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09090208 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7648 KIRWIN LN CONTRACTOR:PRECISION REMODELING PERMIT NO:09090208 OWNER'S NAME: KATHLEEN M DIERKS FAMILY TRUST 1214 SIERRA MAR DR DATE ISSUED:09/29/2009 iER'S PHONE: 4089739487 SAN JOSE,CA 95118 PHONE NO:(408)592-0520 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT T_ PLUMB License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date JOB DESCRIPTION:REMODEL KITCHEN COUNTER,RE-FACE I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions CABINETS,TILE Code and that my license is in full force and effect. FLOOR,REPAIR SUB-FLOOR IN BATH,THE FLOOR.NEW WINDOWS,INTERIM DOORS,FRONT DOOR,CASING, 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. 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 Sq.Ft Floor Area: Valuation:$6000 permit is issued. APPLICANT CERTIFICATION APN Number:35922012.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by:.�� DaWe1-2 --4.r Signature Date LI OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,1 shall maintajR compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Healt Saf Code,Sections 25505,25533,and 25534. 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 O r or a thorized agent: �f-07 forthwith comply with such provisions or this permit shall be deemed revoked. �� Dater_ "'/ APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save mify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address L and expenses which may accrue against said City in consequence of the granting of this ermit. itionally,the applicant understands and will comply with all non- in sourcAeotegulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. G S 1 understand my plans shall be used as public records. Signature Date / Z/ v Licensed Professional CITY OF CUPERTINO 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35922012 . 00 DATE ISSUED. . . . . . . : 09/29/2009 RECEIPT #. . . . . . . . . BS000008786 REFERENCE ID # . . . : 09090208 SITE ADDRESS 7648 KIRWIN LN SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER KATHLEEN M DIERKS FAMILY TRUST ADDRESS 7648 KIRWIN LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4357 RECEIVED FROM K DIERKS FAM TRUST CONTRACTOR REZA BANIKAZEMI LIC # 23736 COMPANY PRECISION REMODELING ADDRESS 1214 SIERRA MAR DR CITY/STATE/ZIP SAN JOSE, CA 95118 TELEPHONE (408) 592-0520 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- - 1BCBSC VALUATION 6, 000 . 00 1 . 00 0. 00 1 . 00 0 .00 1BPFIXTURE NO OF FIXTURE 1 .00 16 . 00 0 . 00 16 . 00 0 . 00 1BREMFIXT NO. FIXTURES 1 . 00 126 .00 0 . 00 126 . 00 0 .00 1BSEISMICR VALUATION 6, 000 . 00 0 .60 0 .00 0 . 60 0 .00 1EPERMITFE FLAT RATE 1 . 00 84 .00 0 . 00 84 . 00 0 . 00 1PPERMITFE FLAT RATE 1. 00 84 . 00 0 .00 84 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 .00 0 . 00 42 . 00 0 . 00 1WINREP EACH 8 2 . 00 1520 . 00 0. 00 1520 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 1873 .60 0. 00 1873 . 60 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CASH 1, 873 .60 --------------- TOTAL RECEIPT 1, 873 .60 �SIDEN IAL P 0"'IGOE RSHEET £ Y Assessor's Parcel Number: 3 5 el Vz D 2- Name Name of owner. IGAr'C14:!.-a r.4 A4 0 t Eme z �' t` y 2t4 SI— Project address. 