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09100050 f CITY OF CUPERTINO BUILDING PERMIT F BUILDING ADDRESS. 10523 ESQUIRE PL CONTRACTOR:TBD-TO BE DETERMINED PERMIT NO:09100050 OWNER'S NAME: GODFREY&PATRICIA MUNGAL DATE ISSUED: 10/07/2009 `ER'S PHONE: 4089620254 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class f� Lic.# to � / f—�J�F�h�� MECH RESIDENTIAL � COMMERCIAL � Contractor iD/7 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMODEL KITCHEN,SAME LAYOUT AND 3 (commencing with Section 7000)of Division 3 of the Business&Professions BATHROOMS, Code and that my license is in full force and effect. REPLACE TRIMS&WALLS(FINISH),NO RE-ROOF&NO STRUCTURAL;E&J GENERAL BUILDING CONT PD FOR BUS 1 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 Sq.Ft Floor Area: Valuation:$34000 permit is issued. APPLICANT CERTIFICATION APN Number:32644023.00 Occupancy Type: 1 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City Cupe o a inst liabilities,judgments, costs,and expenses which may accnr gain said Ci in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Add' ' Il he plicant un rstands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point sour s� atio per e Cupertin Municipal Code,Section 9.18. /` -7 Signature Date /� 'l ® , Issued bDate: L OWNER-BUILDER DEC)ARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,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: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,l shall contaminants as defined by the Ba rea Air Quality Management District I will maintain complian a ith the C er no Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Sal o ,Sectio 2550 ,25533,and 25534. 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 Owner e forthwith comply with such provisions or this permit shall be deemed revoked. Date: ! / APPLICANT CERTIFICATION CONSTR CTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save i� ' -rnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may accrue against said City in consequence of the gr-sting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional U CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32644023 . 00 DATE ISSUED. . . . . . . : 10/07/2009 RECEIPT #. . . . . . . . . : BS000008858 REFERENCE ID # . . . : 09100050 SITE ADDRESS . . . . . : 10523 ESQUIRE PL SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : GODFREY & PATRICIA MUNGAL ADDRESS . . . . . . . . . . : 10523 ESQUIRE PL CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1318 RECEIVED FROM . . . . : ERNESTO PEREZALONSO CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 34, 000 . 00 2 . 00 0. 00 2 . 00 0 . 00 1BSEISMICR VALUATION 34, 000 . 00 3 .40 0 . 00 3 .40 0 . 00 1INSPPAR HOURS 9. 00 1134 . 00 0 . 00 1134 . 00 0 . 00 1PPERMITFE FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 . 00 1PREPPIPE FLAT RATE 7. 00 294 . 00 0. 00 294 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0. 00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 1517 .40 0 . 00 1517 .40 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 1, 517.40 #1050 --------------- TOTAL RECEIPT 1, 517 .40 RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: 2- U Name of owner. 6eP13�v mov� Project address. l d�23 QCT! I � Contact person. A�� Phone. Wb) Fax. J7 J Net square footage of lot. Existing Proposed Square footage: First floor: Second floor: Garage: TOTAL: ~e there at least two 10 foot by 20 foot clear spaces inside the gara ? N Is privacy protection planting required for the project? Y On what floor(s) is work being done? Brief description of work. h7v-D 3 A":7j -aX-PI S 21�b NL�Gc�a�1'Zq-t_ . /SDN ;�I'Lu� G ►>>'1.�6 ��,Y,;�5 ?S �Code editions:2008 CBC �N)2008 CFGC9t-N)200 CMC (Y-N) 5,,,,o l 2008 CPC EY}N)2008 NEC (Y -N) Effective 1/1/08 10ISSFS s�/� COPY -. i'Y Y Plan Review Process Work Book Page-8-Revised 1/1/08 u O �O_ 6Ztr--7,,izA-t_ OIL RESIDENTIAL PROJECT COVER SHEET l Assessor's Parcel Number: 2- L� L-(U Name of owner. , Q Project address. l d�2-3 QIJI I L � Contact person. Phone. S7D) Fax. r 42 35YAY Net square footage of lot. Existing Proposed Square footage: First floor: - Second floor: Garage: TOTAL: re there at least two 10 foot by 20 foot clear spaces inside the gara ' �N Is privacy protection planting required for the project? Y On what floor(s) is work being done? //�� Brief description of work. A�v-D 3 Aviran-ts pe!LDPI1A Jib NL��Z�►'� . /VbN �>i'1J6 R w7, -e. e6ukw W*-tA-* IIVJ-Y , 13,57,- roo r'-7-J, 10 h Code editions: 2008 CBC N)2008 CFC -N)2008CMC (Y-N) 2008 CPC N)2008 NEC (Y -N) I APPRO,, IN ACCORDANCE V. c CUPERTINO CODES i S Effective 1/1/08 