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10100207 CITY OF CUPERTI KO BUILDING PERMIT BUILDING ADDRESS: 10145 MCLAREN PL CONTRACTOR:ZABEL CONSTRUCTION PERMIT NO: 10100207 OWNER'S NAME: JACK&ROSEMARY EARL 1658 YORK ST DATE ISSUED: 10/28/2010 vN S PHONE: 6509171333 SAN JOSE,CA 95124 PHONE NO:(650)465-7239 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class L Lic.#-76 ,z o 9 8 REMODEL 280 SQ FT TO KITCHEN,PANEL UPGRADE, RECESSED LIGHTING THROUGH OUT AND NEW Contractor Date "Z�'_�d FURNACE Jr I hereby affirm that I a 'censed 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:$75000 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:31621051.00 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 relatin; 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 /�� Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. l�_2g�CO 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 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 1,as owner of the property,or my employees with wages as their sole compensatio 1, 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 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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio%25505,C5533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this lQ . Owner or authorized agent- 00 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 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 mu;t 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, 's,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. a.anting 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 TY ct 1 OIALANANCE;- Al GI 6 1 - 24 - 1 98 ---DATE- I ipecific ons USI IThs e I tan tin S a 0 't" -z-- ltert,on.) C�l int jvjf�um make any j(hangie,, 'en pier i nisSlorl"im 'fit, G Lk)eryinG co on Wl ter.,UZom I if i ion t in 9 zostamping�,f �WS r d m v U. Arno, MINI* 1 0 JD � I �. �?1 W - _ cu M- 1 - 30 - 1 a ; � .. 1'a x f ck ri t _ c c ' LAf S } �v�' Kitchen At least 50% of the total wattage is high efficE cy: Fixture Type High efficacy Relaniping x Quantity = High-efficacy or Low-efficacy (y/n) wati:age wattage wattage ie•tu-SS&A x �_ _ 2 or ©� t�i�r�sse x _ = or — r lo:t�cs� wk�ter c��wN x = or x or K (Complies if A _> B) Total: A: 00 B: 3 Z6_ Compliant? YES`_ NO ❑ Additional requirements YES N/A NO lin re rated ICAT and certified 11 13 1:1Recessed fixtures installed m insulated ceilings a ASTM E283 or equivalent. Installation is airtight (caulking, gaskets). High-efficacy and low-efficacy fixtures are swi:ched separately. ❑ ❑ ❑ r, i Ed Bathroom(s) YES N/A NO All light fixtures are high efficacy. ❑ ❑ ❑ Incandescent fixtures are switched with manual-on/automatic-off occupancy sensors. M .❑ 0 Recessed fixtures installed in insulated ceiling;; are rated ICAT and certified ASTM E283 or equivalent. Installation is airtig it(caulking, gaskets). .❑ ❑ ❑ High-efficacy and low-efficacy fixtures are switched separately. ❑ ❑ ❑ I EgLaundry Room / Utility R00M YES N/A NO All light fixtures are high efficacy. Lq ❑ ❑ 6 a� .2 Incandescent fixtures are switched with marn al-on/automatic-off occupancy ❑ ❑ ❑ 6 U sensors. Recessed fixtures installed in insulated ceiling are rated ICAT and certified t v ASTM E283 or equivalent. Installation is airtight(caulking, gaskets). ❑ ❑ ❑ u -) High-efficacy and low-efficacy fixtures are switched separately. ❑ ❑ 11 c 5' UfGarage _ YES N/A NO J All light fixtures are high efficacy. ❑ ❑ ❑ Incandescent fixtures are switched with marnial-on/automatic-off occupancy €~ sensors. ❑ ❑ ❑ r i Recessed fixtures installed in insulated ceilings are rated ICAT and certified G r1d, ASTM E283 or equivalent. Installation is airtight(caulking, gaskets). ❑ ❑ ❑ I a' High-efficacy and low-efficacy fixtures are sw tched separately. ❑ ❑ 13 Y i R. r y _� � .. �:I{in .Aw, I � v J y I x wd.l'� .I{%.�1.�K G .f-, 0 rw •ta...,.n.,y�..�...... Bedrooms) YES N/A NO All light fixtures are high efficacy. ❑ ❑ ❑ Incandescent fixtures are switched with manual-on,'automatic-off occupancy ❑ 1:1sensors OR dimmer switch. Recessed fixtures installed in insulated ceilings are *ated ICAT and certified ASTM E283 or equivalent. Installation is airtight(caulking, gaskets). ❑ ❑ ❑ High-efficacy and low-efficacy fixtures are switched separately. ❑ ❑ ❑ 6d Living Room / Dining Room YES N/A NO All light fixtures are high efficacy. ❑ ❑ ❑ Incandescent fixtures are switched with manual-on,'automatic-off occupancy R sensors OR dimmer switch. M ❑ ❑ Recessed fixtures installed in insulated ceilings are -ated ICAT and certified s ASTM E283 or equivalent. Installation is airtight(caulking, gaskets). ❑ ❑ ❑ High-efficacy