Loading...
12030056CITY OF CUPER"I INO BUILDING PER1NUT ]Ill] LDINGA DDRESS: 7683SHADOW111U.LN CONTRAC'MR: ERIC KALLIO P E.101ITNO: 12030056 CON"I'RAC'FOR O\YNF.R'SNAMF,: ML'ACHAMROBERTLANDJOANNIi 2345 OLLA Cf DATE ISSOED: 03/12/2012 OWNER'S Pl IONF,: 4086912902 GIIMM" CA 9.1020 PHONE NO: (unY) 39x-5994 ❑ LICENSED cOs"I'RACfOR'S I)FCI,AItA'll(1N f r f license Class_ Li<.N SS'f -�g� BUILDING reI(ALF BLDG rfPLuans ❑ Contractor EL2{,�_K,�L(UO__ ;,d ��)z-�J 2— Al 11 RES1DeNTIA1,r COa I BI ERC IA I.r 1 herehy affirm thal I out licensed under the pi-misimns of Chapter 9 JOB DBSCRI PTION: BAI"I(ROOM RIiM0131:1. (35 SQM NON SIRIICIURAL. NO (emnmcncing with Section 7000) of Division 3 of the Business & Professions LAYOUI' CHANGE, Code:md that my license is in full force and effect. I here[), affirm under penalty of perjury one of the following two declarations: ' I have and will maintain a certificate of consent to sell' -insure for Worker's Compensmion, as provided for by Section 3700 of the Labor Code, for the performance al the work for which this pemnit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: \':thin tion: S10000 Section 3700 ofthe Labor Code• for the performance of the work for which this pcnnit is issued. APS :Somber: 36225(117.00 Occupane,'fy pe: ,\I'I'hICA S"I' Clil('I'1 FIC,\'1lOS' I certily that 1 have read this application :old state that the above information is correct. I agree to comply with all city and county ordinances:aid state laws relining to building construction.and hereby authorize representatives ofthiscity toenter I'LRA'IIII.\PIIZLSII'\YORK ISNOISI:SRILD upon tic above mentioned property for inspection purposes. (We) agree to save indemnity and keep harndess the CityofCupertino against liabilities. judgments, WITHIN HIN 180 DAYS OF PI:RIMI I ISSUANCL OR costs, andexpenses which ma) accrue against said City inconsequence ofthc ISII DAYS 1'IZON1 I::SSI CALI.ED INSPECTION. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Issued by: U:ue:3/2 Sigmnurc� T"^�-l.aa Date _�tz 17_ ❑ o\rNf:l(-Buu.D1;R uFCL,utn'ncm Rh: ROOFS: All molls shall be inspected prior to any cooling material being installed Ifo roof is 1 hereby affirm short :un exclaim Train the Contractor's License Law for one mf installed without first obtaining ail inspection. I agree ai remove all new materials lax the following loo reasons: inspection. 1• as owner of the property, or my employees with wages as their sole connpensmion. will do the work, and the structure is not intended or ol7cred for sale (SecMM4. Signature of Applican : Date: Business ,h Professions Code) I, as owner of the property, as exclusively contracting with licensed contractors to construct the project (Sec.70,14. Business C Professions Code). ALL ROOF CONTRINGS'10 ISF CLASS ",\" OR IIP:I-I ER I hereby affirm under penally of perjura' one of [tic following three derlannions: IL\%,\I(DODS .\L\'1 EJOAI S DISCLOSIIRIi I have and will maintain a Certificate of Consent to sell -insure for Worker's I Iha,c read (he hazm'dous materials requirements muter Chapter 6.95 at tile Compensation• Its provided for by Section 3700 of the Labor Code, lair 0w California I health S Safety Curie. Sections 255115• 2]533. Hast ?.5.534. 1 will maintain perfonnancc of the work for which this permit is issued. coni pl ill iee with the Cupermion Municipal Code. Chapter 9.122 and mile I lealilm & I have and will maintain Worker's Compensation Insurance, as provided for by Solely Code, Section 25532(a) should I more or handle hazardous oan•rial. Section 3700 of the Labor Code, for the performance of the work for which this Addiliun:dlp, should I use equipment or devices which emit Iurzardous air permit is issued con ma nli nam, ah s defined , mile line Area ,Mir Onality Management Disr'icm I will h maintain compliance kith the Cuprninu Municipal Cade. Chapter J.I_and the I certify that in the perlormance of the work for which this permit is issued, I shall I health A' Safety Cade. Sections 2550.5. 