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11030092 t CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10061 BIANCHI WAY CONTRACTOR:BIANCHI LEO J TRUSTEE PERMIT NO: 11030092 OWNER'S NAME: BIANCHI LEO J TRUSTEE 3393 CECIL AVE DATE ISSUED:03/18/2011 OWNER'S PHONE: 4082558738 SANTA CLARA,CA 95070-3736 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License Class Lic.# UNIT B- 180 SQ FT TO KITCHEN,INCLUDE M,E,P REPLACE WINDOW 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. Sq.Ft Floor Area: Valuation:$2000 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 APN Number:35907017.00 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 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 FROM LAST CALLED 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 ---"-- " - — granting of this permit. Additionally,the applicant understands and will comply Issued by---,::) Date: r �' , 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 materials for inspection. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Dale: 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 thr °l 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,S d 2553,:'' Section 3700 of the Labor Code,for the performance of the work for which this �- r✓ permit is issued. Owner or authorized o / 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 CONS CTION LE IN 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.) 7 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION --sts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. sting of this permit.Additionally,the applicant understands and will comply di all non-point source regulation per the Cupe no Municipal Code,Section Licensed Professional 9.18. Sigpature ate Building Department City Of Cupertino L2 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: ` PERMIT# p� l6,q ee_ Z OWNER'S NAME: Le(j 'tel PHONE # 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 RS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontract 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 Til ne racCorXigifait Date CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35907017. 00 DATE ISSUED. . . . . . . : 03/18/2011 RECEIPT 4 . . . . . . . . . : BS000012944 REFERENCE ID # . . . : 11030092 SITE ADDRESS . . . . . : 10061 BIANCHI WAY SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : BIANCHI LEO J TRUSTEE ADDRESS . . . . . . . . . . : 3393 CECIL AVE CITY/STATE/ZIP . . . : SANTA CLARA, CA 95070-3736 RECEIVED FROM . . . . : LAURA BIANCHI CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : BIANCHI LEO J TRUSTEE ADDRESS : 3393 CECIL AVE CITY/STATE/ZIP . . . : SANTA CLARA, CA 95070-3736 TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 2, 000 .00 1. 00 0 . 00 1. 00 0. 00 1BSEISMICR VALUATION 2, 000 .00 0. 50 0 . 00 0 . 50 0. 00 1REMRESKIT SQ FEET 180 . 00 570. 00 0 . 00 570 . 00 0. 00 1WINREP EACH 8 1 . 00 380 . 00 0 . 00 380 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 951 . 50 0 . 00 951 . 50 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 951. 50 VISA --------------- TOTAL RECEIPT 951. 50 PROJECT DATA - RESIDENTIAL COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(a)cupertino.org PROJECT ADDRESS APN# OWNER NAME . PHO E E-MAIL 42 k _} STRE� _D7DRESS ,_ � ��. CITY, STATE,41P FAX "' 1 APPLICANT NANJE 'r PHWI MAIL / Gff Q� , S, -* C Y,STATZI n /� F JkX 13 OWNER 0 OWNER-BUILDER 11 OWNER AGENT 1:1 CONTRACTOR C3 CONTRACTOR A/GlENT v❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT T7ESCRTE 01C b � 7 EXISTING USE(S): PROPOSED SE(S): OCCUPANCY(S TYPE OF PARCEL 'F---7 CONSTRUCTION: AREA: FIRE Y N WUI AREA: Y N FLOOD AREA: Y N SIESMIC AREA: Y N SPRINKLERS: t Existing Proposed Floor Area: First Floor: s.f. s.f. Second Floor: -s.f. Garage 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? e N Governing Codes: 2010 California Building Code(based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residelntial Code) 2010 California Plumbing Code(based on the 2009 Vniform,Plumbing Code) ,.rf`i f) 2010 California Mechanical Code(based on the 2009 Uniform Mechanica Cbdd')` 2010 California Electrical Code(based on the 2009 International )qode) 2010 California Energy Code 2010 California Green Building Standards Code ; ✓� r = Cupertino Municipal Code h,, �! j aE era ProjectData-Residential.doc revised 03/09/11 KE,CHome//Pl__anner Printout 3/16/116:34 P � Kitchen-Old - Plan View U0 0000-0836-0102 2381/4 1251/41 21115116 I 11 1!16 1 7/16 5 1 9B 5116 1 601/4 11 1 1 It 1271161 V J 0) L N ZZ M T r_ (� 1 T � T 14 ZZ C-0 ro y J Co CDM T T T T I,- LO Q J C M 1113 64 9A6 1 621/2 109 129114 All measurement in inches -K. �u ttp://kitchenplanner.ikea.com/US/UI/Pages/Printouts/VPUISummaryPrintout.htm Page 3 of E KEN Home Planner Printout � � _ , � 3/16/11 7:08 1F,�� Kitchen-Final Plan - Plan View I,jlN 0000-0836-3915 23 24 11193/41 24 1 9311/16 1 60 N N -MAL Ur ZZ � of N QO r N M M N CO r N N W Eli 07 2 CY) 0 CO r M r 47 kA N V) r~ r~ ti ti r r r r N N J (h M R 104314 1 133114 All measurement in inches . Y ttp://kitchenplanner.ikea.com/US/UI/Pages/Printouts/VPUISummaryPrintout.htm Page 3 of; KEA Home Planner Printout � � ��/� � 3/16/11 7:V8 FF ► %•••'YYY////�ttt��/ �'� Kitchen-Final Plan - Plan View V W 0000-0836-3915 238 - 24 1119 3/4 1 