Loading...
13030075 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1297 ASTER LN CONTRACTOR:BATH FITTER PERMIT NO: 13030075 NORTHERN CALIFORNIA OWNER'S NAME: DRINKWATER JOSEPH L AND BARBAR 2118 ZANKER RD DATE ISSUED:03/14/2013 OWNER'S PHONE: 4085646373 SAN JOSE,CA 95133 PHONE NO:(408)834-1111 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL11 License Class Lic.# 3 �cI.3 REPLACE WATER MIXING VALVES IN(2) BATHS.REPLACE Contra'to Date SHOWER PAN&WALL SURROUND IN MASTER BATH I hereby a rn that I am licensed under the provisions of Chapter 9 (commen ng 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:$3500 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:36611088.00 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 DA F OM 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 3. /c/ /3 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: r with all non-point svurce r gulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date f2 6 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 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.70441 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 B r Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the i Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 5534. Section 3700 of the Labor Code,for the performance of the work for which this / permit is issued. Owner or authorized agent: Date: 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 understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingecupertino.ora '` misc LUMBING EJUBaiANICAL DELECIMCAL ❑MIMISCELLANEOUS PROJECT ADD S � �' APN# OWNER NAME � -n �/ FROM 754 —!0373 E� STREET AD REESSN CITY STA ZtP 9 - } 1 ME FAX CONTACT NAPHONE E-MAIL(/ STREETADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑OWNERAGENT CONTRACTOR ❑CONTPACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE ER LICENSE t'�E BUS. # CO ANY NAME E-MAIL STREET ADDRE' G[ lY.STATE,ZIPAT-Jk115112- ism S C q 5 1j ARCHITEGT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME' E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF or DUPLEX ❑ MULTI-FAMILY PRON=IN WIDLAND ❑ YES 7 PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING. ❑COMUMCJAL URBAN INTERFACE AREA ❑NO FLOOD ZONE ❑NO EICHLFR HOME? ❑NO DESCRIPTION OF WORK n q ve Lz� & I la, TOTAL VALUATION. �7� V RECEIVED BY By my signature below,I certify to each the fo I am the property owner or authorized agent to act onowner's behalf. I have read this application and the information I have p correctt have read the Description of Work and verify it is . I agree to comply with all applicable local ordinances and state laws relating to b ction. I authorize representatives of Cupertino to enter the above-identiff property for inspection puRmes. Signature ofApplIcant/Agent Dau: 3 I:EMENTAL INFORMATION REQUIRED OFFICE USE ONLY OVER-THE-COUNTER e. Y ❑ EXPRESS U ❑ STANDARD V ❑ LARGE n. ❑ MAJOR MEPMucA, 1011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: DATE: 03/14/2013 REVIEWED BY: mendez APN: BP#: ''VALUATION: 1$3,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1 RPFIX USE: PERMIT TYPE: WORK REPLACE WATER MIXING VALVES IN 2 BATHS.REPLACE SHOWER PAN &WALL SURROUND SCOPE IN MASTER BATH ;[iiiUM, a aa'`_ , ✓ Ag NMI dJ,-M, 14 L1ech. Man Check Plumb.Plan Check 0.0 hrs $0.00 Elec.-Plan Cheek L1ec:h.Permit Fee: Plumb.Permit Fee: IPPERMIT Dec.Permit Fee: FOtheF)Yhce;19ech. Insp. r Plumb Insp. 0.0 hrs $45.00 (Tiber Elec.Insp. lfech.Insp. Fere: Plumb. Fist.F',e: Elec,Insp,F'ee NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS(Fee Resolution 11-053 E . 7ff 11112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Plumbing Suppl.PC Feer (j) Reg. ® OT 0.0 hrs $0.00 $20.00 1BPFIXTURE Fixture or Trap PME Plan Check: $0.00 0 1 # Plumbing Permit Fee: Hourly Only? ®Yes Q No $0.00 $0.00 IPRSEWER Sewer,Sanitary Suppl. Insp.Fee-0 Reg. ®OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 (;onsiruction:7iax: F-1 Administrative Fee: IADMIN $42.00 Work Without Permit? 0 Yes (j) No $0.00 0 Advanced Planning Fee $0.00 1 1 1 hours Inspections Travel Documentation Feer 1TRAVDOC $45.00 $133.00 1STINSP Inspection,Hourly Strong Motion Fee:. IBSEISMICR $0.50 Select an Administrative Item. Blda Stds Commission Fee: IBCBSC $1.00 , , y $133.50 $153.00 � = $286.50 Revised: 01/01/2013 Building Department City Of Cupertino 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: I7 �-7z- 4-A-I /er PERMIT# OWNER'S NAME: y1pl �InttJ4 PHONE# GENERAL CONTRACTO : BUSINESS LICENSE ADDRESS: Z114S A-Nll-CR, 12D CITY/ZIPCODE: �!S'! *Our municipal code requires all businesses working in the city to have..a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BF:'.SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL S TRACTO .R HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. / J� I am not using any subcontractors: 77 1 - Signature Date Please check applicable subcontract6r4 and complete the following information: t/ 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/Contractor Signature Date i.