25533. and 25534. nom employ any person In any manner sin as to become subject to Lite Worker's Compensation lasts ofCalifornia. If, after making this certificate of exemption, l Ow�-S or cud�,r' rd �+...... become subject to the Worker's Compensation provisions of the Labor Code, I in st Ste" 1 Dole: lorthwith comply with such provisions or this pernitshot[ be deemed revoked. CONSTRUCTION LP.S'DING AGENCY APPLICANT CERTIFICATION 1 hereby:dlirm that there is a construction lending agenp. for the perlommance of work's I ccnity that I have read this application :old state that the above information is for which this pcnnit is issued (Sec. 3097, Civ C.) correct. I agree to comply with all cityand county ordinances and shine laws relating Lender's Sone to building construction, and hereby uuthorizc representatives of this city to Hoer upon the above mentioned property for inspection purposes. (We) agree to save Lender's Adubrsc indenmily and keep harmless the City of Cupenino against Iiahililics,judgnunts. ' costs, and expenses which may acerae against said City in consequence of the granting of this permit. Additionally the applicant understands and Brill comply ,\ItClll'I'ICe'I'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Seciienn I understand my plans shall be used as public records. 9.18. Licensed I'rofessinnal Signature Date CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT Sec: Twp: Rna: Suis: alk: Lou: APN ......... 36225017.00 DATE ISSUED.......: 03/12/2012 RECEIPT ii.......... 35000016249 REFERENCE ID a ...: 12030056 SITE ADDRESS .....: 7683 SHADOWHILL LN SUBDIVISION ....... CITY .............. CUPERTINO IMPACT AREA ....... OPERATOR: suew COPY :j : 1 OWNER ............: MEACHAM ROBERT L AND JOANNE ADDRESS ......: 7683 SHADOW}{ILL LN CITY/STATE/ZIP ...: CUPERTINO, CA 95014-5053 RECEIVED FROM ....: ERIC KALLIO CONTRACTOR ........ ERIC iALLIO LIC !! 32128 COMPANY ........... ERIC iiALLIO CONTRACTOR ADDRESS .......... 2345 OLEA CT CITY/STATE/ZIP ...: GILROY, CA 95020 TELEPHONE .........: (408) 398-5994 FEE ID UNIT 1BCBSC VALUATION 1BSEISMICR VALUATION IBUSLIC FLAT RATE 1REMRESBAT SQ FEET TOTAL PERMIT . METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT QUANTITY AMOUNT 10,000.00 1.00 10,000.00 1.00 1.00 119.00 35.00 5E8.00 AMOUNT --------------- 709.00 --------------- 709.00 709.00 PD -TO -DT THIS REC NEW !AL 0.00 1.00 0.00 0.00 1.00 0.00 0.00 119.00 0.00 0.00 588.00 0.00 ---------- 0.00 ---------- 709.00 ---------- 0.00 REFERENCE NUMBER -------------------- AflEX GOV ;z 5t r -A N 44r ONIIVYU3d 3'Va Wn GILIM 10 83UL'UIPIO 4.0 Rue to SUOISIAoid Aue jo U0118101A 94I 10 Imidde ue eq of jo Ilwied of pleLl eq ION IIVHS SUO)POIJ13ads pue ueld SI41 jo 6uldwi4s a41 BuiplIng 941 WOjj ILAoidde InoLINm '=491041 QjejA8P 01 JO jOWUS UG SU0118jelle JO S96URL13 Aue aNew ol jr4mulun sl 11 -uolloinjisum Buunp OIIS qo( eLaw ideN eq -Lsnvy suowoupeds pue suejd jo Sas sIqL L_ VX (13AOUddV ONU83dno - NOISIAIO 9NICIline Kl 2i -b IN3KWVd3G IN3VIdO13A30 AJJNr,',NV403 ? 46 Sr VALLIO CPYI-Traclvp�l ce. LCO IF (4- ReVAADC)e) C-V -T., tw 1 C, we IDQO+�v e4 vs bc)+ mop EMSTALL AFrevwre, Flo ict P+�,p Vex- 5e c�,4A.4%Lk, A LL kqll Y, ;Lql\ 4v So— wvok cam,�C)t--T Urj:� CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION NOTE: This estinune does not include fees due to other Departatents (i.e. Planning, Public Works. Fire, Saninny Seuer District. School District. etc. J. These fees are bared on the nrelininary iufinnmtion available and are only an estivate. Contact the Dept for addtt7 info. FEE ITEMS (Fee Resolution 11-053 EA' 7/1/11) ADDRESS: 76813 shadow hill dr. DATE: 03/1212012 REVIEWED BY: bob s. .ifeck Prnuir Fee• APN: ��j a SOjr BP#: / O3©� "VALUATION: $10,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY ' USE: SFDorDuplex if •ch. Intl? Fre: I PENTAMATION PERMITTYPE: 1R3SFDREM WORK sfd single bathroom remodel non structtural no layout change. SCOPE PME Plan Check: NOTE: This estinune does not include fees due to other Departatents (i.e. Planning, Public Works. Fire, Saninny Seuer District. School District. etc. J. These fees are bared on the nrelininary iufinnmtion available and are only an estivate. Contact the Dept for addtt7 info. FEE ITEMS (Fee Resolution 11-053 EA' 7/1/11) itech Plan Check Plumb. Plan Clunk Elea Plan Chick .ifeck Prnuir Fee• Plutnh. Penin Fee: Elec. Pema Fee: odt.