and low-efficacy fixtures are switched separately. ❑ ❑ ❑ Hallway(s) All light fixtures are high efficacy. � ❑ ❑ ❑ Incandescent fixtures are switched with manual-on.'automatic-off-occupancy--- ey___ sensors OR dimmer switch. ta ❑ ❑ Recessed fixtures installed in insulated ceilings are -ated ICAT and certified ASTM E283 or equivalent. Installation is airtight(ceulking, gaskets). ❑ ❑ High-efficacy and low-efficacy fixtures are switched separately. ❑ ❑ ❑ a Entry Area / Foyer YES N/A NO All light fixtures are high efficacy. ❑ ❑ ❑ m Incandescent fixtures are switched with manual-ontautomatic-off occupancy , sensors OR dimmer switch. M ❑ ❑ r Recessed fixtures installed in insulated ceilings are rated ICAT and certified ASTM E283 or equivalent. Installation is airtight(cz ulking, gaskets). ❑ High-efficacy and low-efficacy fixtures are switchec separately. ❑ ❑ ❑ Outdoor Space(s) YES N/A NO All light fixtures are high efficacy. ❑ ❑ ❑ — 4 Incandescent fixtures are controlled by motion sersor with a manual-on/off switch 0 AND photocontrol. ;n Building Department City Of Cupertino La 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: O��j ytiL �,� lc��,rZ PERMIT# 9F d02CD OWNER'S NAME: uL 'c r (, J PHONE # 7 —? GENERAL CONTRACTOR: be-, C BUSINESS LICENSE# ADDRESS: -7&'2 n ,w Go f} .,� CITY/ZIPCODE: C 7� *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. 1 am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millworkju, Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass/ Glazing Heatingo,• 1�1� Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal 13 Co ttia,,L, , e� w. Sheet Rock t / Tile ewu� tel•l-r //al Owner/Cot actor Signature Date CITY OF CUPERTINO FEE ESTIMATOR-- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: "VALUATION: 1$75,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex PENTAMATION 1R3SFDREM USE: p 1 1=)%; _�= PERMIT TYPE: WORK SCOPE Mech.Plan CheckF-0.0 hrs $0.00 Elec.Plan Check 0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Elec.Permit Fee: IEPERMIT Other Mech.Insp. 0.0 hrs $42.00 r� , _" Other Elea Insp. 0.0 hrs $42.00 NOTE: Thesefees are based on the preliminary in ormation G vailable and are only an estimate. Contact the De t or addn 7 info. FEE ITEMS (Fee Resolution 09-05I Ef. T"1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $(1.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl. PC Fee: (D Reg. 0 OT 0.0 hrs $(1.00 $570.00 1REMRESKIT PME Plan Check: $C.00 0 # Mechanical Permit Fee: $(.00 $126.00 IMFR=<100 Furnace,Forced-Air Suppl. Insp.Fee-.0 Reg. 0 OT 0.0 hrs $(.00 200 amps Electrical PME Unit Fee: $(1.00 $42.00 IERT<200 Services PME Permit Fee: $84.00 L19 # Electrical �';?Is(lttr'trttttr.� F $42.00 IBREMRECEP Recep/Switch/Outlets Acoustical Fee: 0 Yes (E) No $C.00 = # Electrical 0 Work Without Permit? 0 Yes 0 No $(1.00 $147.00 IBREmmT Fixtures,Lighting E) Planning F-ee: $(1.00 Select a Non-Residential E) Travel Documentation Fee: 1 TRA VDOC $4'91.00 Building or Structure 0 i Strong Motion Fee: IBSEISMICR $7.50 Select an Administrative Item Bldg;Stds Commission Fee: 1BCBSC $1,11.00 SUBTOTALS: $136.50 $927.00 TOTAL FEE: $1,063.501 Revised: 10/17/2010 CITY OF CUPERTINO ADDITION/REMODEL CUPERTINO FEE SIZHEDULE APN# Date: Is a 2 Id unit being added? Yes ❑ No If Yes, please fill out the permit application for 2,dunit. Building Address: Mailing Address (if different from building address): Owner's Name: Phone# : Contractor: IPhone#: Z�-L,,0k C6,1S4C •-,5 Fax#: Cupertino Business License: State Contractor License#: 6 Contact: .� Phone#: �3-t�, y 6I- 2 3: Fax#: ct 0 2 SIS' Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): If 2,500 sq. fL or less, compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq. ft., a complete Landscape Project Submittal is required. Compliance Method: ❑ Plant Type ❑ Water Budget Building Permit Info: Bldg. Elect. ® Plumb. [21 Mech. 2 Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled (not including addition)? — C,�.� h�v►c�e- 42 1 1y tits Remodel Includes Re-Roof: Yes ❑ No [] If yes list number of squared 9 sw.� �'3 Remodel Includes Structural: Yes ❑ No [] 3 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_9 L Bath Other Type of Construction (Usage Class): Occupancy Type f l_ 7 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V.B Q'" Valuation: 5 Please check this box if the project is a Project Size: Express 9�andard ❑ Large ❑ rIa'or ❑ second-story addition ❑ Please complete relevant portion of the Green Building Checklist & attach it to the application or if applizable, Green Building Points Achieved: include in plan set& the sheet index. Revised )5/18/10