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12120001CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10302 TERRY:WAY CONTRACTOR: BLUE BAY PERMIT NO: 12120001 REMODELING CO OWNER'S NAME: SANTA CLARA, CA 95051 PHONE NO: (408)615-0135 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALE] ❑ LICENSED CONTRACTOR'S DECLARATION License Class &JEA64 Li,. # R 6 . I t'"' UNIT #2- KITCHEN REMODEL (209 SQFT) REVISION # 3 - ADD 7 WINDOWS & 1 SLIDING DOOR (NO Contractor )ate STRUCTURAL CHANGES I hereby affirm that I am licen.,ed 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 Sq. Ft Floor Area: Valuation: $15000 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 APN Number: 35917012.00 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 W94K IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 D T 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 DA LED 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 Issued b Date: / 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. RE -ROOFS: Signature Date 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 rpaterials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from -the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 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 I 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 I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age Date: L` 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction 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"mtderstands and will comply with all non -point source regulations perthe Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date ���,�� CITY OF CUPERTINO 1a'-�J�I FiF.F. FCTIMATOR — RITILDINC DIVISION Lfech. Plan Check" _%, ch. Permit Fee: Other Afech. Insp. Alech. Insp. Tee: Plumb. Plan Check Plumb. Permit Fee: Other Plumb Insp. ET Plumb. lush. Fee: Elec. Plan ("heck f lec. Permit lee: Other Elec. Insp. Elee. Insp, Fee: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Ctre, sanuary sewer u1strict, scnool District etc). Theseees are based on the relimina information available and are on l an estimate. Contact the Det or addn'l ADDRESS: 10302 TERRY WAY # 2 FEE DATE: 03/29/2013 REVIEWED BY: MELISSA Plan Check Fee: APN: 35917 012 1BP#: =# Window / Sliding Glass Door $400.00 1 WINREP Replacement Suppl. PC Fee: (j) Reg. 0 OT0.0 `VALUATION: 1$2,800 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex $0.00 PENTAMATION PERMIT TYPE: 1 GENRE i WORK REV # 3 - REPLACE 7 E WINDOWS NO STRUCTURAL WILL MEET EGRESS & 1 SLIDING SCOPE I GLASS DOOR Lfech. Plan Check" _%, ch. Permit Fee: Other Afech. Insp. Alech. Insp. Tee: Plumb. Plan Check Plumb. Permit Fee: Other Plumb Insp. ET Plumb. lush. Fee: Elec. Plan ("heck f lec. Permit lee: Other Elec. Insp. Elee. Insp, Fee: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Ctre, sanuary sewer u1strict, scnool District etc). Theseees are based on the relimina information available and are on l an estimate. Contact the Det or addn'l FEE ITEMS (Fee Resolution 11-053 E . 7/1/121 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =# Window / Sliding Glass Door $400.00 1 WINREP Replacement Suppl. PC Fee: (j) Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. ® OT0,0 hrs $0.00 PME Unit Feer $0.00 PME Permit Fee: $0.00 Consovetion :Tax: Administrative .Fee: Work Without Permit? ® Yes 0 No $0.00 Advanced Planning Fee: $0.00 Me- I Lfech. Plan Check" _%, ch. Permit Fee: Other Afech. Insp. Alech. Insp. Tee: Plumb. Plan Check Plumb. Permit Fee: Other Plumb Insp. ET Plumb. lush. Fee: Elec. Plan ("heck f lec. Permit lee: Other Elec. Insp. Elee. Insp, Fee: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Ctre, sanuary sewer u1strict, scnool District etc). Theseees are based on the relimina information available and are on l an estimate. Contact the Det or addn'l FEE ITEMS (Fee Resolution 11-053 E . 7/1/121 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =# Window / Sliding Glass Door $400.00 1 WINREP Replacement Suppl. PC Fee: (j) Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. ® OT0,0 hrs $0.00 PME Unit Feer $0.00 PME Permit Fee: $0.00 Consovetion :Tax: Administrative .Fee: Work Without Permit? ® Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential 'A or Structure i Travel Documentation Fees: Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item _ W60-zl� Bldjz Stds Commission Fee: 1BCBSC $1.00 $1.50 $400.00 .50 Revised: 01101/2013 I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10302 TERRY WAY I CONTRACTOR: BLUE BAY REMODELING I PERMIT NO: 12120001 OWNER'S NAME: License Class Lic.