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11020108 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1469 POPPY WAY CONTRACTOR:MALESKI PERMIT NO: 11020108 GREGORY J AND JOAN M T OWNER'S NAME: MALESKI GREGORY J AND JOAN M T 1469 POPPY WAY DATE ISSUED:02/28/2011 ,WNER'S PHONE: CUPERTINO CA, 95014-5316 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# f— (— (� MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REMODEL 200 SQ FT TO KI'T'CHEN,NON-STURUCTURAL (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:$30000 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:36615024.00 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 F74,,L^ AST 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: 2-0 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: Date: 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. 1 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 1 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 agent: Date: permit is issued. 1 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 1 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.) Qin n� 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 ,mnify and keep harmless the City of Cupertino against liabilities,judgments, .,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 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36615024 . 00 DATE ISSUED. . . . . . . : 02/28/2011 RECEIPT #. . . . . . . . . : BS000012783 REFERENCE ID # . . . : 11020108 SITE ADDRESS . . . . . : 1469 POPPY WAY SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : MALESKI GREGORY J AND JOAN M T ADDRESS . . . . . . . . . . : 1469 POPPY WAY CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5316 RECEIVED FROM . . . . : G. MALESKI CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : MALESKI GREGORY J AND JOAN M T ADDRESS . . . . . . . . . . : 1469 POPPY WAY CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5316 TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 30, 000 . 00 2 . 00 0 . 00 2 . 00 0 . 00 1BSEISMICR VALUATION 30, 000 . 00 3 . 00 0 . 00 3 . 00 0 . 00 1PPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1PRREPIPE NO OF FIXTURE 1 . 00 11 . 00 0 . 00 11 . 00 0 . 00 1REMRESKIT SQ FEET 200 . 00 570 . 00 0 . 00 570 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 670 . 00 0 . 00 670 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 670 . 00 chk --------------- TOTAL RECEIPT 670 . 00 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# 1) 0 20 I � OWNER'S NAME: PHONE# 2-!&:_U_— GENERAL ScS=GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: d74e,--..c.w r 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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork TO Cement Finishing Electrical T Excavation Fencing Flooring / Carpeting Linoleum /Wood Glass / Glazing Heating TB_�V Insulation Landscaping Lathing Masonry Painting /Wallpaper TEP Paving Plastering ' Plumbing ] Roofing Septic Tank Sheet Metal Sheet Rock Tile Z��Q z Owner/Contractor Signature ate CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 1469 poppy way DATE: 02/28/2011 REVIEWED BY: bobs. APN: BP#: *VALUATION: $30,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION USE: PERMIT TYPE: 1 R3SFDRE; wORK kitchen remodel non structural SCOPE t 1"='r A Plumb.Plan Check 1 0.0 hrs $0.00 - 7 '�rclt_ Prr rr=ir 1=c Plumb.Permit Fee: IPPERMIT I:r"arc r"'r° rriir f Other Plumb Insp. 0.0 hrs $42.00 C�ttF.>� t;i�c ins 3. Li I NOTE. Thesefees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS lFee Resolution 09-051 L, 77%1%10 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 $570.00 IREMRESKIT PME Plan Check: $0.001= # Plumbing Permit Fee: $0.00 $11.00 IPRREPIPE Re-Pipe Interior Suppl. Insp. Fee.e Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $42.00 on.So-vcfion l a", Acoustical Fee: 0 Yes (F) No $0.00 Work Without Permit? 0 Yes E) No $0.00 0 Planning I;ee: $0.00 Select a Non-Residential E) Travel Documentation Fee: ITRA VDOC $42.00 Building or Structure 0 Strong Motion Fee: 1BSEISMICR $3.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $89.00 $581.00 TOTAL FE $670.00 Revi ::7 2011 OWER-BUILDER DISCLOSURE FORM CCdPERTtNO 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: SITE ADD SS� APN 3�6 —Cl R32P te W631 OWNE AME r OWN D SSS r r - ` DESCRIPTI N F WORK: 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.) 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" 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. � '� k.2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. �3. I 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. V 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license mbers 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. j6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federaI 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. 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. pani8nancial understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. O,m,i7erBuilderForni_2010.doc revised 04/12/10 I understand I may obtain more information regarding my obligations as an "employer" from the Internal evenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand 1 may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am t e part legal and financially responsible for oposed construction activity at the following address: Ce'-w,. V e e ApI agree that, as the party legally and financially responsible for this proposed construction activity, I will abide Q� applicable laws and requirements that govern Owner-Builders as well as employers. .ted �a. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the infotion I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information .) