The URL can be used to link to this page

13080014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23300 VIA ESPLENDOR UNIT X#*- yp45CONTRACTOR:BETACONSTRUCTION PERMIT NO:13080014 OWNER'S NAME: FREDERICK MIELKE 3498 CHERRY AVE DATE ISSUED:08/02/2013 OWNER'S PHONE: 4086230280 SAN JOSE,CA 95118 PHONE NO:(408)623-0280 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL❑ License Class Lic.# ,*Za yl INSTALL 12(N)RECESSED LIGHTS,10(1)SWITCHES& Aq� �+ �� i Date r1a 13 20(N)OUTLET RECEPTACLES Contractor I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000).of Division Sof 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:$2200 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:34255042.00 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 O + T 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 LAS LED 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_.-' ssued b : Date: 13 with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. j/ RE-ROOFS: Signature Date. J " 11� All roofs shall be inspected prior to an roofing 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. 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 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,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent: C%� i�G�<� Date:. /��3 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 00 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 V MISC CUPERTINO (408)777-3228•FAX(408)777-3!P3•building cupertino.oro �O JO 4% ❑PLUMBING ❑MECHANICAL �� ELECTRICAL [:]MISCELLANEOUS PROJECT ADDRESS ��w a Qe",((,f,Q �Q a^�71�,s.�p�f[.y,() APN# 2 - – S S OWNERNAME Fc✓1/!nom r—V I(/�_- _ """1-P_HO /+(OS()/'2 5"�!Z`!�'a E-MAIL STREET ADDRESS JZ('(=6)0 V/;r V`'y�„/�^d0 CITY,STATE,ZIP J b ' ��D „ A 1 0 L/ FAX CONTACT NAME i �V�1`�L 3/}m/�s��b, PHON• nSF�a 2 G-01 E-MAIL L J l LG STREET ADDRESS L (�Cf A_I -Y„ d -_ CTTY,STATE,ZIP q -lG FAX ❑OWNER ❑ OWNER-LBUILDER ❑f/owNEP AGENT v`Y❑`CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAM,E7,/gA � � i LICENSE NUMBER�' �i f� (j LICENSE TYPE BUS.LIC# COMPANY NAMEc.�CS tiara .sTIr41S/��f� E $ nG (i.C�[f✓TrQ`�vl l��100�Ct�rf} FAX STREET ADDRES v f�� , CITY,STATE,ZIP�i}�;��t PHONE ARCI-IITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL. FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ 'MULTI-FAMILY PROJECT IN WILDLAND ❑ YES 7FOGDO- YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO ❑NO EICHLER HOME? ❑ NO DESCRIPTION OF WORK t Gr�c-g TOTAL VALUATIO _1 -J' D$Y: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I 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 relating to b i ' g co traction. I authorize representatives of Cupertino to enter the abo -ide tiified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY W VER-THE-COUNTER EXPRESS ❑ STANDARD V ❑ LARGE - a ❑ MAJOR MEPMiscApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 23300,VIA ESPLENDOR# V57 DATE: 08/02/2013 REVIEWED BY: MELISSA APN: 342 55 042 BP#: *VALUATION: 1$2,200 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY Buildina is PENTAMATION USE: Multi-Family Dwelling >3 Stories ® Yes Q No PERMIT TYPE: 1 REAP1 WORK INSTALL 12 N RECESSED LIGHTS 10 N SWITCHES &20 N OUTLET RECEPTACLES SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Fixtures, Lighting 1BREMFIxT 12 # $70 Recep/Switch/Outlets 1BREMRECEP 30 # $97 TOTALS: $167.00 Xtecli.plan Cheek hinrb.Plan Check Elec.Plan Check 0.0 hrs $0.00 :Tech_ Permit Fee: Plumb.Permit Fee: Elect.Permit Fee: IEPERMIT t�llrczr Uech.lnsr. EIF-t- Other Plumb Insp. Other Elea Insp. 0.0 hrs $47.00 1�ech.Insp.Fee: Plumb.Inst.Fee: lllee.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(tie.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These.fees are based on the prellmina information available and are only an estimate Contact the De t or addn7 info. FEE ITEMS (Fee Resolution 11-053 Eff. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC'.Fe>e PME Plan Check: $0.00 Permit./'ee: Suppl. Rasp 1;e PME Unit Fee: $167.00 PME Permit Fee: $47.00 Conso-action l ar: Administrative Fee: IADMIN $44.00 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Bees: Travel Documentation Fee: 1TRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $306.50 $0.00 $306.50 Revised: 07/01/2013 � L - tea V ,..pc ,'d� cz/kyr- Deck 1510'x 6161 rt. 6'6'x 177- - ._Living RoomMaster-Bedroom I5.3`X 17'8' 15,0,X 12,6 _ z Cl0 ts. . 3'0 '4 Dining-_ Bath - -_ 2I'l l x 8'6' 91'X50 -- - - - Of 0 � cn � 1p ILC n - 9 x $• °�` @� °v O 0 Oo � oA o� N®C6 ip 2 a _ _ 00 Clos .S. e� „ Linen x o � P, 0" QQ� 19 199 - o o 0- Bath-- 6'Bath FL o ° 0- 04 2 OD C m 04eR2® o Garage - .- 1 °� C N c .�� aB O� �� °� 13'6'x 20'0' N 5 0 -- �A Bedroom l/9�C 12'6'x UT 65 f5 DU. k .