11040185 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7642 HOLLANDERRY PL CONTRACTOR: ry PERMIT NO: 11040185
OWNER'S NAME: MC GUIRE PATRICK J AND ELLEN M 534 HORNING STREET DATE ISSUED:04/26/2011
ER'S PHONE: 4082559204 SAN JOSE,CA 95112 PHONE NO:(408)287-4886
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class 9 Lie.# (O (�jj () ✓ /
1. n y, pp MECH RESIDENTIAL COMMERCIAL
Contractor Ch 1 S Dar,4fell� D��(bat, `f L p
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:SFDWL BATHROOM REMODEL(34SQFT).REMOVE&
(commencing with Section 7000)of Division 3 of the Business&Professions REPLACE
Code and that m license is in full force and effect. FIXTURES&FINISHES.NO WALLS MOVEDL INCLUDE
Y ELECTRICAL LIGHTING&MECHANICAL EXHAUST
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.
1 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:$18000
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36229001.00 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date Issued by: Date: 1,
L. OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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.
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
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,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
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. Owner authori agent:
...n ..( Date: 7 �
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
in,'--nify and keep harmless the City of Cupertino against liabilities,judgments,
c rid expenses which may accrue against said City in consequence of the Lender's Address
gru—ing 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
CITY OF CUPERTINO
3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36229001.00
DATE ISSUED. . . . . . . : 04/26/2011
RECEIPT #. . . . . . . . . : BS000013300
REFERENCE ID # . . . : 11040185
SITE ADDRESS . . . . . : 7642 HOLLANDERRY PL
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : MC GUIRE PATRICK J AND ELLEN M
ADDRESS 7642 HOLLANDERRY PL
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5071
RECEIVED FROM . . . . : DEVON L CARLOCK
CONTRACTOR CHRIS DONATELLI LIC # 24814
COMPANY DONATELLI CASTILLO BUILDERS
ADDRESS . . . . . . . . . . : 534 HORNING STREET
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE (408) 287-4886
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 18, 000 .00 1. 00 0. 00 1.00 0. 00
1BSEISMICR VALUATION 18, 000.00 1.80 0. 00 1.80 0. 00
1REMRESBAT SQ FEET 34 . 00 570. 00 0.00 570.00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 572.80 0. 00 572 .80 0. 00
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 7642 hollanderry place. DATE: 04/26/2011 REVIEWED BY: bobs.
APN: BP#: "VALUATION: $18,000
PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair
PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM
USE: p PERMIT TYPE:
WORK remodel sfd bathroom non structural replace fixtures electrical lighting, add mechanical exhaust
SCOPE finishes.
Lj
NOTE: Theseees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info,
FEE ITEMS (Fee Resolution 09-051 F,'tf.' 1.-"10) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = s.£ Remodel,Bath(<=300 sf)
Suppl.PC Fee: E) Reg. 0 OT -0-01hrs $0.00 $570.00 IREMRESBAT
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Acoustical Fee: 0 Yes (E) No $0.00 0
Work Without Permit? 0 Yes G No $0.00
Planning Fee: $0.00 Select a Non-Residential G
Building or Structure 0
Strong Motion Fee: 1BSEISMICR $1.80 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $2.80 $570.00 TOTAL FEE: r $572.80
Revised: 04/01/2011
RESIDENTIAL PROJECT COVER SHEET
tkssessor's Parcel Number: `�'Z - -( —00 I
Name of owner. PAT Af C 6(4iV'e—
Project address. b
Contact person. Det/0 yi r a r i(x Phone. c.-Po ' Z$ -
Fax. y0 S
Net square footage of lot.
Existing Proposed '
Square footage: First floor:
Second floor:
Garag
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage?
Is privacy protection planting required for the projec .
Id it Green Total Points
On what floor(s) is work being done?
Brief cription of work. e vn V e– re 14 C e -5h mI vq l vP P1
c
Code editions:2010 CBC d§)N)2010 CFC '-N)2010 CMC (]�D N)
2010 CPC 5 N)2010 NEC N)
California Green Building Standards Code 2010
Effective 1/01/11 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION-CUPERTINO
APPROVED
This s¢t of p"ans and specifications MUST'be kept at the
job cite Ju ing construction. it is unlawful to make any
cnz 7c; ;s 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 violation
of any provisions of any City
Ordinance or State Law.