# Contractor 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 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 ❑ 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. SANTA CLARA, CA 95051 PHONE NO: (408)615-0135 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB F MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: UNIT #2- KITCHEN REMODEL (209 SQFT) REVISION # 3 - ADD 7 WINDOWS & 1 SLIDING DOOR (NO Sq. Ft Floor Area: I Valuation: $15000 APN Number: 35917012.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: 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 Appl 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. Owner or authorized agent: Date: 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 Ad ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature. Date Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10302 TERRY WAY CONTRACTOR: LIAO CHUNG H AND BEI PERMIT NO: 12120001 W OWNER'S NAME: LOS GATOS, CA 95030 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT F PLUMB r License Class Lic. # MECH r RESIDENTIAL r COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: UNIT #2-KITCHEN REMODEL (209 SQFT) (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. Date OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). Rkv 1, 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 Sq. Ft Floor Area: I Valuation: $10000 APN Number: 35917012.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: z,, 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 25505, 25533, and 25534. Date: f ..,2 — CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Nwrk'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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10302 TERRY WAY CONTRACTOR: BLUE BAY PERMIT NO: 12120001 REMODELING CO OWNER'S NAME: 5 UNIT #2- KITCHEN REMODEL (209 SQFT) License Class B. ' Lic. #F7 i 12-6-12 -REV#1-ADD 1/2 BATH UNDER STAIRS (18 Contractor . -, - Date_C � _ f SQFT)-REV#1 ISS'D 12/6/12 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. Sq. Ft Floor Area: Valuation: $15000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35917012.00 Occupancy Type: 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 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 F CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in of the costs, and.expenses which may accrue against said consequence Issu ate: t t 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. C � RE -ROOFS: being installed. If a roof is Signature Date ro� All roofs shall be inspected prior to any roofing material installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the'following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 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 I 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 with the Cupertino Municipal Code, Chapter 9.12 and 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 will maintain compliance the Health &Safety Code, Sections 25505, 25534. Owner or authorized agent:' Date: 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. 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 CITY OF CUPERTINO BUILDING PERMIT�� _ BUILDING ADDRESS: 10302 TERRY WAY CONTRACTOR: LIAO CHUNG H AN&kF JPERMIT NO: 12120001 W OWNER'S NAME: I LOS GATOS, CA 95030 l PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. Contractor 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 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 ❑ 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) 1, 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. BUILDING PERMIT INFO: BLDG 'F- ELECT r- PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: UNIT #2- KITCHEN REMODEL (209 SQFT) 12-6-12 -REV#1-ADD 1/2 BATH UNDER STAIRS (18 SQFT)-REV#1 ISS'D 12/6/12 Sq. Ft Floor Area: I Valuation: $15000 APN Number: 35917012.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: / z.�%Z& Date: fd •4 °/,�x 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. 12 -06 12 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Nwrk'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. Date G 1 L Licensed Professional CITY OF CUPERTINO ftm FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10302 TERRY WAY DATE: 03/29/2013 REVIEWED BY: APN: BP#: 12120001 *VALUATION: 1$17,800 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFp or Duplex PENTAMATION PERMIT TYPE: 1 GENRE WORK ADD 7 WINDOWS & 1 SLIDING DOOR SCOPE i1;:�<h. F'lf,rt CYt��<dc f'1�nuL. 1'lrut �'�t,cck 1�.t<r, I'knt R�'h�-rk ,l�P+'�It. Nc'rur� l'et': I'lUtuh, f'crnrlt I'rC_ LIE'C. Pr'ln+i! heir+: �h %� �/,. ?