24 1 9311116 60 41 F21 51 1 N N Q2 /Lit N �O r N M M O r w y= Co Zk � 3 C-0 ` M - fti F� ti Ft F N Ch Ul 3 Ol M R 104 3/4 1 1331/4 All rement in inches ittp://kitchenplanner.ikea.com/US/UI/Pages/Printouts/VPUISummaryPrintout.htm Page 3 of G.L. PERRY CONSTRUCTION C.B. ELECTRIC Genera!Contracting License Ntrfgw 623 Stockton Avenue San Jose,CA 95126-2434 PROPOSAL CUSTOMER: Laura Bianchi Payne DATE: 310812011 ADDRESS: 10061 Bianchi Way Unit B Cupertino TO PROVIDE LABOR AND MATERIALS FOR THE FOLLOWING ELECTRICAL WORK: Complete electrical rough-in for kitchen remodel. (6) dedicated circuits- range/hood, refrigerator, microwave, disposal, general GFI (2) Note- no dishwasher to be installed (9) receptacle boxes- (7) receptacles, (2) GFI devices (at sink location) (3) switches - t (2) fluorescent under-cabinet lights (2) replace 2 of 3 existing fixtures with fluorescent fixtures (1) relocate existing phone outlet TOTAL PROPOSAL. $1,265.00 THANK YOU, C. B. ELECTRIC Office: (408) 287-3779 • C.B. Office: (408)287-3772 • Fax: (408) 287-3776 Shop: 623 Stockton Avenue San Jose CA 95126-2434 logOWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE- CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333 • building(a cupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITkApDRESS ; APN BP# /J/ OWNER NAME ` ? OWNERAD,QRESSrz ; C', r--1 �' ► C"�^ DESCRIPTION OF WORK: 'lex 1-4--i ' L t I L AJ We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you,the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- / wilder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. I understand building permits are not required to be signed by property owners unless they are responsible for t e construction and are not hiring a licensed Contractor to assume this responsibility. 3. 1 understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. A_�4. I understand Contractors are required by law to be licensed and bonded in California and to list their license "rSumbers on permits and contracts. 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. '6. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. f'78. 1 understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for f any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. Ot:;nerBuilderForm 2010.doc revised 04/14/10 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10061 bianchi way#B DATE: 03/18/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$2,000 ".PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: PERMIT TYPE: wORK sfd remodel kitchen non structural include M E P. Replace kitchen window. SCOPE Li NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 09-051 I fjf. 7 1.-70) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 $570.00 IREMRESKIT PME Plan Check: $0.00 0 # Window/Sliding Glass Door Permit Fee: $0.00 $380.00 1 WINREP Replacement Suppl. Insp. Feer') 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 Q Work Without Permit? Q Yes 0 No $0.00 0 Planning Fee: $0.00 Select a Non-Residential E) Building or Structure Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $950.00 TOTAL FEE: $951.50 Revised: 01/15/2011 . .. ... . ........ CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333 •buildin4(d)cugertino.org V ❑NEW CONSTRUCTION ADDITION/ALTERATION ❑ REVISION/DEFERRED SUB AL PROJECT ADDRESS APN# -7 - 13 OWNER NAME wV �� ? ' PHOISE� I GO arv4h1 0 j-1- Y STREE ADDRE CITY, S ,ZIP FA _ x L T APPLICANT NAME �� PHONEDiyr 6` STREE_T ADDRES • C ST SSVVCC I V �r•�/ ❑OWNER OWNER-BUILDER OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER TENANT CONTRACT % ,p LICEN -5-� . LICENSE TYPE 'O BUS.LIC# FAX V&J 8a 6 E-MAIL I %0-P m K 7.377 S T ADDRESS, CW,S p ZIP �� O ARCHITECT/ENGINEER NAME /JM— I LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHO DESCRIPTION OF WORK I v.: r 12 EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES/ OF CE II E QNL76 EXISTG IEW FLOr`n nEMOOTAL r AREA AREA UUA NET AREA n t�,..,.. ' BATHROOM /1 KITCHEN / OTHER J� �� tTg4Y v N � t u ,+^. a "'''� ,fir "y a N*•w,. REMODEL AREA REMODEL AREA REMODEL AREA '.:., i =.•--- rt-�, PORCH DECK TOTAL DECKIPORCH AREA GARAGE AREA. DETACH ��+ .-./"� ❑ ATTACH K DWELL&G UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? �NO PPE-APPLICATION ❑ YES IF YES,PROVIDE COPY OF PLANNER'S NAME: RECEIVED . .r jI)ON PLANNING APPL p NO PLANNING APPROVAL LETTER 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 Lead the Desc ption Wor and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to ildin on. I up rtino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent Date: 'L SUPPL zlingos: RMpply Q szi oNLY NewSFD or Multifamily dweAfor demolit n pe /forOUTMGSLW..,.• , PLAN:CHECK TYPE existing building(s). Demolition permit is required prior to issuance of buildings `° r r r f1YER THE COUNTER. ET BE7FLnnvc PLAP[REYIEw permit for new building. _EXPRESS �'PLKNNIN(C PLe�N'RE<VIEVt�,�� 3 + Commercial Bldgs: Provide a completed Hazardous Materials Disclosure _ ,a �" » y form if any Hazardous Materials are being used as part of this project. ;$ , D tP13stleivoRxs z t 2 9 _Copy of Planning Approval Letter or Meeting with Planning prior to Ell i"10 U.J.FIREnErT submittal of Building Permit application. _= Q l4[AJOR ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 03/03/11