEPARTMENT ACTION: After determination,copies to:1)applicant, 2)permit file �i`Iv i '4tWm 2010.doc revised 06/11/10 Building Department City Of Cupertino [is 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: j I IS �, G V1 PERMIT# 'o P'-- OWNER'S NAME: L�,, �? '(� � S- r',-�4?/�/ PHONE# U�� GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. �j I am not using any subcontractors: `' — Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical 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/ ontractor Signat� Date