7 `r8 k 4 GJ tPIL- F. Contact person. A 4 6" 1 _Phone. �o S ` 's 7 Z - e>5 2 O 1� Fax. Net square footage of lot. g 712 Existing Proposed Square footage: First floor: Second floor:-.--- Garage: loor:Garage: TOTAL: re there at least two 10 foot by 20 foot clear spaces inside the g=7?--� ----'N Is privacy protection planting required for the project? Y N On what floor(s) is work being done? IST- Brief description of work. k i 7u4F---4 C-yzk ►T+A2 k t i WWW R 1ef X1W, "' - .A Jr-46w-, /Va 6"rt.-q V. G(,Nw� �3.jj,� GtiC�f" !=r ak 3 T' Fu-�tsr�•�►,' Code editions:2008 CBC -N)2008 CFC (V-N)2008 CMC N) 2008 CPC N)2008 NEC -N) APPROVED Effective l/l/V" IN ACCORDANCE WITH [HE CITY OF CUPERTINO CODES AND ORDINANCES Y DATE_._._'— SIGNE __. __ This set of plans and specifications MUST ' , be kept on the iob at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Department, City of Cupertino, �iv - The stamping of this plan and specifications „ SHALL NOT be held to permit or to be an approval of the violation of any provisions of any City Ordnance•or Mate I aw. Plan Review Process Work Book Page-8-Revised 1/1/08 L O O co4-1 C: 4�* O N V •3 •_ 0 0 x m 00 m C14 � q v 11 m l0 Cl) o m m o OC I- Ln k6 iD s V 4-0 o m o m X \` m X m �l t0 M tD m U i vi p_ c OX 0-EXO-E 0 3 s 4J W x O U `- 'Q LL O c m 3 U. o ip c m OX 0-EXO-E O .c 00 +v_.+ m u w Y N f° 4A N a c v E Jou :J to a� t E -a m +' o O cc � c � OD +'r > > � J � U OfC . CL NO O 'c L .� 00 00 N T-I O L 3 N a--I 3 cA c OX 0-bXO-9 O c m L C V1 0 L J 'Op CL O U N �SZDETIAL PR( JE ' NCQE1Z HEED � Y! Assessor's Parcel Number: 3 5 Name of owner. KiAni(-1FF*J Ad 011ZAA-s Project address. Contact person. J?A ti 3 _Phone. 408 —a. S cS 2 Fax. Net square footage of lot. g 712. Existin Proposed i Square footage: First floor: Second floor: Garage: TOTAL: re there at least two 10 foot by 20 foot clear spaces inside the g \'--"N Is privacy protection planting required for the project? Y N On what floor(s) is work being done? 1S7 Brief description of work. IC Tt4 f-.nl COWNT" /Cr i c���✓ /L �^�'�'�►� ���-�J LI F c oA ^ we ,n 4V 6am,Iva o"rr..V. Code editions:2008 CBC -N)2008 CFC N)2008 CMC (DN) 2008 CPC N)2008 NEC N) Effective 1/1/08 OBM ,' � ET Plan Review Process Work Book Page-B-Revised 1/1/08 L O c r4 C J � 0 N c0 0 m x m N co00 }; o o qc* Q vx t� l0 o cep m DC I� cn Ib V N 0 m 6.L x 9 O M 4o _ ..c m oX M lD m U � �n p_ C OX 0-EXO-E 0 x O U L 'O r- t1- O L X 3 LL x ip m ox 0-EXO-E 3 O 0O m U w �C O 12 IOLO N CL E J J °n o *= +r — N a, dA s o+� 0 N OD m c -a > a � J � U r O to fC a C -c L �O 00 W '�, ri 0 O Ln 3: r-1 ++ 3 tin c ox O-t XO-9 0 c m C N o LU Q� Q 0 U V) CITY OF CUPERTINO ADDITION/REMODEL CUPEkTINO PERMIT APPLICATION FORM APN # 3 5*9 _ 22-- ©17— c Date: Cy _ 2 (4- 0c) Is a 2" unit being added? Yes ❑ No X If yes, please fill out the permit application for 2" unit. Building Address: ..�048 L!fi uj,^1 LAwF- Mailing Address (if different from building address): Owner's Name: Phone# K A-ml.� - D e « -''mss 7- --973-'N67 Contractor: Phone#: Piz 1Et..twm4 9R-1to,OA'&t'04- Fax#: v$- $f2 OS Contractor License#: -19/0$ Cupertino Business License#: Contact: ,, p Phone#: -t�$ 5 2 -02, �- 0 ;� RAR �7 Fax#: ` Building Permit Info: Bldg. [Cl,,- Elect. Eg --- Plumb. �f Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific): g/A, What is being remodeled (not including addition)?Vs M"ei Cotta 1A11t 1?f- ' c CA41A100-13 4 r� Fc.oa�t R�i�#�t gyp-FcraaR �.v +n�►1'r3cE F{.w�t . nl F� i �vs• 1,At TSR 104 Opa 1:S'� �/�aKf" �Z t GA.st�!4� �b�BJ,�+a,of►• 1i�15►.