-r.lfkh. hvp. other Plwab bup Lj 011m, Ore. lonp. if •ch. Intl? Fre: Plmnb. h p. hir: Ete.e. Insp. Fee: NOTE: This estinune does not include fees due to other Departatents (i.e. Planning, Public Works. Fire, Saninny Seuer District. School District. etc. J. These fees are bared on the nrelininary iufinnmtion available and are only an estivate. Contact the Dept for addtt7 info. FEE ITEMS (Fee Resolution 11-053 EA' 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F--35--]s.f. $588.00 Remodel. Bath (<=300 so IREHRESB.tT Suppl. PC Fee: Q Reg. Q OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. O OT 0.0 1 [its $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Canytrinaton Tel: Adminishnnive Fee: O E) Work Without Permit? 0 Yes (j) No $0.00 Advanced Plannine Fee: $0.00 Select Non -Residential Building or Structure (F) 0 14 Tama/ Documentation Fees: Strong Motion Fee: IBSEISHICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $2.00 $588.001 TOTAL FEE: $590.00 Revised: 1/19/2012 1 n C CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION Fwal 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)777-3228 • FAX (408) 777-3333 • buildina�cuoertino.ora CUPERTINO /dD3o05� I��`�a��ilu��i[w�c�l��f��l�]t�6]`���I:�rnat7:iiP7`Jf i �. aax : a� �: [. • a: , on PROH:R ADO I /�(�w -2--z-� NI 36,21 « llc-MAB. ��//��v'vt/P a5 DI r7 OWNER AJC/ V l`Q 'HON HO — T — 6. ST=ADDRESS �J_ �" S .STATE. FAX / CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY. STATE IIP FAX N ❑ OWNER ❑ owNER-suiLoER ❑ OWNERAGErT ❑ CONTRACTOR ❑CoNTRAC ORAGENT ❑ ARCHTTECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CO w L[ ER LICEN` _ Bus. LIC N COMPANY NAME`. /m LL� p EMAIL FAX . STREET D , ' \ I STATE Zit Cl.�l� PHONE 3 N — ARCHTTECUEHGWEEt NAME LICENSE NUMBER BUS. LIC 9 COMPANY NAME E -MAB. FAX STREET ADDRESS CITY, STATE, ZIP I PHONE DF(SSCCRRIPTTON OF WORK v EXISTING USE PROPOSED USE CON TYPE 9STORIES USE TYPE OCC. SQ -FT. VALUATIONS) EXISTG AAFA NEW FLOOR AREA DEMO AREA TOTAL NET AREA �� D BATHROOM K `rcl(N OTHER - REMODEL AREA REMODELAREA REMODEL AREA PORCHAREA DEC'KARTA TOTAL DECWORCH AREA GARAGE AREA: 7TQETACH ' ' ❑ATTACH I 0 DWELLING tRNTIS: ISASECONDUNR YES SECOND STORY ❑YES BEING ADDED! ONO ADDMON'. ONO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF I M=BLOGAN❑YES REcErvED BY: TOTAL VALUATION: PLN'NDNGAPPLa ONO PLANNING APPRDVALLETTER EICELER HOME' Id NO / O By my signature below, I certify to each of the following: lam the property owner cr aud:orized anent m act on the prppary.uwnds behalf,! have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rtlating tD _ng can c ' a I out o ntatives of Cupei'to to cater the above -i rifi property for hupection purposes. tur Signature of Applicant/Agent Date: 5 L Z, SUPP r I AL WFORMATION REQUIRED PLAYCHECKTYPE ROUTLNG SL@ �.TICE-COUNTERf�-B New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building rti%INe PLANK REvrEw permit for new building. ❑ EXPRESS ❑ PLX"MG PLAN REVIEW --Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 11NN srADAR.n ❑ PUBUC WORTS f7 form if any Hazardous Materials are being'used as part of this project ❑ L GE ❑ PIEE bEP-r Copy of Planning Approval Letter or Meeting with Planning prior to _ submittal of Building Permit application. ❑ MA OR El"NITARY SEWER DISTRICT ❑ Y.NVIIiONAtENTAL HEALTH D:ie BldgApp_201 Ldoe revised 06/3!/11 I