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13080079 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10060 CRAFT DR CONTRACTOR:ANTIQUE TERMITE& PERMIT NO:13080079 PEST OWNER'S NAME: RAY LEDESMA TRUSTEE 1913 STONE AVE DATE ISSUED:08/12/2013 OWNER'S PHONE: 4085541818 SAN JOSE,CA 95125 PHONE NO:(408)995-6300 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALE]r License Class_ Lia# (o� ?i 02- UNITS 1,2&3-REPLACE(E)TUB/SHOWERS IN ALL K \2 �� UNITS SAME LOCATIONS.RE-TILE BOTH AREAS Contractor 1�1 Q, Date if I hereby affirm that I am licensed 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: ave and will maintain a certificate of consent to self-insure for Worker's ompensation,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:$1550 I have and will maintain Worker's Compensation Insurance,as provided for by IA Section 3700 of the Labor Code,for the performance of the work for which this APN Number:37502015.00 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 WITHIN0 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 DA LAST CALLED INSPE TI N. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 3 Issued by: Date: granting of this p rmit. Additionally,the applicant understands and will comply with all noloin ource regulations per the Cupertino Municipal Code,Section 79 9.18. �j, RE-ROOFS: Signature Date V tZ D 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 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 ay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the uper'no Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 5505 25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: Z �� permit is issued. _�Ik_ \ 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION \� 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 t V• GUPEFtTINf3 (408)777-3228•FAX(408)777-3333•building aacupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 10060 Craft Drfve Cupertino 1 APN# OWNER NAME Ray Ledesma PHONE gag 5� I '6 E-MAIL STREET ADDRESS CITY,STATE,ZIP L, FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME Michael Meek WSENJ�IBER 6$52$2 CENSE TYPE c BUS.LIC# 24455 COMPANYNAME Antique Termite Inc IIS`-- E-MAIL info@antiquetermitCe..`c/om FAX 408-995-0517 STREETADDREss 1913 Stone Avenue CITY,STATE,ZIP San Jose CA 95125 PHONE 408-995-6300 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK removal ot tubSowers In units and replacement ot same EXISTING USE PROPOSED USE CONSTR,TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES T TOTAL_VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO '`" "'`'`^ ,. i O.00 . . l By my signature below,I certify to each of the following: I am the property owner or author' ed n to act on the property owner's behalf. I have read this application and the information I have prod ed is correct. I have read the Description of Work verify it is accurate. I agree to comply with all applicable local ordinances and state laws re ui ng c struct n./I or a prese tatives of Cupertno to enter the above-i enti�f ed property for inspection purposes. Signature of Applicant/Agent: Date: 7 SUPPLEMENTAL INFORMATION RE UIRED � ower Q PLAN CHE�rYPE R "qa,, , ROUTP`TG SLIP=: _New SFD or Multifamilydwellings: Apply for demolition permit for $ PP Y P ovEx i R b BUILDING�L�E existing building(s). Demolition permit is required prior to issuance of building � - permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure "STAND 1],PUBLICwoxxs�P � form if any Hazardous Materials are being used as part of this project. ©�rI ARGB ti ❑ kTRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to �© JOR�� s�tai� © SAIlrrARYSE!'4'EIZbrA7STR�4'T submittal of Building Permit application. �� BldgApp_2011.doe revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10060 CRAFT DR DATE: 08/12/2013 REVIEWED BY: Mendez APN: BP#: "VALUATION: 1$15,550 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM USE: PERMIT TYPE: A WORK UNITS 1 2 &3- REPLACE E TUB/SHOWERS IN ALL UNITS SAME LOCATIONS. RE-TILE BOTH SCOPE AREAS ,-tach. Plait(.heck Plumb. Plan Check Elec.Plan Check ;L1e1-h. Permit Fee: Plumb. Permit Fee: Elec. Permit Fee: Usher;l9ecrh.Irtsp. Other Plumb Inrp. 0Usher Stec, Inst), Wech.Inch.Fee: Plumb. hist).Fee: Ekc.Imp,Fee: NOTE:This estimate does not include fees due to other Departments(ie.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These ees are based on the relimina information available and are only an estimate. Contact the Dept or addn'l info, FEE ITEMS-Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-1-5-0-1 s.f. Remodel,Bath(<=300 sf) Suppl.PC Fee: 0 Reg, ® OT 0.0 hrs $0.00 $626.00 1REMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. ® OT O,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: Work Without Permit? ®Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Travel Doctanentation Fees: Building or Structure Strong Motion Fee: IBSEISMICR $1.56 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 ti i� = 0ii ` ��f� $2.56 $626.000�1 MM , � $628.56 Revised: 07/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR'/SUBCONTRACT_OR LIST JOB ADDRESS: 10060 PERMIT# OWNER'S NAME:T e_ L Af-,7 n PHONE#LIM'ga 1_"(-3aC7 GENERAL CONTRAC OR: 9,- KBUSINESS LICEITSE#<: 2Q�Z ADDRESS: CITY/ZIPCODE: � e,,,e_ �I5t2�i *Our municipal code requires all businesses working in the city to have a City of Luper- business license. NO BUILDING FINAL OR FINAL O CUP CY NTRINSPECTION(S) WILU�-BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL UB ACTORS HAVE- A CITY OF CUPERTINO BUSINESS LICENSE. t I am not using any subcontractors: Z ' nature Date Please check applicable subcontractors au�omplcte the following information. i SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood - Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date