�+'1slt f�0 c�!opo Remodel Includes Re-Roof. Yes ❑ No ❑ If yes list number of squares Remodel Includes Structural: Yes ❑ No M' Do you have the pre-application planning approval? Yes ❑ No [f If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen Bath Other Type of Construction(Usage Class): Occupancy Type: 1-A, 1-B ❑ IUIII/V-A ❑ IUIII B, IV-HT, V-B [�-- S �aG f«Amt4Y - 1)6 JA 40 Valuation: (000 Please check this box if the project is a � ��; L %L�' second-story addition ❑ Project Size: Express 0 Standard �] Large ❑ Major ❑ 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 0 Revised 07/06/09 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft DECKS 1R3SFDADD OR 1R3SFDREM 1 DECKWOOD Deck (Wood)-Each B (Each) 1DECKRAIL Deck Railing-Each B (Each) GARAGES 1R3SFDADD OR DETACHED 1R3SFDREM 1 GARDTW<=1 K Wood Frame up to B 1,000 SF (each) 1 GARDTM<=1 K Masonry up to 1,000 SF B (each) 1BCONSTAXR Construction Tax Res (new detached garage) PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1PATIOWOOD Wood Frame up to 300 B SF 1 PATIOMETAL Metal Frame up to 300 B SF 1 PATIOOTHER Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR & SUN ROOMS 1R3SFDREM 1PATIOENCLW Enclosed Wood up to 300 B SF 1PATIOENCLM Enclosed Metal up to 300 B SF 1PATIOENCLO Other Enclosed Patio up B to 300 SF 1 COVPORCH Porch Covered-Each B (Each) REMODELS 1R3SFDREM 1 REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 300 SF check 1 REMRESBAT Bath Remodel up to 300 B " SF 1REMREOTH Other Remodel up to 300 B " SF C,v / l.3 PI Fly CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1REMRES2 Remodel Residential B Greater than 1000 sq ft 1REMRES3 Remodel Residential B Greater than 2500 sq ft. 1REROOFRES Residential Re-roof Each B 100 SF REMODEL PLNCK 1 STPLNCK (1-3 for Standard Plan Check B NOT FOR OVER THE remodel) COUNTER PLAN CKS. WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 WINREP Replacement windows B (ea 8 windows) 1 WINNEWNSTR New Window (non- B structural) 1 WINMEWSTR New Window (Structural B Shear Wall/Masonry) 1 WINBAYSTR Bay Window (Structural) B SKYLIGHTS 1R3SFDREM 1 SKYL<10 SF Skylight less than 10 sf B 1 SKYL>10SF Skylight greater than 10 B sf or structural 1STAIRS Stairs-first flight/ea addt'1 B lEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln E Ck (hourly) CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1 MECPLNCK Stand Alone Mechanical M Pln Ck (hourly 1PLMPLNCK Stand Alone Plumbing P Pln Ck(hourly) j 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES j Commission Fee 1BSEISMICRE Seismic Residential B 1TRAVDOC Travel &Documentation B 1BUSLIC Business License B Community Development 10300 Torre Avenue '; .. Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �M TINO Building Department JOB ADDRESS: PERMIT # 12 (`D'c VZO ;' OWNER'S NAME: 016Arj r-� PHONE # Og - z-"Z u GENERAL CONTRACTOR: &4 R FAX # I am not using any subcontractors: 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock T' a Owner/Contractor Signature bate