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner: Date: AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 014'77-erBilildel'F07-77z_010.doc revised 04112110 RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: 3 6 6 `r Name of owner. C;�f ® " le-s /11 Project address. z TSF`' `z Contact person. Phone. Fax. Net square footage of lot. Existing Proposed Square footage: First floor: Second floor: _ Garage: TOTAL: �" ;; Are there at least two 10 foot by 20 foot clear spaces inside the garage-7— Y Is privacy protection planting required for the project? Y N r' Build it Green Total Points On what floor(s) is work being done? 4 1 , r> Brief description of work. Code editions:2007 CBC Q�N)2007CFC i(a)-N)2007 CMC (WN) 2007 CPC (Y N)2007 NEC N) c, l Effective 1/1/08 -s4rw Fr V I 4 1 4i.y k }r-Y�,, r, 4 F }(ry' .t. f�a t L Plan Review Process Work Book Page-8-Revised 8/05/08 ... CO i i N i 001— -4 Ul O ' O N cn I 0 i N y w 0 cn �I 4 _ - - - - - - - - - - - - - - - - - -- - - - - - - - - N W W O � O Ooi� G)D rDm zO .t . v �DIm g � cn p a S: `�ti;3 fir..%` , < Dmf O D Ln ODIC x N a w m c § ;;, 4 0 oC) L w -n 00 F i i G7 a cn 0 C G) cn D o r W C n = p _ 0 Zm w � C w� Dn m rCOW v, a D �v �_ = —I c DZ Z O ZO C— r- m = pC A' m C7 m Dn _ m z D O < LD DNO r X m z a (DD 4h. v qp qp � � - 94 Own ? I o O A(D �. O cn . tutcnen Kemociel Submittal Requirements Three(3)sets of plans wet-signed by the designer/architect,contractor,or homeowner responsible for preparing the plans. A minimum plan size of 8 1/2"x 11"is required for all submittals. All plans submitted must be legible because they will be microfiched as a permanent record after the project has been completed. Provide copies of the cabinet layout plans if available.Contact the Building Inspection Division at(650)903-6313 if you have additional questions. X14asic Code Re uirements $E Two (2) 20 amp dedicated circuits for counter receptacles. Every counter space 12"or more in width shall have an electrical receptacle. Counter receptacles shall be installed no more than 4 feet on center, and there shall not be more than 24"to a counter receptacle from any point on the counter. No equipment(such as dishwashers, garbage disposals, or vents shall connected to the two 20 amp counter circuits. All counter receptacles must be GFCI protected. 09X,Islands/Peninsulas greater than 12"depth x 24"width must have at least one electrical outlet. Dishwasher and Disposal require separate dedicated circuits. The Residential Lighting Standards require that at least half the lighting watts installed in a kitchen must be consumed by high efficacy (fluorescent/LED) luminaries. All lighting that is not high efficacy is required to be a dimmer switch. For example: if 150W of high efficacy lighting is installed,no more than 150W of low efficacy lighting can be installed.Lighting installed inside a cabinet(pantry) is NOT considered part of the kitchen lighting for calculating 50%as long as it is below 20W per linear foot with a maximum of 360W or 18 linear feet. Contact the Building Inspection Division for information. Electric oven and range require separate circuits. ❑ Garage to kitchen openings-Door to garage required to be a minimum 13/8"solid core, or 20 minute fire rated self closing/self latching door. Garage side of wall must have a minimum covering of 5/8"Type X sheetrock. ❑ Skylights -operable skylights must be 10 feet from plumbing vents or three feet below the vent termination. Skylight installation must provide a roof framing detail and the ICC listing number for the skylight. Other Related Handouts: 1. Smoke detector requirements Permit fees will be based upon the Building Inspection Division's square footage cost,if there is no new framing construction and/or moveriient of plumbing fixtures, electrical appliances or cabinets. Projects not meeting these requirements will have fees calculated based on the applicants stated project valuation. 01/01/2010 1469 POPPY WAY; CUPERTINO, CA KITCHEN REMODEL Work Description Revised 2/27/2011 no A Gregory J. Maleski -� ( 1469 Poppy Way Cupertino, CA 95014 gregmal eski(a dslextreme.com Copper Re-piping 1. Replace 3/4" supply pipe from pressure regulator above ground at front of house to rear hose bib on patio. 36 ft. 2. Replace stubs from cold water supply under floor: 3/4" line to hot water heater in garage 10 ft. 1/2" line to laundry in garage 10 ft. 1/2" line to toilet in downstairs bath 4 ft. 1/2" lateral line to cold water union for upstairs shower 10 ft. 1/2" line to kitchen sink 5 ft. 3. Replace %2" hot water stub to laundry in garage 10 ft. Note: Copper hot water supply to kitchen sink/dishwasher exists. Copper cold water supply to downstairs vanity exists. Copper cold water supply to kitchen refrigerator exists. All upper floor copper re-piping to both bathrooms exists. All IPS-to-copper unions accessible at or under 1 st floor. Owner secures permit. Copper stubs to a garage water softener exist. All connections are exposed(prior work). � ` Drywall to be repaired by owner. ,i 5'Y'., ..- .._... .. Other plumbing work: Change laundry drain into main sewer from 1 1/2"to 2" (remove corner obstacle). F' P. ., ,,i' Page 1 of 3 1469 POPPY WAY; CUPERTINO, CA KITCHEN REMODEL Sbeetrock 1. Install wallboard as required behind kitchen cabinets 2. Install wallboard on kitchen ceiling (existing family room ceiling sheetrock to remain in place) 3. Install wallboard along three walls of family room 4. Tape and texture ceilings and walls, kitchen and family room 5. Install wallboard and tape as required in garage areas to cover re-piping k-e-Vt7- a, r) ks Or'. i Page 3 of 3 CITY OF CUPERTINO ADDITION/REMODEL CUPEkTINO PERMIT APPLICATION FORM APN # �'— Q Z 4- Date: Is a 2" unit being added? Yes ❑ No If yes, please fill out the permit application for 2" unit. Buildin ' g Address: /4C, ;-- Fe.; � ,Alm> Mailing Address (if different from building address): Owner's Name: Pbone# � Z Q Contractor: .17 Phone#: Fax #: Contractor License#: Cupertino Business License#: Contact: Phone#: Fax #: Buildin,g.�P it Info: Bldg. Elect. Plumb. Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled (not including addition)? e e__ ,h „NCA/) 's:`W`Alw_o_� 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 ,2,00 Bath Other Type of Construction (Usage Class): Occupancy T e: I-A, I-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Valuation, �© e - a Please check this box if the project is a second-story addition ❑ Project Size: Express Standard ❑ Large ❑ Ma'or❑ 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