DATE sf This ant i - r be kept on the jot, unlawful to make an, S on same Without\t the Building Depart The stamping of th ns SHALL NOT be h, approval of the v,. r1S of any City Or Aak A Plan Review Process Work Book Page-8-Revised 1/1/08 AIX/ 4M, A G ' — 3 S Gtr-L S OIL - M'J'or,4.5 pSa6 �� 0 c) U # CITY OF CUPERTINO ADDITION/REMODEL CUPEkTINO PERMIT APPLICATION FORM APN # 2 -� p Y U Date: Is a 2"d unit being added? Yes No ❑ If yes, please fill out the permit application for 2° unit. Building Address:16 12.5 IE5 au)"JZICPC461c_ Mailing Address (if different from building address): Owner's Namq. Phone# A172�Gt R1JW,6 Z-� d—- 2— 62.E Contractor: Phone#: T_zJ_3 u)) J Pg COAG a-or' fi_ Fax #: � Contractor License#: Q Cupertino Business License#: Contact: Phone#: 67W -7/V—f Zr-3 k9Lk1e3_ WSD Fax #: b 35 I OP BuildinPermit Info: Bldg. Elect. ❑ Plumb. Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled (not including addition)? / � t,� 1-A yd&rf— ? &�P-4-6 omits ¢ was Remodel Includes Re-Roof: Yes ❑ No If yes list number of squares Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning approval? Yes ❑ No If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen Bath Other Type of Construction (Usage Class): Occupancy Type: 1-A, 1-13 ❑ II/III/V-A ❑ IUIII B, IV-HT, V-B EZL,,4V��r���� � Valuationfe: Please check this box if the project is a / second-story addition El Project SiExress ❑ Standard ❑ Large ❑ Major❑ Please complete relevant portion of the Green Building Checklist& attach it to the application or if applicable, Green Building Points Achieved: include in plan set& the sheet index. ***For Office Use Only*** Over-the-Counter ❑ Revised 07/06/09 CITY OF CUPERTINO 4- ADDITION/REMODEL _ CUPEI�TINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD 1PLLONGRNGR Long Range PL Planning/Residential 1R3INSP Dwellings Inspections B 1 R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection 1 R3REPPLNC Dwellings Repeat Plan B Check 1 R3HINSP Dwellings Hillside B inspection 1R3HPLNCK Dwellings Hillside plan B check 1 R3HREINSP Dwellings Hillside B Repeat Inspection 1R3HREPLNC Dwellings Hillside B Repeat Plan Check 1R3ALTINSP Dwellings Alternate B Materials Inspection l R3ALTPLNC Dwellings Alternate B Materials Plan Check 1PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Disposal System 1 PRSEWER Sewers P 1BPSPRINK Lawn Sprinkler/Backflow P 1BPWSVCS Main Water Service P 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES iCommission Fee 1BSEISMICRE SeismicResidential B 1RER00FRES Residential Re-roof Each B 100 SF CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1 REMRES2 Remodel Residential B Greater than 1000 sq ft 1REMRES3 Remodel Residential B Greater than 2500 sq ft. 1REROOFRES Residential Re-roof Each B 100 SF REMODEL PLNCK 1 STPLNCK(1-3 for Standard Plan Check B NOT FOR OVER THE remodel) COUNTER PLAN CKS. WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 WINREP Replacement windows B (ea 8 windows) 1 WINNEWNSTR New Window (non- B structural) 1 WINMEWSTR New Window(Structural B Shear Wall/Masonry) 1 WINBAYSTR Bay Window (Structural) B SKYLIGHTS 1R3SFDREM 1 SKYL<10 SF Skylight less than 10 sf B 1SKYL>10SF Skylight greater than 10 B sf or structural 1STAIRS Stairs-first flight/ea addt'1 B 1 EPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln E Ck (hourly) . 7 pr) PPrP CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1 MECPLNCK Stand Alone Mechanical M Pln Ck(hourly 1PLMPLNCK Stand Alone Plumbing P Pln Ck(hourly) 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B / 1 TRAVDOC Travel &Documentation B 1BUSLIC Business License B .Indoor Air ua rty and Frnrshes 1.Use LOOkINOC Pati 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use Lowltifo VOC Adhesives 3 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes p p 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7-SeWai(fFVmWP, iebwo,arfltl�F 41AQ/Health pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapicly Renewable f=looring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 i 1 Total Points Available: 1-4-Or 130 57 Total Points Project Received: io/7/ o1 G:data/progstgreenbuildingguideeslremodelers/greenpo fina12.12.D4protected.xls Community Development 10300 Torre Avenue s .{ Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 .'UPE�TINO Building Department JOB ADDRESS: PERMIT# � / , -� OWNER'S NAME: �J PHONE # 62- ZS GENERAL CONTRACTOR: 60-f�- AX # I am not using any subcontractors: /") 43i a e �CXIDate Please check applicable subcontractors and complete the folloyzge information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date