BY 64c-
0
DATE
PERMIT NO.
Plan Review Process Work Book Page-8- Revised 12/21/10
1061 /2
3691
(E) W18,
GFI
(E) � C'7
N
N
r SB241 3
I I
op
I
(N) fluorescent recessed
(N) sconces on
occupancy sensor 1,4-,`vmvite r
Scope of Work:
1 ) Remove existing plumbing fixtures including:
shower valve, vanity & toilet
2) Install (2) wall mounted light fixtures w/occuppancy/+We,-
sensor at vanity. Move (E) GFI plug.
Applicable Codes:
2010 CBSC (CPC, CEC) C-� �—
A- GVW ooh-e-I GS{ham VW U4Wo C e, 5MSn� t,-1 ct l
Area of Remodel: 34 sq.ft.
Chris Donatelli BuildersTitle:
��41g DONATEL�� 534 Horning St. McGuire Residence
BUILDERS San Jose, CA 95iiz 7642 Hollanderry Place Page:
N�ORPOR!►I 4o8-287-4886 plhn 4o8-289-8714 fax Cupertino, CA 95014
Date: 4/22/II
Building Department
City Of Cupertino
Is 10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
;U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: L(2 ( r71111
PERMIT# d
OWNER'S NAME: PHONE#
GENERAL CONTRACTOR: IS ` BUSINESS LICENSE#
ADDRESS: $3tjoryj 5 CITY/ZIPCODE: S Z
*Our municipal code require 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. I
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
_a44--Owner/Contractor Signature Da e
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333 • buildingP-cupertino.org
UPERTINO
❑NEW CONSTRUCTION ❑ ADDITION LTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS,/-Z_ )�O jI� fr f / APN# 347 - 2
OWNER NAME �24 PHONE_Q Z E-MAIL
STREETADDRESS -+! LfZo/I CITY, SLT�ATE,ZoIPI�n FAX
CONTACT NAME /L r 0 /' PH n lam,���V. ` E-MAIL A� //
STREET ADDRESSCITY,STATE, ZIP / FAX
r v/I! S�,
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT! ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME /' off LICENSE NUMBER 6/6l oz LICENSE TYPE jJ BUS.LIC#
COMPANY NAME l ��f i r.s 'bo �e/I`- /" E-MAIL dc'&f I FAX
1 �( / �rS o •l . Lp�i z8q• 8�1
STREET ADDRESS Q (j CITY,STATE,ZIP D� /-� /s//z PHONEJj
ARCHITECT/ENGINEER NAME LICENSE NUMBER •1 J l/ Gl BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
RIPTION OF WORK 0 /f, y-U 0 rk? f / •
Cq
EXISTING USE PROPOSED USE
CONSTR-TYPE #STORIES
sr
Tt x:=
EXISTG NEW FLOOR DEMO TOTAL ��
AREA AREA O AREA NET AREA ;; r .. .,,,.,� _ ,. "r-,
BATHROOM7 / J I KITCHEN OTHER
REMODEL AREA S`� REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH ' � "' `� '' •' " _�' "�"`I"',, ` ' a
ATTACH
k DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES , -:�k�
BEING ADDED? NO ADDITION! NO
PRE-APPLICATION ❑ YES IF YES,PROVIDE COPY OF PLANNER'S NAME: RECETyELf BY
PLANNING APPL b ❑NO PLANNING APPROVAL LETTER �^ �y �,$, g' _ !
rtG•�.c d ', rr.
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 h ve read this
application and the information I have provided is correcthave read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to ding construct' n. au rize representatives of Cupertino to enter the above entified roperty for inspection purposes.
Signature of Applicant/Agent: JZ..n Date:
SUPPLEMENTAL INFORMATION REQUIRED PIAN CHECK TYPE .; ItOUTIlVC SLIP G;
_New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building ovR THE couNTEIi �un irlG pLAN"REvrEW
permit for new building. ❑ EXPRESS ❑ .pLKNNING PLAN REVIEW -
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD' - N ❑ PUBLIcwoRxs
if any Hazardous Materials are being used as part of this project.
13LARGE ❑°FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR" ' ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑"-ENVIRONMENTAL HEALTH,
B1dgApp_2011.doc revised 03/16/11