�tsf'. iuv l'G�nrl� IAsJz at(ri'r I Icr. ?ttsn.F-1 L_ Than/, hrcp. 1 w Etcc, lwgj. F�,c: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.. These ees are based on the preliminar information available and are onjV an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 ® # $400.00 Window / Sliding Glass Door 1WINREP Replacement Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 _T_T_ O 0 Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 1 t7tY-c'l 00('11117('thltt/ItAj I'UL' ,%,' Strong Motion Fee: 1BSEISMICR $1.78 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC SUBTOTALS: 1 $ 1, 78 $400.00 TOTAL FEE: I $40,„78 Revised: 07/01 /2012 CITY OF CUPERTINO FFF. F.QTTMATOR — RTTTT DING DIVNION ADDRESS: 10302 Terry way DATE: 02/25/2013 REVIEWED BY: Mendez APN: BP#: 12120001 *VALUATION: $300 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex p PENTAMATION 1 ENRES USE: PERMIT TYPE: WORK / "D 1011) 06} � aw zoa&j- SCOPE Xfec:h. Plan Check Phonb, Plali Check Elec. Plaii Cheeic �/�. Penn it Fee: Plninb. Pevnit Fee' Etm, Permit Fee: Oihei,• Akwh, Insp. ; Other Phm1b hasp. Other Elec. kisp. . 111ech: lay. �Fnf:. Phinib, hi,ep. Fee; Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departmenss�(i.e. vianning, ruatic worlrs, rrre, x3antrary aewenuw•rrlct, actro"t nilnl,la natil nro nnlu ntt octlrttnfv. !'ntttart thv I)rnt fnr addn'I Info. FEE ITEMS (Fee Resolution 11-053 Eff. 711112) FE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $467.00 Window / Sliding Glass Door 1WINNEWNST New (Non -Structural) Suppl. PC Fee: (E) Reg. 0 OT 10701hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg, Q OT 0.0 Xs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 COnsIrliction Tax: ,4ch nnisfrative Fee: 1 1 0 G Work Without Permit? Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 T r(wel Docionentation Fees: Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SU$TOTALS: $1.50 $467.00 TOTAL FEE:.' $468.50 Revised: 01/01/2013 CITY OF CUPERTINO IRIPF F,CTIMATOR — BUILDING DIVISION ADDRESS: 10302 TERRY WAY UNIT #2 DATE: 12/06/2012 REVIEWED BY: SEAN APN: BP#: / *VALUATION: $5,000 ,PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: Multi -Family Dwelling Buildina is >3 Stories Yes No �PENTAMTAYTPION 1 R2REM IT E: i WORK REVISION #1: ADD 1/2 BATH UNDER STAIRS 18 SQ FT). SCOPE Hech. Plan Check Phrnm, Plcm C Elec, Plon Chee kfech. Permit Fee: Plninb. Peonil Fee: Elec. Permit Fee: Other Akc•h. Insp, Other Phimb Inch, Other Elec. htsp. Akch, 111 p. Fee: Plumb. hap, Fec. Dec. Insp, Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School r _ Iri. t 6 « d , th isifnrm"tinn nvailahle and are on1v an estimate. Contact the Dept for addn'l into. Axthct, etc. . 1nese cco we uuuu v.. s..., .._I ..... I.... FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/12) ...-........-...........___ FEE ._---- .-_ _ QTY/FEE ---- MISC ITEMS Plan Check Fee: $0.00 18 s.f. $600.00 Remodel, Bath (<=300 sf) IREMRESBAT A Suppl. PC Fee: Q Reg. 0 OT 0.0 his $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Coiulrticlion Tav A(br?lll ist rol4v i' ec :1 0 G — Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 A Tr(wel Doctnitentotion Fees: Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $600.00 TOTAL FEE: $601.50 Revised: 10/01 /2012 CITY OF CUPERTINO FFE ESTIMATOR — BUILDING DIVISION ADDRESS: 10302 Terry Way DATE: 12/02/2012 REVIEWED BY: Sean APN: BP#: *VALUATION: $10,000 *PERMIT TYPE: Building Permit r PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p PENTAMATION 1 R3SFDREM PERMIT TYPE: i WORK Kitchen remodel in Unit #2 209 sq ft. SCOPE Alfech, Plan CheckT_ Plruub. Plcru Check Elect. Plan Checlr 14ech. Permit Fee: Pltmrb. Permit Fce: Elec. Permit Fec: Other Adech. hasp. Other Phtmb hasp. Other Elec. Insp. lllech. hasp. Fee: Pfrnnb. htsp. Fee: Elec. Insp. Fee: NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, rare, ,Yanttary Never uistrtct, acttoot D'srt 'ct ei, Tltese ees are based on the relimina information available and are onlv an estimate. Contact the Dept for addn'1 into. FEE ITEMS (Fee Resolution 11-053 Ef. . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 209 s.£ $600.00 Remodel, Kitchen (<=300 sf) 1REMRESKIT Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:() Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00. Construction Tmx: AdInlntsiralive FeE: E) Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 A Trcrnel DoctnitE�ntativrt Fees: Strong Motion Fee: IBSEISMICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $2.00 $600.00 TOTAL FEE: $602.00 Revised: 10/01 /2012